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Resumo Introdução: O acidente vascular cerebral isquêmico tem como tratamento a terapia trombolítica, aplicada ainda na fase aguda, promovendo melhora importante nas sequelas acarretadas por este agravo. Considerando a complexidade da terapia trombolítica, torna-se necessário que os enfermeiros compreendam suas competências para auxiliar no cuidado. Objetivo: Identificar evidências científicas acerca das competências do enfermeiro no cuidado a pacientes com acidente vascular cerebral elegíveis à terapia trombolítica. Metodologia: Revisão integrativa composta por seis etapas em seis etapas (elaboração da questão, busca na literatura, coleta de dados, análise, discussão e apresentação da revisão), realizada nas bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase e CINAHL. A busca foi realizada entre agosto e setembro de 2022 adotando como critérios de inclusão estudos primários; gratuitos, disponíveis eletronicamente na íntegra; nos idiomas inglês, português e espanhol. Foram obtidos inicialmente 2.830 estudos, os quais passaram por uma seleção, onde foram incluídos aqueles que atendiam os critérios previamente estabelecidos. Resultados: Com base nos doze estudos incluídos nesta revisão identificaram-se competências voltadas à três atividades do cuidado: gestão do cuidado como trabalho em equipe, códigos, fluxos e protocolos, assistência ao paciente antes, durante e após a utilização da terapia trombolítica e educação em saúde para equipe, pacientes e familiares. Conclusão: Os achados desta revisão puderam evidenciar as competências do enfermeiro no cuidado aos pacientes elegíveis a terapia trombolítica, as quais perpassam diferentes áreas de atuação do enfermeiro. Para este estudo prevaleceram as competências assistências, seguida por competências gerenciais.
Resumen Introducción: El accidente cerebrovascular isquémico se trata con terapia trombolítica, aplicada incluso en la fase aguda, que promueve una mejoría significativa de las secuelas provocadas por este padecimiento. Considerando la complejidad de la terapia trombolítica, es necesario que las personas profesionales de enfermería comprendan sus competencias para ayudar en el cuidado. Objetivo: Identificar evidencias científicas sobre las competencias del personal de enfermería en el cuidado de pacientes con accidente cerebrovascular elegibles para terapia trombolítica. Metodología: Revisión integradora que consta de seis etapas (elaboración de la pregunta, búsqueda bibliográfica, recolección de datos, análisis, discusión y presentación de la revisión), realizada en las bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase y CINAHL. La búsqueda se realizó entre agosto y septiembre de 2022. Los criterio de inclusión fueron: estudios primarios, gratuito, disponible electrónicamente en su totalidad, en inglés, portugués y español. Inicialmente se obtuvieron 2830 estudios, los cuales fueron sometidos a un proceso de selección, que incluyó aquellos que cumplían con los criterios previamente establecidos. Resultados: A partir de los doce estudios incluidos en esta revisión, se identificaron competencias centradas en tres actividades asistenciales: gestión del cuidado como trabajo en equipo, códigos, flujos y protocolos, atención a pacientes antes, durante y después del uso de la terapia trombolítica y educación en salud para personal, pacientes y familias. Conclusión: Los hallazgos de esta revisión pudieron resaltar las competencias de las personas profesionales en enfermería en el cuidado de personas elegibles para terapia trombolítica, que abarcan diferentes áreas de actuación del personal de enfermería. Para este estudio, prevalecieron las habilidades asistenciales, seguidas de las competencias gerenciales.
ABSTRACT Introduction: Ischemic stroke is treated with thrombolytic therapy, applied even in the acute phase, promoting a significant improvement in the after-effects caused by this condition. Considering the complexity of thrombolytic therapy, it is necessary for nurses to understand the skills required to assist in care. Objective: To identify scientific evidence about the competencies of nurses in the care of patients with stroke who are eligible for thrombolytic therapy. Methodology: An integrative review consisting of six stages (elaboration of the question, literature review, data collection, analysis, discussion, and presentation), conducted in MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase, and CINAHL databases. The search was carried out between August and September 2022 using primary studies as the inclusion criteria: free of charge, fully available electronically, published in English, Portuguese, or Spanish. Initially, 2.830 studies were obtained, which underwent a selection process that included only those studies that met the previously established criteria. Results: Based on the twelve studies included in this review, competencies focused on three care activities were identified: care management such as teamwork; codes; flows and protocols; patient care before, during, and after the use of thrombolytic therapy; and education health education for staff, patients, and families. Conclusion: The findings of this review highlighted the nurses' competencies in the care of patients eligible for thrombolytic therapy, which encompass different areas of the nurse's work. For this study, assistance competencies prevailed, followed by management competencies.
Assuntos
Humanos , Terapia Trombolítica/enfermagem , Acidente Vascular Cerebral/enfermagem , Cuidados de EnfermagemRESUMO
Resumo Introdução: As ações desenvolvidas na Atenção Primária à Saúde são um dos pontos fortes de combate à tuberculose. Nesse nível de atenção, o contato contínuo do enfermeiro por meio da consulta de enfermagem permite manter relação com a população adoecida. Diante da relação enfermeiro-pessoa cuidada para o estabelecimento do vínculo e adesão ao tratamento contra tuberculose, compreende-se a importância do referencial teórico de Imogene King para estruturar a interação enfermeiro-pessoa cuidada e oferecer uma dinâmica para esse processo. Objetivo: Analisar a relação enfermeiro-pessoa afetada pela tuberculose fundamentada na Teoria do Alcance de Metas de Imogene King. Método: Estudo descritivo com abordagem qualitativa, com 14 enfermeiros da APS, selecionadas por conveniência. A coleta de dados ocorreu de agosto a novembro de 2018, por meio de entrevista semiestruturada, elaborada com base no Registro Meta-Orientado de Enfermagem de Imogene King. Os dados foram analisados de forme qualitativa pelo Software IRAMUTEQ. A pesquisa foi aprovada pelo Comitê de Ética. Resultados: Após a análise, emergiram quatro classes: 1) relação estabelecida com base no acolhimento; 2) relação enfermeiro-pessoa com tuberculose e o apoio de outros profissionais e familiares; 3) relação estabelecida com vistas ao cumprimento do tratamento; e 4) relação estabelecida para enfrentamento do preconceito diante da tuberculose. Conclusão: O acolhimento, a família e o vínculo entre profissional, paciente e equipe da Atenção Primária à Saúde fortalecem o enfrentamento da doença e reforçam a adesão ao tratamento medicamentoso.
