Subjective Tools for Burn Scar Assessment: An Integrative Review.

OBJECTIVE: To review the clinical and scientific literature on the subjective ways of assessing burn scars and describe their main characteristics. DATA SOURCES: The Latin American, Caribbean Health Sciences Literature, Nursing Database, PubMed, CINAHL, and Scopus and Web of Science databases were used to search for studies published between 2014 and 2018 using descriptors in Portuguese, Spanish, and English. STUDY SELECTION: After establishing the research question and the location and definition of the studies, as well as accounting for differences among databases and application of filters based on inclusion and exclusion criteria, 886 references remained. DATA EXTRACTION: Investigators reviewed the titles and abstracts of the sample and selected 188 relevant studies for full review. DATA SYNTHESIS: Twenty-six subjective forms of assessment were found; most research concerned the Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale. CONCLUSIONS: The Patient and Observer Scar Assessment Scale and the Vancouver Scar Scale are the most common scales for assessing burn scars and have similar evaluation points such as vascularization, pliability, pigmentation, and height, which are the main parameters that contribute to the general assessment and severity of a scar. There is a need to improve instructions for application of the scales to facilitate better understanding and improve agreement among evaluators.

Coping strategies of the nursing team acting in a burn treatment center. / Estratégias de coping da equipe de enfermagem atuante em centro de tratamento ao queimado.

OBJECTIVE To know the strategies of coping reported by the nursing team that works at a burn center. METHOD This is a qualitative, descriptive and exploratory study carried out with four nurses and six practical nurses at a burn center in southern Brazil. The data was collected from September to November 2013 through semi-structured interviews, and it was analyzed through the content analysis technique, which happened with the software Atlas.ti 7.0. RESULTS Two themes have emerged: coping focused on the problem, and coping focused on the emotion. Among the main strategies of coping focused on the problem, decision-making and re-evaluation actions should be highlighted; and in the coping focused on the emotion, actions centered on resigned acceptance and emotional extravasation stand out. CONCLUSIONS As the professionals interviewed opted for objective and practical strategies, compatible with coping based on the problem, it is believed that the elaboration is influenced by the workers' individual, collective and institutional contexts.

User embracement with risk classification in an emergency care unit: an evaluative study. / Acolhimento com classificação de risco em unidade de pronto atendimento: estudo avaliativo.

Objective Describing the evaluation of the Structure, Process and Outcome of User Embracement with Risk Classification of an Emergency Care Unit from the perspective of physicians and nurses. Method An evaluative, descriptive, quantitative study developed in Santa Catarina. Data were collected using a validated and adapted instrument consisting of 21 items distributed in the dimensions of Structure (facilities), Process (activities and relationships in providing care) and Outcome (care effects). In the analysis, descriptive statistics and the Mean Ranking and Mean Score calculations were applied. Results The sample consisted of 37 participants. From the 21 evaluated items, 11 (52.4%) had a Mean Ranking between 3 and 4, and none of them reached the maximum ranking (5 points). "Prioritization of severe cases" and "Primary care according to the severity of the case" reached a higher Mean Ranking (4.5), while "Flowchart discussion" had the lowest Ranking (2.1). The dimensions of Structure, Process and Outcome reached mean scores of 23.9, 21.9 and 25.5, respectively, indicating a Precarious evaluation (17.5 to 26.1 points). Conclusion User Embracement with Risk Classification is precarious, especially regarding the Process which obtained a lower satisfaction level from the participants.

Validation of an educational game about first aid for schoolchildren.

OBJECTIVES: to validate the content and appearance of an educational game about first aid for schoolchildren with experts in education and health. METHODS: this is a methodological, quantitative and descriptive research, carried out using the Delphi technique, using an online collection instrument, covering 55 items of the game. Content and appearance assessment was performed by 26 judges. The data were analyzed using Content Validity index. RESULTS: the final prototype is presented in a board format, composed of four buildable pawns and 117 cards between questions, alerts and challenges. Overall Content Validity index of 0.95 and greater than 0.8 was obtained for all items in two Delphi rounds. CONCLUSIONS: the educational game validated by experts is a pedagogical tool for teaching first aid to schoolchildren as an option to traditional educational practices.

How was the cooking skills and healthy eating evaluation questionnaire culturally adapted to Brazil?

