Infection control and patient safety measures addressed in nursing pedagogical projects.

OBJECTIVE: To characterize teaching about patient safety and standard precautionary measures for infection prevention and control in undergraduate nursing courses. METHOD: A descriptive documentary analysis study carried out in undergraduate courses, with a concept equal to or greater than three in the National Student Performance Exam and in the Preliminary Course Concept, located in the state of Goiás, Brazil. RESULTS: Six education institutions participated, with the majority being private with curricular structure by discipline. Six pedagogical projects and 273 subject plans were analyzed. The most discussed topics for patient safety development were human factors related to communication, interpersonal relationships, and principles and techniques. Thirty-nine (39) disciplines contemplated teaching infection prevention and control measures, and the most approached topics were personal protective equipment and hand hygiene. CONCLUSION: Teaching about patient safety presented strong gaps in the six evaluated courses. There is fragility in teaching infection prevention and control measures. The data indicate the need to review the Course Pedagogical Projects in order to incorporate necessary educational demands for training professionals so that they develop safe and quality care.

Quality of life at work for health professionals during the COVID-19 pandemic.

OBJECTIVE: to evaluate the quality of life at work of health professionals in direct and indirect care of COVID-19 cases. METHODS: this was a cross-sectional study with 156 health professionals from a referral hospital. The relationship between sociodemographic and work-related variables and perceived stress and domains of the Quality of Life at Work Scale was investigated using inferential statistics and regression. RESULTS: Satisfaction with Compassion was moderate (mean: 38.2), with low perception of stress, Burnout and Secondary Traumatic Stress (means: 18.8, 21.6 and 19.1). There were associations between: education, salary, multiple jobs and direct care with Compassion Satisfaction; low income, being a nurse and working overtime with Burnout; and working more than 12 hours, underlying disease and hospitalization for COVID-19 with Secondary Traumatic Stress. CONCLUSION: quality of life at work was satisfactory, despite the presence of Burnout and Secondary Traumatic Stress.

"A lack of information keeps us from medicine, well-being, harmony ": a mixed method study with plaintiffs requesting medicines in administrative cases. / "A falta de informação nos afasta do remédio, do bem-estar, da harmonia...": estudo de método misto com demandantes de medicamentos pela via administrativa.

The need to request public health managers to ensure the right of access to medicines characterizes an administrative case and the method to do so is called the administrative route. This mixed method study aimed to analyze the perceptions of plaintiffs requesting medications by the administrative route about barriers to access medicines in the Brazilian public health sector. Data were gathered through focus groups and questionnaires. The results point to the interdependence of pharmaceutical services with the interfacing areas to ensure access. The barriers related to individuals reflect the commitment to develop citizenship, justifying the cost of the medicine to motivate the demand. Barriers to service provision include irregular availability of medicines, insufficient resources, and unsatisfactory quality of services. The difficulty in obtaining medical consultations and prescriptions originating in the public sector are barriers to the health sector. The barriers above the health sector are compliance with administrative procedures, corruption, and clientelism. The administrative route intensifies inequities in access to healthcare in Brazil.

A necessidade de recorrer ao gestor público de saúde para efetivar o direito ao acesso a medicamentos caracteriza a via administrativa. O estudo analisou as percepções dos usuários que acionaram a via administrativa sobre as barreiras para o acesso a medicamentos no setor público de saúde de uma capital brasileira. Foi realizado estudo de método misto com grupo focal, questionário com demandantes e descrição dos medicamentos demandados pela via administrativa. Os resultados apontam a interdependência da assistência farmacêutica com as áreas de interfaceamento para a garantia do acesso. As barreiras relativas aos indivíduos refletem o comprometimento do desenvolvimento da cidadania, justificando o custo do medicamento motivar a demanda. As barreiras à prestação dos serviços contemplam disponibilidade irregular dos medicamentos, insuficiência de recursos e qualidade insatisfatória dos serviços. A dificuldade para conseguir consultas médicas e a exigência da prescrição originada no setor público são barreiras ao setor saúde. As barreiras acima do setor saúde são cumprimento dos procedimentos administrativos, corrupção e clientelismo. A via administrativa intensifica as iniquidades no acesso à saúde no Brasil.

Evaluating the psychometric properties of the eHealth Literacy Scale in Brazilian adults.

