Impactos da covid-19 sobre a gestaçãono desenvolvimento da pré-eclâmpsia: revisão integrativa / Impacts of COVID-19 during pregnancy on the development of pre-eclampsia: an integrative review

Objetivo: Identificar as evidências cientificas acerca da associação da covid-19 e o desenvolvimento de pré-eclâmpsia. Método: Trata-se de uma revisão integrativa, realizada em abril de 2022, mediante acesso às bases de dados: Medical Literature Analysis and Retrieval System Online (MEDLINE) e Portal Regional da Biblioteca Virtual em Saúde (BVS). A partir da utilização dos descritores em saúde: Gestantes, Pré-eclâmpsia e COVID-19. Resultados: Foram incluídos 15 estudos na síntese avaliativa, onde 13 foram provenientes da PubMed (86,6%) e 02 da BVS (13,3%). Quanto ao desenho, seis (40%) estudos foram do tipo relato ou estudo de caso, cinco (33,3%) do tipo revisão sistemática, com destaque para três revisões com meta-análise, dois (13,3%) se tratou estudos observacionais, um (6,6%) estudo descritivo e um (6,6%) estudo de coorte. Conclusão: Foram identificados estudos que associaram o desenvolvimento da pré-eclâmpsia à infecção causada pelo Covid-19, no entanto, outros estudos destacam a detecção de uma síndrome semelhante a pré-eclâmpsia, destacando a necessidade da realização de um diagnóstico diferencial.(AU)

Objective: To identify the scientific evidence on the association between covid-19 and the development of pre-eclampsia. Method: This is an integrative review, carried out in April 2022, through access to the databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) and Regional Portal of the Virtual Health Library (VHL). Using the health descriptors: Pregnant women, Pre-eclampsia and COVID-19. Results: 15 studies were included in the evaluation synthesis, of which 13 came from PubMed (86.6%) and 02 from the VHL (13.3%). In terms of design, six (40%) studies were of the case report or study type, five (33.3%) were of the systematic review type, with emphasis on three reviews with meta-analysis, two (13.3%) were observational studies, one (6.6%) was a descriptive study and one (6.6%) was a cohort study. Conclusion: Studies were identified that associated the development of pre-eclampsia with infection caused by Covid-19, however, other studies highlight the detection of a syndrome similar to pre-eclampsia, highlighting the need for a differential diagnosis.(AU)

Objetivo: Identificar las evidencias científicas sobre la asociación entre el covid-19 y el desarrollo de preeclampsia. Método: Se trata de una revisión integradora, realizada en abril de 2022, a través del acceso a las bases de datos: Medical Literature Analysis and Retrieval System Online (MEDLINE) y Portal Regional de la Biblioteca Virtual en Salud (BVS). Utilizando los descriptores de salud: Embarazadas, Preeclampsia y COVID-19. Resultados: 15 estudios fueron incluidos en la síntesis de evaluación, de los cuales 13 procedían de PubMed (86,6%) y 2 de la BVS (13,3%). En cuanto al diseño, seis (40%) estudios fueron del tipo informe o estudio de caso, cinco (33,3%) fueron revisiones sistemáticas, especialmente tres revisiones con meta-análisis, dos (13,3%) fueron estudios observacionales, uno (6,6%) fue un estudio descriptivo y uno (6,6%) fue un estudio de cohortes. Conclusión: Fueron identificados estudios que asocian el desarrollo de preeclampsia con infección causada por Covid-19, sin embargo, otros estudios destacan la detección de un síndrome semejante a la preeclampsia, enfatizando la necesidad de realizar un diagnóstico diferencial.(AU)

Afrontamiento al estrés académico en la carrera de Estomatología

Introducción: el estrés académico es un proceso sistémico, adaptativo y esencialmente psicológico; es la manera de reaccionar de una persona frente a ciertos estímulos. El del artículo es evaluar el estrés académico en estudiantes de primer y segundo años de la carrera Estomatología. Método: investigación analítica de corte pedagógico en la Facultad de Estomatología de Camagüey. El universo estuvo constituido por los 42 estudiantes matriculados en primer y segundo año de la carrera; a los que se les aplicó el inventario SISCO de Estrés Académico, diseñado para establecer los niveles de estrés en estudiantes universitarios. Los datos fueron procesados mediante estadística descriptiva e inferencial. Resultados: Predominó el nivel moderado de estrés en ambos grupos, con el 70 y 72,7 % en primer y segundo año respectivamente. Los estresores que más influyeron fueron las evaluaciones de los profesores y el tiempo limitado para realizar el trabajo que solicitan con puntuaciones por encima de 10 en primer año y 9 en segundo. Predominaron las reacciones psicológicas y físicas en segundo año y la estrategia de afrontamiento predominante fue la elaboración de un plan y ejecución de sus tareas con puntuación de 9 en segundo año y 11,4 en primero (p=0,006). Discusión: el ingreso a la universidad y los cambios que suscita, la adopción gradual de responsabilidades y la percepción individual además de los efectos de la pandemia se consideran factores que influyen en el estrés manifestado por los estudiantes; situación que afrontan fundamentalmente mediante la elaboración de un plan y la ejecución de sus tareas.

Introduction: Academic stress is a systemic, adaptive and essentially psychological process; it is the way people react to certain stimuli. Aim: to assess the academic stress in first and second year students of Dentistry. Method: analytic research with pedagogical kind, conducted in Camaguey Faculty of Dentistry involving the 42 students of first and second year of the program. SISCO tool of academic stress was applied since it allows to establish the levels of stress in university students. Data were processed through both descriptive and analytic statistics. Results: Moderate levels of stress were predominant in both years with 70% and 72,7 % in first and second respectively. The most influent stressors were the evaluations and the limited time for accomplishment of assigned tasks with figures above 10 in first year and 9 in second one. Psychological and physical reactions were predominant in second year students, and the most used strategy to face up to stress was elaboration of a plan and carry out its tasks which exhibited figures of 9 in second year and 11,4 in first year (p=0,006). Discussion: university admission and changes associated combined, the gradual responsibilities assumed and individual perception together with the impact of the pandemics are the main factors contributing to the stress exhibited by students; issue faced by elaborating a plan and develop its tasks as it is the preferred strategy.