The study described the cross-cultural adaptation process of the American Cooking Skills and Healthy Eating questionnaire to Brazil. Six stages were followed: Translation; Synthesis of translations; Back-translations; Expert Committee; Synthesis of final version; and the Pretest (self-administered online questionnaire in a Brazilian University). Participants responded to the translated questionnaire twice for test-retest. Conceptual, item, semantic, operational and measurement equivalences were evaluated between original and translated questionnaires, as well as the internal consistency and test-retest reliability. Item, conceptual, semantic equivalences between original and Brazilian questionnaires were reached before the Expert Committee stage. Specific cooking techniques and terms were adapted. Forty-eight students answered the questionnaire in the pre-test stage, achieving the operational and measurement equivalences with kappa's agreement from moderate to substantial, and satisfactory to excellent correlations between measures. Only two measures showed low internal consistency. The combination of stages and equivalences approaches used in this cross cultural adaptation study provided lessons for further Nutrition's researches, disclosing the complexity of cooking skills concepts.

Active teaching strategies improve nursing knowledge and skills to assist burn victims.

OBJECTIVE: to evaluate the impact of an educational intervention, on nurses' self-perception, about knowledge and skills for initial care for burn victims. METHODS: a quasi-experimental study of the type before and after, with 18 nurses who assist burn victims. The intervention was carried out for 11 days in face-to-face meetings and online activities, and comprised active case-based learning strategies, simulation training, concept maps and digital portfolio. A structured instrument was used to collect sociodemographic data, and another one related to the knowledge and essential skills to the initial care for burn victims. RESULTS: The average scores found before the intervention ranged from 2.78 to 3.33 and, after the intervention, they ranged from 3.89 to 4.72. Relevant statistical differences (p <0.005) were found in all questions addressed. CONCLUSION: this educational intervention, based on innovative teaching methods, showed a positive impact on nurses' knowledge and skills on initial care for people with burns.

Burns in the domestic environment: characteristics and circumstances of accidents.

This study characterizes burn accidents in the domestic environment and identifies the circumstances of accidents affecting children, adults or elderly people who need supervision or care. Demographic data and burn characteristics of 61 domestic environment burn victims were collected. The family members of 13 children and one aged adult, who needed supervision or special care, were selected to answer a semi-structured interview. Two thematic groups were identified: social and environmental factors that might have contributed to the burn accidents and circumstances involving the accidents. Risk factors were: low socioeconomic and educational levels of mothers and those responsible for the children at the moment of the accident, small houses considering the number of occupants and unsafe kitchen equipment. Although cases of domestic violence were not identified there was neglect from caregivers. Health professionals should be attentive and investigate the circumstances of accidents involving vulnerable individuals.

Use of nursing technologies for safe perioperative pediatric care.

OBJECTIVE: To understand the nursing team's perception about the use of technology for safe perioperative pediatric care, through photographs. METHOD: A qualitative study using the theoretical framework of Nietsche Specific Nursing Technology, with a total of 18 perioperative nursing professionals from a general hospital in southern Brazil. Data collection occurred from June to August 2018, from a semi-structured interview and photograph production. They were analyzed through the Thematic Content Analysis. Approved by the Research Ethics Committee of the Federal University of Santa Catarina. RESULTS: The Nursing Technologies category used for the safety of the pediatric patient in the perioperative period, with 250 photographs illustrating facts, situations and artifacts considered nursing technologies used in safe care. CONCLUSIONS: In the team's perception, patient safety involves the use of technologies integrated to perioperative care and structural, physical and input aspects.

Relationship between quality of life, self-esteem and depression in people after kidney transplantation.

OBJECTIVE: to assess the relationship between health-related quality of life with depression and self-esteem of people after kidney transplantation. METHOD: a cross-sectional study of 47 outpatients from October 2016 to February 2017. The following tools were applied: The Medical Outcomes Study 36-Item Short-Form Health Survey, Beck Depression Inventory and Rosenberg Self-Esteem Scale. Descriptive statistics and Spearman correlation were used. RESULTS: women had lower scores for health-related quality of life. Young adults, people with up to one and a half years of transplantation and those who had dialysis for more than one year had higher scores. CONCLUSION: the health-related quality of life of people with chronic kidney disease after transplantation ranged from good to excellent. The presence of depression was not identified. The relationship of data indicates that the higher the quality of life, the better the self-esteem assessment.

Self-care in individuals with chronic kidney disease on hemodialysis.

