Validation of Visual Prostate Symptom Score (VPSS) in Brazilian Sample Population.

PURPOSE: The aim of the study was to evaluate the reliability and validity of the Visual Prostate Symptom Score (VPSS), its correlation with the International Prostate Symptom Score (IPSS), and the time required and need for help when completing the instrument. We also aimed to identify variables associated with difficulty completing these instruments. DESIGN: Longitudinal, prospective correlational study. SUBJECTS AND SETTING: The target population was Brazilian men from different cities within the state of São Paulo with lower urinary tract symptoms followed in urological consultation at a university hospital during October 2017. The sample comprised 59 patients with a mean age of 66.53 years. METHODS: Reliability of the VPSS was evaluated using a test-retest approach and its convergent validity with the IPSS. Cronbach α coefficient was also calculated. Both questionnaires were self-administered and, in case of difficulty of comprehension, assistance was provided. RESULTS: Mean completion time of the IPSS was 6.56 minutes and for VPSS was 5.02 minutes. The variables skin color and educational level were associated with the difficulty in completing the IPSS and for comprehending meaning of the VPSS pictograms. Internal consistency evaluated using Cronbach α coefficient was 0.74 for IPSS and 0.15 for VPSS, respectively. Test-retest reliability testing revealed that both instruments had a high intraclass correlation index (>0.75). There was a significant correlation between the health-related quality of life (QoL) scores of the 2 instruments (0.71, P = .0001) and between the total score of each instrument with its corresponding QoL score. CONCLUSION: Although time for response of the VPSS was shorter and it demonstrated good test-retest reliability, it more frequently required help to answer. The VPSS showed low internal consistency and low correlation with the IPSS (except for the QoL item).

Life experiences of Brazilian men with urinary incontinence and erectile dysfunction following radical prostatectomy.

PURPOSE: The objective of this study was to explore the psychosocial meaning and repercussions on lifestyle associated with erectile dysfunction and urinary incontinence (UI) in men following radical prostatectomy. SUBJECTS AND SETTING: Ten men from Southeastern Brazil who underwent radical prostatectomy for prostate cancer were interviewed. All participants underwent treatment at a urology clinic during the period of September 2007 to February 2009. METHODS: A clinical-qualitative study was conducted, using semi-structured interviews with open-ended questions. All interviews were recorded and transcribed verbatim. Each man was interviewed once. The average length of the interviews was 37 minutes (range: 16 to 81 minutes). Data from the interviews were subjected to content thematic analysis and development of categories based on psychodynamic references. RESULTS: Three themes were identified: (1) sexuality called into question; (2) a body without governance; and (3) experiencing loss. These men reported difficulties in dealing both with the physical and emotional impotence resulting from the treatment. Urinary incontinence and erectile dysfunction affected their body by accentuating conflicts related to masculinity, triggering subjective feelings of powerlessness, and psychological distress. CONCLUSION: Study respondents assigned multiple psychological meanings to issues related to feelings of powerlessness in general, leading to a narcissistic wound. The men experienced UI as a bodily deficiency, and erectile dysfunction was experienced as a feeling of being devitalized. These results suggest that UI from prostate cancer treatment affects sexuality and self-esteem.

The meanings of silence in Brazilian women with urinary incontinence.

PURPOSE: We explored the meanings of silence for Brazilian women with urinary incontinence (UI). SUBJECTS AND SETTING: The sample consisted of 8 women, aged 30 to 45 years. Respondents worked as housekeepers or cleaning staff and were from lower social, economic, and educational strata. Their years of formal education varied from 0 to 8 years and they earned up to 4.5 times the Brazilian minimum wage, which is equivalent to US$900. METHODS: A qualitative method using semistructured interviews was employed to gather data. Individual semistructured interviews were recorded and subsequently transcribed, including researchers' observations of subjects' nonverbal behaviors. The interviews began with the question: "Can you tell me about your experience with urinary incontinence?" Data were analyzed using a content analysis technique. RESULTS: Respondents avoided discussing UI and initially resisted labeling themselves as incontinent, but their nonverbal behaviors provided clues to the psychosocial distress caused by urinary leakage. Results suggest that respondents' underprivileged social, economic, and cultural situation may aggravate their limitations when expressing their feelings. We found that the women employed silence as a means to contain the psychosocial distress created by their UI, and that the silence itself should be interpreted as an expression of distress associated with UI. CONCLUSION: The silence of Brazilian women with UI is an essential element of communication about incontinence. We believe that the silence used by these women expresses the pain and anxiety they experienced, and it acts as an adaptive psychosocial mechanism.