Resumen Introducción: Uno de los puntos fuertes de la lucha contra la tuberculosis son las acciones desarrolladas en la atención primaria de salud. En este nivel asistencial, el contacto continuo de las enfermerías a través de la consulta de enfermería permite mantener una relación con la población enferma. Frente a la relación enfermería-persona para el establecimiento del vínculo y la adherencia al tratamiento contra la tuberculosis, se entiende la importancia del referente teórico de Imogene King para estructurar la interacción enfermería-persona y ofrecer una dinámica para este proceso. Objetivo: Análisis de la relación entre el personal de enfermería y las personas afectadas por la tuberculosis, a partir de la teoría del logro de objetivos de Imogene King. Método: Estudio descriptivo con abordaje cualitativo, con 14 enfermeras de atención primaria de salud, seleccionadas por conveniencia. La recolección de datos ocurrió de agosto a noviembre de 2018, a través de una entrevista semiestructurada, elaborada con base en el registro meta-orientado de enfermería de Imogene King. Los datos fueron analizados cualitativamente utilizando el software IRAMUTEQ. La investigación fue aprobada por el Comité de Ética. Resultados: Después del análisis, surgieron cuatro clases: 1) relación establecida con base en la recepción, 2) relación enfermería-persona con tuberculosis y apoyo de otras personas profesionales y familiares, 3) relación establecida con miras al cumplimiento del tratamiento y 4) relación establecida para combatir los prejuicios contra la tuberculosis. Conclusión: La acogida, la familia y el vínculo entre profesional, paciente y equipo de atención primaria de salud fortalecen el afrontamiento de la enfermedad y refuerzan la adherencia al tratamiento farmacológico.
Abstract Introduction: One of the main aspects in the fight against tuberculosis are the actions developed in Primary Health Care (PHC). At this level of care, the nurse's continuous contact through the nursing consultation allows them to maintain a relationship with the sick population. Regarding the nurse-patient relationship for establishing a bond and the compliance with tuberculosis treatment, we understand the importance of Imogene King's theoretical framework for structuring the nurse-patient interaction and offering a dynamic for this process. Objective: To analyze the nurse-tuberculosis patient relationship based on Imogene King's Theory of Goal Achievement. Method: A descriptive study with a qualitative approach, with 14 PHC nurses, selected by convenience. Data were collected from August to November 2018 through semi-structured interviews based on Imogene King's Meta-Oriented Nursing Record. The data were analyzed qualitatively using the IRAMUTEQ software. The research was approved by the Ethics Committee. Results: After the analysis, four classes emerged: 1) relationship established on the basis of welcoming; 2) nurse-tuberculosis patient relationship and the support of other professionals and family members; 3) relationship established towards treatment compliance; and 4) relationship established to confront prejudice associated with tuberculosis. Conclusion: The welcoming, the family, and the bond between the professional, the patient and Primary Health Care team strengthen the coping with the disease and reinforce the compliance with the pharmacological treatment.
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Humanos , Feminino , Atenção Primária à Saúde , Tuberculose/enfermagem , Relações Enfermeiro-Paciente , BrasilRESUMO
Objetivo: Conhecer a percepção dos enfermeiros em ambiente hospitalar sobre a implementação das tecnologias na assistência de enfermagem com foco na segurança do paciente. Métodos: Estudo descritivo, qualitativo, realizado com oito enfermeiros, responsáveis pelo gerenciamento de riscos em hospitais. Utilizou-se a técnica Snowball para eleger os participantes e a plataforma Skype para as entrevistas, realizadas no período de março a abril de 2021. Resultados: Apontou-se a utilização da tecnologia por meio do prontuário eletrônico, com a inserção de programa como o Tasy, o qual avançou para comunicação em rede, com vistas a facilitar checagens, auditorias, indicadores, gerenciamento e análise dos eventos. Desvelou-se também para a utilização do código de barras na identificação do paciente e no controle de dispensação e recebimento de medicamentos. No entanto, foram apresentadas limitações na implementação como dificuldade no manuseio das ferramentas digitais por profissionais antigos, caracterizada como resistência. Conclusão: A aplicabilidade das tecnologias na práxis da enfermagem contribui para a segurança do paciente face a favorecer o controle de eventos e o gerenciamento de riscos. Remete para a importância de capacitação e treinamentos dos profissionais para desenvolvimento de habilidades na utilização das ferramentas digitais. (AU)
Objective: Getting to know the perceptions from nurses on hospital environment about the technology implantation in the aid of patient's safety focused nursing. Methods: Descriptive, qualitative study made with eight nurses, responsible for risk management in hospitals. The Snowball technique was used to select the participants and the Skype platform used in the interviews, from March to April 2021. Results: The technology use was detected on the patient's electronic records through the Tasy program, which advanced to a net communication to facilitate checking, audits, pointers, management and event analysis. It was also detected by the use of bar codes in the identification of patients and control of medication dispensation and receiving. However, some limitations were found in the technology implementation, like elderly people having trouble using the digital tools, which is characterized by resistance. Conclusion: The technology applicability in the nursing practice contributes to the patient's safety to favor event control and risk management. It points to the importance of staff training and qualification to promote the ability of using digital tools. (AU)