OBJECTIVE: To understand how self-care is carried out by people with chronic kidney disease on hemodialysis. METHOD: A qualitative approach was used. Data was collected through semi-structured interviews in 12 individuals on hemodialysis in Chile between September and December 2018. Dorothea Orem's self-care theory was used for directed content analysis. RESULTS: Three categories emerged: self-care requirements, self-care deficit, and education and information management for self-care. People were aware of the importance of carrying out their self-care. They also stated not to carry out the care actions rigorously enough showing some limitations. Finally, people's knowledge about their condition was usually acquired from the Internet and from their own experience rather than through consultations with a health team. CONSIDERATIONS: People are conscious about their role in their health in a flexible way. The health team should know how to recognize conditions interfering in people's self-care and help to overcome them.

Counter-referral in Emergency Care Units: discourse of the collective speech.

OBJECTIVE: To describe the facilities and difficulties of the counter-referral of an Emergency Care Unit in Santa Catarina State. METHOD: Descriptive, qualitative study, with the participation of three nurses and 17 physicians. The data were collected through a semi-structured interview and analyzed using the Discourse of the Collective Subject technique. For the theoretical basis, the Política Nacional de Atenção às Urgências (National Policy of Emergency Care) and the Rede de Atenção às Urgências (Network of Care to the Emergencies) was used. RESULTS: The facilities of the counter-referral correspond to the strategies of communication with the Primary Care: embracement; good interpersonal relationships; and electronic medical record network. The difficulties are related to the deficiencies of Primary Care and specialized services, such as the insufficient number of physicians and the delay in scheduling consultations and more complex exams. FINAL CONSIDERATIONS: The difficulties highlighted indicate significant challenges of the local health system in the search for integration between emergency care points.

Confiabilidade de instrumentos de avaliação de qualidade de vida em crianças e adolescentes com cicatrizes de queimaduras: revisão sistemática / Reliability of quality-of-life assessment instruments in children and adolescents with burn scars: systematic review / Fiabilidad de los instrumentos de evaluación de la calidad de vida en niños y adolescentes con cicatrices de quemaduras: revisión sistemática

Objetivo: investigar as medidas de confiabilidade de instrumentos de qualidade de vida relacionada a saúde (QVRS) em crianças ou adolescentes com cicatrizes de queimaduras. Métodos: trata-se de uma revisão sistemática da literatura, mediante busca no CINAHL, Google Scholar, LILACS, PsycINFO, PubMed, Scopus e Web of Science, sem restrições quanto à data ou idioma de publicação. Foram incluídos estudos originais, nos quais se examinaram instrumentos de avaliação da QVRS de crianças e/ou adolescentes (≤ 18 anos) com cicatrizes de queimaduras. Para a análise das propriedades de medida dos instrumentos de QVRS, utilizaram-se os critérios das diretrizes do Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN). Resultados: nove estudos foram incluídos, dos quais foram abordados os seguintes instrumentos: Children Burn Outcomes Questionnaire (BOQ) ­ versão de 0 a 4 anos, Children Burn Outcomes Questionnaire (BOQ) ­ versão 5 a 18 anos, Brisbane Burn Scar Impact Profile (BBSIP) ­ versão de 0 a menores de 8 anos, Brisbane Burn Scar Impact Profile (BBSIP) ­ versão de 8 a 18 anos e CARe Burn Scale(CBS) ­ 0 a 8 anos. Conclusão: o BBSIP foi o instrumento que atendeu o maior número de itens de qualidade pela COSMIN.

Objective: to investigate the reliability measures of health-related quality of life (HRQOL) instruments in children or adolescents with burn scars. Methods: systematic review of the literature performed through a search in CINAHL, Google Scholar, LILACS, PsycINFO, PubMed, Scopus and Web of Science without restrictions on the date or language of publication. Original studies were included, in which instruments for assessing the HRQOL of children and/or adolescents (≤ 18 years old) with burn scars were examined. The criteria of the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines were used to analyze the measurement properties of HRQOL instruments. Results: nine studies were included, and they covered the following instruments: Children Burn Outcomes Questionnaire (BOQ) 0-4 years version; Children Burn Outcomes Questionnaire (BOQ) 5-18 years version; Brisbane Burn Scar Impact Profile (BBSIP) 0-under 8 years old version; Brisbane Burn Scar Impact Profile (BBSIP) 8-18 years old version; and CARe Burn Scale (CBS) 0-8 years old. Conclusion: the BBSIP was the instrument that met the greatest number of quality items according to the COSMIN.

