Chemsex among men who have sex with men during the Mpox health crisis in Brazil: A nationwide web survey.

OBJECTIVE: To understand the factors associated with the practice of chemsex among MSM in Brazil, especially during the Mpox health crisis, and to design effective prevention and intervention strategies specifically for this population. DESIGN: A cross-sectional and analytical study using an electronic survey, conducted from September to December 2022, during the peak of the Mpox outbreak in Brazil. SAMPLE: A total of 1452 MSM aged 18 and older. MEASUREMENTS: Data were collected via the REDCap platform through a survey with 46 questions. These addressed demographic data, sexual affiliations, practices, experiences with Mpox, healthcare service usage, and stigma or fear related to Mpox. RESULTS: The prevalence of chemsex was 19.42% (n = 282). Multivariate Poisson modeling indicated a high incidence of chemsex among those diagnosed with Mpox and those involved in high-risk behaviors. The practice of chemsex was six times higher among those diagnosed with Mpox (95% CI: 4.73-9.10). MSM who engage in bugchasing had a prevalence twice that of the main outcome (95% CI: 1.31-3.16). CONCLUSION: There is a significant need for targeted interventions for MSM in Brazil, especially given the Mpox outbreak. This study highlights the strong relationships between chemsex, experiences with Mpox, and various sexual behaviors, underscoring the importance of effective public health initiatives.

HIV testing among immigrant men who have sex with men in Brazil.

OBJECTIVE: To evaluate the prevalence of non-testing for HIV among immigrant men who have sex with men (MSM) residing in Brazil and identify associated factors. DESIGN: An analytical web-survey study was conducted across all Brazilian states from January 2020 to May 2021. SAMPLE: The study included 804 MSM immigrants from Portuguese-speaking countries. MEASUREMENTS: Odds ratio (OR) and adjusted Odds Ratio (AOR) were utilized to determine the strength of the association between non-HIV testing and associated factors. RESULTS: Among the participants, 63.7% had never undergone HIV testing. Multivariate analysis revealed several factors associated with a higher likelihood of not being tested for HIV: having a steady/monogamus partner (AOR: 1.5; 95%CI: 1.1-2.3) or both casual and steady partners (AOR: 1.8; 95%CI: 1.2-3.4), not engaging in bareback sex (AOR: 1.91; 95%CI: 3-3.5), being an immigrant in the country for less than 12 months (AOR: 3.7; 95%CI: 2.5-9.7), and having a preference for insertive (AOR: 1.5; 95%CI: 1.1-2.5) or receptive (AOR: 2.9; 95%CI: 1.4-5.7) roles. However, practicing chemsex was found to be a protective factor for testing (AOR: 4). CONCLUSION: To enhance HIV prevention strategies, it is crucial to implement specific measures that ensure accessibility, confidentiality, and a reduction in stigma associated with HIV testing.

Nursing and advocacy in health: An integrative review.

BACKGROUND: The practice of health advocacy in nursing has been defined as a process aimed at promoting the independence and autonomy of users of health services, in addition to providing information on healthcare decision-making and offering support for decisions taken. ETHICAL CONSIDERATIONS: Ethics approval was not required to conduct this review. AIM: This integrative review aims to synthesize evidence in the literature on health advocacy in professional nursing practice. METHODS: An integrative review methodology guided by Whittemore and Knalf was used. Studies were identified by conducting searches on PubMed, Scopus, Web of Science, CINAHL, and LILACS databases. Of 2179 records, 34 studies matched the inclusion criteria. RESULTS: The main aspects involved in the practice of health advocacy by professional nurses are related to the ethical principles of the nursing profession, such as protecting patients seeking autonomy and care. Furthermore, the practice of health advocacy by nurses requires an empathetic attitude, responsibility, and assertive communication. CONCLUSION: The diverse possibilities for the practice of advocacy synthesized in this study allow nurses to approach and become familiarized with the topic, being able to acquire and complement knowledge that will reflect on their professional practice in different work environments such as the educational field, in hospital practice, or basic health care.

Alignment and contribution of nursing doctoral programs to achieve the sustainable development goals.