Salutogénesis, sanación y curación

Introducció n: En salud aún prevalece, a escala mundial, el modelo patogénico, el cual acentúa la etiopatogenia de la enfermedad, la curación o rehabilitación. Progresivamente se viene introduciendo el modelo de salutogénesis, que preconiza la importancia de la prevención primaria, el bienestar y la sanidad. El objetivo del artículo consiste en argumentar los nexos entre salutogénesis, curación y sanación, como categorías conectadas a la condición saludable de los sujetos, tomándose como fuente de sustentación el criterio de profesionales de la salud y la consulta de fuentes bibliográficas acreditadas acerca de la temática. Material y métodos: Se emplearon métodos y técnicas teóricos, empíricos y estadísticos. La sistematización teórica permitió caracterizar y relacionar los procesos de salutogénesis, curación y sanación. Se aplicó un cuestionario en línea a profesionales vinculados con el sector de la salud para indagar acerca de las categorías de sanación y curación, de los que se obtuvo respuesta de 35 especialistas. Los datos fueron procesados mediante la estadística descriptiva. Resultados: La exploración develó algunas diferencias y semejanzas entre los procesos curativo y sanador; destacándose el carácter más restringido del primero; en tanto la metodología más versátil y creativa, el carácter transformador y los efectos más duraderos del segundo. Se advierte que el nivel de dominio relativo a ambos procesos no es suficientemente extendido ni notorio, como se requeriría para una labor asistencial más efectiva.

Introduction: In health, the pathogenic model still prevails worldwide, which emphasizes the etiopathogenesis of the disease, cure or rehabilitation. The salutogenesis model has been progressively introduced, which advocates the importance of primary prevention, well-being and health. The objective of the article is to argue the links between salutogenesis, healing and curing, as categories connected to the healthy condition of the subjects, taking as a source of support the criteria of health professionals and the consultation of accredited bibliographic sources on the subject. Material and method: Theoretical, empirical and statistical methods and techniques were used. The theoretical systematization allowed to characterize and relate the processes of salutogenesis, healing and curing. An online questionnaire was applied to professionals linked to the health sector to inquire about the categories of healing and curing, from which responses were obtained from 35 specialists. The data was processed using descriptive statistics. Results: The exploration revealed some differences and similarities between the curative and healing processes; highlighting the more restricted character of the first; as the most versatile and creative methodology, the transformative character and the most lasting effects of the latter. It is noted that the level of mastery related to both processes is not sufficiently widespread or notorious, as would be required for a more effective care work.

Fundamentos de un programa para el asesoramiento al duelo y afrontamiento a las pérdidas posCovid-19

Fundamento: al reiniciarse las actividades presenciales, las universidades acogieron a estudiantes que experimentaron pérdidas relacionadas con la Covid-19, causadas o no por la muerte, situación que merece ser tratada. Objetivo: fundamentar, desde lo conceptual y metodológico, un programa dirigido a los docentes para el asesoramiento al duelo y el afrontamiento a las pérdidas. Métodos: se realizó un análisis teórico-reflexivo a partir de la sistematización de publicaciones en idioma español e inglés de los últimos tres años. Se introdujeron como descriptores los términos: duelo, universidad, infecciones por coronavirus y asesoramiento. Se realizó un cribado de los artículos elegibles de los 76 encontrados. Se fundamentó y confeccionó un programa para el asesoramiento al duelo y afrontamiento a las pérdidas posCovid-19. Resultados: el programa consta de tres fases con indicaciones generales y específicas, susceptibles de ser modificadas al individualizarlas. Se proponen instrumentos de evaluación y técnicas de intervención. Conclusiones: el programa constituye un instrumento de orientación adecuado para que los profesores ayuden a sus estudiantes a enfrentar el duelo.

Background: when face-to-face activities restarted, the universities welcomed students who experienced losses related to Covid-19, caused or not by death, a situation that deserves to be addressed. Objective: to base, from the conceptual and methodological, a program aimed at teachers for grief counseling and facing with losses. Methods: a theoretical-reflexive analysis was carried out based on the systematization of publications in Spanish and English in the last three years. The terms: grief, university, coronavirus infections and counseling were introduced as descriptors. A screening of the eligible articles of the 76 found was carried out. A program for grief counseling and coping with post-Covid-19 losses was founded and prepared. Results: the program consists of three phases with general and specific indications, which can be modified by individualizing them. Evaluation instruments and intervention techniques are proposed. Conclusions: the program constitutes an adequate guidance instrument for teachers to help their students deal with grief.

Bacterial vaginosis and trichomoniasis: prevalence, associated factors, and performance of diagnostic tests

Introduction: Bacterial vaginosis and vaginal trichomoniasis are frequent causes of health care demand. Objective: To estimate the prevalence, identify associated factors, and investigate the performance of diagnostic tests for bacterial vaginosis and trichomoniasis. Methods: Cross-sectional study with participants over 18 years old. All of them were submitted to an interview and gynecological examination with evaluation of vaginal secretion, pH verification, collection of material for Pap smear, wet mount test, Whiff test, bacterioscopy, and polymerase chain reaction for trichomoniasis detection. Logistic regression analysis was applied to identify associated factors with bacterial vaginosis. Diagnostic performance for bacterial vaginosis was evaluated following Amsel criteria, the Ison and Hay score, and the Pap smear, considering the Nugent score as the gold standard. As for trichomoniasis, diagnostic performance was evaluated through the Pap smear and the wet mount test, using the polymerase chain reaction as the gold standard. Results: The prevalence of bacterial vaginosis was 33.7%, and for trichomoniasis, 0.5%. The complaint of abnormal vaginal secretion was associated with the diagnosis of bacterial vaginosis (odds ratio 2.2). The diagnostic accuracy by Amsel criteria, the Ison and Hay score, and the Pap smear was 35.6, 97.0, and 84.2%, respectively. The sensitivity for trichomoniasis through wet mount test was 0.0%, and through the Pap smear, 100%. Conclusion: The prevalence of bacterial vaginosis was high, and trichomoniasis was low. The only associated factor with bacterial vaginosis was the report of abnormal vaginal secretion. The methods with the most accurate diagnostic performance for bacterial vaginosis were the Ison and Hay score and the Pap smear and, for trichomoniasis, the Pap smear

Percentual de utilização de instrumentais em procedimentos cirúrgicos / Percentage of use of instruments in surgical procedures / Porcentaje de uso de instrumentos en procedimientos quirúrgicos

Objetivo: analisar o percentual de instrumentais cirúrgicos que compõem a caixa de laparotomia exploradora e não são utilizados durante as cirurgias. Método: estudo descritivo, transversal com abordagem quantitativa, que contabilizou instrumentais constituintes da caixa de laparotomia exploradora utilizados e não utilizados durante 13 cirurgias realizadas em um período de 17 dias, em um hospital do interior paulista. Resultados: nas 13 cirurgias analisadas, obteve-se um total de 1300 (100%) pinças presentes nas caixas, onde 832 (64%) não foram utilizadas e 468 (36%) foram utilizadas. Nos tempos cirúrgicos, o maior número de uso foi de 166 (35,5%) artigos, para preensão e afastadores. Conclusão: houve 64% de instrumentais não utilizados nas cirurgias analisadas. Há necessidade de implementar estratégias gerenciais que reduzam os números encontrados e, consequentemente, reduzam gastos, para gerar menor desperdício e reduzir falhas no gerenciamento de recursos materiais.