Objetivo: investigar las medidas de confiabilidad de los instrumentos de calidad de vida relacionada con la salud (CVRS) en niños o adolescentes con cicatrices de quemaduras. Métodos: revisión sistemática de la literatura mediante búsqueda en CINAHL, Google Scholar, LILACS, PsycINFO, PubMed, Scopus y Web of Science, sin restricciones de fecha o idioma de publicación. Se incluyeron estudios originales, en los que se examinaron instrumentos para evaluar la CVRS de niños y/o adolescentes (≤ 18 años) con cicatrices de quemaduras. Se utilizaron los criterios de las directrices de los Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) para analizar las propiedades de medición de los instrumentos de CVRS. Resultados: se incluyeron nueve estudios que abarcaron los siguientes instrumentos: Children Burn Outcomes Questionnaire (BOQ) ­ versión 0-4 años; Children Burn Outcomes Questionnaire (BOQ) ­ versión 5-18 años; Brisbane Burn Scar Impact Profile (BBSIP) ­ versión 0-menos de 8 años; Brisbane Burn Scar Impact Profile (BBSIP) ­ version 8-18 años; y CARe Burn Scale (CBS) ­ versión 0-8 años. Conclusión: el BBSIP fue el instrumento que cumplió con el mayor número de ítems de calidad según el COSMIN.

Virtual Reality in the treatment of burn patients: A systematic review.

AIM: To identify studies that approach immersive virtual realities and its main effects in the treatment of burn patients in the context of the scientific world of literature. METHODS: A systematic review following the steps of Cochrane. The search was conducted in eight databases between May and August 2016. RESULTS: 34 studies were analyzed, including 23 randomized clinical trials. VR was applied using three-dimensional features and video games. The findings demonstrate the association of this technology with increased enjoyment and the reduction of pain, anxiety and stress during dressing changes and also during physical rehabilitation and physiotherapy. Few side effects have been reported. CONCLUSION: VR is a complementary drug strategy that has proven beneficial results in the treatment of burn patients.

Cross-cultural validation of the Child Adolescent Teasing Scale for Colombian students.

OBJECTIVE: to carry out the cross-cultural validation of the instrument "Child Adolescent Teasing Scale" for the Colombian student population. METHOD: methodological study carried out with students aged 8 to 15, from public and private educational institutions in the municipality of Ibagué, Colombia. The form for the characterization of students and the Child Adolescent Teasing Scale were used. RESULTS: the cross-cultural adaptation process was organized in seven steps: comparison of the Spanish version of the instrument with the original English version, back-translation, consensus version, face validity and terminology adjustment by students, face and content validity by experts, assessment committee for the final version, pilot test and reliability. CONCLUSION: the version adapted to the Spanish spoken in Colombia of the Child Adolescent Teasing Scale (Escala de burlas para niños y adolescentes), which assesses the frequency and distress caused by teasing, showed desirable results in terms of validity and reliability.

Incidência de lesões por pressão relacionadas a dispositivos médicos em unidade de terapia intensiva adulto* / Incidencia de lesiones por presión relacionadas con dispositivos médicos en unidades de cuidados intensivos para adultos / Incidence of medical device-related pressure injuries in an adult intensive care unit

Objetivo: determinar a incidência de lesões por pressão relacionadas a dispositivos médicos e os fatores associados em unidade de terapia intensiva adulta. Método: quantitativo, observacional, prospectivo. Os dados foram coletados entre setembro e novembro de 2020, em um hospital público. Utilizou-se instrumento para avaliações diárias da pele sob e peri os dispositivos. Resultados: foram analisados 1.579 dispositivos em 292 avaliações, em 47 pacientes. Identificando-se 233 lesões (14,9%). A incidência de lesões foi de 6,1%. Em 20,9% (n= 61) dos dispositivos utilizados, as lesões foram relacionadas ao tubo orotraqueal. Com relação às regiões acometidas por lesões, 10,4% (n= 24) ocorreram nas orelhas; 7,8% (n= 18), na face. As lesões estágio 1 foram as mais frequentes (n=147; 63,3%) nas avaliações realizadas. Conclusão: observou-se incidência de 6,1%. Ressalta-se a necessidade de manter a vigilância, em especial em pacientes com tubo endotraqueal. Medidas de prevenção devem ser adotadas para diminuir a ocorrência destas lesões.

