Resilience in Older People: A Concept Analysis.

(1) Background: Resilience has been presented as a potential protective factor to be promoted in difficult experiences in older people. However, further clarification of the concept of resilience for this population is required, as this is of critical interest for nursing care. (2) Aim: To develop the concept of resilience in older people to establish the elements that refer to the nursing outcome. Personal resilience (1309) from the Nursing Outcomes Classification (NOC), specifically in older people. (3) Methods: Concept analysis using Beth Rodgers' evolutionary model. The attributes, antecedents, consequents, and empirical elements were described in the integrative review, with searches in PubMed, CINAHL, PsycINFO, LILACS, and Embase databases. A total of 2431 citations have been identified, and 110 studies were included. (4) Results: The concept of "resilience in older people" is composed of two attributes, available resources and positive behaviors, and is defined as positive attitudes of older people with the assistance of resources available from experiences of adversity. Conclusion: This analysis and concept development of resilience in older people provided sensitive indicators for nursing care in the context of adversity, considering available resources and with positive attitudes during this phase of life span.

A Qualitative Study of the Spiritual Aspects of Parenting a Child with Down Syndrome.

Parenting a child with Down syndrome can sometimes present certain difficulties and, thus, spirituality may function as a dimension related to finding meaning in life and as a coping resource. Spirituality is a critical dimension of nursing care, but scarce knowledge is available to specifically inform family nursing practice. The aim of this study was to explore the spiritual aspects of parenting a child with Down syndrome, as a qualitative secondary analysis. This is an observational qualitative study, based on in-depth interviews from 42 participants. Data analysis found seven categories that concern meaning and purpose in life: hope, family strength, spiritual practices, personal beliefs, and love, and trust in healthcare providers. Spirituality is a resource in parents' lives who are living in this situation. Nurses should consider this dimension in supporting families and in improving management of this life and health condition.

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.

Coping da equipe de enfermagem no processo morte-morrer em unidade neonatal / Coping del equipo de enfermería en el proceso muerte-morir en unidad neonatal / Coping of the nursing team in the death-dying process in a neonatal unit

Resumo Objetivo Compreender o coping dos profissionais de enfermagem no processo morte- morrer em neonatologia. Método Estudo qualitativo na abordagem exploratória descritiva, participaram dez profissionais da enfermagem. Histórias rememoradas dos profissionais no cuidado do processo da morte e do morrer em neonatologia foi o meio para a coleta de dados. Organização, tratamento e análise dos dados fundamentado na análise de conteúdo de Bardin e no software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados Emergiram duas categorias da interface da análise e os fundamentos da Teoria Motivacional de Coping de Skinner, Equipe de enfermagem e a teoria motivacional de coping na morte em neonatologia; Ação regulatória de ameaça e o enfrentamento da morte em neonatologia. As estratégias de coping da equipe de enfermagem estudada mostram que os padrões cognitivos e respostas comportamentais referem-se à própria maneira de lidar com o cotidiano do sofrimento vivenciado em família, onde os profissionais buscam informação para ultrapassar a ameaça, num enfrentamento de desamparo e de fuga do acolhimento. Conclusão Os processos autorreferenciais experienciados em situações estressantes por profissionais da enfermagem favorecem à empatia, o vínculo e a comunicação com a família de neonatos à morte. Os indicativos de fragilidade na formação mantêm-se predisponentes para as dificuldades no enfrentamento da morte-morrer.

Resumen Objetivo Comprender el coping de los profesionales de enfermería en el proceso muerte-morir en neonatología. Métodos Estudio cualitativo de enfoque exploratorio descriptivo, donde participaron diez profesionales de enfermería. Las historias contadas por los profesionales sobre el cuidado del proceso de muerte y del morir en neonatología fue el medio para la recopilación de datos. La organización, el tratamiento y el análisis de los datos fue fundamentado en el análisis de contenido de Bardin y en el software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados Surgieron dos categorías de la interfaz de análisis y fundamentos de la teoría motivacional de coping de Skinner: Equipo de enfermería y la teoría motivacional de coping respecto a la muerte en neonatología y Acción reguladora de amenaza y el afrontamiento a la muerte en neonatología. Las estrategias de coping del equipo de enfermería estudiado muestran que los patrones cognitivos y las respuestas de comportamiento se refieren a la propria manera de lidiar con la cotidianidad del sufrimiento vivido en familia, donde los profesionales buscan información para superar la amenaza, en un enfrentamiento de desamparo y de fuga de la acogida. Conclusión Los procesos autorreferenciales vividos en situaciones estresantes por profesionales de enfermería favorecen la empatía, el vínculo y la comunicación con la familia de neonatos a fallecer. Los indicios de fragilidad en la formación se mantienen predisponentes para las dificultades de afrontar la muerte-morir.