Objective: to analyze the percentage of surgical instruments that make up the operating laparotomy box and are not used during surgeries. Method: descriptive, cross-sectional study with quantitative approach, which counted instrumental constituents of the exploratory laparotomy box used and not used during 13 surgeries performed in a period of 17 days, in a hospital in the interior of São Paulo. Results: in the 13 surgeries analyzed, a total of 1300 (100%) tweezers were obtained in the boxes, where 832 (64%) were not used and 468 (36%) were used. In surgical times, the highest number of use was 166 (35.5%) articles, for seizures and reparators. Conclusion: there were 64% of instruments not used in the analyzed surgeries. There is a need to implement management strategies that reduce the numbers found and, consequently, reduce expenses, to generate less waste and reduce failures in the management of material resources.

Objetivo: analizar el porcentaje de instrumentos quirúrgicos que componen la caja de laparotomía quirúrgica y no se utilizan durante las cirugías. Método: estudio descriptivo, transversal con enfoque cuantitativo, que contó constituyentes instrumentales de la caja de laparotomía exploratoria utilizada y no utilizada durante 13 cirugías realizadas en un período de 17 días, en un hospital del interior de São Paulo. Resultados: en las 13 cirugías analizadas, se obtuvieron un total de 1300 (100%) pinzas en las cajas, donde no se utilizaron 832 (64%) y 468 (36%). En tiempos quirúrgicos, el mayor número de uso fue de 166 (35,5%) artículos, para convulsiones y reparadores. Conclusión: hubieran 64% de instrumentos no utilizados en las quirurgias analizadas. Es necesario implementar estrategias de gestión que reduzcan los números encontrados y, en consecuencia, reduzcan los gastos, para generar menos residuos y reducir las fallas en la gestión de los recursos materiales.

Pharmacokinetics and therapeutic target attainment of vancomycin in pediatric post-liver transplant patients

Abstract Introduction Vancomycin is widely prescribed to treat or prevent Gram-positive infections in pediatric liver transplant recipients. The objective of this prospective cohort study is to describe vancomycin pharmacokinetics and to evaluate the therapeutic target attainment after initial dose regimen. Materials and methods Patients with previous renal injury were excluded. Vancomycin therapy started with 40‒60 mg/kg/day. The pharmacokinetic parameters were assessed using two steady-state blood samples and the first-order kinetic equations. Therapeutic target was defined as vancomycin 24-hour Area Under the Curve/Minimum Inhibitory Concentration (AUC/MIC) ≥ 400 and < 600. Results Sixteen patients were included. The found vancomycin clearance, half-life, and volume of distribution were, respectively: 2.1 (1.3‒2.8) mL/kg/min, 3.3 (2.7‒4.4) hours, and 0.7 (0.5‒0.9) L/kg. With the initial dose, only 6 (37 %) patients reached the therapeutic target against Gram-positive pathogens with MIC 1 mg/L. After individual dose adjustments, all patients reached the target. The correlation between trough levels and AUC was low (R2= 0.5). Conclusions Pediatric patients with preserved renal function after liver transplantation have an increased volume of distribution for vancomycin, and most patients present subtherapeutic levels after the standard initial dosing regimen. With the vancomycin AUC-guided monitoring and dosing, it is possible to improve therapeutic target attainment.

Extracorporeal Membrane Oxygenation (ECMO) Training Program in A Pediatric Cardiac Intensive Care Unit: An 8-Year Single-Center Experience in Argentina

ABSTRACT Introduction: Extracorporeal membrane oxygenation (ECMO) for temporary cardiopulmonary support is one of the most intense and technologically complex therapies offered in medicine. It is a high-risk procedure that requires specific knowledge and technical skills to perform it with good results. Objective: The main goal of this study is to describe our extracorporeal membrane oxygenation (ECMO) training program based on the study of specialized nurses and physicians of a simulation teaching experience, conducted in a pediatric cardiac intensive care unit. The program was developed as a theoretical-practical course with final exam and annual maintenance training sessions, caring for ECMO patients, its implementation and results. Methods: A descriptive study for registered nurses, intensivists, and cardiac surgeons. A self-administered, anonymous, and voluntary survey was conducted to assess the long-term perception about the program. Demographic data to describe the population was required, and questions about satisfaction and confidence in acquired skills and competences were asked. A descriptive statistical analysis was performed; patient survival and complications were compared before and after ECMO program using chi-square test, and P<0.05 was considered statistically significant. Results: Twenty-four training courses were performed for 68 professionals. More than 88% of the professionals considered the course components to be adequate and complete; and 94% felt trained to manage the ECMO circuit. Most valued activities were workshops and clinical cases. Since the implementation of the training program, 88 patients were assisted, with a survival rate at discharge of 58%, higher than in the previous period (P=0.03). Conclusion: More than 80% of the professionals considered the workshops and simulations as the most useful components. Reliance on the circuit care was higher than in training problem scenarios. Since 2013 we assisted 88 patients on ECMO, with a survival rate at discharge of 58%, within international standards results.

Pautas para la delimitación y empleo de los resultados científicos en la investigación educativa / Guidelines for the delimitation and use of scientific results in educational research

RESUMEN Las investigaciones educativas ofrecen diversos productos de valor para la ciencia, que incluyen contribuciones de carácter teórico y práctico. A menudo resulta difícil para los investigadores rotular los aportes, diferenciarlos y establecer su tipicidad. Tales resultados involucran modelos, concepciones, sistemas, estrategias, metodologías y programas de intervención, entre los más comunes. Dada la importancia que ello reviste para maestrandos y doctorandos a la luz de las tesis que elaboran y por las exigencias que deben cumplir los investigadores y coordinadores de proyectos al redactar sus informes de investigación; el presente trabajo se propone caracterizar las principales contribuciones científicas derivadas de la investigación educativa, en función de la determinación de la naturaleza que identifica cada resultado y el establecimiento de sus particularidades. Se efectuó un muestreo de tesis doctorales en Ciencias Pedagógicas y Ciencias de la Educación predefendidas y defendidas en la provincia de Camagüey entre 2016 y 2021.