Objective: to determine the incidence of medical device-related pressure injuries and associated factors in adult intensive care unit. Method: quantitative, observational, prospective. Data were collected between September and November 2020, in a public hospital. An instrument was used for daily evaluations of the skin under and peri the devices. Results: 1,579 devices were analyzed in 292 evaluations in 47 patients, identifying 233 injuries (14.9%). The incidence of injuries was 6.1%. In 20.9% (n = 61) of the devices used, the injuries were related to the orotracheal tube. Regarding the regions affected by injuries, 10.4% (n = 24) occurred in the ears; 7.8% (n = 18) in the face. Stage 1 injuries were the most frequent (n=147; 63.3%) in the evaluations performed. Conclusion: incidence was 6.1%. The need to maintain surveillance is emphasized, especially in patients with endotracheal tube. Prevention measures should be adopted to reduce the occurrence of these injuries.

Objetivo: determinar la incidencia de lesiones por presión relacionadas con dispositivos médicos y los factores asociados en la unidad de cuidados intensivos para adultos. Método: cuantitativo, observacional, prospectivo. Los datos fueron recogidos entre septiembre y noviembre de 2020, en un hospital público. Se utilizó instrumento para evaluaciones diarias de la piel bajo y peri los dispositivos. Resultados: se analizaron 1.579 dispositivos en 292 evaluaciones, en 47 pacientes. Identificándose 233 lesiones (14,9%). La incidencia de lesiones fue del 6,1%. En el 20,9% (n= 61) de los dispositivos utilizados, las lesiones fueron relacionadas al tubo orotraqueal. Con relación a las regiones afectadas por lesiones, 10,4% (n= 24) ocurrieron en las orejas; 7,8% (n= 18), en la cara. Las lesiones etapa 1 fueron las más frecuentes (n=147; 63,3%) en las evaluaciones realizadas. Conclusión: se observó incidencia de 6,1%. Se subraya la necesidad de mantener la vigilancia, en especial en pacientes con tubo endotraqueal. Se deben adoptar medidas preventivas para reducir la aparición de estas lesiones.

Cuidados para prevenção de lesão por pressão realizada por enfermeiros em um hospital de ensino / Care for pressure injury prevention performed by nurses in a teaching hospital / Cuidados para la prevención de la lesión por presión realizados por enfermeros en un hospital escuela

Objetivo: Identificar os fatores de risco para lesão por pressão reconhecida e os cuidados de enfermagem realizados em relação à prevenção de lesão por pressão. Metodologia: Estudo com abordagem quantitativa, do tipo transversal e descritivo, realizado em unidades de internação adulto de um hospital de ensino. Os dados foram coletados por meio de um questionário autoaplicável. Os dados foram analisados por meio do Programa SPSS versão 22.0, as variáveis foram analisadas por estatística descritiva com o propósito de avaliar associação entre as variáveis categóricas, utilizou-se o teste Qui-Quadrado com nível de 0,05 de significância. Resultado: O estudo envolveu 40 enfermeiros. Quanto aos fatores de risco para lesão por pressão (100 %) dos enfermeiros indicou mobilidade no leito prejudicado, (97,5 %) proeminência óssea aparente. Quanto, a capacitação sobre prevenção de lesão por pressão,(62,5 %) participou de o algum curso de capacitação. A avaliação da condição da pele no momento da admissão foi indicada como um cuidado realizado pela maioria dos enfermeiros (67,5 %) e (22,5 %) dos enfermeiros não levam em conta o tempo de admissão para realizar a avaliação da pele dos pacientes. Entre os cuidados para a prevenção de lesão por pressão, realizados pelos enfermeiros destacaram-se a mudança de decúbito e a utilização de coxins (95,0 %). Conclusão: Embora os enfermeiros demonstrem conhecimento a respeito do tema, destaca-se a necessidade do desenvolvimento de protocolos de prevenção de lesão por pressão nos hospitais, assim como investimento em materiais e equipamentos adequados.