Abstract Objective This understanding is essential to subsidize interventions of nursing professionals in order to care for families. Method A qualitative study in descriptive exploratory approach involved ten nursing professionals. Recollected stories collected from professionals in the care of the process of death and dying in neonatology was the means for data collection. Data organization, treatment and analysis was based on Bardin's content analysis and the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Results Two categories emerged from the analysis interface and the foundations of Skinner's Motivational Theory of Coping, nursing staff and Motivational Theory of Coping in death in neonatology; Threat regulatory action and coping with death in neonatology. The coping strategies of the nursing team studied show that cognitive patterns and behavioral responses refer to the very way of dealing with the daily suffering experienced in the family, where professionals seek information to overcome the threat, a coping with helplessness and escape from welcoming. Conclusion The self-referential processes experienced in stressful situations by nursing professionals favor empathy, bonding and communication with the family of infants. The indicators of frailty in training remain predisposing to difficulties in coping with death-dying.

Spiritual Needs of Brazilian Children and Adolescents with Chronic Illnesses: A Thematic Analysis.

PURPOSE: To identify the spiritual needs of children and adolescents with chronic illnesses and how these needs are met by health professionals during hospitalization. DESIGN AND METHODS: A qualitative descriptive study was developed with 35 children and adolescents, between 7 and 18 years old, diagnosed with cancer, cystic fibrosis, and type 1 diabetes. Interviews with photo-elicitation were conducted during the hospitalization at a Brazilian public pediatric hospital. Findings were treated using thematic analysis, and the Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed for quality reporting. This research was approved by a research committee. RESULTS: Two themes emerged. The first, entitled 'Spiritual needs', encompasses five types of needs: (1) need to integrate meaning and purpose in life; (2) need to sustain hope; (3) need for expression of faith and to follow religious practices; (4) need for comfort at the end of life; and (5) need to connect with family and friends. The second theme was the 'Definition of spiritual care'. CONCLUSIONS: Children and adolescents with chronic illnesses have spiritual needs while in hospital. Meeting these needs is essential for finding meaning, purpose and hope in the experience of living with chronic illnesses and at the end of life, based on their faith, beliefs and interpersonal relationships. But, these needs have not been fully addressed during hospitalization. PRACTICE IMPLICATIONS: These results emphasize the need to implement spiritual care when caring for hospitalized pediatric patients, which includes addressing spiritual needs.

Professional characteristics and the prevalence of advance directives among palliative care professionals: A cross-sectional study.

OBJECTIVE: This study aimed to investigate the association between professional characteristics and the prevalence of advance directives among palliative care professionals. METHODS: This is a descriptive cross-sectional study. A diverse sample of 327 healthcare professionals completed an online survey investigating demographic variables, length of time working in palliative care, post-graduate qualifications in palliative care, and development of their own advance directives. RESULTS: The prevalence of advance directives among professionals working in palliative care was associated with factors such as higher academic qualifications, holding a post-graduate qualification in palliative care, and working in palliative care for a longer time. Furthermore, psychologists were most likely to have registered their own advance directives, compared with other healthcare professionals. SIGNIFICANCE OF RESULTS: Post-graduate palliative care education and professional experience in this area appear to be important factors associated with palliative care professionals writing of their own advance directives. However, our study suggests that just being involved in or familiar with the context of palliative and end-of-life care does not guarantee that health professionals register their advance directives.

Team-Based Learning: a randomized clinical trial in undergraduate nursing.

OBJECTIVES: To compare the knowledge on surgical safety through the team-based learning methodology and lecture classes for undergraduate Nursing students, and evaluate the learning satisfaction with team-based learning. METHODS: Randomized, controlled, parallel, two-arm, unblinded clinical trial developed in the Faculty of Medicine of a public university in Botucatu, Brazil. The groups included 14 students for team-based learning and 11 students for lecture classes. RESULTS: Students' apprehension of knowledge in the team-based learning group was significantly higher compared to the control group (p<0.002) by considering the pre-test results. After 30 days, there was no significant difference between groups. The experience with the methodology was considered positive among students. CONCLUSIONS: Team-based learning is an important pedagogic tool available and has proven effective in education and learning with students playing the role of protagonists.