Nursing care of women who suffered sexual violence.

The aim of this study was to characterize the nursing care, provided to women who suffered sexual violence, treated at The Women's Hospital-CAISM/UNICAMP. A retrospective, descriptive study performed using 146 nursing care records of women attended from June 2006 to May 2007. The results showed that the majority of attendances occurred during the day period, that there was consistency between the interventions and the nursing diagnoses identified, and that women reported having received guidance in accordance with the protocol of the program. The nursing consultation time was greater at night (p=0.0227) and the women frequently understood the health risks resulting from sexual violence (p=0.0072), the use of antiretrovirals according to their daily activities (p=0.0397) and they were more focused on the purpose of the serology (p=0.0351). We concluded that the care provided was shown to be appropriate and of a better quality in the nightshift period.

Psychocultural meanings of urinary incontinence in women: a review.

The purpose of the present study was to identify and analyze studies in health literature about the psychocultural meanings reported by women who experience urinary incontinence (UI). A bibliographical search was executed in the following databases: Lilacs, Medline, Pubmed and Medscape. The present review showed that studies note several meanings. The articles were grouped in three categories defined as significant: according to age experiences, cultural-religious experiences and experiences in self-care. The studies revealed that the degree of anguish and the range of the difficulties experienced are related both with age, ethnic group or religion and with the perception each individual has of her incontinence, which will lead to different levels of emotional disorders and to seeking (or not seeking) treatment. Besides, barriers regarding self-care are perceived. It is concluded that the UI may cause suffering and incontinent women have difficulties to deal with this problem.

[Risk factors for urinary incontinence in women]. / Fatores de risco para incontinência urinária na mulher.

The goal of this study was to conduct a review of the main papers published between 1983 and 2003 on the main risk factors for urinary incontinence (UI) in women. Thirty-eight publications in English and Portuguese were analyzed using the MEDLINE and LILACS databases as well as through research in libraries. There is evidence that the main risk factors are age, pelvic floor trauma, hereditary factors, race, menopausal status, obesity, chronic diseases, use of some sympathomimetics and parasympatholitics, constipation, smoking, coffee consumption and intense abdominal exercises. Nurses are able to identify these factors through anamnesis and determine interventions for the prevention and treatment of UI, thus contributing to improve incontinent women's quality of life.

[Assistance to women victims of sexual violence: a nursing care protocol]. / Atendimento à mulher vítima de violência sexual: Protocolo de Assistência de Enfermagem.

The Ministry of Health recommends integral and humanized assistance to women victims of sexual violence. This study was aimed at describing the Nursing Protocol in the Attention to Women Victims of Sexual Violence at the Center for Integral Attention to Women's Health of the State University of Campinas (Unicamp), which has recently been revised. To do so, the phases of the nursing process were followed, and after the identification of the main nursing diagnoses of the North American Nursing Diagnosis Association (NANDA) the nursing interventions were determined, based on international and national guidelines care for sexual violence. The current protocol encompasses both immediate and late care, outpatient follow-up and actions regarding legal interruption of pregnancy resulting from rape. The nursing protocol has been providing integral and humanized assistance to women and, for nurses, more autonomy in their area and the possibility of participative and collaborative work with multidisciplinary teams.

[Evaluation of an expert system on nursing diagnoses related to urinary elimination]. / Avaliação de um sistema especialista em diagnóstico de enfermagem relacionados à eliminação urinária.

An expert system on nursing diagnoses related to urinary elimination, according NANDA's taxonomy, was developed and evaluated. Data were collected using a form and a checklist of defining characteristics. The obtained consensus diagnoses by three specialists were considered gold standard. 197 cases were tested. The system proved to be adequate for determining diagnoses such as 'stress urinary incontinence', 'urge urinary incontinence', 'urinary retention' and 'total urinary incontinence' with sensitivity and specificity above 98%. The accuracy evaluation in relation to 'impaired urinary elimination', 'reflex urinary incontinence' and 'functional urinary incontinence' was not possible to be established due to the small size of the sample. The experience in developing and evaluating this program can be applied in creating other expert systems.

