Musculoskeletal discomfort, work ability and fatigue in nursing professionals working in a hospital environment. / Desconforto musculoesquelético, capacidade de trabalho e fadiga em profissionais da enfermagem que atuam em ambiente hospitalar.

OBJECTIVE: To evaluate the musculoskeletal discomfort, work ability and residual fatigue in nursing professionals working in the hospital setting. METHOD: Cross-sectional study with professionals from a medium-sized public hospital. The Nordic symptom questionnaire, the work ability index, and the need for recovery scale (fatigue) were used. Data were analyzed descriptively and inferential tests were applied in order to verify the association of fatigue and work ability, and compare the fatigue among sectors analyzed. RESULTS: Participation of 110 professionals in the study. A total of 86.24% of workers reported musculoskeletal discomfort, with a higher prevalence in the cervical, thoracic and lumbar spine. Approximately 43% of professionals presented residual fatigue. There was a significant association between fatigue and reduction of work ability (p<0.003), as well as association between younger age and greater fatigue (p<0.03). CONCLUSION: Results demonstrated a high prevalence of musculoskeletal discomfort in the previous year and a considerable number of professionals with residual fatigue. There was a substantial portion of workers with moderate work ability and requiring attention in the medium term.

ICNP® terminological subset for preventing falls in the elderly in primary care.

OBJECTIVE: Build and validate a terminological subset of ICNP® for the prevention of falls in the elderly in the context of primary health care, in light of the Self-Care Deficit Theory. METHOD: Methodological study developed in accordance with ICN recommendations and the Brazilian method for constructing terminological subsets, in two stages: 1) construction of ICNP® statements of nursing diagnoses, outcomes, and interventions; 2) content validation of statements by specialist nurses. RESULTS: A total of 182 diagnoses/outcomes and 321 nursing interventions were constructed, which were subjected to content validation by 28 experts, being validated with a Content Validity Index ≥ 0.80. After validation, the statements were organized according to self-care requirements and the majority of diagnoses/outcomes (51.6%) and interventions (52.7%) were classified under health deviation requirements. CONCLUSION: It was possible to construct and validate a terminological subset of ICNP® with a predominance of statements related to health deviation requirements, standing out for being the first terminological subset for the prevention of falls in the elderly in the context of primary care.

Non-invasive neuromodulation in reducing the risk of falls and fear of falling in community-dwelling older adults: systematic review.

Introduction: Neuromodulation is a non-invasive technique that allows for the modulation of cortical excitability and can produce changes in neuronal plasticity. Its application has recently been associated with the improvement of the motor pattern in older adults individuals with sequelae from neurological conditions. Objective: To highlight the effects of non-invasive neuromodulation on the risk of falls and fear of falling in community-dwelling older adults. Methods: Systematic review conducted in accordance with the items of the Cochrane Handbook for Systematic Reviews of Interventions. Searches were carried out in electronic databases: CENTRAL, Clinical Trials, LILACS, PEDro, PubMed, Web of Science, between 13/06/2020 and 20/09/2023, including all indexed texts without language and publication date restrictions, randomized controlled clinical trials, which presented as their main outcome non-invasive neuromodulation for reducing the fear of falling and risk of falls in the older adults, regardless of gender. Results: An extensive search identified 9 eligible studies for qualitative synthesis from 8,168 potential articles. Rigorous filtering through automated tools, title/abstract screening, and full-text evaluation ensured a focused and relevant selection for further analysis. Most studies (80%) used transcranial direct current electrical stimulation as an intervention, over the motor cortex or cerebellum area, with anodal current and monopolar electrode placement. The intensity ranged from 1.2 mA to 2 mA, with a duration of 20 min (80%). The profile of the research participants was predominantly individuals over 65 years old (80%), with a high risk of falls (60%) and a minority reporting a fear of falling (40%). The outcomes were favorable for the use of neuromodulation for the risk of falls in the older adults, through improvements in static and dynamic balance. Conclusion: The results may have limited applicability to direct outcomes related to the risk of falls, in addition to evidence regarding the difference or lack thereof in applicability between genders, fallers and non-fallers, as well as older adults individuals with low and high fear of falling. Systematic review registration: The protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) to obtain the identification of ongoing research (ID: 222429).

Determining Medication Errors in an Adult Intensive Care Unit.

INTRODUCTION: Research addressing the costs of Medication errors (MEs) is still scarce despite issues related to patient safety having significant economic and health impacts, making it imperative to analyze the costs and adverse events related to MEs for a better patient, professional, and institutional safety. AIM: To identify the number of medication errors and verify whether this number was associated with increased hospitalization costs for patients in an Intensive Care Unit (ICU). METHOD: This retrospective cross-sectional cohort study evaluated secondary data from patients' electronic medical records to compile variables, create a model, and survey hospitalization costs. The statistical analysis included calculating medication error rates, descriptive analysis, and simple and multivariate regression. RESULTS: The omission error rate showed the highest number of errors per drug dose (59.8%) and total errors observed in the sample (55.31%), followed by the time error rate (26.97%; 24.95%). The omission error had the highest average when analyzing the entire hospitalization (170.40) and day of hospitalization (13.79). Hospitalization costs were significantly and positively correlated with scheduling errors, with an increase of BRL 121.92 (about USD $25.00) (95% CI 43.09; 200.74), and to prescription errors, with an increase of BRL 63.51 (about USD $3.00) (95% CI 29.93; 97.09). CONCLUSION: We observed an association between two types of medication errors and increased hospitalization costs in an adult ICU (scheduling and prescription errors).

Initial Muscle Quality Affects Individual Responsiveness of Interleukin-6 and Creatine Kinase following Acute Eccentric Exercise in Sedentary Obese Older Women.