OBJECTIVE: To translate and adapt the eHealth Literacy Scale for the cultural reality of Brazil and to evaluate the psychometric properties of its Brazilian Portuguese version. METHODS: The instrument was translated and adapted to Brazilian Portuguese and applied to a sample of 502 individuals from 18 to 80 years old who lived in the surrounding areas of six Family Health Units of a city in the countryside of the state of São Paulo, Brazil. The data was evaluated using exploratory and confirmatory factor analysis, item response theory, and instrument reliability measures (Cronbach's alpha and McDonald's omega). RESULTS: The eHealth Literacy Scale - Brazilian version (eHEALS-Br) presented an excellent internal consistency (α = 0.95 e ω = 0.95), with only one dimension and an explained variation of 81.79%. CONCLUSIONS: The Brazilian version of the instrument showed excellent psychometric properties to measure the levels of digital health literacy in adults from the country.

Strategies for case management in transitional care in emergency services: scoping review.

OBJECTIVE: to map and synthesize the strategies implemented for case management in transitional care for patients with complex needs in emergency services. METHOD: a scoping review conducted under the Joanna Briggs Institute guidance. Twenty-three studies were analyzed, with different methodological designs, on the strategies used in case management involving adult and elderly populations in emergency services. RESULTS: the main strategies employed were patient risk stratification screening/identification, care management plan, coordination of care through multidisciplinary activities, support for the transition process, continuous patient monitoring, and follow-up. FINAL CONSIDERATIONS: these strategies used structured approaches to care in emergency services to promote support for self-management and effective transitional care for people with complex needs, ensuring comprehensiveness, coordination, and continuity of care.

Epidemiological characteristics and strategies for the prevention of diarrheal disease in indigenous children: A scoping review.

AIM: The aim of the present scoping review was to map the scientific evidence about diarrheal disease in indigenous children and the strategies that can be used to prevent it. METHODS: The subject headings were indigenous population; child; diarrhea; dysentery; epidemiology; and prevention, primary; also the following keywords characteristic, epidemiologic study; and children. The databases consulted were Latin American and Caribbean Health Sciences Literature, MEDLINE via the US National Library of Medicine/National Institutes of Health, and Web of Science. Initially, 268 studies were identified, and after being screened using the eligibility criteria, six were selected. Finally, via reference tracking, five more were identified. The final sample was made up of eleven articles. RESULTS: The results confirmed higher mortality rates due to diarrheal disease among indigenous children who are socially disadvantaged and living in poor hygienic and basic sanitation conditions. Among the primary prevention strategies are basic sanitation, health education better hygiene habits, animal control, breastfeeding, supplementing the diet with zinc, vitamins, and the rotavirus vaccine. The preventive strategies included the use of oral rehydration solutions, adequate nutrition, prescribed antimicrobials, and intravenous fluid replacement with glycaemic and electrolyte correction in severe cases. CONCLUSION: In conclusion, public policies regarding the indigenous population and cross-cultural care should be strengthened. The present study confirmed that, at a global level, there is a lack of publications studying this issue.

Quality of life at work for health professionals during the COVID-19 pandemic / Calidad de vida laboral de los profesionales sanitarios durante la pandemia de COVID-19 / Qualidade de vida no trabalho de profissionais da saúde durante a pandemia da covid-19

ABSTRACT Objective: to evaluate the quality of life at work of health professionals in direct and indirect care of COVID-19 cases. Methods: this was a cross-sectional study with 156 health professionals from a referral hospital. The relationship between sociodemographic and work-related variables and perceived stress and domains of the Quality of Life at Work Scale was investigated using inferential statistics and regression. Results: Satisfaction with Compassion was moderate (mean: 38.2), with low perception of stress, Burnout and Secondary Traumatic Stress (means: 18.8, 21.6 and 19.1). There were associations between: education, salary, multiple jobs and direct care with Compassion Satisfaction; low income, being a nurse and working overtime with Burnout; and working more than 12 hours, underlying disease and hospitalization for COVID-19 with Secondary Traumatic Stress. Conclusion: quality of life at work was satisfactory, despite the presence of Burnout and Secondary Traumatic Stress.