BACKGROUND: Different social segments from several regions of the world face challenges in order to achieve the sustainable development goals (SDGs). Nursing represents the greatest number of health workforce in the globe, dealing with these challenges in different paths, among them the training of human resources. In this context, the goal of this study was to compare the relationship between the objectives and research areas underlying nursing doctoral programs in Latin America and the SDGs. METHOD: Documental research comparing data of all Latin American nursing doctoral programs and the SDGs, conducted between January and March 2020. RESULTS: From the total of 56 existing programs in Latin America, this study analyzed 52 of them, representing 92.8% of the total. Most nursing doctoral programs have contributed to SDG 3, in addition to goals 1, 2, 4, 5, 6, 8, 9, 10, 12 and 16. The SDGs 11, 13, 14, 15 and 17 were not related to any of the analyzed programs. Data reveal that the training of nursing PhDs is essential to fulfilling these goals. Results also indicate a need of programs to remain committed to relationships that enhance nursing skills to cope with the current challenges in terms of global health, such as investments for the reduction of social and gender inequities. CONCLUSION: The doctoral training of nurses in Latin America needs to be better aligned with the sustainable development goals (SDGs), since there is a high concentration in SDG 3. We believe that nursing will bring a greater contribution to the movement to protect planetary health as the principles governing nursing practices are better aligned with international health demands and agendas.

Profile of environmental service managers and workers in Brazilian hospitals.

INTRODUCTION: Contamination through the hands of professionals and surfaces is one of the main agents involved in health care-associated infections in health services. Flaws in the execution of hospital housekeeping can lead to the contamination of surfaces and health equipment though, representing a risk for patient safety and highlighting the need to maximize the quality of cleaning processes in these institutions. OBJECTIVE: To describe the profile of managers and environmental service workers (ESWs) in Brazilian hospitals. METHODS: A cross-sectional study was undertaken in January 2018, involving 155 participants, being 12 managers and 143 workers from the housekeeping team of two health institutions, being one private and the other public. RESULTS: Most participants were female (86%), with a mean age of 45 years and primary education level, 52% being outsourced workers. The participants positively assessed their job satisfaction, satisfaction with training, basic knowledge and performance; nevertheless, situations were identified that were perceived as risks for patient safety and occupational health. The questions involving motivational incentives received the lowest scores. CONCLUSION: Inconsistencies were found in the housekeeping professionals'. Preparation, indicating that the institutions studied do not value this type of service and that an investment policy in these workers' motivation is lacking.

Empathizing and systemizing profiles of Brazilian and Portuguese nursing undergraduates.

AIM: To analyze the empathizing and systemizing profiles of Brazilian and Portuguese nursing undergraduates. BACKGROUND: Empathy is a fundamental skill for nursing practice and should be analyzed during the student's education. METHODS: Descriptive study with cross-sectional design. Participants were 968 undergraduate students, including 215 (22.2%) Brazilians from a university in the state of São Paulo and 753 (77.8%) Portuguese students from a higher education institution in central Portugal. The Portuguese and Brazilian versions of the Empathizing/Systemizing Quotient have good internal consistency and reliability. ETHICAL CONSIDERATIONS: In Brazil, approval for the study was obtained from the Research Ethics Committee of the University of São Paulo at Ribeirão Preto College of Nursing (protocol 191/2016) and in Portugal, from the Ethics Committee of the Health Sciences Research Unit: Nursing, Coimbra Higher School of Nursing (protocol P362-09/2016). RESULTS: Most (86%) participants were female and aged between 20 and 24 years. In the general profile analysis between both groups, the domains "Social Skills," "Contents," and "Processes" scored higher. Gender differences exist for the feeling of empathy and systemizing, as women scored better on the short version of the Empathy Quotient and men on the Systemizing Quotient. CONCLUSION: As demonstrated in the domain scores for "Social Skills," "Contents," and "Processes," the undergraduate nursing students analyzed have the ability to deal intuitively and spontaneously with social situations; they are also characterized as methodical people, who like to follow rules, and experience practice better than theory, and the women have a higher empathetic level than men, who in turn are more systemizing.

