Development of a low-cost congenital abdominal wall defect simulator (wall-go) for undergraduate medical education: a validation study.

BACKGROUND: Congenital Anomalies were responsible for 303,000 deaths in the neonatal period, according to the WHO, they are among the world's top 20 causes of morbidity and mortality. Expensive simulators demonstrate several diseases, but few are related to congenital anomalies. This study aims to develop, validate, and evaluate low-cost simulator models (WALL-GO) of the most common abdominal wall defects, gastroschisis, and omphalocele, to enable diagnosis through an accessible tool with study value and amenable to replication. METHODS: Market research was conducted to find materials to build low-cost models. The researchers built the model and underwent validation assessment of the selected experts who scored five or more in the adapted Fehring criteria. The experts were assessed through a 5-point Likert scale to 7 statements (S1-7). Statements were assigned values according to relevance in face and transfer validities. Concomitantly, the model was also evaluated by students from 1st to 5th year with the same instruments. Content Validity Indexes (CVIs) were considered validated between groups with concordance greater than 90%. Text feedback was also collected. Each statement was subjected to Fisher's Exact Test. RESULTS: Gastroschisis and omphalocele model costs were US $15 and US $27, respectively. In total, there were 105 simulator evaluators. 15 experts were selected. Of the 90 students, there were 16 (1st year), 22 (2nd), 16 (3rd), 22 (4th), and 14 (5th). Students and experts obtained CVI = 96.4% and 94.6%, respectively. The CVIs of each statement were not significantly different between groups (p < 0,05). CONCLUSIONS: The WALL-GO models are suitable for use and replicable at a manufacturable low cost. Mannequins with abdominal wall defects are helpful in learning to diagnose and can be applied in teaching and training health professionals in developing and low-income countries.

Quality of life and ethics: A concept analysis.

BACKGROUND:: In health, ethics is an essential aspect of practice and care and guarantees a better quality of life for patients and their caregivers. OBJECTIVE:: To outline a conceptual analysis of quality of life and ethics, identifying attributes, contexts and magnitudes for health. METHOD:: A qualitative design about quality of life and ethics in health, considering the evolutionary approach in order to analyse the concept. To collect the data, a search was done using the keywords ethic*, quality of life and health. After, in total, 152 studies were found, finalizing seven relevant studies for the proposed concept analysis. FINDINGS AND DISCUSSION:: Of seven studies analysed, their main results were shown by means of antecedents, consequences and attributes of the concepts. The three final attributes that synthesize the concept of quality of life and ethics in health were highlighted: Ethics dilemmas and quality of life; Human ethics and quality of life; and Ethics of care and quality of life. In fact, the attributes and context clearly reveal that ethics and quality of life influence the ability to solve ethical dilemmas, guarantee human ethics in healthcare and impact ethics in healthcare for the production of effective health policies and care that encompasses professional quality of life as well. CONCLUSION:: The magnitude of ethical knowledge in each professional discipline permits cultivating a solidary attitude and developing the willingness to improve healthcare. The right to access, dignity and respect in care delivery are rooted in behaviours and are spontaneously applied in practice to the extent that they play an ethical role.

The Relation of Satisfaction, Self-Confidence and Emotion in a Simulated Environment.

Clinical simulation allows discussions about improving the quality on the patient's care. This method have effectiveness on what concerns to satisfaction, self-confidence and student motivation. However, during the assessment, the students have emotional reactions that have tended to be overlooked. In view of this, this article seeks to identify and describe the relationship of the emotions observed by facial expressions and assess their degree of satisfaction and self-confidence by carrying out simulated practices among the nursing students. The analysis based on the scales showed high satisfaction and self-confidence levels, and it was found that the predominant basic emotion was anger, which is caused by other correlated emotions like tension and stress. This divergence between the identified emotions opens up space for further investigations about the level of motivation and the stimulus tolearning that these emotions can provide, and the extent to which they can lead to satisfaction and self-confidence.

Trends in Research on Simulation in the Teaching of Nursing: An Integrative Review.