RESUMEN Objetivo: evaluar la calidad de vida laboral de los profesionales sanitarios que prestan atención directa e indirecta a los casos de COVID-19. Métodos: se trata de un estudio transversal llevado a cabo con 156 profesionales sanitarios de un hospital de referencia. Se investigó la relación entre las variables sociodemográficas, laborales y el estrés percibido y los dominios de la Escala de Evaluación de la Calidad de Vida Laboral mediante estadística inferencial y de regresión. Resultados: la satisfacción por Compasión fue moderada (media: 38,2), con nivel de estrés percibido, Burnout y Estrés Traumático Secundario bajos (medias: 18,8, 21,6 y 19,1). Hubo asociaciones entre: escolaridad, sueldo, pluriempleo y atención directa con la Satisfacción por Compasión; bajos ingresos, ser enfermero y hacer horas extras con el Burnout; y trabajar más de 12 horas, enfermedad subyacente y hospitalización por COVID-19 con Estrés Traumático Secundario. Conclusión: la calidad de vida en el trabajo fue satisfactoria, a pesar de la presencia de Burnout y Estrés Traumático Secundario.

RESUMO Objetivo: avaliar a qualidade de vida no trabalho dos profissionais da saúde em atendimento direto e indireto de casos de covid-19. Métodos: estudo transversal com 156 profissionais da saúde de um hospital de referência. Investigou-se a relação entre variáveis sociodemográficas, laborais e percepção de estresse e domínios da Escala de Avaliação da Qualidade de Vida no Trabalho, por meio de estatística inferencial e de regressão. Resultados: a Satisfação por Compaixão foi moderada (média: 38,2), com percepção de estresse, Burnout e Estresse Traumático Secundário baixos (médias: 18,8, 21,6 e 19,1). Houve associações entre: escolaridade, salário, múltiplos empregos e atendimento direto com o aspecto Satisfação por Compaixão; baixa renda, ser enfermeiro e trabalhar horas extras com Burnout; e trabalhar mais de 12 horas, doença de base e internação por covid-19 com Estresse Traumático Secundário. Conclusão: a qualidade de vida no trabalho foi satisfatória, apesar da presença de Burnout e Estresse Traumático Secundário.

[Heart disease experience of adults undergoing coronary artery bypass grafting surgery]. / Experiência da doença cardíaca entre adultos submetidos à revascularização do miocárdio.

OBJECTIVE: To evaluate the meanings of heart disease experience in patients undergoing rehabilitation post-coronary artery bypass grafting surgery. METHODS: Ethnographic study carried out between 2003 and 2005 in the city Goiânia, Central-West Brazil. Direct observation and in-depth interviews were conducted in 11 patients undergoing rehabilitation post- coronary artery bypass grafting surgery. Using an interpretative anthropology approach, data were gathered in narrative documents and analyzed through the identification of units of meanings and thematic groups. RESULTS: Disease-related meanings included heart disease realization, triggered feelings, formulated explanations, surgery acceptance and post-surgery life. Heart disease experience was understood as a biographic rupture, a situation between life and death, disability, loss of autonomy, inability to work. The meanings, analytically constructed, followed a logic that articulated common sense, religion and fragments of medical discourse for the understanding of disease and surgery. CONCLUSIONS: The study results showed that heart disease and surgery experience mark a rupture in the patient's lifestyle, work and their understanding of the health-disease process. The disease experience approach contributes to transcend the limits of a medical model based on disease, its symptoms and causes, and characterized by a biomedical understanding of the health-disease process focused on biological and/or psychological malfunctioning.

Quality of life from the perspective of revascularized patients during rehabilitation: an ethnographic study.

This ethnographic study aimed to understand the meaning of quality of life from the perspective of people with coronary disease submitted to myocardial revascularization surgery. Direct observations and semi-structured interviews were used for data collection. Data were analyzed through careful reading, identification of units of meaning, thematic groups and themes, and interpreted according to interpretative anthropology and the Centre for Health Promotion conceptual model of quality of life. The identified theme, quality of life being happy as possible, is based on being healthy, having a job and a harmonious family. These were considered dimensions for a "tranquil and happy" life. The meaning of quality of life is complex, subject to new significations throughout life, and related to the socioeconomic and cultural context, including, in the case, the experience of the health-disease process.

Cross-cultural adaptation of the instrument Readiness for Hospital Discharge Scale - Adult Form.

OBJECTIVE: to perform the cross-cultural adaptation of the Readiness for Hospital Discharge Scale - (RHDS) Adult Form for use in Brazil. METHOD: a methodological study was conducted in 2015, in Brazil's federal capital, following the eight stages scientifically established. RESULTS: analysis proved the maintenance of semantic, idiomatic, cultural, and conceptual equivalences and kept both the face and content validity of the original version. The judging committee and the pre-test participants declared they understood the RHDS items and answer scale. CONCLUSION: the instrument is culturally adapted for Brazil and can be used as one of the stages for planning hospital discharge.

Trends of knowledge production in health education in Brazil.

