First Insights into Clinical and Resistance Features of Infections by Klebsiella pneumoniae among Oncological Patients from a Referral Center in Amazon Region, Brazil.

Klebsiella pneumoniae appears as one of the most prevalent pathogens among cancer patients. The present study investigates the clinical, epidemiological and microbiological aspects related to infections caused by K. pneumoniae in cancer patients treated at an oncology referral center in the state of Pará, Amazon region, Brazil. Between July 2017 to July 2019, an epidemiological, observational, cross-sectional study, with a descriptive and analytical approach was conducted, including patients with confirmed diagnosis of cancer who acquired infection by K. pneumoniae 72 h after hospital admission. K. pneumoniae isolates included in the study were obtained from different clinical materials (blood, urine, catheter tip and bladder catheter, orotracheal secretions, oncological and surgical wounds). Antimicrobial susceptibility testing and molecular detection of the carbapenemase-encoding genes were performed. A high prevalence of MDR K. pneumoniae isolates was observed, including two colistin-resistant isolates and seven isolates harboring blaKPC-1 gene. To conclude, our findings provide the firsts insights into the epidemiology and infection by K. pneumoniae in the state of Pará, Brazil, and may be useful on treatment guidance and establishment of strategies to control the spread of resistance strains of K. pneumoniae in the region.

O cuidado na doença de Alzheimer: as representações sociais dos cuidadores familiares / The care in Alzheimer's disease: social representations of family caregivers

Este estudo aborda as representações de cuidadores familiares de idosos com Alzheimer considerando o cuidado à luz da Teoria das Representações Sociais. Objetiva observar e identificar as representações dos cuidadores familiares sobre o cuidado e analisar como influenciam em suas práticas de cuidado. É do tipo empírico, exploratório, qualiquantitativo e utiliza como método o Discurso do Sujeito Coletivo. Participaram 21 cuidadores familiares de idosos com Alzheimer, sendo 24% homens e 76% mulheres, com faixa etária de 32 a 69 anos. Sobre o suporte familiar, 57% afirmaram possuir ajuda de parentes no cuidado com o idoso e 42 % declararam cuidar sozinhos deles. Quanto à renda, 24% afirmaram que era confortável, 63%, que era razoável. Quanto à ajuda de profissionais, 63% afirmaram não possuir qual quer tipo de ajuda em casa e 38% possuíam ajuda, mas frequentemente relacionada aos serviços domésticos. Emergiram as seguintes representações sociais: o cuidado como prisão; como missão; como desarmonia de identidades sociais e como gratidão. As representações atreladas às ideias de prisão e desarmonia de identidades acrescentam ansiedade, estresse e insegurança à vida dos cuidadores. Foram encontradas representações sobre o cuidado, sendo ao menos duas delas representações negativas, associando o cuidado às ideias de prisão e desarmonia de identidades sociais. Não foi possível alcançar de forma direta suas repercussões sobre a prática de cuidado pela ausência de observação da rotina de cuidado durante esta pesquisa.

This study deals with the representations of family caregivers of seniors with Alzheimer considering care under the light of the Social Representations Theory. It aims to observe and identify the represen tations of family caregivers about care and analyze how they influence their care practices. This study is exploratory, empirical, quantitative and qualita tive, using as a method of research the Discourse of the Collective Subject. Participants were 21 family caregivers of seniors with Alzheimer, 24% men and 76% women, aged 32-69 years. About the support of the family, 57% of them reported having help from relatives in caring for the elderly and 42% did not have any help. About the income, 24% said it was comfortable, 63% said it was reasonable. About the help of professionals, 63% said they did not have any help at home, 38% had help, but mostly related to domestic services. The following social repre sentations emerged: the care as prison; the care as mission; the care as disharmony of social identities and the care as gratitude. Representations linked to the ideas of prison and disharmony of social identity add anxiety, stress and insecurity of life of caregiv ers. This study found representations about the care of which at least two represented negative as sociations, comparing care with ideas of prison and disharmony of social identity. It was not possible to reach directly its repercussions on the care practice due to the absence of the care routine observation.

Elaboração e consenso de umatecnologia assistencial para avaliaçãoclínica de enfermagem no período pós- operatório / Elaboration and consensus of technology assistance for nursing clinical evaluation in the post-operative period

A avaliação clínica diária realizada pelos enfermeiros mantém atualizada a situação de cada paciente. Para dinamizar esta assistência, o enfermeiro utiliza tecnologias assistenciais, que muitas vezes não atende às necessidades do profissional e do paciente. Diante disto, este estudo tevecomo objetivo elaborar e obter consenso sobre uma tecnologia assistencial para avaliação clínica de enfermagem no período pós-operatório. Trata-se de uma pesquisa descritiva e metodológicacom abordagem quantitativa, utilizando também o processo de consenso. Para testar sua validade participaram deste estudo 9 juízes-especialistas e 15 enfermeiros como público-alvo. Na avaliação dos juízes-especialistas, a tecnologia assistencial foi considerada como parcialmente adequada, sendonecessária à reformulação da mesma. Após esta etapa, foi realizada a análise do público-alvo, que julgou a tecnologia assistencial reformulada como adequada para a sua finalidade. Concluiu-se que atecnologia assistencial elaborada e condensada neste estudo auxilia os enfermeiros a executarem demaneira dinâmica e eficaz esta assistência de enfermagem...

The daily clinical evaluation performed by nurses keeps each patient’s situation updated. To streamline this assistance, the nurse uses assistive technologies, which sometimes do not meet theprofessional’s and the patient’s needs. Thus, this study aimed to develop and obtain consensus on an assistive technology for nursing clinical assessment in the postoperative period. It is a descriptive and methodological research with quantitative approach, also using the consensus process. To testits validity nine judges-specialists and 15 nurses participated in this study as the target audience. According to the judges-experts evaluation, assistive technology was partially adequate, but it needed some reformulation. After this stage, the analysis from the target audience was performed whoconsidered the reformulated assistive technology appropriate for its purpose. It was concluded that the assistive technology, elaborated and consensed in this study, helps nurses to implement a dynamic and effective nursing care...