AIM: The aim of the study was to identify and reflect on evidence regarding the use of simulation in nursing education. BACKGROUND: The use of simulation as a teaching strategy in nursing is expanding. It is important to check the evidence deriving from research. METHOD: Departing from a guiding question, an international literature search was undertaken between January 2008 and March 2014 in Portuguese, English, and Spanish. RESULTS: Out of 160 articles, 68.1 percent used simulated teaching to develop clinical reasoning; 31.9 percent used it to train skills. Most (about 91.8 percent) discussed positive aspects related to the use of simulation, including support for the teaching process and increased self-efficacy and self-confidence. CONCLUSION: The studies indicate that appropriate tools are needed to measure the true impact of the strategy on the teaching of nursing care and the training needed to use simulation as a teaching strategy.

Telenursing Intervention for Clean Intermittent Urinary Catheterization Patients: A Pilot Study.

Telenursing is a promising strategy to make nursing care feasible in different health situations, mainly to help patients with chronic illnesses. The aim in this study was to test the feasibility (acceptability and usability) of a telenursing intervention in care delivery to patients using clean intermittent urinary catheterization. This descriptive study focused on an intervention involving urology outpatients. The telenursing intervention was implemented synchronously by audio calls and chat and asynchronously by e-mail as part of a pilot study. The contact between nurse and patient was undertaken through an active search or on spontaneous demand, in which the patient contacted the nurse when necessary. During the 5 weeks of study, 21 telenursing care sessions took place, including 13 (61.9%) on spontaneous demand and eight (38.1%) on active demand. With regard to the technological resource used, 13 telenursing sessions (61.9%) took place by telephone call and eight (30.1%) by e-mail. The pilot study demonstrated the potential of the telenursing intervention to achieve important results, and as a complement to the patients' traditional health treatment. In addition, it revealed various barriers that need to be overcome for this type of care to take place effectively.

Validation of self - confidence scale for clean urinary intermittent self - catheterization for patients and health - caregivers.

OBJECTIVE: To validate a measurement instrument for clean intermittent self-catheterization for patients and health-caregivers. MATERIAL AND METHODS: Methodological study of instrument validation performed at a Rehabilitation Center in a University hospital for patients submitted to clean intermittent self-catheterization and their health-caregivers. Following ethical criteria, data were collected during interview with nurse staff using a Likert question form containing 16 items with 5 points each: "no confidence"=1, "little confidence"=2, "confident"=3, "very confident"=4 and "completely confident"=5. Questionnaire called "Self- Confident Scale for Clean Intermittent Self-catheterization" (SCSCISC) was constructed based on literature and previously validated (appearance and content). RESULTS: The instrument was validated by 122 patients and 119 health-caregivers, in a proportion of 15:1. It was observed a good linear association and sample adequacy KMO 0.931 and X2=2881.63, p<0.001. Anti-image matrix showed high values at diagonal suggesting inclusion of all factors. Screen plot analysis showed a suggestion of items maintenance in a single set. It was observed high correlation of all items with the total, alpha-Cronbach 0.944. The same results were obtained in subsamples of patients and health-caregivers. CONCLUSION: The instrument showed good psychometric adequacy corroborating its use for evaluation of self-confidence during clean intermittent self-catheterization.

Quality of Life of Intermittent Urinary Catheterization Users and Their Caregivers: A Scoping Review.