This study aimed to evaluate the time course and responsiveness of plasma interleukin-6 (IL-6) and creatine kinase (CK) levels following acute eccentric resistance exercise in sedentary obese older women with a different muscle quality index (MQI). Eighty-eight participants (69.4 ± 6.06 years) completed an acute eccentric resistance exercise (7 sets of 10 repetitions at 110% of 10-repetition maximum with 3 min rest interval). Participants were divided into two groups: high or low MQI according to 50th percentile cut-off. The responsiveness was based on minimal clinical important difference. There were no differences between groups and time on IL-6 and CK levels (p > 0.05). However, the high MQI group displayed a lower proportion of low responders (1 for laboratory and 2 for field-based vs. 5 and 4) and a higher proportion of high responders for IL-6 (7 for laboratory and 6 for field-based vs. 4 and 5) compared to low MQI group. In addition, the high MQI group showed a higher proportion of high responders for CK (11 for laboratory and 9 for field-based vs. 6 and 6) compared to low MQI. A prior MQI screening can provide feedback to understand the magnitude response. Individual responsiveness should be taken into consideration for maximizing eccentric exercise prescription.

Specialized nursing terminology for the prevention of falls in the elderly in primary care.

OBJECTIVE: to build a specialized nursing terminology for the prevention of falls in the elderly in primary healthcare, based on the ICNP®. METHOD: this is a methodological study developed in two stages: (1) identification of relevant terms for the prevention of falls in the elderly in official documents; (2) cross mapping of the identified terms with the terms contained in the ICNP® Seven-Axis Model, version 2019/2020. RESULTS: a total of 13,408 terms was extracted from official documents, which were submitted to manual screening, resulting in the inclusion of 391 relevant terms. Cross mapping revealed 283 constant terms (67.8% with level of equivalence 1; 32.2% with level of equivalence 2) and 108 non-constant terms (88.9% with level of equivalence 5; 6.5% with level of equivalence 4; 4.6% with level of equivalence 3). In the set of constant terms, the terms of the Focus (43.1%), Action (26.1%), and Means (13.1%) axes stood out; in non-constant terms there was a predominance of the Focus (38.0%), Means (23.1%), and Judgment (15.7%) axes. CONCLUSION: we obtained a specialized nursing terminology that will support the development of nursing diagnoses, outcomes, and interventions to contribute to the prevention of falls in the elderly in primary healthcare.

Comparative evaluation of inflammatory parameters and substitute insulin resistance indices in elderly women with and without type 2 diabetes mellitus.

PURPOSE: To analyze the influence of inflammatory parameters and substitute insulin resistance indices on the risk of type 2 diabetes mellitus (DM) development in elderly women, as well as to compare anthropometric measures and metabolic parameters according to the presence of type 2 DM and HbA1c levels. PATIENTS AND METHODS: One hundred and twenty elderly women (67.9 ± 6.0 years) were submitted to anthropometric analysis, determination of inflammatory and metabolic parameters. They also underwent indices of lipid accumulation product (LAP), high density triglyceride/lipoprotein ratio (TG/HDL), triglyceride glucose index (TyG), as well as TyG by body mass index (BMI) ratio (TyG-BMI) assessment. RESULTS: Body mass index, tumor necrosis factor alpha, interleukin-2, blood glucose, TG, LAP, TG/HDL, TyG and TyG-BMI were significantly higher in elderly women with DM compared to non-diabetic women. LAP ≥ 55.4 (OR = 2.29; P = .027); TyG ≥ 8.8 (OR = 3.52; P < .001) and TyG-BMI ≥ 264.8 (OR = 3.54; P = .001) were identified as risk factors for DM. CONCLUSION: High pro-inflammatory parameters, low levels of anti-inflammatory markers and higher levels of substitute insulin resistance indices are risk predictors for DM development in elderly women in primary health care.

Association of Vitamin D with the TaqI Polymorphism of the VDR Gene in Older Women Attending the Basic Health Unit of the Federal District, DF (Brazil).

Aging is accompanied by various functional modifications determined by their environment, lifestyle, nutrition, and genetics. Based on these factors, it is essential to verify the vitamin deficiency in the elderly population. Hypovitaminosis D is commonly present in human aging, increasing the chances of developing noncommunicable chronic diseases. The VDR gene TaqI polymorphism may modify the vitamin D metabolic pathway by altering the interaction between the vitamin D receptor and the active circulating vitamin D. Therefore, this study aimed to investigate the association between serum vitamin D and biochemical and genetic factors, considering the TaqI polymorphism of the VDR gene, in an elderly population of the Federal District. The study was a descriptive, case-control, quantitative, and cross-sectional type and was conducted in two basic health units in the administrative region of Ceilândia, Federal District, DF, Brazil, with women aged 60 years or older. Anthropometric, biochemical, and genetic parameters (VDR TaqI polymorphism) were evaluated. The adopted significance level was 5%, and statistical analyses were performed using the SPSS version 20.0 program. The study consisted of 128 participants. The most prevalent age was from 60 to 65 years (N = 53; 41.4%). 66 elderly (51.6%) were part of the case group (hypovitaminosis D), while 62 were in the control group. In the case group, 30.2% had grade I obesity, 77.3% were hypertensive, and 51.5% were diabetic. The TT genotype was present in 47% of the case group and 54.8% in the control group (p=0.667). There was no association between serum vitamin D levels and the VDR gene variant TaqI polymorphism in an elderly Brazilian population.

Nursing diagnosis Risk for Falls in the elderly in primary health care.

OBJECTIVE: to evaluate the Nursing Diagnosis (ND) Risk for Falls in elderly subjects in primary health care in the Federal District. METHODS: a descriptive, quantitative, cross-sectional study conducted in two basic health units. Data collection included blood collection, nursing consultation and physical evaluation of 156 elderly subjects with chronic diseases. RESULTS: the most prevalent intrinsic risk factors of NANDA-I were visual impairment (73.7%), impaired mobility (70.5%) and history of falls (69.9%); and extrinsic factors were the use of insufficient material in the bathroom (60.3%) and loose carpets (58.3%). The intrinsic factors that increased the risk for falls were the use of assistive devices (OR 3.50; p=0.030), impaired walking (OR 2.84; p=0.019) and cognitive impairment (OR 1.26; p=0.019); and the extrinsic factor was the use of loose rugs (OR 1.59; p=0.041). CONCLUSION: this ND has proved to be a valuable instrument for the identification of risk factors for falls in elderly subjects in primary care.

Frailty syndrome in the elderly in elderly with chronic diseases in Primary Care.