This literature review aimed to identify the concept of Health Education used by researchers in Collective Health; to present the main trends and pedagogical references defended in these studies and to exemplify studies constructed with the objective to promote health education by means of participant strategies with the community's involvement. After reading and analyzing 22 articles searched in the Scientific Electronic Library Online that answered the study questions, the following categories of analysis were constructed: Health Education in Brazil--conceptual aspects; pedagogical practices in education and health; health education applied to professional practices. Health education is an essential field to the development of a society and educative practices are opportunities to apply knowledge directed to social growth. The importance of educational proposals based on the reflection, critique, involvement and awareness is perceived, as well as the importance of implementing new educative programs to meet the population's needs.

Evaluating the psychometric properties of the eHealth Literacy Scale in Brazilian adults / Evaluación de las propiedades psicométricas del instrumento eHealth Literacy Scale en adultos brasileños / Avaliação das propriedades psicométricas do instrumento eHealth Literacy Scale em adultos brasileiros

ABSTRACT Objective: To translate and adapt the eHealth Literacy Scale for the cultural reality of Brazil and to evaluate the psychometric properties of its Brazilian Portuguese version. Methods: The instrument was translated and adapted to Brazilian Portuguese and applied to a sample of 502 individuals from 18 to 80 years old who lived in the surrounding areas of six Family Health Units of a city in the countryside of the state of São Paulo, Brazil. The data was evaluated using exploratory and confirmatory factor analysis, item response theory, and instrument reliability measures (Cronbach's alpha and McDonald's omega). Results: The eHealth Literacy Scale - Brazilian version (eHEALS-Br) presented an excellent internal consistency (α = 0.95 e ω = 0.95), with only one dimension and an explained variation of 81.79%. Conclusions: The Brazilian version of the instrument showed excellent psychometric properties to measure the levels of digital health literacy in adults from the country.

RESUMEN Objetivo: Traducir y adaptar la eHealth Literacy Scale a realidad cultural Brasileña y evaluar sus propiedades psicométricas de la versión en portugués brasileño. Métodos: El instrumento fue traducido y adaptado al portugués brasileño y, en seguida, aplicado en una muestra de 502 individuos entre 18 y 80 años residentes en áreas cercas a seis Unidades de Salud de la Familia de un municipio del interior del estado de São Paulo, Brasil. Los datos fueron evaluados mediante análisis factorial exploratoria y confirmatoria, Teoría de Respuesta al Ítem y confiabilidad del instrumento (alfa de Cronbach y omega de McDonald). Resultados: El instrumento eHealth Literacy Scale - versión brasileña (eHEALS-Br) presentó excelente consistencia interna (α = 0,95 y ω = 0,95), apenas una dimensión y variancia explicada de 81,79%. Conclusiones: La versión brasileña del instrumento mostró excelentes propiedades psicométricas para contraste de los niveles de alfabetización digital en salud en adultos del nuestro país.

RESUMO Objetivo: Traduzir e adaptar a eHealth Literacy Scale para a realidade cultural do Brasil e avaliar suas propriedades psicométricas da versão em português brasileiro. Métodos: O instrumento foi traduzido e adaptado ao português brasileiro e, em seguida, aplicado em uma amostra de 502 indivíduos entre 18 e 80 anos residentes em áreas circunvizinhas a seis Unidades de Saúde da Família de um município do interior do estado de São Paulo, Brasil. Os dados foram avaliados mediante análises fatorial exploratória e confirmatória, Teoria de Resposta ao Item e confiabilidade do instrumento (alfa de Cronbach e ômega de McDonald). Resultados: O instrumento eHealth Literacy Scale - versão brasileira (eHEALS-Br) apresentou excelente consistência interna (α = 0,95 e ω = 0,95), apenas uma dimensão e variância explicada de 81,79%. Conclusões: A versão brasileira do instrumento mostrou excelentes propriedades psicométricas para aferição dos níveis de letramento digital em saúde em adultos do nosso país.

