Topical formulation containing chitosan-chamomile microparticles in cutaneous wound healing in rats.

Objective: The aim of this research was to evaluate the efficacy of a topical formulation containing chitosan-chamomile microparticles in cutaneous healing in rats. Method: Male Wistar rats (n=57) were randomly distributed into three groups: treatment; vehicle; and control. Evaluations were performed on days 2, 7 and 14 after the surgical procedure using skin lesion photography, and histological and biochemical analyses. Results: The results showed that there was no difference in the healing index and in the histological analysis of the inflammatory infiltrate among groups. Fibrogenesis was more significant in the group treated with the test formulation at day 7, and angiogenesis was greater in the vehicle and chamomile groups at day 2. The quantification of hydroxyproline showed a higher amount of collagen in the group treated with chamomile, mainly at day 14, although the histological quantification of collagen showed no difference between the groups. Conclusion: From the results of this study, it can be concluded that the formulation, although it had no effect on the healing time, improved the quality of the cicatricial tissue formed with a greater quantity of fibroblasts and collagen.

Intercessory Prayer on Spiritual Distress, Spiritual Coping, Anxiety, Depression and Salivary Amylase in Breast Cancer Patients During Radiotherapy: Randomized Clinical Trial.

The goal of this study was to assess the effect of intercessory prayer in the psychological, spiritual and biological scores of breast cancer patients who are undergoing radiotherapy. Double-blind RCT comprising a sample of 31 participants (15 in the Control Group and 16 in the Intervention Group). Data collection was performed in three time points (T0, T1 and T2). Significant changes have been identified in the intra-group analysis, concerning the decrease in spiritual distress score; negative religious/spiritual coping prevailed, while the total religious/spiritual coping increased between the posttest T2 to T0. Intercessory prayer was effective in religious and spiritual scores.

Measuring Spiritual Well-Being in Brazilian Adolescents with Chronic Illness Using the FACIT-Sp-12: Age Adaptation of the Self-Report Version, Development of the Parental-Report Version, and Validation.

Spiritual well-being is a major issue in health care, but instruments for measuring this construct in adolescents are lacking. This study adapted the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12) for use with Brazilian adolescents with chronic diseases and developed a parental observer-rated version, using an expert panel, back-translation, and cognitive interviews with 72 participants. The psychometric properties of both versions were verified with two- and three-factor models by testing with 212 participants. The self- and parental-reported versions showed face validity, content validity, and acceptable levels of internal consistency for the overall scale and the two-factor model. The convergent validity was satisfactory for most items in both two- and three-factor models, but there was a lack of discrimination in the three-factor model using multitrait-multimethod analysis. This study presents the first instrument to assess the spiritual well-being of adolescents from their point of view and to allow their parents to serve as evaluators. However, we recommend further psychometric testing of the self- and parental-report scales to assess spiritual well-being in adolescents with chronic diseases in Brazil.

Spiritual Well-Being and Spiritual Distress in Cancer Patients Undergoing Chemotherapy: Utilizing the SWBQ as Component of Holistic Nursing Diagnosis.

Holistic nursing care requires attention to the spiritual dimension. This is particularly important when caring for patients with cancer. This research presents the results of the assessment of spiritual well-being using the Spiritual Well-Being Questionnaire (SWBQ) to validate the nursing diagnosis of spiritual distress. Structured interviews were conducted with 169 patients in one hospital in Portugal. We concluded that the SWBQ is a useful and reliable instrument to assess spiritual distress, which highlights the importance of listening to patients and questioning them about spiritual needs as well as the importance of differential diagnosis aimed at effective interventions.

[Knowledge produced from the outcomes of the "Nursing Outcomes Classification--NOC": integrative review]. / Conhecimento produzido sobre os resultados da "Nursing Outcomes Classification--NOC": revisão integrativa.

OBJECTIVE: To identify the knowledge produced from the outcomes of the Nursing Outcomes Classification (NOC). METHOD: A literature review using the integrative databases: Latin American and Caribbean Health Sciences (LILACS), US National Library of Medicine (PubMed), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Scopus Info Site (SCOPUS), during the months of August and September 2014. RESULTS: The review consisted of 21 articles that addressed different issues: Translation and Cultural adaptation (4.77%); Applicability in clinical practice (33.33%); and, Validation (63.90%). Analysis of these articles showed that the knowledge produced from the Nursing Outcomes Classification includes translation and cultural adaptation, evaluation of applicability and validation of its items. CONCLUSION: Considering the continuous evolution of this classification, periodic reviews should be carried out to identify the knowledge, use and effects of the NOC.

[Examination of the oral cavities of patients with cancer: clinical evaluation and indirect measurement of the nitric oxide level]. / Exame da cavidade bucal de pacientes com câncer: avaliação clínica e dosagem indireta de óxido nítrico.