OBJECTIVE: To evaluate the frailty syndrome in the elderly nursing diagnosis in elderly with chronic diseases of a health district of the Federal District. METHOD: A quantitative, descriptive, cross-sectional study was conducted with elderly patients served at the Basic Health Units, who presented arterial hypertension and/or diabetes mellitus. The following were used: a sociodemographic questionnaire, the Mini-Mental State Examination, anthropometric data, evaluation of sarcopenia (measured by body composition), muscle strength and functional capacity, and the identification of NANDA-I nursing diagnosis. A statistical software was used for data analysis. RESULTS: Participation of 78 elderly people, of which 93.6% of had Impaired memory, 93.6% had Impaired physical mobility, 82.1% had Fatigue, 76.9% had Impaired ambulation, 53.8% had Dressing self-care deficit, 43.6% had Activity Intolerance, 35.9% had Social Isolation, 30.8% had Hopelessness, 29.5% had Feeding self-care deficit, 29.5% had Bathing self-care deficit, 12.8% had Toileting self-care deficit, and 10.3% had Decreased cardiac output. CONCLUSION: The nursing diagnosis Frailty Syndrome in the Elderly allows a multidimensional view of the elderly. Since one factor can cause health problems in several health fields, nurses must intervene early, plan and implement actions in the short and long term.

ICNP® terminological subset for preventing falls in the elderly in primary care / Subconjunto terminológico CIPE® para la prevención de caídas en ancianos en atención primaria / Subconjunto terminológico da CIPE® para prevenção de quedas em idosos na atenção primária

ABSTRACT Objective: Build and validate a terminological subset of ICNP® for the prevention of falls in the elderly in the context of primary health care, in light of the Self-Care Deficit Theory. Method: Methodological study developed in accordance with ICN recommendations and the Brazilian method for constructing terminological subsets, in two stages: 1) construction of ICNP® statements of nursing diagnoses, outcomes, and interventions; 2) content validation of statements by specialist nurses. Results: A total of 182 diagnoses/outcomes and 321 nursing interventions were constructed, which were subjected to content validation by 28 experts, being validated with a Content Validity Index ≥ 0.80. After validation, the statements were organized according to self-care requirements and the majority of diagnoses/outcomes (51.6%) and interventions (52.7%) were classified under health deviation requirements. Conclusion: It was possible to construct and validate a terminological subset of ICNP® with a predominance of statements related to health deviation requirements, standing out for being the first terminological subset for the prevention of falls in the elderly in the context of primary care.

RESUMEN Objetivo: Construir y validar un subconjunto terminológico de la CIPE® para la prevención de caídas en ancianos en el contexto de la atención primaria de salud, a la luz de la Teoría del Déficit de Autocuidado. Método: Estudio metodológico desarrollado de acuerdo con las recomendaciones del CIE y el método brasileño de construcción de subconjuntos terminológicos, en dos etapas: 1) construcción de declaraciones de diagnóstico, resultados e intervenciones de enfermería de la CIPE®; 2) validación de contenido de declaraciones de enfermeros especialistas. Resultados: Se construyeron 182 diagnósticos/resultados y 321 intervenciones de enfermería, los cuales fueron sometidos a validación de contenido por 28 expertos, siendo validados con un Índice de Validez de Contenido ≥ 0,80. Después de la validación, los enunciados fueron organizados según los requisitos de autocuidado y la mayoría de los diagnósticos/resultados (51,6%) y las intervenciones (52,7%) fueron clasificados bajo requisitos de desviación de salud. Conclusión: Fue posible construir y validar un subconjunto terminológico de la CIPE® con predominio de enunciados relacionados a requerimientos de desviación de salud, destacándose por ser el primer subconjunto terminológico para la prevención de caídas en el anciano en el contexto de la atención primaria.

RESUMO Objetivo: Construir e validar um subconjunto terminológico da CIPE® para a prevenção de quedas em idosos no contexto da atenção primária à saúde, à luz da Teoria do Déficit do Autocuidado. Método: Estudo metodológico desenvolvido conforme recomendações do ICN e do método brasileiro para construção de subconjuntos terminológicos, em duas etapas: 1) construção de enunciados de diagnósticos, resultados e intervenções de enfermagem da CIPE®; 2) validação de conteúdo dos enunciados por enfermeiros especialistas. Resultados: Foram construídos 182 diagnósticos/resultados e 321 intervenções de enfermagem, os quais foram submetidos a validação de conteúdo por 28 especialistas, sendo validados com Índice de Validade de Conteúdo ≥ 0,80. Após a validação, os enunciados foram organizados conforme os requisitos de autocuidado e a maioria dos diagnósticos/resultados (51,6%) e das intervenções (52,7%) foi classificada nos requisitos de desvio de saúde. Conclusão: Foi possível construir e validar um subconjunto terminológico da CIPE® com predomínio de enunciados relacionados aos requisitos de desvio de saúde, destacando-se por ser o primeiro subconjunto terminológico para a prevenção de quedas em idosos no contexto da atenção primária.

Prevalência e fatores associados à síndrome metabólica em idosos atendidos na atenção primária em saúde / Prevalence and factors associated with metabolic syndrome in elderly attended in primary health care / Prevalencia y factores asociados al síndrome metabólico en el cuidado del anciano en la atención primaria de salud

Objetivo: avaliar a prevalência de síndrome metabólica e sua associação com variáveis sociodemográficas, clínicas, antropométricas e estilo de vida em idosos atendidos na atenção primária. Método: estudo transversal realizado com 344 idosos em uma Unidade Básica de Saúde do Distrito Federal. Realizaram-se análises do perfil lipídico, glicemia de jejum e hemoglobina glicada. Foram avaliados dados sociodemográficos, hábitos de vida, pressão arterial, antropometria e percentual de gordura. Realizou-se regressão de Poisson para cálculo da razão de prevalência bruta e ajustada. Resultados: a prevalência de síndrome metabólica foi de 62,2%. A hipertensão arterial (RPajustada=1,31; IC95%=1,02-1,67), cintura aumentada (RPajustada=1,46; IC95%=1,21-1,76), hipertrigliceridemia (RPajustada=1,98; IC95%=1,67-2,34) e HDL diminuído (RPajustada=1,19; IC95%=1,03-1,37) foram significativamente associados à síndrome metabólica. Conclusão: a elevada prevalência de síndrome metabólica e sua associação com fatores modificáveis apontam para a necessidade de identificar e controlar precocemente os fatores de risco em idosos

