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Long-term oxygen therapy (LTOT) reduces hypoxaemia and mitigate systemic alterations in chronic obstructive pulmonary disease (COPD), however, it is related to inactivity and social isolation. Social participation and its related factors remain underexplored in individuals on LTOT. This study investigated social participation in individuals with COPD on LTOT and its association with dyspnoea, exercise capacity, muscle strength, symptoms of anxiety and depression, and quality of life. The Assessment of Life Habits (LIFE-H) assessed social participation. The modified Medical Research Council dyspnoea scale, the 6-Minute Step test (6MST) and handgrip dynamometry were used for assessments. In addition, participants responded to the Hospital Anxiety and Depression Scale (HADS) and the Chronic Respiratory Questionnaire (CRQ). Correlation coefficients and multivariate linear regression analyses were applied. Fifty-seven participants with moderate to very severe COPD on LTOT were included (71 ± 8 years, FEV1: 40 ± 17%predicted). Social participation was associated with dyspnoea (rs=-0.46, p < 0.01), exercise capacity (r = 0.32, p = 0.03) and muscle strength (r = 0.25, p = 0.05). Better participation was also associated with fewer depression symptoms (rs=-0.40, p < 0.01) and a better quality of life (r = 0.32, p = 0.01). Dyspnoea was an independent predictor of social participation (p < 0.01) on regression models. Restricted social participation is associated with increased dyspnoea, reduced muscle strength and exercise capacity. Better participation is associated with fewer depression symptoms and better quality of life in individuals with COPD on LTOT.
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Enfermedad Pulmonar Obstructiva Crónica , Disnea/etiología , Disnea/terapia , Fuerza de la Mano , Humanos , Oxígeno , Terapia por Inhalación de Oxígeno , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Calidad de Vida , Participación SocialRESUMEN
OBJECTIVE: The objectives of this study were to translate and cross-culturally adapt the telehealth usability questionnaire into Brazilian Portuguese and to evaluate its psychometric properties. METHODS: This was a methodological validation study carried out in two phases. In phase 1, the telehealth usability questionnaire was cross-culturally adapted with 10 participants comprising the expert committee members, including 5 healthcare professionals with theoretical and practical knowledge of telehealth, 1 methodologist, and 4 translators. This phase was performed at Universidade Federal de Juiz de Fora Physiotherapy Clinic School. In phase 2, the psychometric properties of telehealth usability questionnaire Brazil were analyzed. This phase included in-person assessments at Márcio Cunha Hospital, Minas Gerais. The recruitment period for both phases was from April 2020 to February 2021. Content validity, reliability, internal consistency, and criterion validity were analyzed. The criterion validity was evaluated using correlation with a validated instrument: the system usability scale. RESULTS: The telehealth usability questionnaire was adequately translated and cross-culturally adapted. The telehealth usability questionnaire Brazil presented an excellent content validity index of 0.96 with percentages of understanding higher than 90%. The telehealth usability questionnaire Brazil demonstrated great internal consistency (α=0.94 and ω=0.94), excellent intra-rater reliability (intraclass correlation coefficient=0.85, 95%CI 0.75-0.91), no difference between the test and retest [T (0.425), p>0.673], and no proportional bias (p=0.205). There was a moderate correlation between telehealth usability questionnaire Brazil and the system usability scale (r=0.52, p<0.0001). CONCLUSION: The telehealth usability questionnaire was adequately translated and cross-culturally adapted into Brazilian Portuguese and showed adequate psychometric properties for use in telehealth clinical practice and research in Brazilian-Portuguese-speaking individuals.