This observational study aimed to verify the association between the clinical state of the oral cavity (based on the Index of Decayed, Missing, and Filled Teeth and the Simplified Oral Hygiene Index) and the indirectly determined nitric oxide level in patients with oncologic and hematologic diseases. This study included 20 hospitalized patients who were in the evaluation phase prior to starting chemotherapy and who had been diagnosed with leukemia (35%), lymphoma (50%) or myeloma (15%). Fifty percent of these patients had normal oral health (no injury or trauma), and most had satisfactory (35%) or typical (35%) hygiene, but 30% had poor or very poor hygiene. The indirectly measured levels of nitric oxide ranged from 13.34 to 257. The nitric oxide level was not associated with other parameters, and there was great variability in its level. Further studies are necessary given the potential of using this indicator in the early detection of oral diseases.

[Nursing diagnoses in patients classified as priority level I and II according to the Manchester protocol]. / Diagnósticos de enfermagem em pacientes classificados nos níveis I e II de prioridade do Protocolo Manchester.

The aim of this study was to identify possible nursing diagnoses in patients classified as priority level I and II according to the Manchester protocol. This descriptive retrospective study evaluated 40 medical charts classified as priority level I and II. To identify nursing diagnoses, two experts analyzed signs and symptoms registered in medical charts at the time of risk classification. For priority level I patients, the most frequent nursing diagnoses were acute pain (65.0%), respiratory insufficiency (45.0%), and impaired gas exchange (40.0%). For the priority level II patients, the most frequent nursing diagnoses were acute pain (80.0%), nausea (10.0%), and risk for electrolyte imbalance (10.0%). This study suggests that the use of the Manchester protocol enabled identification of defining characteristics and risk factors and supports the elaboration of nursing diagnoses in risk classification.

[Religious/spiritual coping in people with chronic kidney disease undergoing hemodialysis]. / Coping religioso/espiritual em pessoas com doença renal crônica em tratamento hemodialítico.

The objective of the present study is to investigate the use of religious/spiritual coping mechanisms in patients with chronic kidney disease undergoing hemodialysis, by means of interviews using a sociodemographic questionnaire and the religious/spiritual coping scale. Data analysis was performed using descriptive statistics and multiple linear regression. A total of 123 individuals were interviewed, 79.6% of whom presented a high score for religious/spiritual coping and none of whom presented low or irrelevant scores. The variables that affected the religious/spiritual coping behavior were: gender, age group, treatment time, family income, and religious practice. In conclusion, the participants used religious/spiritual coping mechanisms as a strategy to cope with the disease, particularly women with a higher family income who attend church every week.

[Creating diagnoses and interventions under the auspices of different nursing classification systems]. / Elaboração de diagnósticos e intervenções à luz de diferentes sistemas de classificações de enfermagem.

This study analyzes the use of different nursing classification systems to meet the standards established by the norm ISO 18.104:2003, based on a fictitious clinical situation. Nursing diagnoses and interventions were created using NANDA-I, NIC and ICNP® and an analysis was performed of the terminology agreement of these classification systems with the model proposed by the norm ISO 18.104:2003. For the creation of nursing diagnoses, NANDA-I and ICNP® comply with norm ISO 18.104:2003. As for the creation of nursing interventions, ICNP® meets the terminology reference model proposed by ISO 18104:2003. NIC, on the other hand, does not propose a combinatory terminology reference model. The unification of nursing terminology depends on reviewing, standardizing and testing these classifications in order to establish a common and sound language for the profession.

Differential validation of nursing diagnoses: An integrative literature review on the use of the method.

PURPOSE: This review aimed to analyze the use of differential validation of nursing diagnosis. METHODS: Integrative literature review with search on international databases. The diagnoses, the type of the diagnosis differential validation, the sample, the method, main results, and the limitations were extracted. Ten studies were included. FINDINGS: Differential diagnostic validation publication dates from 1994, and Brazil was the predominant country. CONCLUSIONS: This method seems helpful in improving diagnosis accuracy, particularly those related to subjective, behavioral, or complex human responses. IMPLICATIONS FOR NURSING PRACTICE: Using this model may facilitate understanding the specificity of nursing diagnosis, which is critical for teaching clinical reasoning and for new opportunities to research.