Objetivo: Conocer las percepciones de las enfermeras del entorno hospitalario sobre la implementación de tecnologias enfocado en la seguridad del paciente. Métodos: Fue realizado un estudio descripctivo, cualitativo, con ocho enfermeras responsables de la gestión de riesgos en los hospitales. Se utilizó la tecnica snowball para elegir a los participantes y la plataforma skype para las entrevistas realizadas de marzo a abril de 2021. Resultados: Con el desarrollo de la tecnologia a través de historias clínicas eletrónicas, la inserción de un programa como Tasy, que avanzó a la comunicación em red, con el objetivo de facilitar verificaciones como auditorias, gestión y análisis en cualquier eventualidad. Tambien se dio a conocer para el uso de códigos de barras en la identificación de pacientes y en el control de la dispensación y recepción de medicamentos. Sin embargo, se presentaron limitaciones en la implementación, como la dificultad en el manejo de herramientas digitales por parte de algunos profesionales. Conclusión: La aplicabilidad de tecnologias en la enfermeria contribuye a la seguridad del paciente favoreciendo en el control de riesgos. Se refiere a la importancia de la calificación y formación de los profesionales, para desarrollar habilidades en el uso de herramientas digitales. (AU)
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Tecnologia , Segurança do Paciente , Cuidados de EnfermagemRESUMO
Objetivo: Relatar a construção e implantação de painel de bordo, desenvolvido por enfermeiros e profissionais da tecnologia da informação, para gerenciamento do Protocolo de Prevenção de Lesão por Pressão. Métodos: Trata-se de um relato de experiência sobre a construção e implantação de painel de bordo informatizado para gerenciamento de protocolo em um hospital privado universitário, localizado no interior do estado de São Paulo. Resultados: A construção do painel de bordo foi dividida nas seguintes etapas: revisão e atualização do protocolo, construção do modelo eletrônico e implementação. A divulgação foi realizada pela Comissão de Prevenção de Lesão por Pressão. Conclusão: O painel de bordo possibilitou a visualização rápida e em tempo real dos riscos dos pacientes, intervenções propostas e efetividade das medidas de prevenção, além de promover a integração e empoderamento dos profissionais na gestão do cuidado. (AU)
Objective: To report the construction and implementation of a dashboard, developed by nurses and information technology professionals, to manage the Pressure Injury Prevention Protocol. Methods: This is an experience report on the construction and implementation of a computerized dashboard for protocol management in a private university hospital, located in the interior of the state of São Paulo. Results: The construction of the dashboard was divided into the following steps: review and update of the protocol, construction of the electronic model and implementation. The Pressure Injury Prevention Commission disclosed the tool. Conclusion: The dashboard enabled the quick and real-time visualization of patient risks, proposed interventions and effectiveness of prevention measures, in addition to promoting the integration and empowerment of professionals in the management of care. (AU)
Objetivo: Informar la construcción e implementación de un panel, desarrollado por enfermeras y profesionales de tecnologías de la información, para gestionar el Protocolo de Prevención de Lesiones por Presión. Métodos: Se trata de un informe de experiencia sobre la construcción e implementación de un panel computarizado para la gestión del protocolo en un hospital universitario privado, en el interior del estado de São Paulo. Resultados: La construcción del panel se dividió en los siguientes pasos: revisión y actualización del protocolo, construcción del modelo electrónico e implementación. La divulgación fue realizada por la Comisión de Prevención de Lesiones por Presión. Conclusión: El panel permitió la visualización rápida y en tiempo real de los riesgos del paciente, las intervenciones propuestas y la efectividad de las medidas de prevención, además de promover la integración y el empoderamiento de los profesionales en la gestión del cuidado. (AU)
Assuntos
Gestão de Riscos , Úlcera por Pressão , Segurança do Paciente , Gestão da Informação em Saúde , Cuidados de EnfermagemRESUMO
Objetivo: Mapear as teorias de enfermagem utilizadas nos diferentes contextos de assistência à criança e ao adolescente. Métodos: Revisão de escopo de acordo com a metodologia do Instituto Joanna Briggs, que incluiu estudos primários, publicados em inglês, espanhol e português, sem restrição de tempo, e disponibilizados nas bases de dados MEDLINE, WOS, BDENF, SCOPUS, CINAHL e SCIELO. Resultados: Foram incluídos nesta revisão 53 artigos, os quais evidenciaram 17 teorias de enfermagem aplicadas aos mais diversos contextos pediátricos, como hospitalização, terapia intensiva, cuidados para doenças crônicas e promoção da saúde. A teoria mais utilizada para direcionar o cuidado foi a Teoria da Adaptação de Roy. São várias as experiências exitosas no campo da pesquisa e prática assistencial com a utilização das teorias de enfermagem. Conclusão: Diferentes teorias de enfermagem embasam o cuidado de enfermagem pediátrica; e a escolha de cada teoria deve ser norteada por um propósito explícito ou assunto de interesse dos autores, com base em suas expectativas pessoais e nas evidências científicas. Por meio deste estudo foi possível vislumbrar o potencial de cada teoria para subsidiar a prática da enfermagem pediátrica. (AU)
Objective: To map the Nursing theories used in the different contexts of assistance to children and adolescents. Methods: Scoping review according to the Joanna Briggs Institute methodology and included primary studies, published in English, Spanish and Portuguese, with no time restrictions, and made available in the MEDLINE, WOS, BDENF, SCOPUS, CINAHL and SCIELO databases. Results: A total of 53 articles were included in this review, which evidenced 17 Nursing theories applied to the most varied pediatric contexts, such as hospitalization, intensive care, care for chronic conditions, and health promotion. The theory most used to direct care was the Roy's Adaptation Theory. There are several successful experiences in the field of research and care practice with the use of Nursing theories. Conclusion: Different Nursing theories support pediatric Nursing care; and the choice of each theory must be guided by an explicit purpose or subject of interest to the authors, based on their personal expectations and on the scientific evidence. Through this study it was possible to glimpse the potential of each theory to support pediatric Nursing practice. (AU)