Perceptions of brazilian nursing faculty members regarding literacy of human rights related to health in nursing undergraduate programs.

BACKGROUND: In the context of global health, the work of nurses is of key importance, given their role as diplomats in global health and as fundamental forces in the construction of global partnerships. This study seeks to identify the understanding and perceptions of Brazilian nursing faculty members regarding literacy of human rights related to health in nursing undergraduate programs. METHODS: Methodological, quantitative and cross-sectional study carried out with nursing faculty members from 20 Brazilian higher education institutions. For the data collection, the Brazilian version of the Basic Core Competencies in Global Health questionnaire was used, available on the website Survey Monkey. In this article, the answers related to the domain "Health as a human right and development resource" were assessed. Descriptive statistics were applied, as well as Cronbach's alpha coefficient. RESULTS: In total, 222 questionnaires were completed. As for the domain "Health as a human right and development resource", Cronbach's alpha coefficient corresponded to 0.839 for the three domain items. Most of the participants fully agreed on the relevance of the contents related to the theme for nurses' education. CONCLUSIONS: It is essential that nurses have contact with human rights international instruments that influence implementation of health and health research policies, though this content's treatment is still incipient in Brazilian nursing programs.

Quality of life and ethics: A concept analysis.

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

Empathic profile of nursing freshmen.

OBJECTIVE: To analyze the empathic profile and the empathy scores of freshmen of the nursing course. DESIGN AND PARTICIPANTS: Descriptive study involving 399 freshmen students of two modalities of nursing courses: Bachelor and Bachelor and Teaching Diploma, in the period from 2012 to 2015. A sociodemographic questionnaire and the Empathy Inventory were applied. ETHICAL CONSIDERATIONS: The research received approval from the Research Ethics Committee of the University of São Paulo at Ribeirão Preto College of Nursing. The students registered their acceptance to participate in the research by signing the Free and Informed Consent Form and anonymity was guaranteed. FINDINGS: The mean age of the participants was 19 years, being 85.5% female. The students were grouped by course modality and all groups presented high empathy scores. A significant difference (p < 0.001) was found, which indicates that students of the Bachelor and Teaching Diploma program presented a higher degree of empathy for the General Score, Domain 2 (Interpersonal Flexibility), and Domain 3 (Altruism) in relation to students in the Bachelor program. CONCLUSION: Results show that nursing undergraduate freshmen are emphatic, with minimum differences between the two courses. This profile is relevant for the development of future professionals capable to demonstrate a balance between instrumental and expressive competences.

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

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

Expectations and perceptions of clients concerning the quality of care provided at a Brazilian hospital facility.

PURPOSE: To identify the expectations and perceptions of clients concerning the quality of hospital care provided to them and their respective companions at a private Brazilian hospital using SERVQUAL. The SERVQUAL questionnaire can provide information concerning expectations and perceptions of clients. In addition, it is able to identify the participation of frontline employees and how they contribute to the organization's end product (service delivery). METHODS: In total, 172 inpatients for surgical reasons answered the SERVQUAL questionnaire. It consists of 23 pairs of statements, 22 of which are distributed into the dimensions of tangibles, reliability, responsiveness, assurance and empathy. Statement 23 refers to the overall quality of care. Exploratory analysis, internal consistency (Cronbach's alpha) and the kappa Coefficient were calculated using the Statistical Package for Social Sciences and SAS 9.2. Ethical approval was obtained from the Institutional Review Board at the Hospital das Clínicas at the University of São Paulo at Ribeirao Preto Medical School. RESULTS: Most participants had a bachelor's degree and were over than 60years old. Cronbach's alpha coefficients indicated good internal consistency (α=0.93) and high levels of agreement were observed (91.10%). CONCLUSION: The SERVQUAL questionnaire was sensitive to items in each dimension for which clients' perceptions surpassed their expectations. IMPLICATIONS FOR NURSING MANAGEMENT: The continuous quality assessment of health services is mandatory for nursing leadership. The nursing leadership can further explore the SERVQUAL with a view to better attending to the clients' expectations.