[Why the nursing staff professionals with urinary incontinence do not seek for treatment]. / Porque profissionais de enfermagen corn incontinência urinária não buscam tratamento.

It was verified the prevalence of urinary incontinence (UI) among the women's nurse staff at a medical school, if the incontinent women seek a doctor for treatment and what was they reasons for not seeking treatment. Among 291 women that answer the survey, 27.5% reported UI and, 79% women didn't seek UI treatment. The most common reasons for not seek treatment were that incontinence was slight degree (28.8%) and the belief that the UI was a common problem for women (22%). The prevalence and the reasons for not seeking treatment for UI were similar the others researches with women in general. It was concluded that the factor at to be health's professional didn't influence their attitudes.

The impact of urinary incontinence on female nursing personnel.

Was assessed the prevalence of urinary incontinence (UI), its interference in the performance of daily occupational activities and its management among the women's nurse staff of a medical school hospital in Campinas, Sao Paulo. Of the 291 employers, 27.5% reported UI complaint at least monthly. The activities that required greater effort increased the urinary loss, what resulted in stress, feeling embarrassed and lack of concentration at work. The use of pad was the most frequent strategy at management of UI and sometimes the task could not be interrupted to use the restroom. In conclusion, the activities that require more effort and the difficulty for an adequate management of the UI in workplace increase the problem and interfere on professional performance.

[Urinary incontinence restrictions in women's life]. / Restrições causadas pela incontinência urinária a vida da mulher.

Our purpose with this study was to verify the restriction of the urinary incontinence (UI) in a woman's daily life, considering the type of incontinence, and find out how women deal with that. It is a secondary analysis of data taken from a previous study that were obtained using open and closed questions. Interviews were held with 164 incontinent inpatients of gynecological and urological clinics of two hospital schools in the city of Campinas, in the State of São Paulo, with ages ranging from 25 to 85 years. Of this universe, 104 (64%) indicated one or more restrictions regarding their daily life activities, such as altered sexual (40.9%), social (33.5%), domestic (18.9%) and occupational activities (15.2%). Mixed urinary incontinence and urge incontinence were mentioned as that affected the most women's daily life. The disposable pad system was the most utilized strategy in dealing with UI. It was concluded that UI has a negative impact on the daily life of these women.

[Factors associated with urinary incontinence in women]. / Fatores associados com a incontinência urinária na mulher.

The aim of this present study was to assess the urinary incontinence (UI) prevalence, and its associate factors among nurse female staff of a school hospital. Of the 378 questionnaires delivered, 291 (77%) were answered, and 80 (27.5%) employers reported complaint Ul. The multivariate analysis had shown that there is a more probability of developing Ul after 41 years of age, having changed the weight, having intestinal constipation and having arterial hypertension. It was concluded that preventable educational measures are necessary in order warn same factors that caused UI among nursing female staff.

[Development of an expert system for identification of nursing diagnosis related to urinary elimination]. / Desenvolvimento de um sistema especialista para identificação de diagnósticos de enfermagem relacionados com a eliminação urinária.

The study involved an evaluation of the ALTURIN.EXP system and its improvement that culminated in the establishment and evaluation of a new system named ALTURIN.SDD. In the present work the evaluation phases of the ALTURIN.EXP and development of the ALTURIN.SDD systems are described. The ALTURIN.SDD system was developed by utilizing a "shell" program specially built for this project, the Program for Diagnose Determination (SDD, 1.0 Version), which had as a target Windows 95/98/Me platforms. The nursing diagnoses are those present in the NANDA 2001-2002 classification. This development experience shall be applied in the development of other specialized systems.

Job satisfaction of nursing staff in a university hospital.

OBJECTIVE: identify the determinants of job satisfaction of the nursing staff of a public university hospital. METHOD: secondary study with mixed data approach and simple and multiple linear regression. A total of 115 subjects participated in the study, 41 nurses and 74 nursing assistants and technicians. The data collection occurred in 2013 using the QST-Caism questionnaire. RESULTS: education, hierarchical level and workplace constitute job satisfaction determinants. However, age, gender, job and work period did not show this relationship. More educated workers held low job satisfaction if exercised not graduated nursing functions. CONCLUSION: graduated workers who perform high school functions are more unsatisfied than those who have high school function and qualification.