Evidências de validade da spiritual care competence scale para estudantes de graduação em enfermagem brasileiros / Evidencias de validez de la escala de evaluación de espiritualidad para estudiantes de grado brasileñosen enfermería / Validity evidence of the spiritual care competence scale for brazilian undergraduate nursing students

RESUMO Objetivo: realizar a tradução e adaptação cultural da Spiritual Care Competence Scale para uso entre estudantes de graduação em Enfermagem e verificar evidências de validade da versão adaptada dessa escala. Método: estudo metodológico conduzido com 266 estudantes de Enfermagem, em uma universidade pública brasileira do estado de São Paulo. A escala foi submetida a um processo de tradução e adaptação cultural e análise das propriedades psicométricas (validade de construto e fidedignidade). Resultados: as equivalências linguística e conceitual foram obtidas; a escala mostrou boa aceitação entre os estudantes; seis subescalas foram obtidas pela análise fatorial exploratória, com cargas fatoriais dos itens superiores a 0,46; alguns itens foram realocados diferentemente da escala original. A consistência interna avaliada pelo alfa de Cronbach das subescalas, a partir da distribuição obtida pela análise fatorial exploratória, variou de 0.54 a 0.87. O indicador AC1 Gwet evidenciou correlação entre os momentos teste e reteste para todos os itens (p<0.01). Conclusão: a versão da Spiritual Care Competence Scale adaptada para estudantes de Enfermagem brasileiros apresentou boas evidências de validade baseada na estrutura interna e confiabilidade. Ela pode ser usada em estudos futuros.

RESUMEN Objetivo: realizar la traducción y adaptación cultural de la Spiritual Care Competence Scale para estudiantes de grado en enfermería y comprobar evidencias de validez de la versión adaptada de dicha escala. Método: estudio metodológico llevado a cabo con 266 estudiantes de enfermería en una universidad pública brasileña del estado de San Pablo. La escala atravesó un proceso de traducción y adaptación cultural y de análisis de propiedades psicométricas (validez de constructo y confiablidad). Resultados: se obtuvo equivalencia linguística y conceptual; la escala demostró buena aceptación entre los estudiantes; del análisis factorial exploratorio se obtuvieron seis subescalas, con carga factorial de elementos superior a 0,46; algunos elementos se reubicaron de manera diferentea la escala original. La consistencia interna de las subescalas evaluada por el alfa de Cronbach, a partir de la distribución obtenida por el análisis factorial exploratorio, varió entre 0.54 y 0.87. El indicador AC1 Gwet comprobó correlación entre los momentos pruebay reevaluación de todos los elementos (p<0.01). Conclusión: la versión de la Spiritual Care Competence Scale adaptada para estudiantes de enfermería brasileños presentó evidencias de validez basada en la estructura interna y confiabilidad. Puede usarseen futuros estudios.

ABSTRACT Objective: to translate and culturally adapt the Spiritual Care Competence Scale to be used among undergraduate Nursing students and verify the validity evidence of the scale's adapted version. Method: a methodological study carried out with 266 Nursing students in a Brazilian public university of the state of São Paulo. The scale was submitted to a translation and cultural adaptation process and analysis of its psychometric properties (construct validity and reliability). Results: linguistic and conceptual equivalences were obtained; the scale was well accepted among the students; six subscales were obtained by the exploratory factorial analysis with factorial loads of the items higher than 0.46; some items were relocated differently from the original scale. The internal consistency assessed by the Cronbach's alpha of the subscales, based on the distribution obtained by the exploratory factorial analysis, ranged from 0.54 to 0.87. The AC1 Gwet indicator evidenced correlation between the test and retest moments for all the items (p<0.01). Conclusion: the Spiritual Care Competence Scale version adapted for Brazilian Nursing students presented good validity evidence based on its internal structure and reliability. It can be used in future research studies.

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.

Team-Based Learning: a randomized clinical trial in undergraduate nursing / Aprendizaje Basado en Equipos: un ensayo clínico randomizado en la graduación en enfermería / Aprendizagem baseada em equipes: um ensaio clínico randomizado na graduação em enfermagem

ABSTRACT Objectives: To compare the knowledge on surgical safety through the team-based learning methodology and lecture classes for undergraduate Nursing students, and evaluate the learning satisfaction with team-based learning. Methods: Randomized, controlled, parallel, two-arm, unblinded clinical trial developed in the Faculty of Medicine of a public university in Botucatu, Brazil. The groups included 14 students for team-based learning and 11 students for lecture classes. Results: Students' apprehension of knowledge in the team-based learning group was significantly higher compared to the control group (p<0.002) by considering the pre-test results. After 30 days, there was no significant difference between groups. The experience with the methodology was considered positive among students. Conclusions: Team-based learning is an important pedagogic tool available and has proven effective in education and learning with students playing the role of protagonists.

