V diagram as a tool for analytical integration of theoretical, conceptual, and methodological knowledge in health care. / O diagrama V como ferramenta de integração analítica de conhecimentos teórico-conceituais e metodológicos na saúde.

OBJECTIVE: To produce a reflection on the ability of the V diagram to integrate theoretical, conceptual, and methodological knowledge obtained from complex, non-explicitly identifiable systems, models, and theories. METHODS: Reflection study with an analytical characteristic. RESULTS: The V Diagram is presented as an instrument that can ensure an integrated analysis between theoretical and conceptual knowledge (worldview and philosophy, theories, principles, constructs, and concepts), and the analysis or production of methodological knowledge (data records, transformations, knowledge assertions, and value assertions). Examples are related to the Unified Health System (SUS), and care in Psychosocial Care Centers for Alcohol and Drugs. CONCLUSIONS: V diagram is an instrument capable of producing an integrated analysis of the knowledge contained in productions linked to complex and non-explicitly identifiable models and theories as a theoretical model, theory or framework applying deductive and inductive procedures.

ICNP® terminology subset for care of women and children experiencing breastfeeding. / Subconjunto terminológico da CIPE® para assistência à mulher e à criança em processo de amamentação.

OBJECTIVE: To describe the development of a terminology subset of the International Classification for Nursing Practice for care of women and children in process of breastfeeding. METHOD: Methodological study developed in six stages according to the guidelines recommended by the International Council of Nurses. RESULTS: Seventy-four nursing diagnoses/outcomes and 213 nursing interventions were performed and classified according to the theoretical model Interactive Theory of Breastfeeding. CONCLUSION: The subset is expected to safely and systematically steer nurses that work in this area, promoting the implementation of the nursing process and quality of care, focusing on women, children and families that are experiencing the breastfeeding process.

Breastfeeding experience of women after mammoplasty. / Experiência de amamentação de mulheres após mamoplastia.

OBJECTIVE: To describe and interpret the experience of breastfeeding among women who underwent mammoplasty surgery prior to motherhood. METHOD: A descriptive, qualitative study developed with women attended at a Human Milk Bank between 2014 and 2015. Data analysis was based on the content analysis method and supported by the Interactive Theory of Breastfeeding. RESULTS: 13 women participated in the study. Four categories emerged: 1) Success (or lack thereof) in Exclusive Breastfeeding: influence of maternal and child biological conditions; 2) Maternal feelings: perception about breastfeeding; 3) Decision making on the continuity of breastfeeding or the use of formula; 4) The role of health professionals in protecting, promoting and supporting breastfeeding: Information (or lack thereof) on the implications of the surgery. CONCLUSION: Unfavorable biological conditions of the women who underwent mammoplasty generated unsuccessful experiences in exclusive breastfeeding and limited their decision-making, despite their desire to breastfeed.

Violence against women and cervical cancer screening: a systematic review.

AIMS AND OBJECTIVES: To present a systematic review of papers published on the relationship between violence against women and cervical cancer screening. BACKGROUND: Violence against women is a serious public health problem. This phenomenon can have negative effects on victims' health and affect the frequency at which they receive cervical cancer screening. DESIGN: A systematic literature review. METHODS: This study was carried out in October 2015 with searches of the Lilacs, PubMed and Web of Science databases using the following keywords: violence, domestic violence, battered women, spouse abuse, Papanicolaou test, vaginal smears, early detection of cancer and cervix uteri. RESULTS: Eight papers published between 2002-2013 were included in this review, most of which were cross-sectional studies. Three studies found no association between victimisation and receiving Pap testing, and five studies reported an association. These contradictory results were due to higher or lower examination frequencies among the women who had experienced violence. CONCLUSION: The results of this study indicate that the association between violence against women and cervical cancer screening remains inconclusive, and they demonstrate the need for more detailed studies to help clarify this relationship. RELEVANCE TO CLINICAL PRACTICE: Professionals who aid women should be knowledgeable regarding the perception and detection of violence so that they can interrupt the cycle of aggression, which has harmful impacts on victims' health.

Quality assessment of a system of prenatal information. / Avaliação da qualidade de um sistema de informação de pré-natal.

Objective To evaluate the quality of the Prenatal Information System of the city of Vitoria - ES. Methods This is a cross-sectional study with an analysis of the Prenatal Information System Data (SISPRENATAL) from a municipality in the Southeast Region of Brazil. The quality of the system was evaluated according to the accessibility criteria, methodological clarity, timeliness and completeness defined by the Economic Commission for Latin America and the Caribbean (ECLAC). Completeness was evaluated according to the criteria of incompleteness proposed by Romero and Cunha, and assigned scores in degrees of evaluation for: excellent, good, fair, bad and very bad. Results Most of the results presented scores of bad and very bad quality. Fields with excellent or good quality for incompleteness are related to the mandatory items. Conclusion Professionals need to be aware of the proper registration of the care provided to pregnant women.