AIMS: This study aimed to examine and map the scientific evidences regarding quality of life in neurogenic bladder patients and consequently their caregivers by means of a scoping review. DESIGN: This is a scoping review proposal of the Joanna Briggs Institute. METHODS: It was conducted to examine and map the scientific evidences about quality of life (QoL) in neurogenic bladder patients and their caregivers, to identify the meanings attributed to QoL and its relation with intermittent urinary catheterization. The following guiding question was: "What scientific evidence has been produced on the QoL of neurogenic bladder patients using intermittent urinary catheterization and their caregivers?" A total of 2945 research studies were identified using The Cochrane Library, CINAHL, LILACS, Academic Search Premier (via EBSCO platform), PubMed, SCOPUS, the platforms Web of Science, the b-on and Gray Literature. The keywords established were patient, intermittent urinary catheterization, neurogenic urinary bladder, quality of life and caregiver. RESULTS: From 2,945 studies, 13 studies were selected. Most of the selected studies that analyzed variables related to the patients' QoL were regarding the urinary catheterization technique, assessment of urinary incontinence, individual perceptions of the procedure and experiences with urinary catheter in childhood and adult life. The meanings attributed to QoL, when compared to adult and child individuals with normal bladder functioning, presented lower QoL scores. Concerning caregivers, the QoL of caregivers of children using intermittent urinary catheterization demonstrated low scores. LINKING EVIDENCE TO ACTION: The QoL of patient's who use intermittent urinary catheterization can be determined by improvement of urinary symptoms and self-confidence. Research related to QoL of patients who use urinary catheter indicates the importance of adequate professional support and appropriate health public policies.

Development of a theoretical-practical script for clinical simulation.

OBJECTIVE: To develop a theoretical-practical script based on the opinion of experts to be used in simulated clinical activities. METHOD: Qualitative study through analysis of content of interviews with experts on the theme in order to develop the proposed script. Of the 24 invited experts, 12 specialists from educational institutions in Brazil and abroad participated in the study in compliance with the ethical precepts. The experts responded to questions on the characterization of their study attributes and described the items required for the development of a simulated scenario. In view of the responses obtained, data content was analyzed and classified into units and subunits of significance. RESULTS: The items mentioned for the development of the script generated seven units of significance. The units and subunits of significance were gathered in three stages of the main components of the simulated scenario: prior, preparation, and finals. CONCLUSION: This study enables an innovative, stimulating teaching experience, making it easier for professors to use the simulation resource as a learning process in an effective and objective manner, as a guide to professors and researchers in the area of clinical simulation. OBJETIVO: Construir, com base na opinião de peritos, roteiro teórico-prático para uso em atividade clínica simulada. MÉTODO: Trata-se de um estudo qualitativo por meio de análise de conteúdo de entrevistas de peritos no assunto para construção do roteiro proposto. Seguido os preceitos éticos, entre os 24 peritos convidados pertencentes a instituições de ensino do Brasil e do exterior. Os peritos responderam a questões sobre a caracterização dos seus atributos de estudo e descreveram os itens imprescindíveis à construção de um cenário simulado. Diante das respostas obtidas, os dados foram analisados em relação ao seu conteúdo e organizados em unidades e subunidades de significância. RESULTADOS: Participaram 12 especialistas. Os itens mencionados para construção do roteiro originaram sete unidades de significância. As unidades e suas subunidades de significância foram ainda reunidas em três fases dos componentes principais do cenário simulado: prévios, preparo e finais. CONCLUSÃO: Este estudo permite um ensino inovador, estimulante e possibilita a facilidade ao professor, quanto à utilização do recurso de simulação, como processo de aprendizagem de maneira eficiente e objetiva, sendo um norteador aos docentes e pesquisadores na área de simulação clínica.

Intermittent urethral catheterisation: the reality of the lubricants and catheters in the clinical practice of a Brazilian service.

AIMS AND OBJECTIVES: To identify how catheters and lubricants have been used among patients using intermittent urinary catheterisation in rehabilitation. BACKGROUND: The clean intermittent urinary catheterisation technique is an invasive procedure can cause discomfort, pain and urethral traumas. The use of lubricants and lubricated urinary catheters reduces the friction between the catheter and the urethral mucosa, minimising the risks. DESIGN: A descriptive exploratory design was used. METHODS: Quantitative and descriptive study developed at a rehabilitation centre of a University Hospital in the interior of the state of São Paulo, Brazil, at the Intermittent Urinary Catheterisation Outpatient Clinic, between June 2012-December 2014. After ethical approval, the data were collected through an interview with the support of a semistructured questionnaire, held during the nursing consultation. Among the users, patients using intermittent urinary catheterisation were interviewed, over 18 years of age and minors younger than eight years accompanied. Descriptive statistical analysis was applied. RESULTS: Most of 214 (100·0%) patients were interviewed were male, single, young adults and with a primary medical diagnosis of bone marrow injury and myelomeningocele. Most patients perform the urinary catheterisation between four and six times per day. For the procedure, the majority uses polyethylene (polyvinyl chloride) catheter and, as a lubricant, 2·0% lidocaine hydrochloride on the catheter itself. Many mention lack of sensitivity when passing the catheter. CONCLUSION: In the study sample, a risk of urethral traumas was evidenced, related to the inappropriate use of catheters and lubricants. For the patients' safety, the professionals need to acknowledge the importance of the appropriate use of lubricants and lubricated catheters to implement evidence-based practices that mobilise public policies. RELEVANCE TO CLINICAL PRACTICE: The use of evidences demonstrates that the appropriate use of lubricants for intermittent urinary catheterisation is fundamental for patient safety and the performance of the best practices.