Objective: to evaluate the prevalence of metabolic syndrome and association with sociodemographic, clinical, anthropometric and lifestyle variables in elderly people attended in primary care. Method: cross-sectional study carried out with 344 elderly in a Basic Health Unit in the Federal District. Analyzes of lipid profile, fasting glucose and glycated hemoglobin were performed. Sociodemographic data, lifestyle habits, blood pressure, anthropometry and fat percentage were evaluated. Poisson regression was performed to calculate the crude and adjusted prevalence ratio. Results: the prevalence of metabolic syndrome was 62.2%. The arterial hypertension (PRadjusted =1.31; 95%CI=1.02-1.67), increased waistline (PRadjusted=1.46; 95%CI=1.21-1.76), hypertriglyceridemia (PRadjusted=1.98; 95%CI=1.67-2.34) and decreased HDL (PRadjusted=1.19; 95%CI=1.03-1.37) were significantly associated with metabolic syndrome. Conclusion: the high prevalence of metabolic syndrome and association with modifiable factors point to the need to early identify and control risk factors in the elderly

Objetivo: evaluar la prevalencia del síndrome metabólico y su asociación con variables sociodemográficas, clínicas, antropométricas y de estilo de vida en ancianos atendidos en atención primaria. Método: estudio transversal realizado con 344 ancianos en una Unidad Básica de Salud del Distrito Federal. Se realizaron análisis del perfil lipídico, glucosa en ayunas y hemoglobina glucosilada. Se evaluaron datos sociodemográficos, hábitos de vida, presión arterial, antropometría y porcentaje de grasa. Se realizó regresión de Poisson para calcular la razón de prevalencia cruda y ajustada. Resultados: la prevalencia de síndrome metabólico fue del 62,2%. Hipertensión arterial (RPajustada=1,31; IC95%=1,02-1,67), aumento de cintura (RPajustada=1,46; IC95%=1,21-1,76), hipertrigliceridemia (RPajustada=1,98; IC95%=1,67-2,34) y la disminución de HDL (RPajustada= 1,19; IC del 95 % = 1,03-1,37) se asoció significativamente con el síndrome metabólico. Conclusión: la alta prevalencia del síndrome metabólico y su asociación con factores modificables apuntan a la necesidad de identificar y controlar precozmente los factores de riesgo en los ancianos

How do old men take care of their own health in Primary Care?

OBJECTIVE: To understand the care of elderly men with their own health. METHOD: A qualitative study with the participation of ten elderly men, through responses to the semi-structured interview guided by the "Tell me about your experiences of care with your health", carried out in a basic health unit, during the period of October-December 2014. The speeches, after being transcribed were submitted to content analysis. RESULTS: The ten interviewees were retired and had an average age of 67.3 years. From the analysis of the data, two categories have emerged: Elderly health care ways and health service as a supporter in the care (less) of the elderly, which revealed the restriction of health care to the triad: medicines, consultation to professionals and exams. FINAL CONSIDERATIONS: Institutional and sociocultural barriers that need to be overcome so that the male population can be consolidated, guaranteeing care of their peculiarities, encouraging active behaviors for self-care.

Dor crônica relacionadaa ansiedade e depressão de pacientes com diabetes mellitus / Chronic pain related toanxiety and depression of patients with diabetes mellitus / Dolor crónico relacionado conansiedad y depresión enpacientes con diabetes mellitus

Objetivo: Relacionar a dor crônica a depressão e ansiedade de pacientes com Diabetes Mellitus. Método: Estudo transversal, amostra n=50, avaliou a dor crônica pela escala numérica de dor, identificou o Diagnóstico de Enfermagem Dor crônica da Taxonomia da NANDA,e Ansiedade e Depressão foi avaliada pela Hospital Anxiety and Depression Scale (Escala Hospitalar de Ansiedade e Depressão). Resultados:A prevalência de ansiedade foi de 36,0% e 32,0% dedepressão, acometeu mulheres entre 60 e 69 anos. A relação entre intensidade de dor foi moderada, em ambos que tinham ansiedade ou depressão. Identificou as características definidoras do Diagnósticos de Enfermagem Dor Crônica: Alteração da capacidade em continuar atividades prévias, 61,1% tinham ansiedade e 56,3% apresentaram depressão; Alteração no padrão de sono, 72,2% com ansiedade e 56,3% com depressão; Autorrelato usando escala padronizada de dor, 98,0% tinham ansiedade e depressão respectivamente. Os Fatores Relacionados do Diagnósticos de Enfermagem 88,9% com Aumento de IMC tinham ansiedade e 93,8% com depressão; Alteração no padrão de sono 72,2% com ansiedade e 56,3% depressão; 92% com Idade ≥50 anos 93,8% com ansiedade e 88,9% com depressão. Conclusão:As mulheres tinham dor crônica de intensidade moderada e foi relacionado a ansiedade e a depressão.

Method:Cross-sectional study, sample n=50, assessed chronic pain using the numerical pain scale, identified the Nursing Diagnoses Chronic pain from the NANDA Taxonomy, Anxiety and Depression was assessed using the Hospital Anxiety and Depression Scale. Results:The prevalence of anxiety was 36.0% and 32.0% of depression, affecting women between 60 and 69 years old. The relationship between pain intensity was moderate, in both those who had anxiety or depression. Identified the defining characteristics of the Chronic Pain Nursing Diagnosis: Change in the ability to continue previous activities, 61.1% had anxiety and 56.3% had depression; Change in sleep pattern, 72.2% with anxiety and 56.3% with depression; Self-reported using a standardized pain scale, 98.0% had anxiety and depression respectively. Related Factors of Nursing Diagnoses 88.9% with increased BMI had anxiety and 93.8% with depression; Change in sleep pattern 72.2% with anxiety and 56.3% depression; 92% aged ≥50 years, 93.8% with anxiety and 88.9% with depression. Conclusion: Women had chronic pain of moderate intensity and it was related to anxiety and depression.

