Mundo de Pólus serious game for people with bipolar disorder.

BACKGROUND: Serious games are play-based technologies designed to teach users a wide range of concepts and skills applicable in the non-virtual environment. OBJECTIVES: This paper describes the process of developing a serious game for people with bipolar disorder to promote symptom recognition and the safe use of medications. METHODS: This study was based on the User-Centered Design methodological model and the theoretical framework for Participatory Design. We conducted interviews with health professionals and discussion circles with people with bipolar disorder and their family members in order to identify the learning needs related to symptom recognition and safe medication use. A categorical analysis was completed of the participants' reports and the scientific literature and formed the basis for the design of Mundo de Pólus. RESULTS: The game development process had three pillars (detailed in this manuscript): missions, simulation, and journal. The serious game focuses on the users' perceptions about their experience with the disorder, their interpersonal relationships, coping strategies, use of medications, and non-pharmacological treatments. CONCLUSIONS: These scientific and technological outcomes are useful to promote literacy and safety in medication therapy for people with bipolar disorder.

Skin-to-Skin Contact in the Third Stage of Labor and Postpartum Hemorrhage Prevention: A Scoping Review.

INTRODUCTION: Literature supports numerous benefits of skin-to-skin contact for neonatal adaptation to extrauterine life and bonding/attachment, but few studies explore the effects of skin-to-skin contact on maternal outcomes. This review aims to map the evidence on skin-to-skin contact in the third stage of labor for postpartum hemorrhage prevention. METHODS: Scoping review, which covered stages recommended by the Institute Joanna Briggs, including studies from the PubMed, EMBASE, CINAHL, LILACS, Web of Science, and Scopus databases, using the descriptors "Postpartum hemorrhage", "Labor stages, third", "Prevention" and "Kangaroo care/Skin-to-skin". RESULTS: 100 publications on the subject found, 13 articles met the inclusion criteria, with 10,169 dyads were assessed in all studies. Publications from 2008 to 2021 were mostly written in English and designed as a randomized controlled trial. Skin-to-skin contact was effective and significant in: reducing the duration of the third stage of labor; placenta delivery; uterine contractility and physiological involution; absence of atony, decreasing blood loss with lower rates of erythrocyte and hemoglobin drop; reducing the need for synthetic oxytocin and/or ergometrine to control bleeding; and reducing changing pads per period and length of stay. DISCUSSION: Skin-to-skin contact was considered an effective, low-cost, and safe strategy, with positive effects already established in the literature for infants and extremely favorable results in postpartum hemorrhage prevention cases, being highly recommended in assistance for the dyad. Open Science Framework Registry ( https://osf.io/n3685 ).

Influence of simulation design on stress, anxiety and self-confidence of nursing students: Systematic review with meta-analysis.

AIM: To evaluate the simulation design characteristics that may influence the stress, anxiety and self-confidence of undergraduate nursing students during learning. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Searchers were conducted in October 2020 and updated in August 2022 in the databases CENTRAL, CINAHL, Embase®, ERIC, LILACS, MEDLINE, PsycINFO®, Scopus and Web of Science, PQDT Open (ProQuest), BDTD, Google Scholar and specific journals on simulation. REVIEW METHODS: This review was conducted according to the recommendations of Cochrane Handbook for Systematic Reviews and reported according to the PRISMA Statement. Experimental and quasi-experimental studies that compared the effect of simulation on stress, anxiety and self-confidence of nursing students were included. The selection of studies and data extraction was performed independently by two reviewers. Simulation information was collected as prebriefing, scenario, debriefing, duration, modality, fidelity and simulator. Data summarization was performed by qualitative synthesis and meta-analytical methods. RESULTS: Eighty studies were included in the review, and most reported in detail the structure of the simulation, contemplating prebriefing, scenario, debriefing and the duration of each step. In subgroup meta-analysis, the presence of prebriefing, duration of more than 60 min and high-fidelity simulations helped reduce anxiety, while the presence of prebriefing and debriefing, duration, immersive clinical simulation modalities and procedure simulation, high-fidelity simulations and use of mannequins, standardised patients and virtual simulators, contributed to greater students' self-confidence. CONCLUSIONS: Different modulations of simulation design components imply reduction of anxiety and increased self-confidence in nursing students, especially highlighting the quality of the methodological report of simulation interventions. RELEVANCE TO CLINICAL PRACTICE: These findings help to support the need of more rigorous methodology in simulation designs and research methods. Consequently, impact on the education of qualified professionals prepared to work in clinical practice. No Patient or Public Contribution.