ABSTRACT Educational research offers various products of value for science, including contributions of a theoretical and practical nature. It is often difficult for researchers to label such contributions, differentiate them and establish their typicity. Such results involve models, conceptions, systems, strategies, methodologies and intervention programs, among the most common. Due to the importance that this has for master's and doctoral students in light of the theses they prepare and because of the requirements that researchers and project coordinators must meet when writing their research reports; The present work intends to characterize the main scientific contributions derived from educational research, based on the determination of the nature that identifies each result and the establishment of its particularities. A sampling of doctoral theses in Pedagogical Sciences and Educational Sciences pre-defended and defended in the province of Camagüey between 2016 and 2021 was carried out.

Estructura conceptual de la competencia afrontamiento en estudiantes de Licenciatura en Enfermería / Conceptual structure of coping skills in Bachelor of Nursing's students

RESUMEN Las características de los contextos asistenciales y la praxis de los profesionales de la Enfermería justifican la educación emocional. Sin embargo, en Cuba, la formación de estos profesionales enfatiza la adquisicion de habilidades y destrezas con escasa referencia a la formación de competencias socioemocionales. Estas competencias se dividen en cinco grupos que contienen otras de menor generalidad. Incluido en la regulación emocional se encuentra el afrontamiento, considerado paso inicial para la autoconfianza, el manejo de la incertidumbre, la adaptación a los cambios y la resiliencia. El presente trabajo describe conceptualmente la competencia afrontamiento, con el propósito de contribuir a su mayor comprensión e incentivar su formación en el contexto de la educación médica superior. Se proponen tres ejes procesuales, sus indicadores en términos de desempeños deseables y las evidencias requeridas.

ABSTRACT The characteristics of the healthcare contexts and the praxis of the Nursing professionals justify emotional education. However, in Cuba, the training of these professionals emphasizes the acquisition of skills and abilities with little reference to formation of socio-emotional competencies. These competencies are divided into five groups that contain others of lesser generality. Included in emotional regulation is coping, considered an initial step for self-confidence, managing the uncertainty, adaptation to changes and resilience. The work describes conceptually the competence coping, with the purpose of contributing to their greater understanding and encourage their training in the context of medical higher education. Three procedural axes are proposed, their indicators in terms of desirable performance and required evidence.

Monitoramento orientado pela área sob a curva da vancomicina em pacientes pediátricos / Vancomycin area under the curve-guided monitoring in pediatric patients

RESUMO Objetivo: Avaliar a probabilidade de atingir o alvo pela razão entre a área sob a curva e a concentração inibitória mínima de vancomicina em pacientes pediátricos após o esquema de dose empírica e demonstrar a aplicabilidade desse método para o monitoramento da vancomicina. Metódos: Foi realizado um estudo de coorte retrospectivo que incluiu pacientes pediátricos com função renal normal internados entre janeiro e dezembro de 2020. O modelo de um compartimento com cinética de primeira ordem foi utilizado para estimar os parâmetros farmacocinéticos, e a área sob a curva foi calculada pela regra do trapézio. O alvo terapêutico foi definido como a razão entre a área sob a curva e a concentração inibitória mínima ≥ 400 e < 600. O teste do qui-quadrado foi aplicado para comparar a probabilidade de atingir o alvo nos grupos etários, enquanto os parâmetros farmacocinéticos foram comparados pelo teste de Kruskal-Wallis com o teste de Dunn para análises post hoc. Consideraram-se significativos os valores de p < 0,05. Resultados: Foram analisados, no total, 42 pares de níveis de vancomicina de 17 pacientes inscritos neste estudo. Após a dose diária empírica de vancomicina, o alvo terapêutico foi atingido em cinco (29%) pacientes; quatro pacientes (24%) apresentavam razão entre a área sob a curva inicial supraterapêutica e o valor de concentração inibitória mínima (> 600mg.h/L) e oito (47%) tinham valores subterapêuticos (< 400mg.h/L). Os patógenos mais identificados foram Staphylococcus spp. (n = 7). Os níveis de vale e as áreas sob a curva mostraram valores moderados de correlação (R2 = 0,73). Um (6%) paciente apresentou lesão renal aguda. Conclusão: A maioria dos pacientes não atingiu o alvo terapêutico com esquema de dose empírica de vancomicina, e a implementação de dosagem baseada na área sob a curva usando duas medições de amostra permitiu ajustes de dose em tempo real com base nos parâmetros farmacocinéticos dos indivíduos.

ABSTRACT Objective: To assess the percentage of vancomycin area under the curve/minimum inhibitory concentration target attainment in pediatric patients after the empirical dose regimen and to demonstrate the applicability of this method for vancomycin monitoring. Methods: A retrospective cohort study was performed including pediatric patients with normal renal function admitted between January 2020 and December 2020. The one-compartment model with first-order kinetics was used to estimate the pharmacokinetic parameters, and the area under the curve was calculated by the trapezoidal rule. The therapeutic target was defined as area under the curve/minimum inhibitory concentration ≥ 400 and < 600. The Chi-squared test was applied to compare the percentage of target attainment over age groups, while the pharmacokinetic parameters were compared by the Kruskal-Wallis test with Dunn's test for post hoc analyses. We considered significant p-values < 0.05. Results: In total, 42 pairs of vancomycin levels were analyzed from 17 patients enrolled in this study. After empirical vancomycin daily dosing, the therapeutic target was achieved in five (29%) patients; four patients (24%) had a supratherapeutic initial area under the curve/minimum inhibitory concentration value (> 600mg.h/L), and eight (47%) patients had subtherapeutic values (< 400mg.h/L). The most identified pathogens were Staphylococcus spp. (n = 7). Trough levels and areas under the curve showed moderate correlation values (R2 = 0.73). Acute kidney injury occurred in one (6%) patient. Conclusion: Most patients did not reach the therapeutic target with a vancomycin empirical dose regimen, and the implementation of area under the curve-based dosing using two sample measurements allowed for real-time dose adjustments based on individuals' pharmacokinetic parameters.

Bacterial vaginosis, cervical Human Papillomavirus infection and cervical cytological abnormalities in adult women in Central Brazil: a cross-sectional study / Vaginose bacteriana, infecção cervical pelo Papilomavírus humano e anormalidades citológicas cervicais em mulheres adultas no Brasil Central: um estudo transversal