Exclusive breastfeeding practices reported by mothers and the introduction of additional liquids.

AIM: To assess the concept of exclusive breastfeeding held by nursing women by comparing the period they consider that they perform it and the infants' age at the introduction of additional liquids. METHOD: Cross-sectional descriptive study conducted with 309 women who delivered babies at a university hospital in the interior of São Paulo, Brazil. The data were subjected to descriptive analysis; the variables of interest were crossed using the non-parametric Kruskal-Wallis test, the chi-square test and Fisher's exact test. RESULTS: Approximately 30% of the women reported having introduced additional liquids before the infants reached aged six months old, while asserting that they were performing exclusive breastfeeding. The following variables were associated with early introduction of liquids: lack of employment (p = 0.0386), younger maternal age (p = 0.0159) and first pregnancy (p = 0.003). CONCLUSION: The concept of exclusive breastfeeding might not be fully clear to women, as they seem to believe that it means not to feed the children other types of milk but that giving other liquids is allowed. These results show that promotion of breastfeeding should take beliefs and values into consideration to achieve effective dialogue and understanding with mothers.

Fuzzy cognitive map in differential diagnosis of alterations in urinary elimination: a nursing approach.

PURPOSE: To develop a decision support system to discriminate the diagnoses of alterations in urinary elimination, according to the nursing terminology of NANDA International (NANDA-I). METHODS: A fuzzy cognitive map (FCM) was structured considering six possible diagnoses: stress urinary incontinence, reflex urinary incontinence, urge urinary incontinence, functional urinary incontinence, total urinary incontinence and urinary retention; and 39 signals associated with them. The model was implemented in Microsoft Visual C++(®) Edition 2005 and applied in 195 real cases. Its performance was evaluated through the agreement test, comparing its results with the diagnoses determined by three experts (nurses). The sensitivity and specificity of the model were calculated considering the expert's opinion as a gold standard. In order to compute the Kappa's values we considered two situations, since more than one diagnosis was possible: the overestimation of the accordance in which the case was considered as concordant when at least one diagnoses was equal; and the underestimation of the accordance, in which the case was considered as discordant when at least one diagnosis was different. RESULTS: The overestimation of the accordance showed an excellent agreement (kappa=0.92, p<0.0001); and the underestimation provided a moderate agreement (kappa=0.42, p<0.0001). In general the FCM model showed high sensitivity and specificity, of 0.95 and 0.92, respectively, but provided a low specificity value in determining the diagnosis of urge urinary incontinence (0.43) and a low sensitivity value to total urinary incontinence (0.42). CONCLUSIONS: The decision support system developed presented a good performance compared to other types of expert systems for differential diagnosis of alterations in urinary elimination. Since there are few similar studies in the literature, we are convinced of the importance of investing in this kind of modeling, both from the theoretical and from the health applied points of view. LIMITATIONS: In spite of the good results, the FCM should be improved to identify the diagnoses of urge urinary incontinence and total urinary incontinence.

Vivências de gestantes em situação de prisão / Experiences of pregnant women in prison situation

Buscou-se conhecer as vivências de gestantes em situação prisional. Trata-se de estudo qualitativo e descritivo realizado em uma penitenciária feminina do Estado de São Paulo/Brasil, com 14 gestantes e uso da técnica de análise de conteúdo fundamentada nas abordagens psicoemocionais. Identificaram-se as categorias: Busca da Autoproteção, Sentimento de Culpa e Construção da Nova Identidade. A vivência em cárcere significou solidão, medo, impotência e resignação. Há restrição nas relações familiares, na convivência social, no suprimento alimentar, da privacidade e do direito ao sono/repouso, além de impedimento do exercício da maternidade. Demonstraram sentimento de culpa e dor devido a privação de vivenciar a maternidade e a amamentação, além de medo de perder a guarda de seu filho. Para conviver no cárcere, as mulheres tiveram que se adaptar à nova realidade. Conclui-se que as gestantes presidiárias buscam se auto-proteger para sobreviver as perdas e ao rompimento dos laços afetivos e sociais.