RESUMEN Objetivos: Comparar la aprehensión del conocimiento en seguridad quirúrgica por la metodología del aprendizaje basada en equipos y clase expositiva para alumnos de graduación en enfermería y evaluar la satisfacción del aprendizaje en el aprendizaje basado en equipos. Métodos: Ensayo clínico aleatorizado, controlado, paralelo, con dos brazos, no ciego, desarrollado en una universidad pública ubicada en Botucatu, Brasil. Los grupos fueron compuestos por 14 alumnos para el aprendizaje basado en equipos y 11 alumnos para clase expositiva. Resultados: La aprehensión del conocimiento de los alumnos del grupo aprendizaje basado en equipos fue significativamente mayor comparado al grupo control (p <0,002) considerados los resultados del pre-test. Después de los 30 días, no hubo diferencia significativa entre los grupos. La experiencia con la metodología fue considerada positiva entre los alumnos. Conclusiones: El aprendizaje basado en equipos es una importante herramienta pedagógica disponible y se muestra eficaz en el proceso de enseñanza-aprendizaje teniendo al alumno como su protagonista.

RESUMO Objetivos: Comparar a apreensão do conhecimento em segurança cirúrgica pela metodologia da aprendizagem baseada em equipes e aula expositiva dialogada para alunos de graduação em enfermagem e avaliar a satisfação do aprendizado na aprendizagem baseada em equipes. Métodos: Ensaio clínico randomizado, controlado, paralelo, com dois braços, sem cegamento, desenvolvido em uma universidade pública paulista. Os grupos foram compostos por 14 alunos para aprendizagem baseada em equipes e 11 alunos para aula expositiva dialogada. Resultados: A apreensão de conhecimento dos alunos do grupo aprendizagem baseada em equipes foi significativamente maior em comparação com o grupo controle (p<0,002) considerados os resultados do pré-teste. Após os 30 dias, não houve diferença significativa entre os grupos. A experiência com a metodologia foi considerada positiva entre os alunos. Conclusões: A aprendizagem baseada em equipes é uma importante ferramenta pedagógica disponível e mostra-se eficaz no processo de ensino-aprendizagem tendo o aluno como seu protagonista.

Team-Based Learning: a randomized clinical trial in undergraduate nursing / Aprendizaje Basado en Equipos: un ensayo clínico randomizado en la graduación en enfermería / Aprendizagem baseada em equipes: um ensaio clínico randomizado na graduação em enfermagem

ABSTRACT Objectives: To compare the knowledge on surgical safety through the team-based learning methodology and lecture classes for undergraduate Nursing students, and evaluate the learning satisfaction with team-based learning. Methods: Randomized, controlled, parallel, two-arm, unblinded clinical trial developed in the Faculty of Medicine of a public university in Botucatu, Brazil. The groups included 14 students for team-based learning and 11 students for lecture classes. Results: Students' apprehension of knowledge in the team-based learning group was significantly higher compared to the control group (p<0.002) by considering the pre-test results. After 30 days, there was no significant difference between groups. The experience with the methodology was considered positive among students. Conclusions: Team-based learning is an important pedagogic tool available and has proven effective in education and learning with students playing the role of protagonists.

RESUMEN Objetivos: Comparar la aprehensión del conocimiento en seguridad quirúrgica por la metodología del aprendizaje basada en equipos y clase expositiva para alumnos de graduación en enfermería y evaluar la satisfacción del aprendizaje en el aprendizaje basado en equipos. Métodos: Ensayo clínico aleatorizado, controlado, paralelo, con dos brazos, no ciego, desarrollado en una universidad pública ubicada en Botucatu, Brasil. Los grupos fueron compuestos por 14 alumnos para el aprendizaje basado en equipos y 11 alumnos para clase expositiva. Resultados: La aprehensión del conocimiento de los alumnos del grupo aprendizaje basado en equipos fue significativamente mayor comparado al grupo control (p <0,002) considerados los resultados del pre-test. Después de los 30 días, no hubo diferencia significativa entre los grupos. La experiencia con la metodología fue considerada positiva entre los alumnos. Conclusiones: El aprendizaje basado en equipos es una importante herramienta pedagógica disponible y se muestra eficaz en el proceso de enseñanza-aprendizaje teniendo al alumno como su protagonista.