Objetivo: Mapear las teorías de Enfermería utilizadas en los diferentes contextos de atención a la niñez y adolescencia. Métodos: Revisión de alcance según la metodología del Joanna Briggs Institute que incluyó estudios primarios, publicados en inglés, español y portugués, sin restricciones de tiempo, y disponibles en las bases de datos MEDLINE, WOS, BDENF, SCOPUS, CINAHL y SCIELO. Resultados: En esta revisión se incluyeron un total de 53 artículos, que evidenciaron 17 teorías de enfermería aplicadas a los más variados contextos pediátricos, como hospitalización, cuidados intensivos, cuidados de enfermedades crónicas y promoción de la salud. La teoría más utilizadas para dirigir el cuidado fue la Teoría de la Adaptación de Roy. Existen varias experiencias exitosas en el campo de la investigación y la práctica asistencial con el uso de las teorías de Enfermería. Conclusión: Diferentes teorías de Enfermería sustentan la atención de Enfermería pediátrica; y la elección de cada teoría debe estar guiada por un propósito explícito o tema de interés para los autores, con base en sus expectativas personales y en la evidencia científica.A través de este estudio se pudo vislumbrar el potencial de cada teoría para sustentar la práctica de la Enfermería pediátrica. (AU)
Assuntos
Teoria de Enfermagem , Enfermagem Pediátrica , Literatura de Revisão como Assunto , Cuidados de EnfermagemRESUMO
Cancer impacts the person's physical health, psychosocial and spiritual wellbeing. The humanization of care is an essential element to achieve integral wellbeing of the individual. The aim of this article is to present a clinical case, using the nursing process with the NANDA, NOC and NIC taxonomies, and based on the principles of Watson's theory of humanized care. The participant is a 45-year-old woman with gastric cancer in palliative stage. The assessment was performed using Gordon's functional patterns and the Watson Caritas Patient Score scale to evaluate the care received previously in the health system. Eight nursing diagnoses were identified, prioritizing 3 diagnoses using the clinical reasoning web (decisional conflict, anxiety, and ineffective self-management of health). Expected outcomes and nursing interventions were planned and implemented through moments of care using health education through tele-nursing and the intentional use of Caritas processes of care in the transpersonal relationship. The results were evaluated with the scales of the indicators and anxiety was also evaluated with the Beck Anxiety Inventory. Health education in oncology nursing contributed to improve informed decision making, reducing anxiety and providing emotional support to facilitate self-management of health. The participant perceived as humanized care throughout the sessions, reflected in the final evaluation with the Watson Caritas Patient Score scale.
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Objectives: In recent years, there has been increasing attention on the cluster approach to symptom management. Two significant challenges in the symptom cluster (SC) approach are identifying and predicting these clusters. This multiphase protocol aims to identify SCs in patients with advanced cancer as the primary objective, with the secondary objective of developing machine learning algorithms to predict SCs identified in the first phase. Methods: The 2-MIXIP study consists of two main phases. The first phase involves identifying SCs, and the second phase focuses on developing predictive algorithms for the identified SCs. The identification of SCs involves a parallel mixed-method design (quantitative and qualitative). Quantitative and qualitative methods are conducted simultaneously and given equal importance. The data are collected and analyzed independently before being integrated. The quantitative part is conducted using a descriptive-analytical method. The qualitative analysis is conducted using a content analysis approach. Then, the identified SCs from both parts are integrated to determine the final clusters and use them in the second phase. In the second phase, we employ a tree-based machine learning method to create predictive algorithms for SCs using key demographic and clinical patient characteristics. Conclusion: The findings of the 2-MIXIP study can help manage cancer patients' symptoms more effectively and enhance clinical decision-making by using SCs prediction. Furthermore, the results of this study can provide guidance for clinical trials aimed at managing symptoms.
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Introduction: Hospitalised patients could benefit from the emergence of novel technologies for nursing care. There are numerous technical products available, but these rarely find their way into practice. Further knowledge is required about the circumstances under which technology in nursing is accepted and used. In the research project "Centre for Implementing Nursing Care Innovations", technical innovations are implemented on a trauma surgery inpatient ward in Germany. After implementation, it was investigated: Which implemented technologies are accepted/rejected, and which factors influence the acceptance/rejection of technology for nurses? Material and methods: A focused ethnography was used, containing two approaches: First, participant observation was conducted to examine nurses' and patients' interaction with technologies. Observations were fixed in a field research diary and analysed using evaluative qualitative content analysis. Second, a questionnaire was used by nurses to provide information about the use frequency and technology suitability. The results of the study were consolidated and analysed using the UTAUT model. Results: Seven studied technologies can be summarised in four result categories: (1) A Mobilising mattress, a Special projector and a Sound pillow are accepted and used by nurses and patients, because they offer a way to provide high quality care with little additional effort. (2) A Fall prevention system is consistently used in patient care as a work obligation, but since nurses consider the system error-prone, acceptance is low. (3) An Interactive therapy ball is accepted but nurses cannot use it due to the high workload. (4) An App for nurse-patient communication and a work-equipment tracking system are not used or accepted because nurses do not see a practical benefit in the systems. Discussion: Acceptance or rejection of a product does not necessarily equate to use or non-use of the technology. Before implementation, technology acceptance among users occurs as prejudice-when users are given time to experiment with technology, intention-to-use can stabilize into sustained use. Accepted and used technologies can serve to mask problems (such as staff shortages) and encourage problematic developments, such as the reduction of contact time at the bedside. Therefore, technology acceptance should be qualified in asking to what accepted technology contributes.