"A falta de informação nos afasta do remédio, do bem-estar, da harmonia... ": estudo de método misto com demandantes de medicamentos pela via administrativa / "A lack of information keeps us from medicine, well-being, harmony... ": a mixed method study with plaintiffs requesting medicines in administrative cases

Resumo A necessidade de recorrer ao gestor público de saúde para efetivar o direito ao acesso a medicamentos caracteriza a via administrativa. O estudo analisou as percepções dos usuários que acionaram a via administrativa sobre as barreiras para o acesso a medicamentos no setor público de saúde de uma capital brasileira. Foi realizado estudo de método misto com grupo focal, questionário com demandantes e descrição dos medicamentos demandados pela via administrativa. Os resultados apontam a interdependência da assistência farmacêutica com as áreas de interfaceamento para a garantia do acesso. As barreiras relativas aos indivíduos refletem o comprometimento do desenvolvimento da cidadania, justificando o custo do medicamento motivar a demanda. As barreiras à prestação dos serviços contemplam disponibilidade irregular dos medicamentos, insuficiência de recursos e qualidade insatisfatória dos serviços. A dificuldade para conseguir consultas médicas e a exigência da prescrição originada no setor público são barreiras ao setor saúde. As barreiras acima do setor saúde são cumprimento dos procedimentos administrativos, corrupção e clientelismo. A via administrativa intensifica as iniquidades no acesso à saúde no Brasil.

Abstract The need to request public health managers to ensure the right of access to medicines characterizes an administrative case and the method to do so is called the administrative route. This mixed method study aimed to analyze the perceptions of plaintiffs requesting medications by the administrative route about barriers to access medicines in the Brazilian public health sector. Data were gathered through focus groups and questionnaires. The results point to the interdependence of pharmaceutical services with the interfacing areas to ensure access. The barriers related to individuals reflect the commitment to develop citizenship, justifying the cost of the medicine to motivate the demand. Barriers to service provision include irregular availability of medicines, insufficient resources, and unsatisfactory quality of services. The difficulty in obtaining medical consultations and prescriptions originating in the public sector are barriers to the health sector. The barriers above the health sector are compliance with administrative procedures, corruption, and clientelism. The administrative route intensifies inequities in access to healthcare in Brazil.

Cerebral Palsy: how the child's age and severity of impairment affect the mother's stress and coping strategies. / Paralisia cerebral: faixa etária e gravidade do comprometimento do filho modificam o estresse e o enfrentamento materno.

The aim of the study was to comprehend how the age group and the severity of the motor impairment of children with cerebral palsy modify the mothers' experiences of stress and to understand the coping strategies they use. A qualitative approach was used, with the method framed on Grounded Theory Analysis. Nineteen mothers of children and adolescents with different degrees of motor impairment participated in individual semi-structured interviews. A lack of support and increased time and effort invested in parenting, at the cost of other areas of life threaten participants' physical and emotional health. Mothers of children with mild impairment suffer more from the challenge of dealing with their children's emotional problems, aggression and learning difficulties. For mothers whose children have severe impairment, the major difficulties relate to coping with health complications and functional limitations. Mothers of younger children report diverse sources of stress and scarcity of resources; while mothers of adolescents have greater experience and are able to take up their life projects again. Experience, knowledge and support received are critical for adaptation.

Letramento em saúde de cuidadores domiciliares de uma capital brasileira / Alfabetización en salud de cuidadores domiciliarios de una capital brasileña / Health literacy of home caregivers in a Brazilian capital

Resumo Objetivo Analisar as condições de letramento em saúde dos cuidadores de usuários vinculados ao Serviço de Atenção Domiciliar de uma capital brasileira. Métodos Estudo transversal realizado com 90 cuidadores vinculados ao Serviço de Atenção Domiciliar, de município na região central do Brasil. Coleta realizada no domicílio dos usuários, usando questionário sociodemográfico e a versão brasileira do Health Literacy Questionnaire (HLQ-Br). Utilizada estatística descritiva para variáveis sociodemográficas, a média dos escores nas escalas do HLQ e testes não paramétricos para medidas de associação do letramento em saúde. Resultados A maioria dos entrevistados era mulher (90,0%), com companheiro (58,9%), vivia no mesmo local do usuário (75,6%), possuía renda pessoal até um salário mínimo (72,2%), não possuía o hábito de ler (57,8%), estudou nove anos ou mais (53,3%), era cuidador informal (91,1%) e tinha pais que não estudaram (42,2%). Limitações foram identificadas nas escalas "Cuidado ativo em saúde" e "Navegar no sistema de saúde". As condições de letramento em saúde foram influenciadas negativamente por não ter hábito de ler; escolaridade do cuidador e de seus pais; pelo fato de ser cuidador informal; pela renda e tempo cuidando dos pacientes. As potencialidades foram relacionadas ao acesso a quem entende e apoia o cuidador; à compreensão das informações sobre saúde e saber o que fazer, e a entenderem o que os profissionais de saúde lhes pedem. Conclusão Necessário incorporar os princípios do letramento em saúde no cotidiano dos cuidadores, profissionais e gestores para melhores desfechos e decisões em saúde no contexto da assistência no domicílio.