Objetivo: Identificar los factores de riesgo reconocidos para lesión por presión y los cuidados de enfermería realizados con relación a la prevención de lesión por presión. Metodología: Estudio con planteamiento cuantitativo del tipo transversal y descriptivo realizado en unidades de hospitalización adulta de un hospital escuela. Se recolectaron los datos por medio de un cuestionario autoaplicable. Se analizaron los datos mediante la versión SPSS 22.0 mientras las variables, por estadística descriptiva con el propósito de evaluar la asociación entre las variables categóricas. Se utilizó la prueba Chi-cuadrado con nivel 0.05 de significancia. Resultado: Cuarenta enfermeros participaron en el estudio. En cuanto a los factores de riesgo para lesión por presión, el 100 % de los enfermeros reportó movilidad perjudicada en la cama y el 97,5 %, prominencia ósea aparente. En cuanto a la capacitación sobre la prevención de lesión por presión, el 62,5 % había participado en algún curso de capacitación. La evaluación de la condición de la piel en el momento de la hospitalización fue reportada como un cuidado realizado por la mayoría de los enfermeros (67,5 %) mientras el 22,5 % no toma en consideración el tiempo de hospitalización para evaluar la piel de los pacientes. Entre los cuidados realizados por los enfermeros para la prevención de lesión por presión se destacaron el cambio de decúbito y la utilización de cojinetes (95,0 %). Conclusión: Aunque los enfermeros demuestren conocimiento acerca del tema, se resalta la necesidad de desarrollar protocolos de prevención de lesión por presión en los hospitales, así como la inversión en materiales y equipos adecuados.

Objective: To identify the recognized risk factors for pressure injury and the nursing care performed in relation to the prevention of pressure injury. Methodology: Study with a quantitative approach, cross-sectional and descriptive, performed in adult hospitalization units of a teaching hospital. The data were collected through a self-applied questionnaire. The data were analyzed using the SPSS Program version 22.0; the variables were analyzed using descriptive statistics with the purpose of evaluating the association between categorical variables, using the Chi-Square test with a 0.05 significance level. Result: The study involved 40 nurses. Regarding the risk factors for pressure injury, 100 % of the nurses indicated harmed bed mobility, 97.5 % apparent bone prominence. As for training on pressure injury prevention, 62.5 % attended to some training course. The evaluation of the skin condition at the time of admission was indicated as a care performed by most nurses(67.5 %) and 22.5 % of the nurses do not consider admission time to perform skin evaluation of patients. Among the care for the prevention of pressure injury performed by the nurses, the change in decubitus and the use of cushions stood out (95.0 %). Conclusion: Although nurses demonstrate knowledge on the subject, the need to develop pressure injury prevention protocols in hospitals is highlighted, as well as investment inappropriate materials and equipment.

Realidade virtual na redução da dor em crianças queimadas: Estudo piloto quase-experimental / Virtual reality in pain reduction in burnt children: Quasi-experimental pilot study

OBJETIVO: Descrever a realização do teste piloto de estudo quase-experimental utilizando a realidade virtual (RV) para o alívio da dor durante a troca de curativo de crianças queimadas. MÉTODO: Estudo piloto, quase-experimental, do tipo série temporal interrompida com um grupo. Amostra consecutiva e de conveniência de cinco crianças internadas em um Centro de Tratamento de Queimados no Sul do Brasil, no período de dezembro/2015 a março/2016, que receberam intervenção com RV durante a troca de curativos, por três dias. A dor foi avaliada por meio da escala numérica e de faces. RESULTADOS: A RV foi aplicada três vezes em cada criança. A criança com maior superfície corporal queimada apresentou maiores picos de dor antes, durante e após o curativo. Ademais, as crianças apresentaram diminuição da dor imediatamente após o curativo. CONCLUSÕES: A intervenção com a RV foi considerada importante para as crianças queimadas, visto que tiveram uma diminuição da dor durante e após o procedimento com sua utilização.

OBJECTIVE: To describe the carrying out of the pilot test of a quasi-experimental study using virtual reality (VR) for pain relief during dressing change in burnt children. METHODS: Pilot study, quasi-experimental, interrupted time series type with one group. Consecutive and convenience sample of five children hospitalized at a Burn Treatment Center in southern Brazil, from December/2015 to March/2016, who received intervention with VR during dressing change, for three days. Pain was assessed using the numerical and faces scale. RESULTS: VR was applied three times to each child. The child with the largest body surface area burned had the highest peaks of pain before, during and after the dressing. Furthermore, the children showed a decrease in pain immediately after the dressing. CONCLUSIONS: The intervention with VR was considered important for burned children, as they had a decrease in pain during and after the procedure with its use.