Protective measures feasibility for infants of low income SARS-CoV-2 positive breastfeeding mothers: a prospective multicenter cohort study.

AIM: The aim was to evaluate the feasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers. BACKGROUND: Breastfeeding mothers with SARS-CoV-2 positive should avoid exposing the infant through protective measures (PM), but it could be challenging in a low-income population. METHODS: A prospective, multicenter study was conducted between July and October 2020 (BRACOVID). The participants were recruited at birth and interviewed through a structured questionnaire at seven and 14 days in the home environment. The feasibility of PM during breastfeeding at home was defined by guidelines recommendations (mask using, handwashing, and distancing from newborn when not breastfeeding). Three groups according to the feasibility of guidelines: complete guidelines feasibility (CG): all PM; partial guidelines feasibility (PG): at least one PM feasible; no guidelines (NG): infeasibility to all of PM. Flu-like neonatal symptoms, mothers' breastfeeding practices. We evaluated the association between PM feasibility and socioeconomic factors. RESULTS: 117 infected mothers from 17 Brazilian hospitals were enrolled. 47 (40%) mothers followed all recommendations, 14 (11.9%) could not practice at least one recommendation, and 50 (42.7%) did not execute any of them. The breastfeeding rate was 98%. Factors associated with infeasibility were monthly family income < 92.7 dollars/person, high housing density (>1 inhabitant/room), teenage mothers, responsive feeding, and poor schooling. Regarding infants' flu-like symptoms, 5% presented symptoms at fourteen days (NG group). CONCLUSION: The guidelines were not applied to infants of SARs-CoV-positive mothers in 54.6% of the dyads since the recommendations were unviable in their environments. During pandemics, we should look for feasible and effective guidelines to protect neonates from low-income populations. IMPLICATIONS FOR NURSING MANAGEMENT: Poor socioeconomic conditions lead to the unfeasibility of protective measures for infants of low-income SARS-CoV-2 positive breastfeeding mothers during the isolation period in the pandemics. The orientations and the support provided to dyad should consider the socioeconomic factors to guide feasible measures in the home environment and promote adequate protections; only an individual approach will allow a safe environment for low-income infants.

[Evaluation of digital educational student-technology interaction in neonatal nursing]. / Avaliação da interação estudante-tecnologia educacional digital em enfermagem neonatal.

OBJECTIVE: To assess the digital educational technology interface Caring for the sensory environment in the neonatal unit: noise, lighting and handling based on ergonomic criteria. METHODS: Descriptive study, in which we used the guidelines and ergonomic criteria established by ISO 9241-11 and an online Likert scale instrument to identify problems and interface qualities. The instrument was built based on Ergolist, which follows the criteria of ISO 9141-11. There were 58 undergraduate study participants from the School of Nursing of Ribeirao Preto, University of Sao Paulo, who attended the classes about neonatal nursing content. RESULTS: All items were positively evaluated by more than 70% of the sample. CONCLUSION: Educational technology is appropriate according to the ergonomic criteria and can be made available for teaching nursing students.

Development of the e-Baby serious game with regard to the evaluation of oxygenation in preterm babies: contributions of the emotional design.