Usability Assessment of Moodle by Brazilian and Portuguese Nursing Students.

Distance education has turned into an important tool for nursing education. The virtual learning environments contribute toward an interactive and attractive educational process. In this study, we assess the usability of a virtual learning environment that was developed to teach nursing students how to care for patients with urinary retention. A multicenter and descriptive study was undertaken, which involved nursing students from the University of São Paulo at Ribeirão Preto College of Nursing, Brazil, and the Escola Superior de Enfermagem de Coimbra, Portugal. The participants were 79 students, mostly female, between 20 and 24 years of age. The virtual learning environment revealed good properties in terms of usability on most criteria. Future research will help to confirm the results.

Application of telenursing in nursing practice: an integrative literature review.

AIMS AND BACKGROUND: Telenursing is the use of technological resources and communication systems to encourage the development of nursing. Its efficiency has been demonstrated to help countries overcome barriers to healthcare. This study investigates the current telenursing strategies utilized in nursing practice, as found in the literature. METHOD: Integrative literature review of the application of telenursing, using the descriptors: telenursing, nursing care and communication means, in Portuguese, English and Spanish, between 2003 and 2013. RESULTS: Telenursing is found particularly in care through telephone use for health services and orientations. The country with the largest number of research publications was the United States with 14 (37.8%), followed by Canada and the United Kingdom. FINAL CONSIDERATIONS: It could be verified that telenursing is growing, in view of its presence in different countries, with strong evidence and benefits of its use. It proves to be an efficient tool to help countries overcome geographical barriers and provide health care information to the population.

Meanings attributed by nurses to ensure the care of critical patients in the light of simulations' premises.

AIM: The aim of this study was to identify the feelings experienced by nurses in caring the first visit to a critical patient. BACKGROUND: Understand the ethical aspects from the first experiences in the nursing profession lead us to reflect on the teaching-learning methodologies and also their improvements. METHODS: A study with a mixed and exploratory approach was realized with the nurses. RESULTS: From 72 (100.0%) nurses who participated in the study, 56 (77.8%) did their first visit to critical patients in the clinical practice and did not feel prepared. The feelings mentioned were as follows: insecurity due to lack of skill, risk both to the patient and also the professional, feelings of fear, anxiety, discomfort and related aspects to ethical competence. CONCLUSION: The feelings experienced by professionals led us to reflect about the function of institutions, which must have the commitment and the responsibility of providing to the society able professionals who are acting safely and with technical and scientific expertise in valuing human integrity.

Urinary retention: implications of low-fidelity simulation training on the self-confidence of nurses.