Bacterial vaginosis is the most common cause of vaginal discharge and occurs when there is an imbalance in the vaginal microbiota, predominantly composed of Lactobacillus spp. Human Papillomavirus is the most common sexually transmitted virus in the world. Persistent infection with high-risk Human Papillomavirus genotypes is the main cause of the development of cervical intraepithelial neoplasia and cervical cancer. Objective: To investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection and between bacterial vaginosis and cervical cytological abnormalities in adult women. Methods: Cross-sectional study carried out in a gynecology outpatient clinic of the public health network. A total of 202 women were included in the study and underwent gynecological examination with cervical specimen collection. Cervical cytopathological examinations and bacterioscopy by the Nugent method were performed to identify bacterial vaginosis, and PCR and reverse hybridization were carried out for Human Papillomavirus detection and genotyping. Bivariate analysis was performed to investigate the association between bacterial vaginosis and cervical Human Papillomavirus infection, and between bacterial vaginosis and cervical cytological abnormalities. The odds ratio was calculated, with the respective 95% confidence intervals (95%CI) and 5% significance level (p≤0.05). Results: The prevalence of bacterial vaginosis was 33.2% (67/202), the prevalence of cervical Human Papillomavirus infection was 38.6% (78/202) and the prevalence of cervical cytological abnormalities was 6.0% (12/202). Bivariate analysis showed no significant association between bacterial vaginosis and cervical Human Papillomavirus infection (OR 0.69; 95% CI 0.37­ 1.27; p=0.23), or between bacterial vaginosis and cervical cytological abnormalities (OR 0.65; 95%CI 0.17­2.50; p=0.54). Conclusion: In this study, bacterial vaginosis did not represent a risk factor for cervical Human Papillomavirus infection or for the presence of cervical cytological abnormalities in the investigated adult women.

A vaginose bacteriana é a causa mais comum de corrimento vaginal e ocorre quando há um desequilíbrio da microbiota vaginal, composta predominantemente de Lactobacillus spp. O papilomavírus humano é o vírus sexualmente transmissível mais comum no mundo. A infecção persistente com genótipos do papilomavírus humano de alto risco é a principal causa do desenvolvimento de neoplasias intraepiteliais cervicais e câncer de colo do útero. Objetivo: Investigar a associação entre vaginose bacteriana e infecção cervical pelo papilomavírus humano e entre vaginose bacteriana e anormalidades citológicas cervicais em mulheres adultas. Métodos: Estudo de corte transversal realizado em um ambulatório de ginecologia da rede pública de saúde. O total de 202 mulheres foi incluído no estudo e submetido ao exame ginecológico com coleta de espécime cervical. Foram realizados os exames citopatológicos cervicais, a bacterioscopia pelo método de Nugent para a identificação da vaginose bacteriana e reação em cadeia da polimerase e hibridização reversa para a detecção e genotipagem do papilomavírus humano. Análise bivariada foi realizada para investigar a associação entre vaginose bacteriana e infecção cervical pelo papilomavírus humano e entre vaginose bacteriana e anormalidades citológicas cervicais. Foi calculado o odds ratio, com os respectivos intervalos de confiança de 95% (IC95%) e nível de significância de 5% (p≤0,05). Resultados: A prevalência da vaginose bacteriana foi de 33,2% (67/202), a da infecção cervical pelo papilomavírus humano foi de 38,6% (78/202) e a de anormalidades citológicas cervicais foi de 6,0% (12/202). A análise bivariada não demonstrou associação significativa entre vaginose bacteriana e infecção cervical pelo papilomavírus humano (OR 0,69; IC95% 0,37­1,27; p=0,23), nem entre vaginose bacteriana e anormalidades citológicas cervicais (OR 0,65; IC95% 0,17­2,50; p=0,54). Conclusão: Neste estudo a vaginose bacteriana não representou um fator de risco para a infecção cervical pelo papilomavírus humano e nem para presença de anormalidades citológicas cervicais nas mulheres adultas investigadas

Living with an intestinal ostomy and urinary incontinence / Vivir con una estomía intestinal e incontinencia urinaria / Convivendo com estomia intestinal e a incontinência urinária

ABSTRACT Objective: to understand how aged people with intestinal ostomies experience this situation together with urinary incontinence. Method: a qualitative, descriptive and exploratory research study, developed with 77 aged individuals with intestinal ostomies assisted by the Unified Health System, in four municipalities from the Metropolitan Region of Florianópolis. Data collection was conducted using semi-structured interviews from October 2019 to February 2020. The theoretical framework used was Dorothéa Orem's Self-Care Theory and the data were submitted to content analysis, in its thematic modality. Results: the analysis allowed generating three thematic categories: 1) Feelings generated by the intestinal ostomy and urinary incontinence: acceptance, denial, fear, insecurity, constraints experienced due to the ostomy and to the urinary incontinence symptoms; 2) Lifestyle changes; and 3) Deficit in self-image. Conclusion: it was evidenced that, for most of the research participants, it is difficult to accept the experience of living with an intestinal ostomy and urinary incontinence, which generally produce negative feelings. However, the participants proved to be resilient and able to adapt to the changes in lifestyle. Many of these behaviors are due to the health professionals' important contribution in providing them the necessary attention, encouraging self-care strategies in both situations.

RESUMEN Objetivo: comprender de qué manera los ancianos con ostomías intestinales viven esta situación junto con la incontinencia urinaria. Método: investigación cualitativa, descriptiva y exploratoria, desarrollada con 77 ancianos con estomías intestinales atendidos por el Sistema Único de Salud en cuatro municipios de la Región Metropolitana de Florianópolis. La recolección de datos se realizó entre octubre de 2019 y febrero de 2020 por medio de entrevistas semiestructuradas. El marco de referencia teórico empleado fue la Teoría de Autocuidado de Dorothéa Orem; los datos se sometieron a análisis de contenido, en su modalidad temática. Resultados: el análisis permitió generar tres categorías temáticas: 1) Sentimientos generados por la estomía intestinal y por la incontinencia urinaria: aceptación, negación, miedo, inseguridad, restricciones experimentadas a raíz de la ostomía y de los síntomas de la incontinencia urinaria; 2) Cambios en el estilo de vida; y 3) Déficit en la imagen propia. Conclusión: se hizo evidente que a la mayoría de los participantes de la investigación les resulta difícil aceptar la vida con una estomía intestinal e incontinencia urinaria, que generalmente les provocan sentimientos negativos. Sin embargo, los participantes se mostraron resilientes y aptos para adaptarse a los cambios en el estilo de vida. Muchos de estos comportamientos se deben al importante aporte de los profesionales de la salud al brindarles la atención necesaria, estimulando estrategias de autocuidado en ambas situaciones.