Breastfeeding assistance for preterm and low birth weight infants: best practices implementation project.

OBJECTIVE: To describe the process of best practices implementation for breastfeeding assistance for preterm and low birth weight infants. METHOD: Participatory research that used the evidence implementation methodology of the JBI, held at a university hospital in southeastern Brazil, with the participation of a multidisciplinary team and managers. STAGES: Situational diagnosis, baseline audit and feedback, protocol development, training, implementation, and monitoring. RESULTS: Seven audit criteria were defined. In the baseline audit, three criteria were met, with eleven barriers to be resolved being listed. The strategies carried out were protocol development and multidisciplinary and intersectoral training. After the training, compliance was achieved with the seven criteria audited in the first follow-up audit and five in the second, emphasizing the increase in compliance after the implementation of the outlined strategies. CONCLUSION: The project achieved the objective of improving evidence-based practice, and allowed the implementation of the institution's first breastfeeding protocol. However, it shows the need to maintain training for adherence and enculturation of new practices.

Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study.

OBJECTIVES: to map the nursing theories developed in stricto sensu graduate programs in nursing in Brazil. METHODS: a bibliometric study, carried out on the Coordination for the Improvement of Higher Education Personnel Theses and Dissertations Portal in October 2023. The controlled descriptors "Nursing Theory" and "Nursing Models" and the uncontrolled descriptors "Theories" and "Middle-Range Theory" were used. Selected studies were cataloged for analysis, which was conducted by the study authors, who have a doctoral degree and expertise in research on nursing theories. RESULTS: thirty-nine nursing theories were mapped, with a predominance of middle-range theories (79.5%), focusing on nursing diagnostic concepts and use of the theoretical-methodology strategy of theoretical-causal validity. CONCLUSIONS: the study identified nursing theories developed in Brazil, recognizing trends, development strategies, theorized objects of disciplinary interest and investments necessary for practical application in Brazilian contexts.

Contributions of representing the elements of nursing practice in the ISO 18.104:2023 standard: a theoretical study.

OBJECTIVE: To reflect on the contributions of representing nursing practice elements in the ISO 18.104:2023 standard. METHOD: This is a theoretical study with standard analysis. Categorical structures were described to represent nursing practice in terminological systems and contributions identified in the parts of the version were analyzed. RESULTS: There is innovation in the inclusion of nurse sensitive outcomes, nursing action, nursing diagnosis explanation as an indicator of nursing service demand and complexity of care, representation of concepts through mental maps and suggestion of use of restriction models for nursing actions. It describes that the Nursing Process is constituted by nursing diagnosis, nursing action and nurse sensitive outcomes. FINAL CONSIDERATIONS: Indicating a nursing diagnosis as an indicator will bring benefits for knowledge production and decision-making. Although care outcomes are not exclusive responses to nursing action, the modifiable attributes of a nursing diagnosis generate knowledge about clinical practice, nursing action effectiveness and subjects of care' health state. There is coherence in understanding the Nursing Process concept evolution.

Systematization of Nursing Care: how did the concept mature?

OBJECTIVES: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility. METHODS: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019. RESULTS: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes. CONCLUSIONS: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

Elaboration and implementation of a protocol for the Golden Hour of premature newborns using an Implementation Science lens. / Elaboración e implementación de un protocolo para la Hora Dorada de recién nacidos prematuros utilizando ciencia de la implementación.

OBJECTIVE: describe the process of designing and implementing a care protocol for the first hour of life of premature newborns. METHOD: a participatory research study using an implementation science framework, the Consolidated Framework for Implementation Research (CFIR) was employed to determine drivers and facilitators of implementation success of the Golden Hour protocol for newborns at a large university hospital in southeastern Brazil. A multi-professional team, including first line providers and managers participated in six stages of quality improvement: situational diagnosis; protocol elaboration; training protocol implementation; barrier and facilitator assessment; and protocol monitoring and review. Qualitative and monitoring data collected across these six stages were analyzed using descriptive statistics and content analysis. RESULTS: the institution's Golden Hour protocol was organized by the multi-professional team based on a collective and dialogical approach. The protocol prioritized the infant's cardiopulmonary stability, as well as prevention of hypothermia, hypoglycemia and infection. After four months of implementation, the care team was evaluated the protocol as a good quality intervention, necessary for the service, low-cost and not very complex. One suggested improvement recommended was to carry out refresher training to address staff turnover. CONCLUSION: implementation of the Golden Hour protocol introduced an appropriate and feasible neonatal care quality improvement process, which requires periodic refresher training to ensure greater adherence and better neonatal results.