The aim was to understand the experiences of pregnant women in prison situation. We conducted a qualitative and descriptive study in a female prison in the State of São Paulo/Brazil, with 14 pregnant women and we used the content analysis technique grounded on psycho-emotional approaches. We identified the categories: Search for Self-Protection, Guilt Feeling, Building the New Identity. The experience in jail meant solitude, fear, impotence, and resignation. There are restrictions on family relationships, social conviviality, food supplement, privacy and on the right to sleep/rest, besides the impediment to exercise motherhood. Women demonstrated guilt and pain due to the privation to experience maternity and breastfeeding, besides the fear to lose their child's custody. The women had to adjust themselves to the new reality to live in prison. We conclude that pregnant inmates try self-protection to survive the losses and the affection and social disruptions.

Evaluation of the nursing process used at a Brazilian teaching hospital.

PURPOSE: To evaluate how the nursing process has been registered at a Brazilian teaching hospital. METHODS: Descriptive and retrospective study of 68 medical records. FINDINGS: The data collection of history was more frequent on the admission day. The documentation of physical exam was prioritized. Sometimes there were records of nursing interventions but not of nursing diagnoses. CONCLUSIONS: It was found some failures in the record of some steps of the nursing process. Although all steps had been used, they were not carried out consistently. IMPLICATIONS FOR NURSING PRACTICE: Some aspects deserve to be considered to improve the use and registration of all steps of the nursing process as to develop specific protocols, redesign the formulary of data record with careful and equal consideration of all steps, and empower all members of the nursing staff to implement the nursing process more effectively.

"Virei um mendigo": vivências de ex-moradores de rua acolhidos por uma instituição confessional brasileira / "Me torné un mendigo": vivencias de antiguos sin techo acogidos en una institución confesional brasileña / "I became a beggar": life experience reports of former homeless people sheltered in a brazilian confessional institution

Objetivo: analisar as vivências de ex-moradores de rua usuários de álcool acolhidos por uma Instituição Confessional. Método:fundamentado nométodo clínico-qualitativo, de agosto de 2007 a maio de 2008 foram realizadas entrevistas semi estruturadas com moradores de uma organização filantrópica do interior do Estado de São Paulo. O critério de saturação definiu a amostra de oito participantes. Resultados: três categorias foram constituídas com a técnica de análise de conteúdo temática: Você fica com vergonha: expressa tendência ao isolamento ou formação de grupos; Virei um mendigo: apresenta a ruptura da vida social e perda da identidade; O que passou não volta mais: demonstra a tentativa de livrar-se da imagem de si mesmo, negação social e identificação com os novos papéis. Conclusão: para sobreviver, o ex-morador nega elementos centrais da sua identidade e vivencia a reconstrução da nova identidade. Para retornar ao antigo lar/sociedade necessita reconfigurar a identidade perdida.

Aim: to analyze the life experiences of former homeless alcohol users sheltered in a Confessional Institution. Method: the study is based on the clinical-qualitative method. FromAugust 2007 to May 2008, semi-structured interviews were carried out with residents of a philanthropic organization in the state of São Paulo. The saturation criterion defined a sample of eight participants. Results: three categories were composed through the content analysis technique: You get embarrassed: expresses tendency to isolation or forming groups; I became a beggar: shows the breakdown of social life and loss of identity; The past will not return: demonstrates an attempt to get rid of their self-image, social denial and identification with the new roles. Conclusion:to survive, the former homeless person denies central elements of their identity and experiences the reconstruction of a new identity. In order to return to the former home/society, itis necessary to recompose the lost identity.

Objetivo:analizar las experiencias de vida de antiguos sin-techo alcoholicos acogidos en institución confesional. Método: basado en el método clínico-cualitativo, entre Agosto/2007 y mayo/2008 se realizaron entrevistas semi-estructuradas con residentes de una organización filantrópica del estado de São Paulo (Brasil). El criterio de satuaração definió la muestra de ocho participantes. Resultados: la técnica de análisis de contenido constituyó tres categorías: “Estás avergonzado”: expresa una tendencia al aislamiento o formación de grupos; “Me torné un mendigo”: presenta una ruptura de la vida social con pérdida de identidad; "El pasado no volverá": muestra intento de deshacerse de la imagen de sí mismo, negación social e identificación con los nuevos roles. Conclusión: para sobrevivir, ellos niegam elementos centrales de su identidad y experimentan la reconstrucción de la nueva identidad. Para volver al antiguo hogar/sociedad necesita reconfigurar la identidad pérdida.