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Comparación Transcultural , Telemedicina , Humanos , Brasil , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , TraduccionesRESUMEN
BACKGROUND: Fatigue is a common symptom in patients with inflammatory bowel diseases (IBD). A translated and culturally adapted, instrument with robust psychometric for measuring fatigue in Brazilian patients with IBD is needed. OBJECTIVE: To translate and cross-culturally adapt the inflammatory Bowel Disease Fatigue Scale (IBD-F) into Brazilian-Portuguese and to test its measurement properties in Brazilian patients with IBD. METHODS: Data from 123 patients with IBD were collected. In addition to IBD-F, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) was used. The measurement properties tested were: internal consistency, reproducibility (reliability and agreement), construct validity, internal and external responsiveness, and ceiling and floor effects. RESULTS: The Brazilian-Portuguese version of the IBD-F showed excellent internal consistency (Cronbach's alpha of 0.95), excellent reproducibility (ICC=0.97) and a minimal detectable change of 6.0 points. The construct validity was demonstrated with a good correlation between the IBD-F and FACIT-F (r=- 0.46). Effect sizes used for measuring internal responsiveness were moderate among those with Crohn's (0.66) disease and low in patients with ulcerative colitis (0.24). The Brazilian-Portuguese version of the IBD-F presented with high external responsiveness for Crohn's disease (0.84) and with low external responsiveness for ulcerative colitis (0.33). The area under the curve considered for responsiveness was 0.84. Twenty-five percent of floor effects and no ceiling effect were recorded. CONCLUSION: The Brazilian-Portuguese version of IBD-F has adequate measurement properties and its use can be recommended in clinical practice and research.
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Colitis Ulcerosa/complicaciones , Enfermedad de Crohn/complicaciones , Fatiga/diagnóstico , Fatiga/etiología , Autoevaluación (Psicología) , Encuestas y Cuestionarios , Brasil , Comparación Transcultural , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , TraduccionesRESUMEN
SUMMARY OBJECTIVE: The objectives of this study were to translate and cross-culturally adapt the telehealth usability questionnaire into Brazilian Portuguese and to evaluate its psychometric properties. METHODS: This was a methodological validation study carried out in two phases. In phase 1, the telehealth usability questionnaire was cross-culturally adapted with 10 participants comprising the expert committee members, including 5 healthcare professionals with theoretical and practical knowledge of telehealth, 1 methodologist, and 4 translators. This phase was performed at Universidade Federal de Juiz de Fora Physiotherapy Clinic School. In phase 2, the psychometric properties of telehealth usability questionnaire Brazil were analyzed. This phase included in-person assessments at Márcio Cunha Hospital, Minas Gerais. The recruitment period for both phases was from April 2020 to February 2021. Content validity, reliability, internal consistency, and criterion validity were analyzed. The criterion validity was evaluated using correlation with a validated instrument: the system usability scale. RESULTS: The telehealth usability questionnaire was adequately translated and cross-culturally adapted. The telehealth usability questionnaire Brazil presented an excellent content validity index of 0.96 with percentages of understanding higher than 90%. The telehealth usability questionnaire Brazil demonstrated great internal consistency (α=0.94 and ω=0.94), excellent intra-rater reliability (intraclass correlation coefficient=0.85, 95%CI 0.75-0.91), no difference between the test and retest [T (0.425), p>0.673], and no proportional bias (p=0.205). There was a moderate correlation between telehealth usability questionnaire Brazil and the system usability scale (r=0.52, p<0.0001). CONCLUSION: The telehealth usability questionnaire was adequately translated and cross-culturally adapted into Brazilian Portuguese and showed adequate psychometric properties for use in telehealth clinical practice and research in Brazilian-Portuguese-speaking individuals.