RESUMO Objetivo: compreender como o idoso com estomia intestinal vivencia essa situação em conjunto com a incontinência urinária. Método: pesquisa qualitativa, descritiva e exploratória, desenvolvida junto a 77 idosos com estomia intestinal atendidos pelo Sistema Único de Saúde, em quatro municípios da Região Metropolitana de Florianópolis. A coleta de dados foi realizada de outubro/2019 a fevereiro/2020, por meio de entrevista semiestruturada. O referencial teórico utilizado foi a Teoria de Autocuidado de Dorothéa Orem; os dados foram submetidos à análise de conteúdo, na modalidade temática. Resultados: a análise permitiu a geração de três categorias temáticas: 1) sentimentos gerados pela estomia intestinal e pela incontinência urinária: aceitação, negação, medo, insegurança, constrangimentos vivenciados pela estomia e os sintomas da incontinência urinária; 2) alterações do estilo de vida; 3) déficit na autoimagem. Conclusão: evidenciou-se que para a maioria dos participantes da pesquisa é difícil aceitar a vivência com estomia intestinal e incontinência urinária, que geralmente lhes provocam sentimentos negativos. No entanto, os participantes mostraram-se resilientes e aptos a se adaptar às mudanças no estilo de vida. Muitos desses comportamentos se devem à importante contribuição dos profissionais da saúde em dar-lhes a necessária atenção, estimulando estratégias de autocuidado em ambas as situações.

Avaliação do risco de quedas entre pessoas com doença de Parkinson / Evaluación del riesgo de caídas en personas con enfermedad de Parkinson / Assessment of risk of falls in people with Parkinson's disease

RESUMO Objetivo identificar os fatores associados ao risco de quedas entre as pessoas com doença de Parkinson cadastradas na Associação Parkinson Santa Catarina. Método estudo transversal exploratório descritivo e de abordagem quantitativa, realizado com 53 pessoas cadastradas na Associação Parkinson Santa Catarina, no município de Florianópolis, Brasil, no período de junho a setembro de 2019. Foram aplicados questionário sociodemográfico, Escala de Hoehn e Yahr, Mini Exame do Estado Mental e Teste de Rastreio do Risco de Queda no Idoso. Os dados foram tabulados e analisados por meio do Sistema online de Ensino-Aprendizagem de Estatística SEstatNet®. Resultados foram identificados fatores de risco, como sexo, aumento da idade, redução da força muscular, instabilidade postural e diminuição da velocidade da marcha. Em relação aos estágios da doença, foi constatado que em todos houve piora da velocidade da marcha e o medo de cair é constante, aumentando com o agravamento da doença e o tempo de diagnóstico. Conclusão e implicações para a prática ao aprofundar o estudo do tema, o enfermeiro consegue compreender os acometimentos motores que levam à fragilização e à queda em pessoas com doença de Parkinson, elaborando estratégias para preveni-las.

RESUMEN Objetivo identificar los factores asociados al riesgo de caídas en personas con enfermedad de Parkinson registradas en la Asociación de Parkinson Santa Catarina. Método estudio descriptivo exploratorio transversal, con abordaje cuantitativo realizado con 53 personas registradas en la Asociación Parkinson Santa Catarina, en la ciudad de Florianópolis, Brasil, de junio a septiembre de 2019. Se aplicaron un cuestionario sociodemográfico, la Escala de Hoehn y Yahr, el Mini Examen del Estado Mental y la Prueba de Detección del Riesgo de Caídas en Ancianos. Los datos se tabularon y analizaron utilizando el Sistema en línea de enseñanza-aprendizaje de estadísticas SEstatNet®. Resultados se identificaron factores de riesgo como sexo, mayor edad, disminución de la fuerza muscular, inestabilidad postural y disminución de la velocidad de la marcha. En cuanto a las etapas de la enfermedad, se encontró que en todas ellas se produjo un empeoramiento de la velocidad de la marcha y el miedo a caer es constante, aumentando con el empeoramiento de la enfermedad y el momento del diagnóstico. Conclusión e implicaciones para la práctica al profundizar en el estudio del tema, el enfermero es capaz de comprender las deficiencias motoras que conducen a la fragilidad y caída en personas con enfermedad de Parkinson, ideando estrategias para prevenirlas.

ABSTRACT Objective to identify the factors associated with risk of falls among people with Parkinson's disease registered at the Parkinson Santa Catarina Association. Method this is a cross-sectional exploratory descriptive study with a quantitative approach, carried out with 53 people registered at the Parkinson Santa Catarina Association, in the city of Florianópolis, Brazil, from June to September 2019. Sociodemographic questionnaire, Hoehn and Yahr scale, Mini Mental State Examination and Simple Screening Test for Risk of Falls in the Elderly were applied. The data were tabulated and analyzed using the SEstatNet® Statistics Teaching-Learning Online System. Results risk factors were identified, such as sex, increased age, reduced muscle strength, postural instability and decreased gait speed. Regarding the stages of the disease, it was found that in all of them there was a worsening of gait speed and the fear of falling is constant, increasing with the worsening of the disease and diagnosis time. Conclusion and implications for practice by deepening the study of the topic, nurses are able to understand the motor impairments that lead to frailty and fall in people with Parkinson's disease, developing strategies to prevent them.

Simulación de intubación pediátrica con videolaringoscopio de bajo costo en contexto de pandemia por COVID-19 / Simulation of pediatric intubation using a low-cost videolaryngoscope in the setting of the COVID-19 pandemic

En pacientes con infección por SARS-CoV-2 la intubación endotraqueal es un procedimiento con riesgo elevado de contagio. La videolaringoscopia complementa la protección del profesional, pero los videolaringoscopios comerciales son caros y no siempre están disponibles en las terapias intensivas pediátricas argentinas. El objetivo fue describir la práctica de intubación en un modelo de cabeza de simulación de lactante con un videolaringoscopio artesanal de bajo costo.Quince pediatras sin experiencia previa con el dispositivo participaron de una práctica de intubación en una cabeza de simulación con un videolaringoscopio artesanal. El tiempo promedio del primer intento fue de 116,4 segundos (intervalo de confianza del 95 % [IC95 %]: 84,8-148,0) y, el del siguiente fue de 44,2 segundos (IC95 %: 27,7­60,6). El tiempo disminuyó de forma significativa en el segundo intento (p : 0,0001). El dispositivo permitió la intubación exitosa en todos los intentos acortando la duración del procedimiento en la segunda práctica

In patients with SARS-CoV-2 infection, endotracheal intubation is a procedure with a high risk for transmission. A videolaryngoscopy is a supplementary level of health care provider protection, but commercial videolaryngoscopes are expensive and not always available in pediatric intensive care units in Argentina. Our objective was to describe intubation practice using an infant head mannequin with a low-cost, handcrafted videolaryngoscope.Fifteen pediatricians with no prior experience using the device participated in an intubation practice in a head mannequin with a handcrafted videolaryngoscope. The average time for the first attempt was 116.4 seconds (95 % confidence interval [CI]: 84.8-148.0) and, for the second one, 44.2 seconds (95 % CI: 27.7-60.6). Time decreased significantly for the second attempt (p: 0.0001).A successful intubation was achieved with the device in all attempts, and the procedure duration decreased with the second practice

Estructura conceptual de la competencia intervención comunitaria desde el paradigma emancipador de autodesarrollo / Conceptual structure of community intervention competence from the emancipatory paradigm of self-development