Objetivo: Relacionar el dolor crónica con la depresión y la ansiedad de pacientes con Diabetes Mellitus. Método:Estudio transversal, muestra n=50, se evaluó el dolor crónico mediante la escala numérica de dolor, se identificaron los Diagnósticos de Enfermería El dolor crónico de la Taxonomía NANDA, la Ansiedad y Depresión se evaluó mediante la Escala Hospitalaria de Ansiedad y Depresión. Resultados:La prevalencia de ansiedad fue de 36,0% y de depresión de 32,0%, afectando a mujeres entre 60 y 69 años. La relación entre la intensidad del dolor fue moderada, tanto en los que presentaban ansiedad como en los que presentaban depresión. Se identificaron las características definitorias del Diagnóstico de Enfermería del Dolor Crónico: Cambio en la capacidad de continuar actividades anteriores, el 61,1% presentó ansiedad y el 56,3% presentó depresión; Cambio en el patrón de sueño, 72,2% con ansiedad y 56,3% con depresión; Autoinformados mediante una escala de dolor estandarizada, el 98,0% tenía ansiedad y depresión respectivamente. Factores Relacionados con el Diagnóstico de Enfermería el 88,9% con IMC elevado presentó ansiedad y el 93,8% depresión; Cambio en el patrón de sueño 72,2% con ansiedad y 56,3% depresión; 92% con edad ≥50 años, 93,8% con ansiedad y 88,9% con depresión. Conclusión:Las mujeres presentaron dolor crónico de intensidad moderada y se relacionó con ansiedad y depresión.

Trend of the hospitalizations due to ambulatory care sensitive conditions in pediatrics in distrito federal / Tendencia de las internaciones por patologías pasibles de atención primaria em pediatría en el distrito federal / Tendência das internações por condições sensíveis à atenção primária em pediatria no distrito federal

ABSTRACT Objective: to analyze the trend of hospitalizations due to Ambulatory Care Sensitive Conditions in Pediatrics in Distrito Federal, during the 2008-2018 period. Method: a time series study conducted between 2008 and 2018 with data from Distrito Federal, Brazil, in the age group from 0 to 14 years old. The data were collected in the SUS Hospital Information System, and they were used to perform trend analyses of the most frequent groups. Results: there was a trend towards a significant increase in hospitalizations in the age group studied, with an annual percentage variation of 1.42% and a confidence interval between 0.05 and 2.81. Four groups of reasons for hospitalization and diagnoses were more frequent in the period, namely: bacterial pneumonias, infectious gastroenteritis and complications, pulmonary diseases, and asthma. Among the most frequent groups, considering the study period, there was a trend towards a significant increase in pulmonary diseases (15.71%; 12.40 and 19.12); a trend towards a significant reduction in infectious gastroenteritis and complications (-5.35%; -8.01 and 2.61); and a stationary trend in bacterial pneumonias (-0.43%; -3.80 and 3.07) and asthma (3.82%; 0.57 and 8.40). Conclusion: the results of this study can contribute to the planning, evaluation and monitoring of primary care actions, as this indicator aims at indirectly evaluating access and effectiveness of this care level. In this sense, considering the results of the trend analysis performed, it can be concluded that they do not yet reflect the expected results with the expansion of FHS coverage.

RESUMEN Objetivo: analizar la tendencia de las internaciones por patologías pasibles de atención primaria en Pediatría en el Distrito Federal, en el período de 2008 a 2018. Método: estudio de series temporales con datos del Distrito Federal, Brasil, en el grupo etario de 0 a 14 años, realizado entre 2008 y 2018. Los dados se recolectaron desde el Sistema de Información Hospitalaria del SUS, con los cuales se realizaron análisis de tendencia de los grupos más frecuentes. Resultados: se registró una significativa tendencia de aumento en las internaciones, dentro del grupo etario del estudio, cuya variación porcentual anual fue del 1,42% con un intervalo de confianza entre 0,05 y 2,81. Cuatro grupos de causas de internación y diagnósticos fueron más frecuentes en el período, a saber: neumonías bacterianas, gastroenteritis infecciosas y complicaciones, enfermedades pulmonares y asma. Entre los grupos más frecuentes, considerando el período del estudio, hubo una significativa tendencia de aumento en las enfermedades pulmonares (15,71%; 12,40 y 19,12); así como una significativa tendencia decreciente en las gastroenteritis infecciosas y complicaciones (-5,35%; -8,01 y 2,61) y una tendencia estacionaria en las neumonías bacterianas (-0,43%; -3,80 y 3,07) y en el asma (3,82%; 0,57 y 8,40). Conclusión: los resultados de este estudio pueden contribuir en la planificación, la evaluación y el control de las acciones en atención primaria, ya que la intención de este es evaluar indirectamente el acceso y la efectividad de este nivel de atención. En este sentido, y considerando los resultados del análisis de tendencia realizado, se puede concluir que dichos resultados todavía no reflejan los esperados con la ampliación de la cobertura de la ESF.

RESUMO Objetivo: analisar a tendência de internações por condições sensíveis à atenção primária em pediatria no Distrito Federal, no período de 2008 a 2018. Método: estudo de séries temporais com dados do Distrito Federal, Brasil, na faixa etária de 0-14 anos, entre 2008 e 2018. Os dados foram coletados no Sistema de Informações Hospitalares do SUS, com os quais foram realizadas análises de tendência dos grupos mais frequentes. Resultados: houve tendência de aumento significante nas internações, na faixa etária do estudo, cuja variação percentual anual foi de 1,42% e intervalo de confiança entre 0,05 e 2,81. Quatro grupos de causas de internação e diagnósticos foram mais frequentes no período: pneumonias bacterianas, gastroenterites infecciosas e complicações, doenças pulmonares e asma. Entre os grupos mais frequentes, considerando o período do estudo, houve tendência de aumento significante nas doenças pulmonares (15,71%; 12,40 e 19,12); tendência de redução significante nas gastroenterites infecciosas e complicações (-5,35%; -8,01 e 2,61); e tendência estacionária nas pneumonias bacterianas (-0,43%; -3,80 e 3,07) e asma (3,82%; 0,57 e 8,40). Conclusão: os resultados deste estudo podem contribuir no planejamento, avaliação e monitoramento das ações da atenção primária, visto que este indicador se propõe a avaliar indiretamente acesso e efetividade desse nível de atenção. Nesse sentido, considerando os resultados da análise de tendência realizada, pode-se concluir que os mesmos não refletem, ainda, os resultados esperados com a ampliação da cobertura de ESF.