Resumen Objetivo Analizar las condiciones de alfabetización en salud de los cuidadores de usuarios vinculados al Servicio de Atención Domiciliaria de una capital brasileña. Métodos Estudio transversal realizado con 90 cuidadores vinculados al Servicio de Atención Domiciliaria de un municipio en la región central de Brasil. La recopilación fue realizada en el domicilio de los usuarios, mediante un cuestionario sociodemográfico y la versión brasileña del Health Literacy Questionnaire (HLQ-Br). Se utilizó la estadística descriptiva para variables sociodemográficas, el promedio de puntuaciones de las escalas del HLQ y pruebas no paramétricas para medidas de asociación de la alfabetización en salud. Resultados La mayoría de los entrevistados era mujer (90,0 %), con compañero (58,9 %), vivía en el mismo lugar que el usuario (75,6 %), tenía un ingreso personal de hasta un salario mínimo (72,2 %), no tenía el hábito de leer (57,8 %), estudió nueve años o más (53,3 %), era cuidador informal (91,1 %) y sus padres no estudiaron (42,2 %). Se identificaron limitaciones en las escalas "Cuidado activo de la salud" y "Navegar en el sistema de salud". Las condiciones de alfabetización en salud fueron influenciadas de forma negativa por no tener el hábito de leer, por la escolaridad del cuidador y de sus padres, por el hecho de ser cuidador informal y por los ingresos y tiempo cuidando a los pacientes. Las posibilidades se relacionaron con el acceso a quien entiende y apoya al cuidador, con la comprensión de la información sobre salud y saber qué hacer y entender lo que los profesionales de la salud les piden. Conclusión Es necesario incorporar los principios de la alfabetización en salud en la cotidianidad de los cuidadores, profesionales y administradores para obtener mejores resultados y tomar mejores decisiones respecto a la salud en el contexto de la atención domiciliaria.

Abstract Objective To analyze the health literacy conditions of caregivers of Brazilian Home Care Program users. Methods Cross-sectional study conducted with 90 caregivers of the Brazilian Home Care Program in a municipality in central Brazil. Data collection was performed at users' homes using a sociodemographic questionnaire and the Brazilian version of the Health Literacy Questionnaire (HLQ-Br). Descriptive statistics were used for sociodemographic variables, the mean scores of the HLQ scales and non-parametric tests for measures of association of health literacy. Results Most respondents were women (90.0%), with a partner (58.9%), lived in the same location as the user (75.6%), had a personal income of up to one minimum wage (72.2%), did not have the habit of reading (57.8%), studied nine years or more (53.3%), were informal caregivers (91.1%) and had parents who did not study (42.2%). Health literacy limitations were identified in the scales "Actively managing my health" and "Navigating the healthcare system". Health literacy conditions were negatively influenced by the infrequent reading habit; schooling of caregivers and their parents; the fact of being an informal caregiver; by the low income and less time as a caregiver. The strengths of caregivers were related to the access to those who understand and support the caregiver; understanding health information and knowing what to do, and understanding health professionals' requests. Conclusion It is necessary to incorporate the principles of health literacy in the routine of caregivers, professionals and managers for better health outcomes and decisions in the home care context.

[Difficulties experienced by the patient care team at the intensive care unit]. / Dificuldades vivenciadas pela equipe multiprofissional na unidade de terapia intensiva.

This interpretative case study aimed to identify the difficulties experienced by the patient care team while working at the Intensive Care Unit. Data were collected through participant observation and semistructured interviews with doctors, nurses and nurse's aides. Two major categories emerged from the data analysis: Care delivery in intensive care-- "it is difficult to deal with death and inform the patient's family" and care delivery in intensive care-- "the lack of material resources and the difficulty to work in a team". The difficulties are related to the contact with family members, dealing with death and the lack of material resources, and particularly with the relation between team members. Therefore, teams need to promote opportunities and discussions to reflect on the technical, scientific and ethic aspects of care for critical patients as well as family members, with a view to better care quality and interpersonal relations.