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

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

'Global health' and 'global nursing': proposed definitions from The Global Advisory Panel on the Future of Nursing.

AIMS: To propose definitions of global health and global nursing that reflect the new paradigm that integrates domestic and international health. BACKGROUND: Increased globalization has led to expanded awareness of the importance of global health and global nursing among students and faculty in the health professions and among policymakers and practitioners. DESIGN: Discussion paper that includes a discussion and review of the literature related to global health and global nursing. DATA SOURCES: A task force searched for and reviewed articles published in English, Spanish or Portuguese between 2005-2015, developed summaries, listed key elements, identified prevalent themes and developed consensus definitions. IMPLICATIONS FOR NURSING: The definitions will be used by the Global Advisory Panel on the Future of Nursing to guide promoting a voice and vision for nursing that will contribute to the advancement of the profession's contribution to global health. CONCLUSIONS: Definitions of global health and global nursing were developed based on main themes and concepts identified in the literature review to guide contributions of nursing to global health.

Usability Assessment of Moodle by Brazilian and Portuguese Nursing Students.

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

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

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

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

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

The Evolution of World Health Organization's Initiatives for the Strengthening of Nursing and Midwifery.

PURPOSE: To describe the evolution in the resolutions approved by World Health Organization (WHO)'s World Health Assembly (WHA) to strengthen nursing and midwifery. METHODS: Qualitative and descriptive study, undertaken through a search of resolutions presented by WHA, on the WHO website, regarding the theme "strengthening of nursing and midwifery." The resolutions on the theme "nursing and midwifery" were included, whose titles were available and whose full texts were accessed, excluding those on general health themes. The key words used were resolutions, strengthening, and nursing and midwifery. Among the 20 resolutions found, 12 were selected, adopted between 1948 and 2013, in accordance with the study inclusion criteria. The data were interpreted using thematic qualitative analysis, identifying and grouping the data in categories related to the study theme. FINDINGS: Based on the content analysis of the 12 resolutions studied, three thematic categories were defined: "nursing and midwifery in primary health"; "role of nursing and midwifery in health for all"; and "nurses and midwives' professional training." CONCLUSIONS: Based on the categories, the evolution in the strengthening of nursing and midwifery was demonstrated through the initiatives and resolutions approved by WHA, highlighting the importance of nurses and midwives as multiprofessional health team members and their fundamental role in the improvements of the health system. Therefore, in accordance with the needs of each country, the member states can implement strategies presented by the WHA resolutions to strengthen nursing and midwifery services. CLINICAL RELEVANCE: This study has relevance for the development of health policies considering the relevant contributions of nurses and midwives to healthcare systems and services, based on the analysis of WHO resolutions involving these professions.

Empathy in Brazilian nursing professionals: a descriptive study.

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

RESEARCH ETHICS COMMITTEES' ANALYSIS OF NURSING PROJECTS IN BRAZIL.

The objective in this exploratory study is to consider the demand for nursing related projects in the Ethics Committees registered on the website of the National Information System Commission about Ethics in Research Involving Human Beings (SISNEP) between 2003 and 2010. The data were collected in two phases: research projects approved in specific Ethics Committees of Nursing Schools/ Faculties registered for at least four years, and projects whose title contained the keywords Nurse and/or Nursing, approved in general Ethics Committees. In total, 2576 projects were approved in the six Committees analyzed.

[Reflecting on nursing contributions to global health]. / Refletindo sobre as contribuições da enfermagem para a saúde global.

OBJECTIVES: Discuss possibilities of nursing contribution for global health approaching knowledge bases and the potential for global health, reflecting upon nursing education and their skills and abilities to perform into global health. RESULTS: Nurses contribute to global health in areas related to the health system policies, social determinants of health/disease, global issues related to culture, epidemics, communicable and non-communicable diseases, epidemiology, humanitarian actions and emergencies. Universities play an important role for this contribution. CONCLUSIONS: Nurses are professionals who actively contribute to global health, whether in political, social, economic or cultural situations, and universities play an important role for the training of these professionals.