OBJETIVO: O objetivo desta revisão foi analisar a utilização da validação diferencial de diagnósticos de enfermagem. MÉTODOS: Revisão integrativa da literatura com pesquisa em bases de dados internacionais. Foram extraídos dados referentes ao tipo de diagnóstico, validação diferencial, amostra, metodologia, principais resultados e limitações. Foram incluídos 10 estudos. RESULTADOS: Foram identificadas publicações desde 1994, sendo o Brasil o país predominante. CONCLUSÕES: Este modelo parece ser útil para melhorar a precisão do diagnóstico, particularmente aqueles relacionados a respostas humanas subjetivas, comportamentais ou complexas. IMPLICAÇÕES PARA A PRÁTICA: O uso deste modelo pode facilitar a compreensão da especificidade do diagnóstico de enfermagem, que é fundamental para o ensino do raciocínio clínico, para novas oportunidades de pesquisa.

[Prevention strategies for testicular and penile cancer: an integrative review]. / Estratégias de prevenção para câncer de testículo e pênis: revisão integrativa.

Testicular and penile cancers are genital disorders that affect a small part of population, but are generally aggressive mainly because of the dramatic psychological effect they impose over patients. The purpose of this study was to identify evidence concerning preventing strategies for the referred types of cancer. An integrative literature review was performed on the COCHRANE, PubMed/MEDLINE, LILACS, BDENF and CINAHL databases using the following controlled descriptors: health promotion, risk factors, primary prevention, and urogenital neoplasms; and uncontrolled descriptors: prevention, penile cancer, testicle cancer. The studies were unanimous in concluding that self-examination of testicles is the best way to identify a possible event of testicular cancer. Circumcision, prevention for sexual transmission diseases and adequate hygiene were the most important manners for penile cancer prevention. Nurses should assume the role for general and specific health promotion, considering the major impact it would have for prevention of diseases, especially for the urogenital cancers studied in this review.

[What teaching by telephone about insulin means for diabetes mellitus patients]. / O significado do ensino por telefone sobre a insulina para pessoas com diabetes mellitus.

This study identifies what the telephone follow-up in the process of preparing and administering insulin means to patients with diabetes Mellitus (DM). This is a descriptive study with a qualitative approach, with 26 patients with type 2 DM using insulin and participating in a Brazilian program of capillary blood glucose self-monitoring at home, which uses telephone follow-up as a nursing strategy. Directed interviews were conducted in a single telephone contact, with questions based on Ogden and Richards' Theory of Meaning. The obtained meaning was related to the learning-teaching process and to the help perceived by the strategy (symbol), elements related to the management of insulin (referent), and to an acknowledgement of the telephone follow-up as convenience, tranquility, care, and a time for clearing up doubts (thought). We consider that the telephone followup is appropriate to instruct patients with DM in the use of insulin.

Infusion of hematopoietic stem cells: types, characteristics, adverse and transfusion reactions and the implications for nursing.

Hematopoietic stem cell infusion is an important procedure in Hematopoietic Stem Cell Transplantation (HSCT). This study identifies transfusion and other adverse reactions that can occur during infusion and the nursing care related to the procedure. This epidemiologic study used transplantations performed between 2006 and 2008. A total of 166 transplantations were performed: 114 were autologous, 47 allogeneic and five haploidentical. Three transfusion reactions and 96 adverse reactions were observed. Adverse reactions were related to the presence of cryoprotectant, though the infusion rate and quantity of infused cryoprotectant were not related to the occurrence of reactions. The products were fresh and infused within the recommended time when transfusion reactions occurred. In regard to cell source, lower engraftment time was found in peripheral blood. Nursing documentation is relevant for patients' safety as well to planning an infusion in order to minimize the occurrence of reactions.

Clinical validation of impaired spirituality in patients with chronic renal disease.

This study aimed to identify and validate the defining characteristics of the nursing diagnosis Impaired spirituality. The methodological framework proposed by Fehring for the clinical validation of nursing diagnosis was used. The investigation was carried out in a dialysis clinic and had as participants 120 patients with chronic renal disease. Data were collected by two expert nurses, through interviews. The prevalence of the nursing diagnosis Impaired spirituality in the sample was 27.5%. It was found that the most frequent defining characteristics were Expresses behavioral changes: rage, Inability to express creativity, Questions suffering and Expresses alienation. The clinical validation of Impaired spirituality contributed to refine this diagnosis. Its identification in patients with chronic renal disease undergoing dialysis treatment can offer alternatives for a safer and more effective intervention, aiming at the satisfaction of the spiritual needs of these patients.

[From the production to the use of research results in care practice: a consolidating experience]. / Da produção à utilização de resultados de pesquisa na prática assistencial: uma experiência em consolidação.

Although it is desirable that professionals use research results, often they are not prepared for that. This article aims to present the process of development and establishment of innovations, based on Rogers' model, through strategies to train nurses to use the best evidences for a quality clinical practice. It is a partnership between a educational institution and a hospital care institution. Following identification of problems from nurses' own practice in a health institution research proposals were developed to search for evidences and to test interventions. Results of this experience evidenced the viability of use of a model presented as a methodological framework what contributed to reach the institutions' goal.