Strategies for case management in transitional care in emergency services: scoping review / Estratégia para el manejo de casos em la atención de transición em servicios de emergência: scoping review / Estratégias para o gerenciamento de casos no cuidado transicional em serviços de emergência: scoping review

ABSTRACT Objective: to map and synthesize the strategies implemented for case management in transitional care for patients with complex needs in emergency services. Method: a scoping review conducted under the Joanna Briggs Institute guidance. Twenty-three studies were analyzed, with different methodological designs, on the strategies used in case management involving adult and elderly populations in emergency services. Results: the main strategies employed were patient risk stratification screening/identification, care management plan, coordination of care through multidisciplinary activities, support for the transition process, continuous patient monitoring, and follow-up. Final considerations: these strategies used structured approaches to care in emergency services to promote support for self-management and effective transitional care for people with complex needs, ensuring comprehensiveness, coordination, and continuity of care.

RESUMEN Objetivo: mapear y sintetizar las estrategias implementadas para el manejo de casos en la atención de transición de pacientes con necesidades complejas en los servicios de emergencia. Método: una scoping review realizada según los supuestos metodológicos del Instituto Joanna Briggs y de Levac, Colquhoun y O'Brien. Se analizaron 23 estudios, con diferentes diseños metodológicos, sobre las estrategias utilizadas en el manejo de casos en poblaciones de adultos y ancianos, en el contexto de los servicios de emergencia. Resultados: las principales estrategias empleadas fueron: seguimiento/identificación del paciente y estratificación del riesgo; plan de gestión de la atención; coordinación de la atención a través de actividades multiprofesionales; apoyo para el proceso de transición; monitoreo continuo y seguimiento del paciente. Consideraciones finales: estas estrategias utilizaron enfoques de atención estructurada en los servicios de emergencia, para promover el apoyo para el autocontrol y la atención de transición efectiva para las personas con necesidades complejas, asegurando la integralidad, coordinación y continuidad de la atención.

RESUMO Objetivo: mapear e sintetizar as estratégias implementadas para o gerenciamento de caso no cuidado transicional de pacientes com necessidades complexas nos serviços de emergência. Método: scoping review conduzido segundo os pressupostos metodológicos do Instituto Joanna Briggs. Foram analisados 23 estudos, com diferentes delineamentos metodológicos, sobre as estratégias empregadas no gerenciamento de casos envolvendo populações adultas e idosas, no contexto dos serviços de emergência. Resultados: as principais estratégias empregadas foram: rastreamento/identificação e estratificação de risco do paciente; plano de gerenciamento do cuidado; coordenação do cuidado por meio da atuação multiprofissional; apoio ao processo de transição; monitoramento e seguimento contínuo do paciente. Considerações finais: essas estratégias utilizaram abordagens estruturadas do cuidado nos serviços de emergência, para promover o apoio ao autogerenciamento e o efetivo cuidado transicional de pessoas com necessidades complexas, garantindo a integralidade, coordenação e continuidade do cuidado.

Evidências de Validade da Champion's Health Belief Model Scale para o Brasil / Evidencias de Validez de la Champion's Health Belief Model Scale para Brasil / Champion's Health Belief Model Scale Validity Evidence for Brazil

Resumo Objetivo Realizar tradução e adaptação transcultural da Champion's Health Belief Model Scale (CHBMS) para uso no Brasil, no rastreamento mamográfico, e verificar as evidências de validade da versão brasileira desta escala. Métodos Estudo metodológico, realizado com 206 mulheres frequentadoras de unidade básica de saúde, na cidade de Fortaleza-CE, Brasil, de agosto de 2015 a dezembro de 2017. A escala passou por processo de tradução e adaptação transcultural, incluindo validação de face e conteúdo. Posteriormente, foram verificadas as evidências de validade (1.Validade baseada na estrutura interna, avaliada mediante análise exploratória, com rotação ortogonal varimax e retenção de fatores por análises paralelas; 2. Confiabilidade, a partir da homogeneidade por alfa de Cronbach e estabilidade por teste-reteste). Resultados Na validação de face e conteúdo, o instrumento apresentou boa aceitação entre os juízes e o público-alvo. O modelo final da análise fatorial exploratória resultou em escala com sete itens, divididos em três domínios, com variância explicada de 71,4%, com alfa de Cronbach variando de 0,50 a 0,88. Para confiabilidade da escala, o r de Pearson e o ρ de Spearman mostraram alta confiabilidade (0,997 e 0,986). Conclusão A versão brasileira da Champion's Health Belief Model Scale apresenta boas evidências de validade baseada na estrutura interna e é confiável, podendo ser empregada no Brasil para avaliação do monitoramento da adesão à mamografia.