The present study aimed to describe the development process of a serious game that enables users to evaluate the respiratory process in a preterm infant based on an emotional design model. The e-Baby serious game was built to feature the simulated environment of an incubator, in which the user performs a clinical evaluation of the respiratory process in a virtual preterm infant. The user learns about the preterm baby's history, chooses the tools for the clinical evaluation, evaluates the baby, and determines whether his/her evaluation is appropriate. The e-Baby game presents phases that contain respiratory process impairments of higher or lower complexity in the virtual preterm baby. Included links give the user the option of recording the entire evaluation procedure and sharing his/her performance on a social network. e-Baby integrates a Clinical Evaluation of the Preterm Baby course in the Moodle virtual environment. This game, which evaluates the respiratory process in preterm infants, could support a more flexible, attractive, and interactive teaching and learning process that includes simulations with features very similar to neonatal unit realities, thus allowing more appropriate training for clinical oxygenation evaluations in at-risk preterm infants. e-Baby allows advanced user-technology-educational interactions because it requires active participation in the process and is emotionally integrated.

Development of a serious game for learning about safe sex and contraception in adolescence.

OBJECTIVES: to develop a serious game in a mobile application for learning about safe sex and contraception with the active participation of adolescents; and evaluate the content, appearance and usability of the technology with adolescents and experts. METHOD: this is an applied research project into the development of a serious game, carried out in two stages: development of the technology itself; and evaluation of the content, appearance and usability of the application. Teenagers from a public school in the city of São Paulo-Brazil took part in the technology development stage. The evaluation was carried out by the adolescents and experts in the areas of public health and health technology. The following criteria were used: educational aspects, environment interface and didactic resources. RESULTS: Prinventon App ® was developed, a serious game set in a virtual city, designed to address adolescent sexuality. The app received 90% positive responses and had a Content Validity Index of 0.80, which was considered adequate. The suggestions and notes were accepted and implemented. The serious game was considered interesting and important in terms of the subject matter. CONCLUSION: it was found that the technology developed can help adolescents learn about safe sex and contraception, by addressing sexuality in adolescence in a playful and realistic way.

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.

A Mobile App to Promote Breastfeeding Self-Efficacy in Preterm Infants' Mothers: Development and Validation.

Improving breastfeeding rates is a global goal. To achieve it, actions targeting modifiable factors that influence the breastfeeding experience, such as maternal self-efficacy, could be a promising path, especially with preterm infants' mothers. Considering the current ubiquitous technology, we developed a mobile application for mothers of preterm infants to constitute a breastfeeding information and support platform. The study was developed in three phases: a survey to determine characteristics and preferences of preterm infants' mothers; the app development by an interdisciplinary team, following the principles of Disciplined Agile Delivery; and the face and content validation by 10 professionals. The app contains 80 screens and 11 strategies to address prematurity, lactation, breastfeeding, peer support, maternal emotions, resilience, and motivation. Nurses can apply their expertise by designing mHealth-based interventions, employing scientific evidence, and considering the interests and preferences of the target population. Future studies will assess the user experience, the effect on breastfeeding self-efficacy, and breastfeeding rates, and develop a culturally adapted English version of the app for women in Canada.

[Handling of preterm infants in a neonatal intensive care unit]. / A manipulação de prematuros em uma Unidade de Terapia Intensiva Neonatal.

While hospitalized in neonatal units, preterm infants undergo various manipulations and procedures that have negative health consequences. The aim of this study was to describe the manipulations that preterm infants are subjected to over a 24-hour period in a neonatal intensive care unit (NICU). An observational, descriptive, exploratory study was conducted with 20 preterm infants who were filmed continuously in a NICU over a 24-hour period from September 2008 to March 2009. Preterm infants were subjected to an average of 768 manipulations and 1341 procedures. The average duration of the manipulations over the 24-hour period was 2 hours and 26 minutes. Each manipulation included an average of 2.2 procedures, most occurring during the morning shift. Individual manipulations accounted for 65.6% of all manipulations, and most manipulations lasted less than a minute. The results of this study show that preterm infants in the NICU underwent an excessive number of manipulations over the 24-hour period evaluated.

The simulation design in health and nursing: A scoping review.