Risco de glicemia instável em pessoas idosas com diabetes mellitus tipo 2 / Riesgo de glucemia inestable en ancianos con diabetes mellitus tipo 2 / Risk of unstable glycemia in elderly people with type 2 diabetes mellitus

Objetivo: avaliar os fatores de risco do diagnóstico de enfermagem Risco de glicemia instável em pessoas idosas com diabetes mellitus tipo 2. Método: estudo transversal realizado com 152 pessoas idosas atendidas na atenção primária de agosto a outubro de 2021. Na consulta de enfermagem, avaliaram-se dados clínicos, perda de sensibilidade protetora plantar e checklist com fatores de risco do Risco de glicemia instável da NANDA. Empregaram-se análise descritiva e testes de associação. Resultados: 46,7% apresentaram HbA1c ≥ 7,0 e maior prevalência dos fatores de risco: Conhecimento insuficiente sobre o controle da doença (p<0,001); Conhecimento insuficiente sobre os fatores modificáveis (p<0,001); Controle insuficiente do diabetes (p<0,001); Falta de adesão ao plano de controle do diabetes (p=0,002); e Monitorização inadequada da glicemia (p<0,001). Conclusão: os fatores de risco foram relacionados ao conhecimento insuficiente e à falta de manejo com a doença, ressaltando a importância do enfermeiro no planejamento de cuidados adequado.

Objective: to assess the risk factors of the nursing diagnosis Risk of unstable glycemia in elderly people with type 2 diabetes mellitus. Method: cross-sectional study carried out with 152 elderly people assisted in primary care from August to October 2021. In the nursing consultation, clinical data, loss of plantar protective sensitivity and a checklist with risk factors of unstable NANDA glycemia risk were evaluated. Descriptive analysis and association tests were used. Results: 46.7% had HbA1c ≥ 7.0 and higher prevalence of risk factors: Insufficient knowledge about disease control (p<0.001); Insufficient knowledge about modifiable factors (p<0.001); Insufficient control of diabetes (p<0.001); Lack of adherence to the diabetes control plan (p=0.002); and Inadequate blood glucose monitoring (p<0.001). Conclusion: risk factors were related to insufficient knowledge and lack of management with the disease, emphasizing the importance of nurses in the planning of appropriate care.

Objetivo: evaluar los factores de riesgo del diagnóstico de enfermería Riesgo de glucemia inestable en ancianos con diabetes mellitus tipo 2. Método: estudio transversal realizado con 152 ancianos atendidos en la atención primaria de agosto a octubre de 2021. En la enfermería consulta, se evaluaron datos clínicos, pérdida de sensibilidad protectora plantar y se utilizó la lista de verificación con factores de riesgo de NANDA Riesgo para glucemia inestable. Se utilizaron análisis descriptivos y pruebas de asociación. Resultados: 46,7% tenían HbA1c ≥ 7,0 y mayor prevalencia de factores de riesgo: Insuficiente conocimiento sobre control de la enfermedad (p<0,001); Conocimiento insuficiente sobre factores modificables (p<0,001); control insuficiente de la diabetes (p<0,001); Falta de adherencia al plan de control de la diabetes (p=0,002); y Monitoreo inadecuado de glucemia en sangre (p<0.001). Conclusión: los factores de riesgo se relacionaron con el conocimiento insuficiente y la falta de administración de la enfermedad, destacando la importancia de los enfermeros en la planificación de la atención adecuada.

Padrão de sexualidade ineficaz de idosos com Diabetes mellitus / Patrón de sexualidad ineficaz de ancianos con Diabetes mellitus / Ineffective sexuality pattern of elderly people with Diabetes mellitus

RESUMO Objetivo investigar o diagnóstico de enfermagem Padrão de sexualidade ineficaz em idosos com Diabetes mellitus na atenção primária e analisar o seu perfil de sexualidade. Método estudo transversal realizado em uma Unidade Básica de Saúde com uma amostra de 134 idosos diabéticos. Entrevista foi realizada entre julho e agosto de 2019 com instrumentos estruturados, assim como foram coletados exames laboratoriais. Para investigação do diagnóstico de enfermagem Padrão de Sexualidade Ineficaz, foi utilizado um instrumento com as definições conceituais e operacionais das características definidoras e fatores relacionados de acordo com a taxonomia NANDA-I (2018-2020). Resultados predominaram mulheres, mas os homens eram mais ativos sexualmente (p<0,001). Os mais jovens eram sexualmente mais ativos (p = 0,001). Com relação aos parâmetros hormonais, idosos com maiores níveis de testosterona relataram serem ativos sexualmente (p<0,001). A maioria não utiliza preservativo durante a relação sexual. Ao analisar o diagnóstico de enfermagem Padrão de Sexualidade Ineficaz, a característica definidora mais prevalente foi "alteração no comportamento sexual", e o fator relacionado foi "déficit de habilidades sobre alternativas relacionadas à sexualidade". Conclusão e implicações para a prática o diagnóstico de enfermagem Padrão de Sexualidade Ineficaz tem sua importância na avaliação de idosos diabéticos, visto que a sexualidade tem influência em seu comportamento e sua satisfação pessoal.