Resumen Objetivo Realizar la traducción y adaptación transcultural de la Champion's Health Belief Model Scale (CHBMS) para su aplicación en Brasil en el rastreo mamográfico y para verificar las evidencias de validez de la versión brasileña de esta escala. Métodos Estudio metodológico, realizado con 206 mujeres que asistían con frecuencia a una unidad básica de salud, en la ciudad de Fortaleza, estado de Ceará, Brasil, de agosto de 2015 a diciembre de 2017. La escala pasó por un proceso de traducción y adaptación transcultural, que incluyó validación aparente y de contenido. Posteriormente, se verificaron las evidencias de validez (1. Validez basada en la estructura interna, evaluada mediante análisis exploratorio, con rotación ortogonal varimax y retención de factores por análisis paralelos; 2. Confiabilidad a partir de la homogeneidad por alfa de Cronbach y estabilidad por test-retest). Resultados En la validación aparente y de contenido, el instrumento presentó buena aceptación entre los jueces y el público destinatario. El modelo final del análisis factorial exploratorio tuvo como resultado una escala con siete ítems, divididos en tres dominios, con varianza explicada de 71,4%, con alfa de Cronbach que varía de 0,50 a 0,88. En la confiabilidad de la escala, el r de Pearson y el ρ de Spearman demostraron alta confiabilidad (0,997 y 0,986). Conclusión La versión brasileña de la Champion's Health Belief Model Scale presenta buenas evidencias de validez basada en la estructura interna y es confiable, por lo que puede emplearse en Brasil para evaluar el monitoreo de la adherencia a la mamografía.

Abstract Objective Performing translation and cross-cultural adaptation of the Champion's Health Belief Model Scale (CHBMS) for use in Brazil for mammographic screening, and verify the validity evidence of the Brazilian version of this scale. Methods Methodological study, conducted with 206 women attending a Basic Health Unit, in the city of Fortaleza, state of Ceará, Brazil, from August 2015 to December 2017. The scale went through a process of translation and cross-cultural adaptation, including face and content validation. Afterwards, validity evidence was verified (1.Vality based on internal structure, assessed by exploratory analysis, with varimax orthogonal rotation and retention of factors by parallel analyzes; 2. Reliability from Cronbach's alpha homogeneity and test-retest stability). Results In face and content validation, the tool showed good acceptance among the judges and the target audience. The final exploratory factor analysis model resulted in a seven-item scale, divided into three domains, with an explained variance of 71.4%, with Cronbach's alpha ranging from 0.50 to 0.88. For scale reliability, Pearson r and Spearman ρ showed high reliability (0.997 and 0.986). Conclusion The Brazilian version of Champion's Health Belief Model Scale provides good evidence of validity based on internal structure and is reliable. It may be used in Brazil to assess mammography compliance monitoring.

[Cultural meaning of humanized care at intensive care units: "lots of words, little action"]. / O significado cultural do cuidado humanizado em unidade de terapia intensiva: "muito falado e pouco vivido".

This work consists in an ethnographic study which aimed at understanding the cultural meaning attributed by nursing teams to humanized care in Intensive Care Units of the University Hospital of Goiás Federal University. Participant observations and semi-structured interviews were used for data collection with nursing teams at their workplace. Three main categories emerged from the data: humanized care--"love the other as you love yourself"; humanized care--"it's not present as it should be"; stress and suffering--"the ones who care need to be looked after". The cultural theme that emerged from the data was: the humanized care--"a lot is said about it, but little is experienced". This theme emphasize the reality of the care at the ICU that involves a nursing team with the humanization concept synthesized on the expression: "love the other as you love yourself"; but in a practical way, the caring process does not reveal this deep thought.

[Meanings of social support for people submitted to coronary artery by-pass graft surgery: ethnographic study]. / Significados de apoio social de acordo com pessoas submetidas a revascularizacao do miocardio: estudo etnografico.

The aim of this ethnographic study was to understand the meanings of social support according to a group of people submitted to coronary artery bypass graft surgery. Semi structured interview and direct observations were the techniques used for data collection, which took place at the participants' homes and during outpatient return appointments. Data were collected between April/2010 and April/2011, involving eleven individuals, mostly married, between 49 and 73 years of age. The main reported source of support came from relatives. Religious support was another type mentioned, considered fundamental when making decisions about the surgery. The meaning of support was related to direct help from relatives, concerning instrumental (accomplishment of domestic and self-care activities) as well as emotional and religious help (focus on coping with the disease and surgery and explanations for the disease and surgery as a moment of threat and rupture).