AIMS: The aims of this study were to map the components of the simulation design in health and nursing and to propose a classification based on their definitions to support the planning of simulation-based experiences. DESIGN: Scoping review. METHOD: Searches were performed in the databases LILACS, Embase, MEDLINE/PubMed, SCOPUS, Web of Science, Google Scholar and ProQuest Thesis and Dissertation were performed, without time limitation, to identify studies about simulation design. RESULTS: This study mapped 19 components of the simulation design found in 26 studies included, which can contribute to the development of simulation-based experiences, classified into structural, methodological and theoretical-pedagogical components. The simulation design can be described according to its fundamental components: structural-define the basic formulation of a simulation in terms of infrastructure and conceptual framework; methodological-define the participants, roles and the instruction format; and theoretical-pedagogical-define the educational references used to support the simulation strategy.

Child vaccination in animated infographic: technology for permanent education about the nursing process.

OBJECTIVE: To develop and validate an animated infographic about the nursing process in childhood vaccination. METHOD: Methodological study for the development and validation of educational technology, an animated infographic, on childhood vaccination. First, contents from the Ministry of Health that should compose the infographic were selected. Then, a script was prepared and a storyboard used to guide the production of the animated infographic. Once finalized, the technology went through the content and appearance validation process with nursing experts in the study area. RESULTS: Sixty-nine screens of storyboard were done and the infographic lasted five minutes and 52 seconds. Forty-five nurses were selected and, of these, 21 agreed to participate in the study. The infographic was evaluated according to its objectives, structure, presentation, and relevance, resulting in an overall CVI of 97%. CONCLUSION: The animated infographic produced was validated by experts and, once adapted following the judges' suggestions, it became a valid educational tool to be used by students and nursing professionals.

Fear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?

OBJECTIVE: to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic. METHODS: a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis. RESULTS: of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016). CONCLUSION: among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women's mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.

Nurseped: educational technology for safety in the management of intravenous antibiotics in pediatrics. / Nurseped: tecnología educativa para la seguridad en el manejo de antibióticos intravenosos en pediatría.

OBJECTIVE: to develop and validate the content of a serious game on the safe management of intravenous medications in pediatrics. METHOD: methodological study for the development and content validation of an educational technology. The cases and challenges of the serious game were developed based on a literature review and validated by 11 nurses with training and experience in the area. Content validity and agreement indices were adopted to analyze agreement and internal consistency (minimum of 0.8). RESULTS: the content is based on the main antibiotics used in the clinical management of infections in hospitalized children and patient safety. Absolute agreement was obtained in 60 of the 61 items evaluated, and the minimum obtained was 0.82 in the content validation index and 0.80 in agreement. Adjustments were suggested by experts in the response statement for a specific case and implemented to improve the quality of the technology content. CONCLUSION: the content of the serious game Nurseped was validated by nurse experts in child health regarding clinical cases, question statements and multiple-choice answers, in addition to feedback that presents the user with an evidence-based answer after getting the challenge right or wrong.

Breastfeeding prevalence in newborns of mothers with COVID-19: a systematic review.

OBJECTIVES: to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19. METHODS: a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation. RESULTS: fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences. CONCLUSIONS: despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.

Development of educational videos about bathing in bed newborns admitted to a neonatal unit.

OBJECTIVE: to develop and analyze evidence of content validity of educational videos about bathing newborns in bed in a neonatal unit. METHOD: applied and methodological research, carried out from December/2020 to February/2022, in three phases: pre-production, production, post-production. Validity was carried out by nurses specializing in social communication and nursing professionals, including the Brazilian Sign Language and assessment by nursing students. The Content Validity Index and Cronbach's alpha above 0.8 were considered for analysis. RESULTS: the videos were entitled "Best practices: bathing newborns in the heated crib" and "Best practices: bathing newborns in the incubator", lasting seven minutes each, divided into six scenes that demonstrated the approach to parents, environment and material organization, preparing newborns, bathing and after-bath care. CONCLUSION: the videos will support permanent education processes, academic training and professional training in nursing.