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OBJECTIVE: To determine the oral health status of patients on maintenance hemodialysis (MHD) and to identify the factors influencing their oral health. METHODS: This observational study included 1,186 patients with chronic kidney disease who received MHD across 33 hospitals in China. The patients were recruited for a questionnaire survey between April and August 2023 at Beijing Chaoyang Hospital using stratified sampling. Data collection tools included the General Information Questionnaire for Maintenance Hemodialysis Patients, the Oral Health Assessment Tool, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale. Spearman's rank correlation coefficients were used to assess the relationships between the oral health of patients on MHD and continuous variables such as sleep quality and emotional status. Multiple linear regression analysis was employed to explore the relationship between oral health and various variables. RESULTS: The oral health scores of the patients ranged from 8 to 22, with a mean score of 12.54 ± 2.63. The final model of the multiple linear regression analysis indicated a goodness of fit of 22.19%. Independent factors affecting the oral health of patients included smoking, the proportion of medical expenses, water consumption, sleep quality, and anxiety scores (all P < 0.05). High levels of smoking, substantial medical expenses, poor sleep quality, and elevated anxiety scores were risk factors for poor oral health (all P < 0.05). Adequate daily water intake served as a protective factor for oral health (P < 0.05). CONCLUSION: This study proposes targeted interventions to enhance the management and improvement of oral health in patients on hemodialysis, aiming to provide highly personalised and effective oral health care. These interventions are expected to improve oral health outcomes in future clinical practice.
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INTRODUCTION: Postoperative urinary retention (POUR) is a common complication after hip surgery. The enhanced recovery urinary protocol (ERUP) is a tool that employs several perioperative strategies to facilitate optimal conditions for surgery and recovery. The aim of this study was to evaluate the effect of ERUP on POUR in patients undergoing hip surgery. METHODOLOGY: A controlled pre- and post-quasi-experimental study was conducted. Data was collected between May 2018 and January 2019 at the orthopedic department of one of the largest teaching hospitals affiliated with Menoufia University in Egypt. A convenience sample of 100 Egyptian patients (of both genders) undergoing elective hip surgery was equally allocated into two groups. The control group (n = 50) was given traditional routine perioperative nursing care, while the intervention group (n = 50) was subjected to ERUP. Data was collected from socio-demographic, medical, and surgical data sheets, preoperative medication assessment sheets, postoperative data sheets, and fluid balance charts. RESULTS: ERUP application significantly reduced the length of hospital stay and the incidence of POUR in the intervention group. CONCLUSIONS: Implementation of the ERUP is recommended for patients undergoing hip surgery, as it has a significantly positive effect on reducing the incidence of POUR.
Assuntos
Complicações Pós-Operatórias , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Egito , Adulto , Tempo de Internação , Retenção Urinária/etiologia , Idoso , Quadril/cirurgia , IncidênciaRESUMO
OBJECTIVES: Androgen deprivation therapy (ADT), a common treatment for prostate cancer, has debilitating impacts on physical and psychological quality of life. While some interventions focus on managing the physical side effects of ADT, there is a paucity of interventions that also address psychosocial and educational needs. The objective of this systematic review was to identify psychological and educational survivorship interventions targeting health-related quality of life (HRQoL) outcomes in men on ADT. DESIGN: A systematic review of randomised controlled trials. DATA SOURCES: Web of Science, Cochrane, EBSCO Host, PubMed, SCOPUS from inception (1984) to 28 January 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Psychological and/or educational survivorship interventions targeting HRQoL outcomes for men on ADT; minimum 80% of participants on ADT; used a validated HRQoL outcome measure; published in English in a peer-reviewed journal. DATA EXTRACTION AND SYNTHESIS: Data extraction using pre-specified study criteria was conducted. Heterogeneity of eligible studies precluded a meta-analysis. RESULTS: A total of 3381 publications were identified with eight meeting the criteria. Interventions were either psychological with a cognitive behavioural approach (n=4), or educational with (n=2) or without (n=2) psychoeducational components.Two studies reported a statistically significant improvement using a specific HRQoL measure. Most studies were not adequately powered and/or included small sample sizes limiting the conclusions that can be drawn on effectiveness. The most effective interventions were (i) individually based, (ii) educational with a psychoeducational component, (iii) supplemented with information packages and/or homework and (iv) included personalised needs assessments. CONCLUSION: There is a paucity of literature reporting psychological and educational survivorship interventions targeting HRQoL outcomes for men on ADT. What is urgently needed are person-centred survivorship interventions that are flexible enough to identify and address individual needs, taking into account the impact ADT has on both physical and psychological quality of life. PROSPERO REGISTRATION NUMBER: CRD4202230809.
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Antagonistas de Androgênios , Neoplasias da Próstata , Qualidade de Vida , Humanos , Masculino , Neoplasias da Próstata/psicologia , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/terapia , Antagonistas de Androgênios/uso terapêutico , Antagonistas de Androgênios/efeitos adversos , Educação de Pacientes como Assunto/métodos , Sobreviventes de Câncer/psicologia , Sobrevivência , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
OBJECTIVE: To explore the knowledge, attitudes and practice (KAP) towards the postoperative nursing of patients with digit replantation and skin flap transplantation among new nurses. DESIGN: Cross-sectional survey. SETTING: Two tertiary medical centres in Beijing, China. PARTICIPANTS: New nurses with working experience within 2 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The demographic characteristics of the nurses and their KAP towards the postoperative nursing of patients with digit replantation and skin flap transplantation were collected using a self-administered questionnaire. The primary outcome was the KAP scores towards the postoperative nursing of patients with digit replantation and skin flap transplantation. The secondary outcomes were the factors associated with the KAP scores and how the KAP dimensions interacted among them. RESULTS: A total of 206 valid questionnaires were collected. The mean KAP scores were 7.72±3.28 (total score 13; 59.3%), 37.95±6.05 (total score 50; 75.9%) and 38.23±6.12 (total score 45; 84.9%), indicating poor knowledge, moderately favourable attitudes and active practice. The structural equation model analysis showed that knowledge directly influences attitudes (ß=0.82, 95%CI 0.60 to 1.05, p<0.001) and that attitudes directly influence practices (ß=0.72, 95%CI 0.62 to 0.83, p<0.001). Knowledge had no direct influence on practices (ß=0.10, 95%CI -0.09 to 0.29, p=0.313), but the indirect influence was significant (ß=0.60, 95%CI 0.41 to 0.78, p<0.001). CONCLUSION: The lack of sufficient knowledge towards the postoperative nursing of patients with digit replantation and skin flap transplantation among nurses with <2 years of experience and the correlation among the KAP dimensions suggested the importance of proper training.