METHOD: This was a quasi-experimental study carried out among nurses stationed in municipal care units in the interior of São Paulo State. Data were collected during the course of a pedagogical workshop that used low-fidelity simulation training. RESULTS: The study included 42 nurses, mostly female with over 15 years of experience. After low-fidelity simulation training, nurses showed a significant increase (p<0.05) in confidence related to nursing care in urinary retention. The lowest self-attributed scores during the activity were related to the objective assessment of urinary retention. CONCLUSION: Low-fidelity simulated training is an effective resource for the development of nurses with respect to nursing care in urinary retention. OBJETIVO: Avaliar o nível de autoconfiança de enfermeiros na assistência de enfermagem na retenção urinária antes e após atividade simulada de baixa fidelidade. MÉTODO: Estudo quase-experimental realizado junto aos enfermeiros lotados nas unidades de atendimento de município do interior do estado de São Paulo. Os dados foram coletados durante a realização de uma oficina pedagógica que contou com atividade simulada de baixa fidelidade. RESULTADOS: Participaram do estudo 42 enfermeiros, a maioria do sexo feminino e com mais de 15 anos de atuação. Após o treino simulado de baixa fidelidade os enfermeiros demonstraram aumento significativo (p < 0,05) na autoconfiança relacionada à assistência de enfermagem na retenção urinária. Os menores escores autoatribuídos durante a atividade foram relacionados à avaliação objetiva da retenção urinária. CONCLUSÃO: A simulação de baixa fidelidade é um recurso efetivo no aprimoramento de enfermeiros no que diz respeito à assistência de enfermagem na retenção urinária.

Empathy in Brazilian nursing professionals: a descriptive study.

BACKGROUND: Essential for the help relation, empathy is the ability to understand, share, and perceive the subjective experience of other human beings. OBJECTIVE: The objective in this non-experimental, exploratory, and descriptive research was to verify, observe, and document empathy in nursing professionals. RESEARCH DESIGN: Non-experimental, exploratory, and descriptive research. Participants and research context: the study was conducted at two large hospitals, one public and the other private, across all shifts. The sample included 159 individuals. A questionnaire was used to identify sociodemographic characteristics and the empathy inventory was applied. ETHICAL CONSIDERATIONS: This study received approval from the Research Ethics Committee at the University of São Paulo at Ribeirão Preto College of Nursing, opinion 1348/2011, and authorization from the health institutions involved. FINDINGS: The association tests demonstrated that professionals working in the night shift and in a work scale rotation scheme, older professionals, and professionals with longer professional experience are less empathetic. On the other hand, professionals working in the day shift and in a single shift are more empathetic. Other influential factors are the time on the job, education, and work shift. CONCLUSION: There is a lack of empathy studies in professional practice contexts, in human resource development programs, and throughout the professional education process.

Intermittent urethral catheterization-descriptive study at a Brazilian service.

AIMS AND BACKGROUND: The rehabilitation process of patients with neurogenic bladder involves psychosocial, cultural, political and economic human factors, representing a challenge for patients/caregivers as well as health professionals. This study was aimed at characterizing patients with neurogenic bladder who use intermittent urethral catheterization and were going through rehabilitation at a teaching hospital. METHOD: This descriptive study was undertaken in the interior of São Paulo State-Brazil. All ethical guidelines were complied with. To collect the data, interviews were held during nursing consultations with patients more than 18years of age suffering from neurogenic bladder who used intermittent urethral catheterization. RESULTS: Most patients had spinal cord trauma, are single, male and gain a low income. They have been using catheterization for several years, at irregular frequencies, using polyethylene catheters. CONCLUSIONS: No standardization exists in the accomplishment of the practices used and strategies are needed to remodel the service.

Implications of clinical simulation in motivation for learning: scoping review.

OBJECTIVE: To identify, synthesize, and analyze the scientific knowledge produced regarding the implications of using clinical simulation for undergraduate nursing or medical students' motivation for learning. METHODS: The search for articles was conducted between July 28 and August 3, 2022, on the PubMed/MEDLINE, Scopus, Web of Science, and SciELO databases. The following was used for the search: P - undergraduate students attending Nursing or Medicine courses; C - motivation for learning, and C - skills and clinical simulation laboratory. The following research question guided the study: "What are the implications of clinical simulation on the motivation for learning of undergraduate students of nursing and medicine?" Of the 1,783 articles found, 13 were included in the sample for analysis. All stages of the selection process were carried out by two independent evaluators. The results were presented as charts and a discursive report. RESULTS: The studies analyzed indicated the beneficial effects of clinical simulation on students' motivation, in addition to other gains such as competencies, technical and non-technical skills, knowledge, belonging, autonomy, clinical judgment, critical and reflective thinking, self-efficacy and decreased anxiety, self-management, and improvements in learning and learning climate. CONCLUSION: Clinical simulation provides a positive learning environment favorable to the development of technical and interpersonal skills and competencies, and raising the level of motivational qualities.