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Introdução: A doença pulmonar obstrutiva crônica (DPOC) possui alta prevalência e gera altos custos aos sistemas de saúde. A reabilitação pulmonar (RP) é uma intervenção não-farmacológica que gera benefícios clínicos para os pacientes e economia de gastos para o sistema de saúde devido a redução do número de exacerbações da doença e internações hospitalares. Embora fortemente recomendada, a RP tem sido subutilizada havendo um baixo índice de indicações. Objetivo: Identificar as barreiras e os facilitadores para o encaminhamento de pacientes com DPOC à RP e à prática de atividade física. Métodos: Estudo qualitativo, realizado com médicos atuantes na atenção primária à saúde (APS) e uso de entrevistas semiestruturadas. As entrevistas foram gravadas e transcritas literalmente e submetidas a análise de conteúdo. Itens (trechos) identificados nos discursos e relacionados ao encaminhamento de pacientes com DPOC à RP e à prática de atividade física foram classificados como barreiras ou facilitadores. Tal classificação se baseou entre os quatorze domínios da Theoretical Domains Framework (TDF) e suas definições para identificar determinantes de comportamento entre os participantes relevantes para a mudança na prática clínica. Resultados: Setecentos e cinquenta e seis itens foram identificados nos discursos de vinte e um participantes e classificados como sendo barreiras (n= 279, 37%) ou facilitadores (n= 477, 63%) relacionados principalmente aos domínios da TDF de "Conhecimento" (n= 245, 32%), "Contexto e recursos ambientais" (n= 124, 16%) e "Papel e identidade social/profissional" (n= 107, 14%). Conclusão: As principais barreiras identificadas foram relacionadas aos programas de RP devido ao conhecimento restrito dos profissionais médicos sobre programas de RP, a disponibilidade reduzida de locais que oferecem estes programas e as dificuldades de acesso dos pacientes à RP. Os principais facilitadores identificados foram relacionados a orientação e o conhecimento pelos médicos sobre os benefícios da atividade física e a presença dos grupos de exercícios fornecidos na APS.
Introduction: Chronic obstructive pulmonary disease (COPD) has a high prevalence and entails high costs to health systems. Pulmonary rehabilitation (PR) is a non-pharmacological intervention that generates clinical benefits for patients and cost savings for the health system due to a reduced number of exacerbations and hospitalizations. Although strongly recommended, PR has been underutilized, with a low rate of indications. Objective: To identify barriers and facilitators for referring patients with COPD to PR and physical activity. Method: Qualitative study was carried out with medical staff working in primary health care using semi-structured interviews. The interviews were recorded, transcribed literally and underwent content analysis. Items (text excerpts) identified in the speeches and related to the referral of patients with COPD to PR and physical activity were classified according to as barriers or facilitators, and among the fourteen domains of the Theoretical Domains Framework (TDF) and its definitions; aiming to identify the determinants of behaviour which were relevant to change in clinical practice. Results: Seven hundred and fifty-six items were identified in the speeches of twenty-one participants and classified as barriers (n= 279, 37%) or facilitators (n= 477, 63%) mainly related to the TDF domains of "Knowledge" (n= 245, 32%), "Context and environmental resources" (n=124, 16%) and "Role and social/professional identity" (n= 107, 14%). Conclusion: The main barriers identified were related to referring patients PR due to lack of knowledge by medical staff about PR programs, the limited number of programs available, and the restricted access to PR program locations. The main facilitators were related to physical activity, mainly the medical staff's knowledge on physical activity benefits and availability of exercise group activities delivered at primary health care centres.
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Enfermedad Pulmonar Obstructiva Crónica , Atención Primaria de Salud , Rehabilitación , Ejercicio Físico , Prevalencia , Recursos en SaludRESUMEN
Abstract Introduction: The Six-Minute Walk Test (6MWT) is widely used to assess functional capacity in children. The measure of work during 6MWT can add important information to the 6MWT assessment in this population as it relates to walking efficiency. Objective: To verify the determinants of work during the Six-Minute Walk Test (6MWTwork) in school-aged children. Method: This is a cross-sectional and exploratory study that included healthy children recruited from the public and private schools of the cities of Belo Horizonte and Uberlândia, Brazil. The inclusion criteria were: children aged 7 to 12 years without diagnosis of chronic cardiorespiratory disease, cognitive, behavioral disorder or physical function impairment (information obtained through self-report of those responsible for children). Exclusion criteria were children who refused to perform the 6MWT; who did not understand the 6MWT or who did not answer the test commands. Three hundred and nineteen school-aged children were included in the study. Correlation analyses and multiple linear regression analysis were used to identify the variables associated with the 6MWTwork. Results: Age, height, nutritional status, physical activity and heart rate showed significant correlation with 6MWTwork (p <0.001) and explained 87% of its variation (p = 0.0001). Conclusion: Age, height, nutritional status and heart rate variation are determinants of 6MWTwork that is able to evaluate functional capacity of school-aged children.