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Conhecimentos, Atitudes e Prática em Saúde , Reimplante , Humanos , Estudos Transversais , Pequim , Inquéritos e QuestionáriosRESUMO
Purpose: The purpose of the study was to determine the status of spiritual needs and influencing factors of postoperative breast cancer (BC) women undergoing chemotherapy. Participants and Methods: This study is a cross-sectional study. A total of 173 participants completed a general information questionnaire and a Chinese version of the Spiritual Needs Scale at the Guangxi Medical University Cancer Hospital. Data were collected by purposive sampling from December 2022 to April 2023. Data were analyzed by descriptive statistics, independent t-test, ANOVA, non-parametric test, and logistic regression analysis. Results: The spiritual needs of postoperative BC women undergoing chemotherapy were at a high level (84.20 ± 12.86). The need for "hope and peace" was considered paramount and the need for a "relationship with transcendence" was considered the least important. Significant differences were found in the following: spiritual needs total score (P=0.040) and "hope and peace" (P=0.021) in education level; "love and connection" in disease stage (P=0.021); "meaning and purpose" in education level (P=0.013), household income (P=0.012), and payment method (P=0.015); "relationship with transcendence" in religion (P<0.001); and "acceptance of dying" in marital status (P=0.023). The level of education was the influencing factor of spiritual needs (OR=1.50, P=0.005), especially for "hope and peace" (OR=1.50, P=0.012). Conclusion: The spiritual need of postoperative BC Chinese women undergoing chemotherapy is at a high level and should receive more attention. In clinical work, nurses should fully assess the spiritual needs of patients and meet their specific needs. Results may help nurses to develop targeted and comprehensive spiritual intervention strategies according to the characteristics of patients.
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BACKGROUND: To enhance patient satisfaction, nurses engaged in preoperative care must possess a comprehensive understanding of the most up-to-date evidence. However, there is a notable dearth of relevant information regarding the current status of preoperative care satisfaction and its impact, despite a significant rise in the number of patients seeking surgical intervention with complex medical requirements. OBJECTIVE: To assess patient satisfaction with preoperative nursing care and its associated factors in surgical procedures of, 2023. METHODS: A cross-sectional study was conducted, and the data was collected from the randomly selected 468 patients who had undergone surgery during the study period. The collected data was entered into Epidata version 3.1 and analyzed using SPSS version 25 software. RESULTS: The complete participation and response of 468 participants resulted in a response rate of 100%. Overall patient satisfaction with preoperative nursing care was 79.5%. Sex (Adjusted odds ratio (AOR): 1.14 (95% confidence interval (CI): 0.21-2.91)), payment status for treatment (AOR: 1.45 (95% CI: 0.66-2.97)), preoperative fear and anxiety (AOR: 1.01, 95% CI: 0.49-2.13)), patient expectations (AOR: 3.39, 95% CI: 2.17-7.11)), and preoperative education (AOR: 1.148, 95% CI: 0.54-2.86)) exhibited significant associations with patient satisfaction with preoperative nursing care. CONCLUSION: It is important to exercise caution when interpreting the level of preoperative nursing care satisfaction in this study. The significance of preoperative nursing care satisfaction lies in its reflection of healthcare quality, as even minor deficiencies in preoperative care can potentially lead to life-threatening complications, including mortality. Therefore, prioritizing the improvement of healthcare quality is essential to enhance patient satisfaction.
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PURPOSE: To construct the comfort status scale for patients with lung cancer after thoracoscopic surgery. DESIGN: Delphi method inquiry to 15 clinical and nursing experts. METHODS: On the basis of the comfort status scale and the subjective experience and objective symptoms of patients with lung cancer after thoracoscopic surgery, the relevant literature was consulted, semistructured interviews and group discussions were conducted, the pool of items of the postoperative comfort status scale for patients with lung cancer was initially formed, and the postoperative comfort status scale for patients with lung cancer was finally established. FINDINGS: The positive coefficient of experts was 100%, the coefficient of authority was 0.92 and 0.93, and the Kendal's W was 0.257 and 0.298, the degree of coordination of expert opinions was statistically significant (P < .05). Finally, a total of 28 items in four dimensions were formed to assess the postoperative comfort status of patients with lung cancer after thoracoscopic surgery. CONCLUSIONS: The Delphi method-based comfort status scale for patients with lung cancer after thoracoscopic surgery is scientific and reliable, and can provide a quantitative basis for the evaluation of the comfort status of patients after lung cancer thoracoscopic surgery, to further provide individual comfort care measures.
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BACKGROUND: The postoperative period is the recovery time after surgery and is defined as an individual process whose purpose is to return the person to the state of normality and integrity that they had prior to surgery. AIM: Demonstrate the modification of the level of health of people in the early postoperative period through the development and validation of the Health Index Instrument, which is built from the Nursing Outcomes Classification (NOC) standardized language. DESIGN: The design used a mixed method, which involved a first phase of instrument development and a second phase of instrument validation. METHODS: The methods was based on focus group techniques with text analysis techniques, internal validation with a group of care language experts, external validation with a group of clinical nursing experts and a clinical validation with quantitative and qualitative analysis. A panel of experts in Language of Care evaluated the (NOC) labels and their correlation with the 11 Health Variables to construct the instrument. The instrument developed was subjected to external validation with a panel of clinical nurse experts in post-anesthesia care. The clinical validation included a cross-sectional descriptive study in a postoperative unit. The final sample of the cross-sectional descriptive study was 139 cases. RESULTS: Of the 89 NOCs proposed in the preliminary construction phase of the instrument, 36 passed through the first round. Of those 36 NOCs, 25 passed through to the second round with a review performance and 11 directly as approved. The total number of approved NOCs were 4. The results of the research show that there are changes in the global score of the health level and in each health variable. It is observed that there was a significant increase in the scores of the health variables at admission and discharge (p < 0.001). CONCLUSIONS: The results of the data analysis show that six groups present a similar pattern of evolution of the health variables. A correlation was found between the time of stay in the unit with the scores obtained in the health variables, the physical functioning, comfort status and the presence of symptoms being particularly significant.