RESUMEN Objetivo investigar el diagnóstico de enfermería "Patrón de sexualidad ineficaz" en ancianos con Diabetes mellitus en atención primaria y analizar su perfil de sexualidad. Método estudio transversal realizado en una Unidad Básica de Salud, con una muestra de 134 ancianos diabéticos. Las entrevistas se realizaron entre julio y agosto de 2019 con instrumentos estructurados y se recolectaron pruebas de laboratorio. Para investigar el diagnóstico de enfermería Patrón de Sexualidad Ineficaz, se utilizó un instrumento con definiciones conceptuales y operativas de las características definitorias y factores relacionados según la taxonomía NANDA-I (2018-2020). Resultados predominaron las mujeres, pero los hombres fueron más activos sexualmente (p < 0,001). Las personas más jóvenes eran más activas sexualmente (p = 0,001). En cuanto a los parámetros hormonales, las personas mayores con niveles más altos de testosterona refirieron ser sexualmente activas (p < 0,001). La mayoría no usa condones durante las relaciones sexuales. Al analizar el diagnóstico de enfermería de Patrón de Sexualidad Ineficaz, la característica definitoria más prevalente fue "cambio en la conducta sexual" y el factor relacionado "déficit de habilidades sobre alternativas relacionadas con la sexualidad". Conclusiones e implicaciones para la práctica el diagnóstico de enfermería Patrón de Sexualidad Ineficaz tiene su importancia en la evaluación de los ancianos diabéticos, ya que la sexualidad influye en su comportamiento y satisfacción personal.

ABSTRACT Objective to investigate the nursing diagnosis ineffective sexuality pattern in elderly people with Diabetes mellitus in primary care and analyze their sexuality profile. Method this is a cross-sectional study carried out in a Basic Health Unit with a sample of 134 elderly diabetics. Interviews were carried out between July and August 2019 with structured instruments and laboratory tests. An instrument was used to investigate the nursing diagnosis ineffective sexuality pattern with conceptual and operational definitions of the defining characteristics and related factors according to the NANDA-I taxonomy (2018-2020). Results women predominated, although men were more sexually active (p < 0.001). Younger people were more sexually active (p = 0.001). Regarding hormonal parameters, elderly people with higher testosterone levels reported being sexually active (p < 0.001). Most do not use condoms during sexual intercourse. When analyzing the nursing diagnosis of ineffective sexuality pattern, the most prevalent defining characteristic was "a change in sexual behavior" and the related factor was "skills deficit in sexuality-related alternatives". Conclusions and implications for practice the nursing diagnosis ineffective sexuality pattern has importance in assessing elderly diabetics, as sexuality influences their behavior and personal satisfaction.

Actn3 gene polymorphism and factors associated with functional performance in elderly women assisted in primary health care / Polimorfismo do gene actn3 e os fatores associados ao desempenho funcional de idosas atendidas na atenção primária em saúde

ABSTRACT Objective: To analyze potential influences of the R/X genetic polymorphism of the ACTN3 gene, as well as of anthropometric and metabolic characteristics on the functional performance of elderly women assisted in primary health care. Method: One hundred and forty-one elderly women were assessed in terms of anthropometric, metabolic and functional aspects, in addition to clinical, cognitive and demographic characteristics. Allele and genotype frequencies of ACTN3 gene polymorphism were determined. Results: 141 elderly women (68.30 ± 6.18 years) were evaluated. No significant differences (p > 0.05) were observed between the RR and RX/XX genotypes in the elderly women's functional performance, anthropometric or metabolic characteristics. The TUG test completion time showed positive correlations with age, body mass index, waist circumference, and fat percentage (s = 0.315; p < 0.001; s = 0.238; p = 0.005; s = 0.174; p = 0.039; s = 0.207; p = 0.014), respectively. Negative correlations were found between the TUG test with absolute handgrip strength (s = - 0.314; p < 0.001) and relative handgrip strength (s = - 0.380; p < 0.001). Conclusion: In our study, there were no influences from ACTN3 gene polymorphisms on the functional performance of the elderly women, which is influenced by other factors.

RESUMO Objetivo: analisar as potenciais influências do polimorfismo genético R/X do gene ACTN3 e das características antropométricas e metabólicas no desempenho funcional de mulheres idosas atendidas na atenção primária em saúde. Método: Cento e quarenta e uma idosas foram avaliadas em relação as características antropométricas, metabólicas, funcionais, aspectos clínicos, cognitivos e demográficos. Foram determinadas as frequências de alelos e genótipos do polimorfismo do gene ACTN3. Resultados: 141 idosas (68,30 ± 6,18 anos) foram avaliadas. Não foram observadas diferenças significativas (p > 0,05) entre os genótipos RR e RX/XX no desempenho funcional, características antropométricas ou metabólicas das idosas. O tempo de realização do TUG apresentou correlações positivas com idade, índice de massa corporal, circunferência da cintura e percentual de gordura (s = 0,315; p < 0,001; s = 0,238; p = 0,005; s = 0,174; p = 0,039; s = 0,207; p = 0,014) respectivamente. Correlações negativas foram observadas entre o TUG com força de preensão manual absoluta (s = - 0,314; p < 0,001) e relativa (s = - 0,380; p < 0,001). Conclusão: Em nosso estudo, não foram observadas influências dos polimorfismos do gene ACTN3 no desempenho funcional das idosas, sendo este, influenciado por outros fatores.

Feridas de diabéticos tratados com LED e látex e o risco de glicemia instável / Diabetic wounds treated with LED and latex and the risk of unstable glycemia / Heridas diabéticas tratadas con LED y látex y el riesgo de glucemia inestable

Objetivo: caracterizar o Risco de Glicemia Instável de pacientes com feridas de membros inferiores em uso látex associado ao LED. Método: Estudo de coorte prospectivo com amostra n=15. Divididos em três grupos Grupo 1 curativo com látex e LED; Grupo 2 carvão ativado; e Grupo 3 realizavam autocurativo com látex e LED e identificação do Risco de glicemia instável. Análise de dados realizada pelo software SPSS®. Resultados: Os participantes 60% homens, idade 59,93±10,88 anos, fatores de Risco de glicemia instável: atividade física diária menor que o recomendado; conhecimento insuficiente do controle da doença, em todos os grupos; condição de saúde comprome-tida grupos I e III; controle insuficiente do diabetes grupo I; falta de adesão ao plano de controle do diabetes início ao fim, exceto pelo grupo II. Ocorreu redução das feridas em todos os grupos e melhor cicatrização no grupo III. Conclusão: A feridas maiores estavam no grupo I e ocorreu redução das feridas todos os grupos. Os principais fatores de risco de glicemia instável atividade física diária menor que o recomendado no início e final, condição de saúde comprometida grupos I e III, conhecimento insuficiente do controle da doença em todos os grupos