Resumo Introdução: O teste de caminhada de seis minutos (TC6min) é amplamente utilizado para avaliar a capacidade funcional em crianças. A medida do trabalho durante o TC6 poderia adicionar informações importantes à avaliação do TC6 nessa população, no que se refere à eficiência da marcha. Objetivo: Verificar os determinantes do trabalho durante o Teste de Caminhada (TC6min) em crianças em idade escolar. Método: Trata-se de um estudo transversal e exploratório que incluiu crianças saudáveis recrutadas nas escolas públicas e privadas das cidades de Belo Horizonte e Uberlândia, Brasil. Os critérios de inclusão foram: crianças de 7 a 12 anos sem diagnóstico de doença cardiorrespiratória crônica, distúrbio cognitivo, comportamental ou comprometimento da função física (informações obtidas por auto-relato dos responsáveis pelas crianças). Os critérios de exclusão foram: crianças que se recusaram a realizar o TC6; que não entenderam o TC6 ou que não responderam aos comandos de teste. Trezentos e dezenove crianças em idade escolar foram incluídas no estudo. Análises de correlação e análise de regressão linear múltipla foram utilizadas para identificar as variáveis associadas ao trabalho com TC6. Resultados: Idade, altura, estado nutricional, atividade física e frequência cardíaca apresentaram correlação significativa com o trabalho durante o TC6min (p <0,001) e explicaram 87% de sua variação (p = 0,0001). Conclusão: Idade, altura, estado nutricional e variação da frequência cardíaca são determinantes do trabalho no TC6, e portanto, devem ser considerados na avaliação da capacidade funcional de crianças em idade escolar.
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ABSTRACT BACKGROUND: Fatigue is a common symptom in patients with inflammatory bowel diseases (IBD). A translated and culturally adapted, instrument with robust psychometric for measuring fatigue in Brazilian patients with IBD is needed. OBJECTIVE: To translate and cross-culturally adapt the inflammatory Bowel Disease Fatigue Scale (IBD-F) into Brazilian-Portuguese and to test its measurement properties in Brazilian patients with IBD. METHODS: Data from 123 patients with IBD were collected. In addition to IBD-F, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) was used. The measurement properties tested were: internal consistency, reproducibility (reliability and agreement), construct validity, internal and external responsiveness, and ceiling and floor effects. RESULTS: The Brazilian-Portuguese version of the IBD-F showed excellent internal consistency (Cronbach's alpha of 0.95), excellent reproducibility (ICC=0.97) and a minimal detectable change of 6.0 points. The construct validity was demonstrated with a good correlation between the IBD-F and FACIT-F (r=- 0.46). Effect sizes used for measuring internal responsiveness were moderate among those with Crohn's (0.66) disease and low in patients with ulcerative colitis (0.24). The Brazilian-Portuguese version of the IBD-F presented with high external responsiveness for Crohn's disease (0.84) and with low external responsiveness for ulcerative colitis (0.33). The area under the curve considered for responsiveness was 0.84. Twenty-five percent of floor effects and no ceiling effect were recorded. CONCLUSION: The Brazilian-Portuguese version of IBD-F has adequate measurement properties and its use can be recommended in clinical practice and research.