Exclusive breastfeeding practices reported by mothers and the introduction of additional liquids / Prática de aleitamento materno exclusivo informado pela mãe e oferta de líquidos aos seus filhos / Prácticas de lactancia materna exclusiva reportadas por las madres y la introducción de líquidos adicionales

Aim: To assess the concept of exclusive breastfeeding held by nursing women by comparing the period they consider that they perform it and the infants' age at the introduction of additional liquids. METHOD: Cross-sectional descriptive study conducted with 309 women who delivered babies at a university hospital in the interior of São Paulo, Brazil. The data were subjected to descriptive analysis; the variables of interest were crossed using the non-parametric Kruskal-Wallis test, the chi-square test and Fisher's exact test. RESULTS: Approximately 30% of the women reported having introduced additional liquids before the infants reached aged six months old, while asserting that they were performing exclusive breastfeeding. The following variables were associated with early introduction of liquids: lack of employment (p = 0.0386), younger maternal age (p = 0.0159) and first pregnancy (p = 0.003). CONCLUSION: The concept of exclusive breastfeeding might not be fully clear to women, as they seem to believe that it means not to feed the children other types of milk but that giving other liquids is allowed. These results show that promotion of breastfeeding should take beliefs and values into consideration to achieve effective dialogue and understanding with mothers. .

OBJETIVO: avaliar o conceito de aleitamento materno exclusivo para nutrizes, comparando o período em que consideraram realizá-lo e a idade de introdução de outros líquidos. MÉTODO: estudo descritivo transversal, com 309 mulheres que tiveram filhos em um hospital universitário do interior de São Paulo, Brasil. Foi realizada análise descritiva dos dados, com cruzamento das variáveis de interesse por meio de teste não paramétrico de Kruskal-Wallis, teste quiquadrado e teste exato de Fisher. RESULTADOS: aproximadamente 30% das mulheres informaram introdução de outros líquidos antes dos seis meses de vida, enquanto afirmavam estar em aleitamento materno exclusivo. Verificou-se associação das seguintes variáveis com a introdução precoce de líquidos: mulheres sem vínculo empregatício (p=0,0386), mais jovens (p=0,0159) e primíparas (p= 0,003). CONCLUSÃO: é possível que o conceito de aleitamento exclusivo não seja claro para as mulheres, pois entendem que praticá-lo significa não dar outro tipo de leite, podendo oferecer outros líquidos. Isto mostra que a promoção do aleitamento materno deve contemplar a abordagem de crenças e valores, assegurando diálogo efetivo e compreensão junto às mães. .

OBJETIVO: evaluar el concepto de la lactancia materna exclusiva mantenido por mujeres lactantes en comparación con el período de duración de la lactancia considerado por ellas y la edad de los bebés al momento de introducción de líquidos adicionales. MÉTODO: Estudio descriptivo transversal realizado con 309 mujeres que dieron a luz bebés en un hospital universitario en São Paulo, Brasil. Los datos fueron sometidos a análisis descriptivo; las variables de interés fueron cruzados mediante la prueba no paramétrica de Kruskal-Wallis, el chi-cuadrado y la prueba exacta de Fisher. RESULTADOS: el 30% de las mujeres reportaron haber introducido líquidos adicionales antes de que los bebés llegaran a los seis meses de edad, al mismo tiempo afirmaron haber dado lactancia materna exclusiva. Las siguientes variables se asociaron con la introducción temprana de líquidos: la falta de empleo (p=0,0386), edad materna juvenil (p=0,0159) y el primer embarazo (p=0,003). CONCLUSIÓN: el concepto de la lactancia materna exclusiva puede no ser totalmente claro para las mujeres, ya que parecen creer que significa no alimentar a los niños con otros tipos de leche, pero que la administración de otros líquidos se permite. Esto demuestra que la promoción de la lactancia materna debería tomar en consideración creencias y valores para lograr el diálogo y la comprensión efectiva con las madres. .