Body image of women during breastfeeding: analysis supported by nursing theory.

OBJECTIVE: To describe and interpret a woman's perception of her body image during the breastfeeding process. METHOD: Descriptive qualitative study conducted at a university hospital in the Southeast region, Brazil. Forty-three puerperal women who were breastfeeding were interviewed. The interviews were submitted to lexical analysis using the IRAMUTEQ software and interpreted based on the Interactive Theory of Breastfeeding. RESULTS: Women report dissatisfaction with changes in body image during breastfeeding. But they also value and want to keep breastfeeding because of the benefits for the child. Finally, several women express the desire to perform plastic surgery in the future because of these body changes. CONCLUSION: The woman's perception of her body image as satisfactory/unsatisfactory indicates that body changes cover the breastfeeding process with feelings of ambiguity.Body changes are perceived by women in a personal, subjective and complex way.

Elaboration of a nursing record standard for an Emergency Care Unit.

OBJECTIVE: To develop a registration standard with diagnoses, outcomes and nursing interventions for an Emergency Care Unit. METHOD: This is applied research of technological development developed in three steps: elaboration of diagnoses/outcomes and interventions statements following the International Classification for Nursing Practice; assessment of diagnosis/outcome relevance; organization of diagnosis/outcome and interventions statements according to health needs described in TIPESC. RESULTS: A total of 185 diagnoses were prepared, of which 124 (67%) were constant in the classification, and 61 had no correspondence. Of the 185 diagnoses, 143 (77%) were rated as relevant by 32 experienced emergency room nurses, and 495 nursing interventions were correlated to diagnoses/outcomes. CONCLUSION: It was possible to build a record standard for the Emergency Care Unit following standardized terminology, containing diagnostic statements/outcomes and relevant interventions for nursing practice assessed by nurses with practice in emergency.

Guide for Systematization of Care and Nursing Process: educational technology for professional practice.

OBJECTIVE: to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process. METHODS: applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout. RESULTS: the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges. FINAL CONSIDERATIONS: the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.

Risk management: implementation of a clinical protocol for the prevention and management of pediatric falls.

OBJECTIVE: To describe the process of elaboration and implementation of a protocol for the prevention and management of pediatric falls. METHOD: This was an actionresearch developed at a public hospital in Southeast Brazil with 10 members of the multidisciplinary team from the pediatrics, maternity, neonatal intensive care sectors, and the patient safety center. To elaborate the protocol, literature review, three meetings with the group, and two rounds ofonline correction were carried out. Online training was carried out for all professionals and then the use of the protocol was started at the sectors. RESULTS: A pediatric fall prevention protocol was implemented. Educational materials were developed and the Humpty Dumpty Falls Scale was chosen to assess the risk of falling. CONCLUSION: The process was conducted in a collective and participatory way. The protocol and the educational materials guide and standardize behavior based on the best evidence and involve users, family members and professionals in the management of the risk of falling.

Risk for Imbalanced Blood Glucose Pattern: Construct Analysis and Nursing Diagnosis Proposal.

To identify a clinical judgment of susceptibility referring to the development of glycemic fluctuations in adults with Diabetes Mellitus undergoing treatment. Theoretical study with construct analysis. The exploration of the phenomena of glycemic variations provided clues for the description of the blood glucose pattern construct and the proposal of a new risk Nursing diagnosis as a judgment of susceptibility to the balance of this pattern. The risk factors for "Risk for Imbalanced Blood Glucose Pattern" are cognitive dysfunction; excessive alcohol consumption; excessive daily exercise; inadequate follow through with treatment regimen; increased frequency of self-monitoring of blood glucose; inadequate knowledge of disease process; inadequate management of amount of food; inadequate regularity of meal consumption; obesity; overweight; smoking; underweight. The elaboration of "Risk for Imbalanced Blood Glucose Pattern" Nursing diagnosis contributes to the advancement in the Nursing classifications and to the elaboration of planning actions and specific interventions.

ICNP® terminology subset for people with tuberculosis.