Objective: to characterize the risk of unstable blood glucose in patients with lower limb wounds using latex associated with LED. Method: Prospective cohort study with sample n=15. Divided into three groups Group 1 dressing with latex and LED; Group 2 activated charcoal; and Group 3 performed self-healing with latex and LED and identified the risk of unstable blood glucose. Data analysis performed by SPSS® software. Results: Participants 60% men, age 59.93±10.88 years, risk factors for unstable blood glucose: daily physical activity less than recommended; insufficient knowledge of disease control, in all groups; compromised health condition groups I and III; insuffi-cient control of group I diabetes; lack of adherence to the diabetes control plan from beginning to end, except for group II. There was a reduction of wounds in all groups and better healing in group III. Conclusion: The major wounds were in group I and there was a reduction of wounds in all groups. The main risk factors for unstable glycemia daily physical activity less than rec-ommended at the beginning and at the end, compromised health condition groups I and III, insufficient knowledge of disease control in all groups.

Objetivo: caracterizar el riesgo de inestabilidad glucémica en pacientes con heridas en miembros inferiores utilizando látex asociado a LED. Método: Estudio de cohorte pros-pectivo con muestra n=15. Dividido en tres grupos Grupo 1 aderezo con látex y LED; carbón activado del grupo 2; y el Grupo 3 realizó autocuración con látex y LED e identi-ficó el riesgo de glucosa en sangre inestable. Análisis de datos realizado por el software SPSS®. Resultados: Participantes 60% hombres, edad 59,93±10,88 años, factores de riesgo para glucemia inestable: actividad física diaria inferior a la recomendada; conoci-miento insuficiente del control de enfermedades, en todos los grupos; condiciones de salud comprometidas grupos I y III; control insuficiente de la diabetes del grupo I; falta de adherencia al plan de control de la diabetes de principio a fin, excepto en el grupo II. Hubo reducción de heridas en todos los grupos y mejor cicatrización en el grupo III. Conclusión: Las heridas mayores estaban en el grupo I y hubo reducción de heridas en todos los grupos. Los principales factores de riesgo para la glucemia inestable activi-dad física diaria inferior a la recomendada al principio y al final, condiciones de salud comprometidas grupos I y III, y conocimiento insuficiente del control de la enfermedad en todos los grupos.

Avaliação do absenteísmo da equipe de enfermagem no contexto hospitalar de um pronto socorro público / Assessment of absenteeism of the nursing staff in the hospital context of a public emergency room / Evaluación del absentismo del personal de enfermería en el contexto hospitalario de una sala de urgencias pública

Objetivo: Analisar o absenteísmo entre a equipe de enfermagem de uma unidade do Pronto Socorro de um Hospital Público Escola do Distrito Federal. Método: Trata-se de um estudo transversal de abordagem quantitativa, realizado com 29 profissionais de enfermagem lotados na unidade de Pronto Socorro de um Hospital Público Regional do Distrito Federal. Utilizou um instrumento para caracterizar a população do estudo e para identificar os fatores relacionados ao absenteísmo. Resultado: Evidenciou que 75,9% eram técnicos de enfermagem e 24,1% enfermeiros, os fatores relacionados ao absenteísmo foram 58% a licença médica e atestados médicos. Os principais fatores internos que colaborou com absentismo relacionou a dor (p≤0,039) foram fatores internos relacionados a instituição, não dispor de materiais para assistência, falta de membros da equipe, sentir constantemente cansado, sobrecarregado, e trabalhar com a equipe reduzida. Conclusão: Os fatores identificados a instituição e os relacionados aos funcionários e a dor, devem ser analisados no cenário ocupacional a fim de contribuir para a elaboração do diagnóstico situacional e intervir nos fatores determinantes. Com vistas a contribuir para a melhoria da qualidade de vida da equipe de enfermagem no âmbito laboral quanto pessoal

To analyze absenteeism among the nursing staff of an Emergency Room at a Public Teaching Hospital in the Federal District. Method: His is a cross-sectional study with a quantitative approach, carried out with 29 nursing professionals working in the Emergency Room of a Regional Hospital Public in the Federal District. An instrument was used to characterize the study population and identify factors related to absenteeism. Results: Evidenced that 75.9% were nursing technicians and 24.1% nurses, the factors related to absenteeism 58% sick leave and medical certificates. The main internal factors that contributed to absenteeism related to pain (p≤0.039) were internal factors related to the institution, not having care materials, lack of team members, constantly feeling tired, overloaded, and working with a reduced team. Conclusion: The factors identified by the institution and those related to employees and pain should be analyzed in the occupational scenario in order to contribute to the elaboration of the situational diagnosis and intervene in determining factors. With a view to contributing to the improvement of the quality of life of the nursing team in the labor and personal spheres

Objetivo: Analizar el ausentismo entre el equipo de enfermería de una unidad de Sala de Emergencias de una Escuela Hospitalaria Pública del Distrito Federal. Método: Se trata de un estudio transversal de abordaje cuantitativo, realizado con 29 profesionales de enfermería que trabajan en la unidad de Sala de Emergencias de un Hospital Público Regional del Distrito Federal. Utilizó un instrumento para caracterizar la población de estudio e identificar factores relacionados con el ausentismo. Resultado: Mostró que 75,9% eran técnicos de enfermería y 24,1% enfermeros, los factores relacionados al ausentismo fueron 58% licencias médicas y pruebas médicas. Los principales factores internos que colaboraron con el ausentismo relacionado con el dolor (p≤0,039) fueron factores internos relacionados con la institución, falta de materiales para la asistencia, falta de miembros del equipo, sentirse constantemente cansado, abrumado y trabajar con el equipo reducido. Conclusión: Los factores identificados por la institución y los relacionados a los empleados y el dolor deben ser analizados en el escenario ocupacional con el fin de contribuir a la elaboración del diagnóstico situacional e intervenir en los factores determinantes. Con el fin de contribuir a la mejora de la calidad de vida del equipo de enfermería en el ámbito laboral y personal.