RESUMO CONTEXTO: A fadiga é um sintoma comum em pacientes com doenças inflamatórias intestinais (DII). Um instrumento de avaliação de fadiga traduzido, culturalmente adaptado e com psicometria robusta para medir a fadiga em pacientes brasileiros com DII é necessário. OBJETIVO: Traduzir e adaptar culturalmente a Inflammatory Bowel Disease Fatigue Scale (IBD-F) para o português do Brasil e testar suas propriedades de medida em pacientes brasileiros com DII. MÉTODOS: Foram coletados dados de 123 pacientes com DII. Além do IBD-F, foi utilizada a Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). As propriedades de medida testadas foram: consistência interna, reprodutibilidade (confiabilidade e concordância), validade de construto, responsividade interna e externa e efeitos teto e chão. RESULTADOS: A versão em português do IBD-F mostrou excelente consistência interna (alfa de Cronbach de 0,95), excelente reprodutibilidade (ICC=0,97) e uma diferença mínima detectável de 6,0 pontos. A validade do construto foi demonstrada por meio de uma boa correlação entre o IBD-F Brasil e o FACIT-F (r= -0,46). Na análise de responsividade interna, os tamanhos de efeito obtidos foram moderado entre aqueles com doença de Crohn (0,66) e baixo em pacientes com colite ulcerativa (0,24). O IBD-F Brasil apresentou alta responsividade externa entre aqueles com doença de Crohn (0,84) e baixa responsividade externa em pacientes colite ulcerativa (0,33). A área sob a curva considerada para responsividade foi de 0,84. Foram registrados 25% de efeito chão e nenhum efeito teto nas avaliações realizadas. CONCLUSÃO: O IBD-F Brasil possui propriedades de medida adequadas e seu uso pode ser recomendado na prática clínica e na pesquisa em pacientes com DII.
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Humanos , Masculino , Femenino , Autoevaluación (Psicología) , Colitis Ulcerosa/complicaciones , Enfermedad de Crohn/complicaciones , Encuestas y Cuestionarios , Fatiga/diagnóstico , Fatiga/etiología , Psicometría , Traducciones , Índice de Severidad de la Enfermedad , Brasil , Comparación Transcultural , Reproducibilidad de los Resultados , Persona de Mediana EdadRESUMEN
Introdução: A asma é uma doença respiratória caracterizada por sintomas como sibilo à ausculta pulmonar, dispneia e tosse, causados por limitação variável ao fluxo aéreo expiratório. A prática de atividades física pode auxiliar o controle da doença. Objetivo: Investigar o nível de atividade física de asmáticos adultos, e como estes indivíduos reportam receber orientação dos profissionais de saúde quanto à realização de atividade física. Método: Este estudo de métodos mistos foi realizado com indivíduos asmáticos, com idade superior a 18 anos. Os participantes realizaram teste de função pulmonar, responderam questionários sobre atividade física e entrevista semiestruturada. A entrevista foi realizada com questões voltadas ao tema central da pesquisa, as respostas foram transcritas de forma literal e analisadas por meio de metodologia da análise de conteúdo. Resultados: Vinte e cinco indivíduos participaram do estudo, a maioria do sexo feminino (n = 18; 72,0%) e idade média de 36 anos. A maioria dos indivíduos eram "irregularmente ativos" dos tipos A e B (n = 13; 52,0%). Foram identificados sete temas principais nos discursos: "conhecimento sobre os efeitos da atividade física regular" (n = 23; 92,0%), "atividade física específica para pacientes asmáticos" (n = 21; 84,0%), e "influência da orientação de um profissional de saúde" (n = 20; 80,0%). Conclusão: Os indivíduos asmáticos reportaram receber orientações dos profissionais de saúde quanto aos benefícios da prática regular de atividade física. Porém, estas informações podem ser insuficientes quanto ao tipo e frequência dos exercícios, modalidades apropriadas, manejo de possíveis sintomas durante ou após a prática da atividade e como preveni-los. Orientações adequadas sobre a prática da atividade regular para indivíduos asmáticos podem contribuir para o automanejo da doença.