OBJECTIVES: to develop an ICNP® terminology subset to care for people with tuberculosis. METHODS: a methodological research that followed the following steps: identification and validation of empirical indicators of altered needs relevant to people with tuberculosis based on literature; cross-mapping of the empirical indicators of altered needs identified with ICNP® 2017 terms; construction of nursing diagnoses/outcomes and interventions; assessment of relevance of nursing diagnoses /outcomes and interventions and ICNP® terminology subset structuring. RESULTS: an ICNP® terminology subset was developed to care for people with tuberculosis with 51 diagnoses/outcomes and 264 nursing interventions, assessed by nurses from Primary Health Care and structured according to Wanda Horta's Theory of Basic Human Needs. FINAL CONSIDERATIONS: the subset is a technological instrument through which it is possible to identify the elements of nursing practice from the affected human needs.

Validation of Nursing Diagnoses for people with chronic kidney conditions on conservative treatment.

OBJECTIVE: To develop and validate Nursing Diagnoses statements of the International Classification for Nursing Practice (ICNP®) aimed at the care of people with chronic kidney conditions undergoing conservative treatment. METHOD: This is a methodological research structured in sequenced construction stages, cross-mapping, content validation by the Delphi Technique by specialist nurses, and categorization of Nursing Diagnoses. RESULTS: Forty-two specialist nurses participated in the first round and 34 in the second. A total of 179 Nursing Diagnoses statements were prepared, categorized according to Roy's adaptation model, of which 160 were validated for content, with Content Validity Index ≥ 0.80. CONCLUSION: The Diagnoses developed and validated show the modes of adaptation to health of people with chronic kidney conditions undergoing conservative treatment, influenced by biological, psychological, social, and cultural needs, with the Physiological Mode being the most prevalent.

Pregnant women's contribution in the construction and evaluation of an educational technology: the "Comics for Pregnant Women".

OBJECTIVES: to describe the contribution of pregnant women to the construction and evaluation of educational technology. METHODS: a participatory study developed in three stages, which occurred between March 2018 and June 2019 for identifying the content, construction, and evaluation of the comic. Non-directive interviews were conducted in educational groups with 34 pregnant women. After the comic was built by a team, including a designer, an instrument was applied to 41 pregnant women to evaluate the items Objectives, Organization, Writing style, Appearance, and Motivation. RESULTS: the comic contains 40 pages of contents, illustrations, and quizzes (word search, cross-puzzle, seven mistakes, etc). The pregnant women evaluated it as easy to understand, self-explanatory, aesthetically attractive, and capable of motivating good care practices during pregnancy, obtaining a minimum agreement of 92.1%. FINAL CONSIDERATIONS: the innovation of the educational technology consisted of incorporating the voices of pregnant women in prenatal care, with the potential to stimulate reflections and the learning process of this target audience.

Prevalence of postpartum depression symptoms and their association with violence: a cross-sectional study, Cariacica, Espírito Santo, Brazil, 2017. / Prevalência de sintomas depressivos pós-parto e sua associação com a violência: estudo transversal, Cariacica, Espírito Santo, 2017.

OBJECTIVE: To assess the prevalence of postpartum depression symptoms among puerperal women and their association with violence. METHODS: This was a cross-sectional study with puerperal women cared for at a public maternity hospital in Cariacica, ES, Brazil, in 2017. A questionnaire prepared by the authors and validated instruments were used. Pearson's chi-square test was performed in the analysis and association was expressed in prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS: Postpartum depression symptom prevalence was 36.7% (95%CI 31.6;42.0). Total family income was inversely associated with this prevalence (p<0.05). Mothers who were single (PR=1.75 - 95%CI 1.17;2.64), wished to abort (PR=1.96 - 95%CI 1.50;2.56), drank alcohol during pregnancy (PR=1.37 - 95%CI 1.00;1.86), experienced intimate partner violence in their lifetime (PR=1.94 - 95%CI 1.38;2.73), and during pregnancy (PR=1.41 - 95%CI 1.07;1.85), had higher prevalence of depression symptoms. CONCLUSION: Postpartum depression symptoms are associated with marital status, wanting to abort, alcohol consumption during pregnancy and intimate partner violence.

Software development for emergency bed management.

OBJECTIVE: to describe the process of developing a software for emergency bed management. METHODS: a participatory research based on User-Centered Design in four stages: 1) definition of requirements and structure elaboration; 2) generation of alternatives and prototyping; 3) tests; 4) implementation. Seminars were held with health professionals between May 21, 2018 and May 31, 2019 for the preparation and assessment of software content. RESULTS: the software CuidarTech KRONOS was developed for emergency bed management using the kanban methodology. FINAL CONSIDERATIONS: this software will assist professionals' and managers' decision-making providing more reliable data to enable the improvement of work processes and the quality of patient care. Developing a bed management software is innovative in the health field, and no articles were found describing this methodology.