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BACKGROUND: Amiodarone is a prophylactic rhythm-regulating drug used to prevent arrhythmia; However, especially during infusion, it has the potential to cause a number of complications, especially phlebitis. AIM: The aim of the study is to determine the effects of sesame oil, which has the potential to prevent phlebitis that may occur during amiodarone infusion administered to patients after cardiac surgery. DESIGN: This prospective, two-arm (1:1), block randomized controlled interventional study. METHODS: This study was conducted with 44 patients treated in the coronary intensive care unit of a university hospital, who received parenteral infusion of amiodarone. Sesame oil was applied superficially by applying 10 drops to a 10 cm perimeter of the cannula for 10 min. This application was repeated every 8 h during the 24-h amiodarone infusion. No intervention was made to the patients in the control group. However, standard nursing care measures and a standard transparent dressing were applied to the patients in both groups during the peripheral catheter application phase. Patients in the intervention and control groups were evaluated in terms of phlebitis at the end of every 24 h using the Visual Infusion Phlebitis Scale. The study was reported according to the CONSORT declaration. RESULTS: Phlebitis symptoms occurred in 15/22 (68.2%) of the patients in the intervention group on the first day, 3/22 (13.6%) on the second day and 2/22 (9.1%) of the patients on the third day, while in the control group, 20/22 (90.9%) of the patients had phlebitis on the first day and 2/22 (9.1%) on the second day. The incidence of phlebitis was 20/22 (90.9%) in the intervention group and 22/22 (100%) in the control group. There was no statistically significant difference in phlebitis symptoms between groups. CONCLUSION: The research results showed that the application of sesame oil did not significantly reduce the frequency of phlebitis. However, a trend indicating delayed onset of phlebitis symptoms was observed in the sesame oil group. Nevertheless, larger sample studies are needed. These studies are expected to assist in determining the effects of sesame oil on phlebitis more precisely and provide stronger support for the results. RELEVANCE TO CLINICAL PRACTICE: Training of nurses on non-pharmacological methods should be supported and opportunities should be given for their application.
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BACKGROUND: Nursing-sensitive events (NSEs) are common, accounting for up to 77% of adverse events in hospitalized patients (eg, fall-related harm, pressure ulcers, and health care-associated infections). NSEs lead to adverse patient outcomes and impose an economic burden on hospitals due to increased medical costs through a prolonged hospital stay and additional medical procedures. To reduce NSEs and ensure high-quality nursing care, appropriate nurse staffing levels are needed. Although the link between nurse staffing and NSEs has been described in many studies, appropriate nurse staffing levels are lacking. Existing studies describe constant staffing exposure at the unit or hospital level without assessing patient-level exposure to nurse staffing during the hospital stay. Few studies have assessed nurse staffing and patient outcomes using a single-center longitudinal design, with limited generalizability. There is a need for multicenter longitudinal studies with improved potential for generalizing the association between individual nurse staffing levels and NSEs. OBJECTIVE: This study aimed (1) to determine the prevalence, preventability, type, and severity of NSEs; (2) to describe individual patient-level nurse staffing exposure across hospitals; (3) to assess the effect of nurse staffing on NSEs in patients; and (4) to identify thresholds of safe nurse staffing levels and test them against NSEs in hospitalized patients. METHODS: This international multicenter study uses a longitudinal and observational research design; it involves 4 countries (Switzerland, Sweden, Germany, and Iran), with participation from 14 hospitals and 61 medical, surgery, and mixed units. The 16-week observation period will collect NSEs using systematic retrospective record reviews. A total of 3680 patient admissions will be reviewed, with 60 randomly selected admissions per unit. To be included, patients must have been hospitalized for at least 48 hours. Nurse staffing data (ie, the number of nurses and their education level) will be collected daily for each shift to assess the association between NSEs and individual nurse staffing levels. Additionally, hospital data (ie, type, teaching status, and ownership) and unit data (ie, service line and number of beds) will be collected. RESULTS: As of January 2024, the verification process for the plausibility and comprehensibility of patients' and nurse staffing data is underway across all 4 countries. Data analyses are planned to be completed by spring 2024, with the first results expected to be published in late 2024. CONCLUSIONS: This study will provide comprehensive information on NSEs, including their prevalence, preventability, type, and severity, across countries. Moreover, it seeks to enhance understanding of NSE mechanisms and the potential impact of nurse staffing on these events. We will evaluate within- and between-hospital variability to identify productive strategies to ensure safe nurse staffing levels, thereby reducing NSEs in hospitalized patients. The TAILR (Nursing-Sensitive Events and Their Association With Individual Nurse Staffing Levels) study will focus on the optimization of scarce staffing resources. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56262.