RESUMEN Objetivo: El artículo que se presenta aporta como resultado científico la descripción de la estructura conceptual de la competencia intervención comunitaria desde el paradigma emancipador de autodesarrollo para su formación en el contexto universitario. Métodos: Los métodos del nivel teórico empleados fueron el histórico-lógico, analítico-sintético, inductivo-deductivo, sistémico-estructural-funcional y del nivel empírico, el análisis de documentos. Resultado: A partir de la sistematización teórica realizada resultó posible develar las particularidades de la competencia objeto de análisis que apuntan hacia su identificación. Se determinaron los problemas contextuales a los que da solución, los ejes procesuales que de ella se derivan, los criterios de desempeño y las evidencias requeridas. Además se proponen niveles y patrones de logro que facilitan su formación y evaluación por cada uno de sus ejes procesuales, constituyendo un valioso instrumento para el trabajo metodológico. Conclusión: La investigación constituye un antecedente teórico necesario para sustentar un modelo pedagógico conducente a la formación de la competencia intervención comunitaria como expresión de la pertinencia social de la universidad y calidad del desempeño profesional en este ámbito.

ABSTRACT Objective: The article that is presented provides as a scientific result the description of the conceptual structure of community intervention competence from the emancipatory paradigm of self-development for its training in the university context. Method: The theoretical level methods used were the historical-logical, analytical-synthetic, inductive-deductive, systemic-structural-functional and the empirical level, the analysis of documents. Results: From the theoretical systematization carried out, it was possible to reveal the particularities of the competence under analysis that point towards its identification. The contextual problems to which it gives a solution, the procedural axes that derive from it, the performance criteria and the required evidence were determined. In addition, levels and patterns of achievement are proposed that facilitate their formation and evaluation for each of their process axes, constituting a valuable instrument for methodological work. Conclusion: The research constitutes a necessary theoretical background to support a pedagogical model conducive to the formation of community intervention competence as an expression of the social relevance of the university and the quality of professional performance in this field.

Niveles de resiliencia en estudiantes de Estomatología en la Universidad de Ciencias Médicas de Camagüey / Resilience levels in Dentistry students at Camagüey University of Medical Sciences

RESUMEN Fundamento: la resiliencia es un proceso dinámico y en equilibrio que involucra la combinación e interacción de factores de riesgo y protección entre los atributos del individuo y su ambiente familiar, social y cultural, lo que posibilita superar adversidades de forma constructiva. Objetivo: determinar los niveles de resiliencia de los estudiantes de primer año de la carrera de Estomatología. Métodos: se realizó una investigación descriptiva y transversal en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Camagüey, entre enero-marzo de 2020. Se utilizaron métodos teóricos y empíricos para la fundamentación de la investigación y recogida de la información. Se aplicó la Escala de Resiliencia de 14 ítems de Wagnild (RS-14). Los datos fueron procesados utilizando la estadística descriptiva. Resultados: se constató que la mayoría de los educandos presentaban resiliencia entre baja y normal. En el sexo femenino predominaron los mayores niveles de resiliencia alta y normal, mientras que el masculino presentó los más bajos. Los que obtuvieron un nivel alto mostraron estar preparados para las adversidades y aquellos que poseían resiliencia normal indicaron sentirse seguros en los momentos difíciles. Entre ellos los que ingresaron por la vía preuniversitario presentaron un menor nivel de resiliencia. Conclusiones: se determinó el nivel de resiliencia de los estudiantes de primer año de la carrera Estomatología por su importancia para emprender nuevas estrategias para su desarrollo, lo cual facilitaría una mejor calidad de vida de los estudiantes en el contexto universitario.

ABSTRACT Background: resilience is a dynamic and balanced process that involves the combination and interaction of risk and protection factors, that is, between the attributes of the individual and family, social and cultural environment, which enables them to overcome risk and adversity constructively. Objective: to determine the levels of resilience of the first year students of the dentistry degree. Methods: a descriptive and cross-sectional investigation was carried out at the Dentistry Faculty of Camagüey University of Medical Sciences, from January to March 2020. Theoretical and empirical methods were used to support the research and collect the information. Wagnild's 14-item Resilience Scale (RS-14) was applied. The data were processed using descriptive statistics. Results: It was found that most of the students presented resilience between low and normal. In the female sex, the highest levels of high and normal resilience predominated, while the male one presented the lowest. Those who obtained a high level showed to be prepared for adversity and those who possessed normal resilience indicated feeling safe in difficult times. Among them, those who entered through the pre-university presented a lower level of resilience. Conclusions: the level of resilience of the first-year students of the Dentistry degree was determined due to its importance in the individual adaptation of the students.

Incidência de dengue e indicadores socioeconômicos e entomológicos em Santos, São Paulo, 2012-2016 / Incidence of dengue and socioeconomic and entomological indicators in Santos, São Paulo State, 2012-2016 / Incidência de dengue e indicadores socioeconómicos y entomológicos en Santos, Estado De São Paulo, 2012-2016

Objetivo: descrever incidência de dengue em Santos/SP e relacionar coeficiente de incidência (CI) de dengue com indicadores socioeconômicos e entomológicos de 2012-2016. Método: estudo epidemiológico, descritivo, ecológico dos casos confirmados de dengue, residentes em Santos, de 2012-2016, do Sistema de Informação de Agravos de Notificação-Online; foram obtidos seis indicadores socioeconômicos da base de setores censitários do Instituto Brasileiro de Geografia e Estatística-2010; o sétimo do Índice Paulista de Vulnerabilidade Social-2010 e os indicadores entomológicos da Secretaria de Saúde; foi aplicada Correlação bivariada de Spearman (SPSS-Statistics®). Aprovado pelo Comitê de Ética em Pesquisa-CAAE nº79776017.1.0000.5479. Resultados: de 2012-2016 ocorreram 16.451 casos, com CI de 117,4 (2012) a 2.122,8 (2013) casos/100.000 habitantes, maior no sexo feminino e de 15-29 anos; os fatores socioeconômicos foram mais significativos entre 2015-2016; o Índice de Densidade de fêmeas Aedes aegypti apresentou maior correlação positiva. Conclusão: descreveu-se perfil epidemiológico/entomológico da dengue, apoiando gestores nas ações locais de controle.(AU)