Introduction: Asthma is a respiratory disease characterized by symptoms of wheezing, dyspnea, and cough, caused by some degree of limitation to expiratory airflow. Engagement in regular physical activity can help control the disease. Objective: To assess physical activity levels in asthmatic adults and to investigate how these individuals report guidance received from health professionals regarding physical activity. Method: This mixed-methods study included asthmatic adults aged 18 years or over. Participants underwent pulmonary function tests, completed physical activity questionnaires, and did a semistructured interview. The interview consisted of questions focused on the central topic of interest, and responses were transcribed literally and then analyzed using content analysis methods. Results: Twenty-five individuals participated in the study, most were female (n=18; 72.0%), and mean age was 36 years. Most individuals were classified as "irregularly active" (n=8; 32.0%). Seven main topics were identified in content analysis, including "knowledge about the effects of regular physical activity" (n=23; 92.0%), "specific physical activity for asthmatic patients" (n=21; 84.0%), and "influence of guidance from a health professional" (n=20; 80.0%). Conclusion: Asthmatic individuals reported having received guidance from health professionals regarding the benefits of engagement in regular physical activity. However, there is insufficient information regarding type and frequency of exercise, appropriate modalities, and management of possible symptoms during or after the activity and how to prevent them. Adequate guidance on regular activity for asthmatic individuals may contribute to self-management of the disease.
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Humanos , Asma , Ejercicio Físico , Personal de Salud , Orientación , Pacientes , Enfermedades Respiratorias , Encuestas y CuestionariosRESUMEN
OBJECTIVE: This study established the incidence and primary causes of unplanned extubation in newborns in the neonatal intensive care units of the Hospital Sofia Feldman, Belo Horizonte (Minas Gerais). METHODS: This retrospective study was conducted between July 1, 2009 and April 30, 2010. Unplanned extubations and their primary causes were assessed using an adverse events form. The following variables were assessed: gender, corrected age, present weight, duration of mechanical ventilation time, and motives/causes of the event on the day of the unplanned extubation event. RESULTS: Fifty-four unplanned extubations occurred, which corresponded to an incidence of 1.0 event/100 days of mechanical ventilation. This rate was higher among newborns with a corrected age of 30 to 36 weeks and weight < 1,000 g. The primary causes of unplanned extubations included patient agitation, inappropriate handling of patients during the performance of procedures, and inappropriate fixation and positioning of the endotracheal tube. CONCLUSION: The incidence of unplanned extubation in the investigated neonatal intensive care units was low during the study period compared to previously reported data. Nevertheless, the assessment of the quality of procedures, the continuous follow-up of newborns, and the monitoring of the causes of extubation are required to further reduce this incidence.
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Objetivo: investigar a atuação do enfermeiro no cuidado ao recém-nascido nas unidades neonataisdiante desse novo modelo de equipe. Métodos: estudo transversal e descritivo do qual participaram 53 enfermeiros que atuam na assistência ao recém-nascido na Unidade de Terapia Intensiva e na Unidade de Cuidado Intermediário Neonatal. Resultados: a maior parte dos profissionais é de dedicação profissional exclusiva; e apenas uma pequena parte é especialista em neonatologia (18,87%).Destacaram-se a vontade dos profissionais em participar de procedimentos como inserção de Cateter Central de Inserção Periférica (31,88%) e a participação nas discussões de casos com a equipe multiprofissional (15,94%). Grande parte dos profissionais (92,4%) acredita que esse modelo pode melhorar a qualidade da assistência. Conclusão: a literatura é escassa sobre esse tipo de modelo assistencial de enfermagem no Brasil. Esta pesquisa registrou a atuação do profissional enfermeiro nesse novo arranjo de equipe...
Objective: to investigate the role of nurses in the care of newborns in neonatal units, before this newteam model. Methods: descriptive study which was attended by 53 nurses working in the care of thenewborn in the Intensive Care Unit and Neonatal Care Unit Intermediate. Results: the most of the professionals is the exclusive professional dedication; and only a small portion specializes in neonatology (18.87%). They stood out the will of professionals to participate in procedures such as insertion ofCentral Catheters Peripherally Inserted (31.88%) and participation in case discussions with the multidisciplinary team (15.94%). Much of the professionals (92.4%) believe that this model can improvethe quality of care. Conclusion: the literature is scarce on this type of care model of nursing in Brazil.This survey recorded the role of the professional nurse in this new team arrangement...