Clinical indicators of ineffective airway clearance in children with congenital heart disease.

AIMS AND OBJECTIVES: To analyse the sensitivity and specificity of clinical indicators of ineffective airway clearance in children with congenital heart disease and to identify the indicators that have high predictive power. BACKGROUND: The precise establishment of nursing diagnoses has been found to be one of the factors contributing to higher quality of care and cost reduction in healthcare institutions. The use of indicators to diagnose ineffective airway clearance could improve care of children with congenital heart disease. Design. Longitudinal study. METHODS: Participants consisted of 45 children,

[Nursing outcome classification (NOC): identification of the related scientific production]. / Classificação de resultados de enfermagem (NOC): identificação da produção científica relacionada.

This study aimed at identifying through an integrative literature review, the scientific knowledge produced until 2008 about the Nursing Outcome Classification (NOC), which is used to evaluate nursing care. Among 15 selected articles, most (73.4%) were published in American journals, and by American authors (60.2%). Regarding the addressed themes, studies were categorized into four groups: use of the taxonomy in care practice (40%), validation of the elements (results, indicators and scales) of the taxonomy (40%), translation and validation of NOC (6.6%), and its use in computerized systems (13.4%). There is an increase in the production of works approaching NOC, however, further studies are needed to provide a better basis to use this classification, especially in clinical practice, as it is an important instrument in the systematization of the nursing care.

Psychometric Assessment of the Nursing Outcome Swallowing Status: Rasch Model Approach.

PURPOSE: To apply the Rasch model to test the psychometric assessment of the nursing outcome Swallowing status among poststroke patients. METHODS: Cross-sectional study was conducted with 227 poststroke patients, which were evaluated by a nurse. The Rasch model was used to examine psychometric properties. FINDINGS: Indicators fit the Rasch model and presented good reliability and good ability for separation index. The 5-point Likert scale did not present adequate discrimination and classification levels were compiled into three. CONCLUSIONS: Data evidenced the use of a robust method to perform a clinical validity of the Swallowing status, complementing previous validation studies. RELEVANCE TO CLINICAL PRACTICE: Using Rasch analysis serve as reference points to assess Swallowing status on a single scale. OBJETIVO: Aplicar o modelo Rasch para testar as medidas psicométricas do resultado de enfermagem Estado da deglutição em pacientes acometidos por acidente vascular cerebral. MÉTODOS: Estudo transversal, realizado com 227 pacientes após AVC avaliados por um único enfermeiro. O modelo Rasch foi usado para examinar propriedades psicométricas. RESULTADOS: Os indicadores se ajustaram ao modelo Rasch e apresentam boa confiabilidade e boa capacidade de separação. A escala Likert de 5 pontos não apresentou discriminação adequada e os níveis de classificação foram compilados em três pontos. CONCLUSÃO: Os dados evidenciaram o uso de um método robusto para a validade clínica do Estado da deglutição, complementando os estudos de validação anteriores. RELEVÂNCIA PARA A PRÁTICA CLÍNICA: O uso do modelo Rasch serve como ponto de referência para avaliar o Estado da deglutição em uma única escala.

Superficial peripheral vein type classification of adolescents, adults and elderly according to the Delphi technique.

This descriptive research attempts to cooperate with the standardization of communication about vein types in nursing. Authors utilized the "Delphi" technique and aimed at elaborating and validating a peripheral vein type classification of adolescents/adults/elderly according to their vein characteristics. Initially, authors identified different vein types in literature. This was a preliminary classification that contained the titles and definitions, which were complemented during the expert (nurses, angiologists, anesthetists and biochemists) validation process. Twelve criteria and 27 vein types were validated (agreement level > or =90%). In addition, authors organized a set of pictures representing the different vein types. From these, 144 were used; 35 experts chose one picture to exemplify each classification title. The pictures representing 21 vein types were identified. This classification contributes to the clinical assessment of blood vessels and can be used in teaching, research and patient care management.

Relations between nursing data collection, diagnoses and prescriptions for adult patients at an intensive care unit.

This descriptive, retrospective study aimed to analyze the relation between nursing data collection, diagnoses and prescriptions for 26 adult patients who were hospitalized at the intense care unit of a large teaching hospital for at least 24 hours. Through the analysis of medical records, 135 diagnoses and 421 nursing prescriptions were established, and 24 different diagnosis categories and 20 different items for prescriptions were identified. The most frequent diagnosis risk was that for infection, present in the medical records of 22 (84.60%) patients, with 175 prescriptions (42%) related to this diagnosis. The data the nurses collected were sufficient to establish the nursing diagnoses, and the majority of prescriptions (87.9%) were related to the diagnoses.