Termografia como método de avaliação das lesões de pele por queimaduras / Infrared thermographic image as a tool for evaluating skin lesions caused by burns

OBJETIVO: Analisar a evolução das lesões de pele por queimaduras por meio de imagem termográfica infravermelha e 2D. MÉTODO: Estudo observacional, prospectivo, realizado no Centro de Tratamento de Queimados de um hospital universitário público do estado do Paraná com os pacientes com lesões de pele por queimaduras, admitidos entre agosto e setembro de 2022. A coleta de dados foi realizada por meio do prontuário eletrônico para caracterização sociodemográfica e clínica, entrevista, aferição da temperatura e umidade ambiente, captura da imagem (2D) com celular Samsung A51® e termografia infravermelha com câmera termográfica FLIR ONE Pro®, das lesões de pele por queimaduras durante a realização do 1º curativo (24h) e do segundo curativo (entre 48h e 72h). RESULTADOS: Predominaram pacientes do sexo masculino (64,1%), faixa etária de 18 a 59 anos (59%), da cor branca (62,5%), e o local do acidente foi domiciliar (69,2%), sendo a escaldadura com líquidos superaquecidos (46,2%) o principal agente causal. Para 92%, a superfície corporal queimada < 20% e 59,1% evoluiu para o enxerto. À captura da imagem termográfica infravermelha, observou-se que as lesões de evoluíram para epitelização apresentavam temperaturas maiores, média de 31,99ºC, quando comparadas às lesões que necessitaram de enxerto, média de 31,92ºC e, estas, por sua vez, temperaturas maiores em relação às que necessitaram de amputação do membro, média de 31,18ºC. CONCLUSÕES: A termografia infravermelha apresenta-se como um método complementar eficaz na avaliação da profundidade das lesões de pele por queimaduras, indicando precocemente as características da lesão, contribuindo na conduta mais assertiva.

OBJECTIVE: To analyze the evolution of skin lesions caused by burns using infrared and 2D thermographic images. METHODS: Observational, prospective study carried out at the Burn Treatment Center of a public University Hospital in the state of Paraná with patients with skin lesions due to burns, admitted between August and September 2022. Data collection was performed using the electronic medical record for sociodemographic and clinical characterization, interview, measurement of ambient temperature and humidity, digital image capture (2D) with a Samsung A51® cell phone and infrared thermography with a FLIR ONE Pro® thermographic camera, of skin lesions due to burns during the performance of the first dressing (24h) and the second dressing (between 48h and 72h). RESULTS: There was a predominance of male patients (64.1%), aged between 18 and 59 years (59%), white (62.5%), and the accident site was home (69.2%), with scalding with superheated liquids (46.2%) being the main causal agent. For 92%, the burned body surface < 20% and 59.1% evolved to the graft. The capture of the infrared thermographic image, it was observed that the lesions that evolved to epithelialization, had higher temperatures, average of 31.99ºC, when compared to the lesions that needed graft, average of 31.92ºC and, these, in turn, higher temperatures than those that required limb amputation, mean of 31.18ºC. CONCLUSIONS: Infrared thermography is an effective complementary method for assessing the depth of skin lesions caused by burns, indicating the characteristics of the lesion at an early stage, contributing to a more assertive conduct.

Personal protective equipment in hospital nursing care: a scoping review / Equipo de protección personal en la atención hospitalaria de enfermería: revisión de alcance / Equipamentos de proteção individual na assistência hospitalar de enfermagem: revisão de escopo

ABSTRACT Objective: to analyze the scientific production on the use of Personal Protective Equipment by Nursing professionals during the care provided in the hospital environment. Method: this is a scoping review, based on the 2020 Joanna Briggs Institute Manual and guided by PRISMA-PCR. PUBMED, EMBASE, CINAHL, LILACS, BDENF, SCOPUS and WEB of SCIENCE were used as databases, choosing a search period corresponding to the last 20 years. Data collection took place from September to October 2021. The study protocol is available in the Open Science Framework: https://osf.io/7d8q9/files/. Studies on the use of Personal Protective Equipment in direct care provided by the Nursing team in hospitals were included; and those that addressed reviews, theses and dissertations in other settings were excluded, as well as studies not available in full. Results: the sample consisted of 26 documents. The items most cited and with the highest adherence in the studies were procedure gloves, while use of goggles was the least mentioned. The following stand out among the factors that facilitate PPE use by nurses: interpersonal relationships, knowledge, workload, standardization of guidelines, and participation of the care team in management decisions. Conclusion: the need to educate the professionals using behavioral knowledge as a strategy, as well as maintenance of communication in the sectors to avoid contamination, the influence of workload and the standardization of guidelines are necessary in the hospital health services to increase health professionals' engagement towards the biosafety practices.