Objectives: describe incidence of dengue in Santos/SP and relate dengue incidence coefficient (IC) with socioeconomic and entomological indicators from 2012-2016. Methods: epidemiological, descriptive, ecological study of confirmed cases of dengue, resident in Santos, from 2012-2016, of the Online-Notifiable Diseases Information System; six socioeconomic indicators were obtained from census sectors base of Brazilian Institute of Geography and Statistics-2010; the seventh from the São Paulo Index of Social Vulnerability-2010 and the entomological indicators from the Health Department; Spearman's Bivariate Correlation (SPSS-Statistics®) was applied. Approved by the Research Ethics Committee-CAAE nº79776017.1.0000.5479. Results: from 2012-2016 there were 16.451 cases, with IC from 117,4 (2012) to 2.122,8 (2013) cases/100.000 inhabitants, higher in females and between 15-29 years old; socioeconomic factors were more significant between 2015-2016; the Density Index of Aedes aegypti females showed a greater positive correlation. Conclusion: epidemiological/entomological profile of dengue was described, supporting managers in local control actions.(AU)

Objetivos: describir incidencia del dengue en Santos/SP y relacionar coeficiente de incidencia (CI) del dengue con indicadores socioeconómicos y entomológicos para 2012-2016. Métodos: estudio epidemiológico, descriptivo, ecológico de casos confirmados de dengue, residentes en Santos, desde 2012-2016, del Sistema de Información de Enfermedades de Notificación-Online; obtuvieron-se seis indicadores socioeconómicos desde base de sectores censales del Instituto Brasileño de Geografía y Estadística-2010, el séptimo del Índice de Vulnerabilidad Social de São Paulo-2010 y los indicadores entomológicos del Departamento de Salud. Aplicó-se Correlación Bivariada de Spearman (SPSS-Statistics®). Aprobado por el Comité de Ética en Investigación-CAAE nº79776017.1.0000.5479. Resultados: desde 2012-2016 hubo 16.451 casos, con CI de 117,4 (2012) a 2.122,8 (2013) casos/100.000 habitantes, mayor en mujeres y de 15-29 años; los factores socioeconómicos fueron más significativos entre 2015-2016; el Índice de Densidad de hembras Aedes aegypti mostró mayor correlación positiva. Conclusión: describió-se perfil epidemiológico/entomológico del dengue, apoyando a los gerentes en acciones de control local.(AU)

Dementia in institutionalized elderly: a nursing team's experiences and perceptions / Ancianos con demencia institucionalizados: vivencias y percepciones del equipo de enfermería / Idosos com demência institucionalizados: vivências e percepções da equipe de enfermagem

ABSTRACT Objective: to understand nursing workers' experiences with the nursing care provided to elderly individuals with dementia living in a long-term care facility. Method: comprehensive qualitative study conducted in a long-term care facility located in Joinville, Santa Catarina, Brazil, from July to September 2018. Thirteen nursing technicians and one nurse participated. Data were collected using questionnaires, field diaries, individual interviews, and participatory observation. Thematic content analysis was used to interpret content. Results: three themes emerged from data analysis: "Knowledge acquired with practice and gap existing in the care provided to institutionalized elderly individuals with dementia"; "Individualized care provided to elderly individuals and bonding"; and "Conflicts the nursing staff faces when reconciling care needs, the time available, and the facility's routines". These themes originated the central theme: Meanings assigned to the nursing care provided to institutionalized elderly individuals with dementia. By sharing information regarding care actions that obtained positive results, the staff perceived the importance of an individualized approach and of establishing bonds as a therapeutic process. Gaps were identified in the professionals' knowledge regarding how to provide hygiene care when individuals become aggressive, agitated, or resist care. Conclusion: health workers' experience is a source of evidence for evidence-based practice and is also essential to fill in existing gaps between knowledge and care delivery.

RESUMEN Objetivo: comprender las vivencias de los profesionales de enfermería acerca del cuidado de enfermería para ancianos con demencia, residente en institución de larga permanencia. Método: investigación cualitativa de abordaje comprensivo, desarrollado en una institución de larga permanencia para ancianos, en el Municipio de Joinville, estado de Santa Catarina, en el período de julio a septiembre de 2018. Participaron de la investigación 13 técnicos de enfermería y una enfermera. Para la recolección de datos fueron aplicados cuestionarios, diarios de asistencia, entrevistas individuales y observación participante. Para el análisis de contenido se utilizó el método de análisis temático. Resultados: del análisis de los datos surgieron tres temas principales: "El conocimiento adquirido con la práctica y el vacío existente en el cuidado al anciano con demencia institucionalizado"; "El cuidado al anciano en su individualidad y la construcción del vínculo"; y, "Los conflictos del equipo de enfermería entre el cuidado necesario, el tiempo para el cuidado y las rutinas de la institución", los cuales dieron origen a la temática principal: significados del cuidado de enfermería para el anciano con demencia institucionalizado. Al compartir informaciones sobre los cuidados con resultados positivos, el equipo percibió la importancia del abordaje individualizado al anciano; de este surgió el establecimiento del vínculo como proceso terapéutico. Se constató un vacío de conocimiento en los profesionales sobre cómo prestar cuidados de higiene y confort, cuando los ancianos se mostraban agresivos, agitados y resistentes. Conclusión: la experiencia de los profesionales de la salud es considerada una fuente de evidencias en la práctica basada en evidencias, condición importante, también en el proceso de disminuir el vacío entre el conocimiento y la asistencia prestada.

RESUMO Objetivo: compreender as vivências dos profissionais de enfermagem acerca do cuidado de enfermagem ao idoso com demência, residente em instituição de longa permanência. Método: pesquisa qualitativa, de abordagem compreensiva, desenvolvida em instituição de longa permanência para idosos, no Município de Joinville, Santa Catarina, no período de julho a setembro de 2018. Participaram da pesquisa 13 técnicos de enfermagem e uma enfermeira. Para a coleta de dados foram aplicados questionários, diários de assistência, entrevistas individuais e observação participante. Para a análise de conteúdo utilizou-se o método de análise temática. Resultados: da análise de dados emergiram três temas principais: "O conhecimento adquirido com a prática e a lacuna existente no cuidado ao idoso com demência institucionalizado", "O cuidado ao idoso em sua individualidade e a construção do vínculo" e "Os conflitos da equipe de enfermagem entre o cuidado necessário, tempo para o cuidado e as rotinas da instituição", os quais deram origem à temática principal: Significados do cuidado de enfermagem ao idoso com demência institucionalizado. Ao compartilhar informações sobre os cuidados com resultados positivos, a equipe percebeu a importância da abordagem individualizada ao idoso e, desta, o estabelecimento do vínculo como processo terapêutico. Constatou-se lacuna de conhecimento dos profissionais sobre como prestar cuidados de higiene e conforto quando os idosos se mostravam agressivos, agitados e resistentes. Conclusão: a experiência dos profissionais de saúde é considerada fonte de evidências na prática baseada em evidências, condição importante também no processo de diminuir a lacuna entre o conhecimento e a assistência prestada.