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions.

BACKGROUND: Angola is one of the African countries with the highest morbidity and mortality rates and a devastating lack of human resources for health, including nursing. The World Health Organization stimulates and takes technical cooperation initiatives for human resource education and training in health and education, with a view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with nursing education institutions perceive the challenges nursing education is facing in Angola. METHODS: After consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with professional nursing education institutions in Angola were invited to participate in the study by email. Data were collected in February 2009 through the focus group technique. The group of participants was focused on the central question: what are the challenges faced for nursing education in your country? To register and understand the information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using content analysis. RESULTS: Fourteen nurses participated in the meeting, most of whom were affiliated with technical nursing education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources,bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions they present are predominantly centered on the valuation of nursing professionals, which implies cultural and attitude changes. CONCLUSIONS: Public health education policies need to be established in Angola, including action guidelines that permit effective nursing activities. Professional education institutions need further regularizations and nurses need to be acknowledged as key elements for the qualitative enhancement of health services in the country.

Construction and validation of a distance learning module on premedication antisepsis for nursing professionals.

The aim of this descriptive study, carried out at a public university, was to design, develop, and validate a distance learning module on intramuscular premedication antisepsis. The content was introduced in the Modular Object-Oriented Dynamic Learning Environment, based on the Systematic Model for Web-Based Training projects. Ten nurses and information technologists at work consented to participate, in compliance with ethical guidelines, and answered a questionnaire to validate the Virtual Learning Environment. The educational aspects of the environment interface were mostly evaluated as "excellent," whereas the assessment of didactic resources indicated interactivity difficulties. It is concluded that distance learning is an important tool for the teaching of premedication antisepsis. To ensure its effectiveness, appropriate methods and interactive devices must be used.

Spirituality and post-graduate students' attitudes towards blood donation.

College students have become more representative as blood donors, mainly to help other people. This study ascertained the association between spirituality and adherence or intention to donate blood in post-graduate students. In this quantitative and cross-sectional study, participants were 281 students from a post-graduate programme at a Brazilian public university. After complying with ethical requirements, data were collected through a questionnaire for sociodemographic characterization and identification of blood donation practices, followed by the Spiritual Well-Being Scale. Descriptive statistics and parametric tests were used for data analysis. A total of 74% of the participants were female and 26% were male. Previous experience and/or intention to donate blood were found in 75.3%; 14.3% donated blood periodically. In addition, 12.2% were not adept to donation and 12.5% were inapt. Spiritual Well-Being scores were similar between individuals who are not adept and those who donate periodically. In conclusion, in the sample, spirituality and blood donation are not associated, but spiritual well-being and gender are. To enhance blood donation, further research is needed.

Prevalence of overweight and obesity among health professionals with shift work schedules: A scoping review.

Epidemiological evidence show that shift work can contribute to increased body weight. This study aims to map the prevalence of obesity and overweight among health professionals who work in shifts and analyse the factors that contribute to weight gain. A scoping review was conducted, following the proposal of the Joanna Briggs Institute. The Population, Concept, and Context strategy was used to formulate the guiding question. The proposed question was: "What is the prevalence of overweight and obesity among health professionals with shift work schedules?" After excluding duplicate articles, analysing titles and abstracts, and excluding articles that did not answer the guiding question, 20 articles remained and were included in this review. The studies have shown that the main factors that could influence weight gain among health professionals that are shift workers, are hormonal dysregulation, eating unhealthy meals, and low rates of physical activities practice. This scoping review showed that shift work can be an important risk factor for the development of overweight and obesity among these professionals. This implies the need of developing and implementing health policies aimed at reducing the excessive exposure of these workers to shift schedules and encouraging healthier and long-lasting changes in their lifestyles, both at workplace and outside of it.