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Recursos Humanos de Enfermagem Hospitalar , Admissão e Escalonamento de Pessoal , Humanos , Estudos Longitudinais , Recursos Humanos de Enfermagem Hospitalar/provisão & distribuição , Admissão e Escalonamento de Pessoal/organização & administração , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Estudos Multicêntricos como AssuntoRESUMO
Objetivo: analisar a percepção do enfermeiro acerca dos processos de cuidado durante a pandemia da COVID-19. Métodos: estudo de campo, descritivo e abordagem qualitativa, realizado entre dezembro de 2020 a abril de 2021. Participaram 45 enfermeiros atuantes há três anos ou mais na Atenção Primária de municípios paraibanos classificados em urbano, intermediário adjacente e remoto, rural adjacente e remoto. Realizou-se a coleta através de entrevistas semiestruturadas pela plataforma Google Meet, essas eram gravadas pela própria plataforma e transcritas na íntegra para análise. A análise de dados deu-se por meio da Análise de Conteúdo considerando as etapas de pré-análise, codificação do texto e a inferência e interpretação dos resultados. O estudo atendeu ao que preconiza os padrões éticos. Resultados: no contexto pandêmico, os enfermeiros identificaram déficits existentes em suas práticas, elencando desafios e limitações nas condutas, como as de biossegurança e prevenção de doenças, fazendo-os repensar sobre futuras mudanças a serem realizadas após o período de pandemia. Conclusão: infere-se que os enfermeiros atuantes da Atenção Primária obtiveram novas percepções relacionadas ao cuidado, a preocupação com a saúde física e mental no planejamento desse cuidado, não apenas do usuário, mas de si mesmo e às pessoas do convívio. (AU)
Objective: to analyze nurses' perceptions of care processes during the COVID-19 pandemic. Methods: field study, descriptive and qualitative approach, carried out between December 2020 and April 2021. Participated 45 nurses working for three years or more in Primary Care in municipalities in Paraíba classified as urban, intermediate adjacent and remote, rural adjacent and remote. The collection was carried out through semi-structured interviews through the Google Meet platform, these were recorded by the platform itself and transcribed in full for analysis. Data analysis was carried out through Content Analysis considering the pre-analysis steps, text coding and the inference and interpretation of results. The study complied with ethical standards. Results: in the pandemic context, nurses identified existing deficits in their practices, listing challenges and limitations in conduct, such as biosecurity and disease prevention, making them rethink about future changes to be made after the period of pandemic. Conclusion: it is inferred that nurses working in Primary Care obtained new perceptions related to care, the concern with physical and mental health in the planning of this care, not only of the user, but of himself and the people around him. (AU)
Objetivo: analizar las percepciones de los enfermeros sobre los procesos de atención durante la pandemia de COVID-19. Métodos: estudio de campo, de abordaje descriptivo y cualitativo, realizado entre diciembre de 2020 y abril de 2021. Participaron 45 enfermeros que actúan desde hace tres años o más en Atención Básica en municipios de Paraíba clasificados como urbano, intermedio adyacente y remoto, rural adyacente y remoto. La recolección se realizó a través de entrevistas semiestructuradas a través de la plataforma Google Meet, estas fueron grabadas por la propia plataforma y transcritas en su totalidad para su análisis. El análisis de los datos se realizó a través del Análisis de Contenido considerando las etapas del preanálisis, la codificación del texto y la inferencia e interpretación de los resultados. El estudio cumplió con las normas éticas. Resultados: en el contexto de la pandemia, los enfermeros identificaron déficits existentes en sus prácticas, enumerando desafíos y limitaciones en la conducta, como la bioseguridad y la prevención de enfermedades, lo que les hizo repensar sobre los cambios futuros que se deben realizar después del período de pandemia. Conclusión: se infiere que los enfermeros que actúan en la Atención Primaria obtuvieron nuevas percepciones relacionadas con el cuidado, la preocupación por la salud física y mental en la planificación de este cuidado, no sólo del usuario, sino de sí mismo y de las personas que lo rodean. (AU)
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Enfermagem , Atenção Primária à Saúde , COVID-19 , Cuidados de EnfermagemRESUMO
Objetivo: Discutir acerca do trabalho interdisciplinar na prática do enfermeiro na Atenção Primária à Saúde e as suas condições de trabalho. Métodos: Pesquisa descritiva, qualitativa, realizada com 45 profissionais Enfermeiros, que atuam na Atenção Primária à Saúde do estado da Paraíba, de dezembro de 2020 a abril de 2021. A coleta de dados foi guiada por um roteiro semiestruturado. Os dados foram interpretados com base na Análise de Conteúdo e discutidos a partir da literatura existente. Resultados: Evidenciou-se que, apesar de os enfermeiros conseguirem firmar parceria com os outros trabalhadores da unidade, usuários e gestão, e sentirem autonomia para realizar procedimentos, existem condições que dificultam suas práticas, como o pouco reconhecimento profissional, os problemas com a gestão, a falta de insumos e a sobrecarga de função. Conclusão: Os enfermeiros na Atenção Primária vêm buscando seu espaço e melhores condições de trabalho que facilitem suas práticas e favoreçam o cuidado ao usuário. Dessa forma, tais profissionais necessitam de visibilidade e reconhecimento social de suas competências técnicas. (AU)
Objective: Discuss about the interdisciplinary work in the practice of nurses in Primary Health Care and their working conditions. Methods: Descriptive, qualitative research, carried out with 45 professional nurses, who work in Primary Health Care in the state of Paraíba, from December 2020 to April 2021. Data collection was guided by a semi-structured script. Data were interpreted based on Content Analysis and discussed from the existing literature. Results: It was evidenced that, although the nurses manage to establish a partnership with the other workers of the unit, users and management, and feel autonomy to carry out procedures, there are conditions that hinder their practices, such as little professional recognition, problems with management, the lack of inputs and the function overload. Conclusion: Nurses in Primary Care have been seeking their space and better working conditions that facilitate their practices and favor user care. Thus, such professionals need visibility and social recognition of their technical skills. (AU)
Objetivo: Discutir sobre el trabajo interdisciplinario en la práctica de los enfermeros en la Atención Primaria de Salud y sus condiciones de trabajo. Métodos: Investigación descriptiva, cualitativa, realizada con 45 enfermeros profesionales, que actúan en la Atención Primaria de Salud en el estado de Paraíba, de diciembre de 2020 a abril de 2021. La recolección de datos fue guiada por un guión semiestructurado. Los datos fueron interpretados con base en el Análisis de Contenido y discutidos a partir de la literatura existente. Resultados: Se evidenció que, aunque los enfermeros logran establecer una sociedad con los demás trabajadores de la unidad, usuarios y gerencia, y sienten autonomía para realizar los procedimientos, existen condiciones que dificultan sus prácticas, como poco reconocimiento profesional, problemas con la gestión, la falta de insumos y la sobrecarga de funciones. Conclusión: Los enfermeros en Atención Básica vienen buscando su espacio y mejores condiciones de trabajo que faciliten sus prácticas y favorezcan la atención al usuario. Por lo tanto, estos profesionales necesitan visibilidad y reconocimiento social de sus habilidades técnicas. (AU)