Objetivo: investigar el papel de las enfermeras en el cuidado de los recién nacidos en las unidades neonatales, antes de que este nuevo modelo de equipo. Métodos: se trata de un estudio descriptivo a la que asistieron 53 enfermeras que trabajan en el cuidado del recién nacido en la Unidad de Cuidados Intensivos y Unidad Neonatal de Cuidados Intermedios. Resultados: la mayoría de los profesionales es ladedicación profesional exclusiva; y sólo una pequeña parte está especializado en neonatología (18,87%).Se destacaron la voluntad de los profesionales de participación en procedimientos tales como lainserción de catéteres central de inserción periférica (31,88%) y la participación en las discusiones decasos con el equipo multidisciplinario (15,94%). Gran parte de los profesionales (92,4%) creen que estemodelo puede mejorar la calidad de la atención. Conclusión: la literatura es escasa en este tipo demodelo de atención de enfermería en Brasil. Esta encuesta registró el papel de la enfermera profesionalen este nuevo arreglo de equipo. Descriptores: Atención de enfermería; Neonatología; Grupo deenfermería; Recién nacido...
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Humanos , Masculino , Femenino , Adulto Joven , Persona de Mediana Edad , Atención de Enfermería , Grupo de Enfermería , Neonatología , Recién NacidoRESUMEN
OBJETIVO: Determinar a incidência e as principais causas de extubação não planejada em recém-nascidos nas unidades de terapia intensiva neonatais do Hospital Sofia Feldman, de Belo Horizonte (MG). MÉTODOS: Estudo retrospectivo, realizado durante o período de 1º de julho de 2009 a 30 de abril de 2010. Os eventos de extubação não planejada e as principais causas associadas a estes foram avaliados por meio de uma ficha de eventos adversos. Foram analisadas as seguintes variáveis: gênero, idade gestacional corrigida, peso atual, tempo em ventilação mecânica, horário e motivos/causas do evento no dia da extubação não programada. RESULTADOS: Ocorreram 54 eventos de extubação não planejada, com incidência de 1,0 extubação não planejada/100 dias em ventilação mecânica. Essa taxa foi maior nos recém-nascidos com idade gestacional corrigida entre 30 e 36 semanas e peso < 1.000 g. As principais causas dos eventos de extubação não planejada foram: agitação do recém-nascido; manipulação inadequada do paciente durante execução de procedimentos; fixação inadequada e posicionamento do tubo endotraqueal. CONCLUSÃO: A incidência de extubação não planejada nas unidades de terapia intensiva neonatais pôde ser considerada baixa, de acordo com o período avaliado, quando comparada aos dados relatados na literatura. Contudo, uma avaliação da qualidade dos procedimentos e um acompanhamento contínuo desses recém-nascidos, assim como a monitoração das causas, são necessários para reduzir, ainda mais, tal incidência.
OBJECTIVE: This study established the incidence and primary causes of unplanned extubation in newborns in the neonatal intensive care units of the Hospital Sofia Feldman, Belo Horizonte (Minas Gerais). METHODS: This retrospective study was conducted between July 1, 2009 and April 30, 2010. Unplanned extubations and their primary causes were assessed using an adverse events form. The following variables were assessed: gender, corrected age, present weight, duration of mechanical ventilation time, and motives/causes of the event on the day of the unplanned extubation event. RESULTS: Fifty-four unplanned extubations occurred, which corresponded to an incidence of 1.0 event/100 days of mechanical ventilation. This rate was higher among newborns with a corrected age of 30 to 36 weeks and weight < 1,000 g. The primary causes of unplanned extubations included patient agitation, inappropriate handling of patients during the performance of procedures, and inappropriate fixation and positioning of the endotracheal tube. CONCLUSION: The incidence of unplanned extubation in the investigated neonatal intensive care units was low during the study period compared to previously reported data. Nevertheless, the assessment of the quality of procedures, the continuous follow-up of newborns, and the monitoring of the causes of extubation are required to further reduce this incidence.