RESUMEN Objetivo: analizar la producción científica sobre el uso del Equipo de Protección Personal en profesionales de Enfermería durante la atención provista en el ámbito hospitalario. Método: revisión de alcance basada en el Manual del Joanna Briggs Institute de 2020 y guiada por PRISMA-PCR. Se utilizaron las bases de datos PUBMED, EMBASE, CINAHL, LILACS, BDENF, SCOPUS y WEB of SCIENCE, eligiéndose los últimos 20 años como período de búsqueda. Los dados fueron recolectados de septiembre a octubre de 2021. El protocolo del estudio se encuentra disponible en Open Science Framework: https://osf.io/7d8q9/files/. Se incluyeron estudios sobre el uso del Equipo de Protección Personal en la atención directa provista por el equipo de Enfermería en hospitales y se excluyó a los que tenían como tema revisiones, tesis y disertaciones en otros ámbitos, al igual que estudios no disponibles en formato de texto completo. Resultados: la muestra estuvo compuesta por 26 documentos. Los elementos de protección más citados y con mayor adhesión en los estudios fueron los guantes de procedimiento, mientras que las gafas protectoras fueron las menos mencionadas. Entre los factores que facilitan el uso del PPE en los profesionales de Enfermería se destacan las relaciones interpersonales, el conocimiento, la carga de trabajo, la estandarización de las pautas y la participación del equipo asistencial en las decisiones gerenciales. Conclusión: la necesidad de educar a los profesionales empleando como estrategia el conocimiento conductual, mantener la comunicación entre los sectores para para evitar la contaminación, la influencia de la carga de trabajo, y la estandarización de las pautas son medidas necesarias en los servicios de salud hospitalaria para mejorar el nivel de compromiso de los profesionales de la salud con las prácticas de bioseguridad.

RESUMO Objetivo: analisar a produção científica sobre o uso de equipamento de proteção individual pelos profissionais da enfermagem durante a assistência no âmbito hospitalar. Método: trata-se de uma revisão de escopo, baseada no Manual Institute Joanna Briggs de 2020 e norteado pelo PRISMA-PCR. Utilizou-se como base de dados PUBMED, EMBASE, CINAHL, LILACS, BDENF, SCOPUS e WEB of SCIENCE, sendo o período de busca escolhido nos últimos 20 anos. A coleta de dados ocorreu de setembro a outubro de 2021. Protocolo de estudo disponível em Framework: https://osf.io/7d8q9/files/. Foram incluídos estudos sobre o uso dos Equipamentos de Proteção Individual na assistência direta da equipe de enfermagem nos hospitais e excluídos aqueles que abordassem em outros cenários, revisões, teses, dissertações e estudos não disponíveis na íntegra. Resultados: a amostra foi composta por 26 documentos. O equipamento mais citado e com maior adesão nos estudos foram as luvas de procedimento, enquanto que o uso dos óculos foi o menor. Dos fatores que facilitam o uso dos EPIs pelos enfermeiros destacam-se as relações interpessoais, conhecimento, carga de trabalho, padronização das diretrizes e participação da equipe assistencial nas decisões gerenciais. Conclusão: a necessidade de educação dos profissionais utilizando como estratégia o conhecimento comportamental, a manutenção da comunicação nos setores para evitar a contaminação, a influência da carga de trabalho, a padronização das diretrizes são necessárias nos serviços de saúde hospitalar para aumentar o engajamento dos profissionais de saúde às práticas de biossegurança.

Use of virtual reality for treating burned children: case reports.

OBJECTIVE: To report the use of virtual reality (VR) in pain intensity during dressing change of two burned children hospitalized in a Burn Treatment Center (BTC) in Southern Brazil. METHOD: Case report on the use of VR during dressing change of two burned children hospitalized in a BTC, from May to July 2016. For assessing pain, a facial pain rating scale was applied at four times: just before the dressing, during the dressing without the use of VR, during the dressing with the VR, and after the use of VR. RESULTS: The use of goggles was easy to apply and well-accepted by the children, and also had a relevant effect reducing pain. CONCLUSION: VR can become an important nonpharmacological method for treating pain in burned children.