Breastfeeding during the COVID-19 pandemic: what do we know so far?

OBJECTIVE: This study aimed to conduct a literature review on safety in breastfeeding in mothers with COVID-19. An integrative review of national and international literature was carried out. METHODS: The search took place in the SciELO, LILACS and MEDLINE® databases. RESULTS: A total of 25 scientific articles that specifically addressed the theme of breastfeeding and its risk and protective factors for infection by SARS-CoV-2 were selected. According to the studies analyzed, although the presence of viral RNA had already been detected by reverse transcriptase polymerase chain reaction in breast milk samples, there are still no proven cases of vertical transmission via human milk. CONCLUSION: Breastfeeding appears to be safe if practiced according to precaution measures recommended by the World Health Organization. In addition, there is evidence of a potential for immunological protection by transfer of antibodies against SARS-CoV-2 in breast milk. Breastfeeding should continue to be promoted even in cases of mothers with clinical suspicion or confirmation of COVID-19, as well as the provision of expressed breast milk in cases where there is no possibility of direct breastfeeding.

Adolescent pregnancies and adherence to puerperal consultation. / Gestações na adolescência e adesão à consulta puerperal.

OBJECTIVE: to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais. METHOD: cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy - dependent variable; sociodemographic, clinical and obstetric - independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher's exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance. RESULTS: we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women. CONCLUSION: adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance.(1) Adolescent puerperal women had low educational level. (2) Association between early age and absence of diseases during pregnancy. (3) There were higher rates of normal vaginal deliveries among adolescents. (4) Adolescents did not present negative obstetric and neonatal outcomes. (5) There were no differences regarding adherence and age of puerperal women.

Telesimulation about home visits and child care: facilitators, barriers and perception of Nursing students.

OBJECTIVE: to evaluate the facilitators, barriers and perceptions of Nursing students in learning about home visiting and child care through Telesimulation during the COVID-19 pandemic. METHOD: a qualitative study to evaluate Telesimulation via computers, grounded on Kolb's theoretical model. A semi-structured questionnaire and the Student Satisfaction and Self-Confidence in Learning Scale were applied, with descriptive analysis and qualitative thematic analysis on the perceptions of 41 Nursing students. RESULTS: the contextualized Telesimulation provided learning opportunities in dimensions of the pedagogical strategy, telesimulated scenario, communication and specificities of child care in home visits. It was considered a safe and dynamic activity that helped knowledge consolidation and reflective attitudes, proximity to reality, and develop interaction, observation and types of approaches. There were restrictions due to Internet connection failures. A large percentage of the students indicated good satisfaction and self-confidence level with learning in the scale applied. CONCLUSION: the real clinical situation with remote immersion allowed observation, decision-making, reflection and elaboration of conclusions, inherent to the experiential learning cycle. The set of elements of this Telesimulation created an environment that stimulated the interest of Nursing students for other learning stages, suggesting a space that strengthens knowledge and maintains dialogue with face-to-face practices.

Prebriefing in clinical simulation in nursing: scoping review.

OBJECTIVE: To map the concept and structural elements of the prebriefing phase in clinical simulations in nursing. METHOD: Scoping review with searches between May and June 2021 in the databases PubMed, Virtual Health Library, EMBASE, CINAHL, SCOPUS, Web of Science, CAPES Catalog of Theses and Dissertations, Brazilian Digital Library of Theses and Dissertations and Google Scholar, in portuguese, spanish and english, without time limit. RESULTS: 24 studies were selected. In 17 articles (70.8%) the authors used the spelling prebriefing (in italics and amended), to refer to the stage that precedes the simulation, including preparatory activities and guidance. Alternative methods for prebriefing were described (reflective practices, laboratories, games and videos). CONCLUSION: There is no consensus regarding the concept and elements that constitute the prebriefing. This simulation stage contributes to participant satisfaction, participation and psychological safety, with better learning outcomes.