RESUMO Objetivos: Comparar a apreensão do conhecimento em segurança cirúrgica pela metodologia da aprendizagem baseada em equipes e aula expositiva dialogada para alunos de graduação em enfermagem e avaliar a satisfação do aprendizado na aprendizagem baseada em equipes. Métodos: Ensaio clínico randomizado, controlado, paralelo, com dois braços, sem cegamento, desenvolvido em uma universidade pública paulista. Os grupos foram compostos por 14 alunos para aprendizagem baseada em equipes e 11 alunos para aula expositiva dialogada. Resultados: A apreensão de conhecimento dos alunos do grupo aprendizagem baseada em equipes foi significativamente maior em comparação com o grupo controle (p<0,002) considerados os resultados do pré-teste. Após os 30 dias, não houve diferença significativa entre os grupos. A experiência com a metodologia foi considerada positiva entre os alunos. Conclusões: A aprendizagem baseada em equipes é uma importante ferramenta pedagógica disponível e mostra-se eficaz no processo de ensino-aprendizagem tendo o aluno como seu protagonista.

Spiritual Coping: A Focus of New Nursing Diagnoses.

OBJECTIVE: To define the antecedents, consequents, and attributes of spiritual coping. METHODS: Rodgers' evolutionary model for concept analysis was used to guide an integrative literature review of qualitative research. FINDINGS: Six qualitative articles were included and elements that define and contextualize the concept were identified. CONCLUSIONS: Three new nursing diagnoses are proposed, based on qualitative findings. IMPLICATIONS FOR PRACTICE: These new diagnoses should be submitted to clinical validation in different cultural and religious backgrounds, but the inclusion in the taxonomy highlights a holistic perspective concerning the spiritual dimension of patients' responses in life and health transitions, and so, bringing the approach to spirituality into nursing practice. OBJECTIVO: Definir os antecedentes, os consequentes e os atributos de coping espiritual. MÉTODOS: Modelo evolucionário de análise de conceitos de Beth Rodgers baseado numa revisão integrativa de literatura de pesquisa qualitativa. RESULTADOS: Seis pesquisas qualitativas foram incluídas e os elementos que definem e contextualizam o conceito foram identificados. CONCLUSÕES: São propostos três novos diagnósticos de enfermagem, baseados na evidência de estudos qualitativos. IMPLICAÇÕES PARA A PRÁTICA: Estes novos diagnósticos devem ser submetidos a estudos de validação clínica em diferentes contextos culturais e religiosos, e quando incluídos na taxonomia estarão a enfatizar uma perspectiva holística das respostas dos pacientes relacionada à dimensão espiritual e, assim, promovendo a inclusão da espiritualidade na prática clínica.

The Contribution of the Rasch Model to the Clinical Validation of Nursing Diagnoses: Integrative Literature Review.

PURPOSE: To analyze the knowledge related to the use of the Rasch model in validation of nursing diagnoses. METHODS: Integrative literature review with search in LILACS, PUBMED, CINAHL, and SCOPUS. FINDINGS: Five studies comprised the sample, which analyzed unidimensionality, local independence, item calibration, item reliability, separation of items and people, and differential item functioning for analyzing nursing diagnoses. CONCLUSIONS: The Rasch model seems to be a useful method to validate nursing diagnoses and probably also for the validation of nursing outcomes in the Nursing Outcomes Classification. The use of this model is promising, considering the advantages that it can be used in studies with several methodological designs. IMPLICATIONS FOR NURSING: Methods that are able to provide more robust evidence of nursing diagnosis validity are needed to support highly accurate diagnostic findings in clinical practice.

The possibilities and challenges in providing pediatric spiritual care.

The purpose of this article was to present discussions on how pediatric nurses can perform spiritual care to children and adolescents and discuss the challenges of integrating such care in health-care settings. Based on the literature, the article presents an overview of spiritual care in pediatric settings highlighting the assessment of spirituality, expected outcomes, and the corresponding nursing interventions. Spiritual care provided to children and adolescents should take into account all aspects of the developmental stage, life experiences, and familiar and sociocultural contexts. Different approaches can be used to perform spiritual care. However, lack of knowledge and time are highlighted as the main challenges in integrating spiritual care into the clinical practice. Spiritual care is crucial to the well-being of children and adolescents in times of illness and hospitalization when the goal is to provide holistic care.

Functional Independence of Children With Myelomeningocele: Is It Associated With the Informal Caregivers' Burden?

PURPOSE: This study aims to evaluate the association between the functional independence of children after postnatal spinal dysraphism correction and informal caregivers' burden. DESIGN AND METHODS: This is a cross-sectional study conducted in a child neurosurgery clinic at a University hospital. We included informal caregivers of children between six months and seven-and-a-half years old who were operated on for spinal dysraphism correction due to myelomeningocele. Functional independence was assessed using the Pediatric Evaluation of Disability Inventory (PEDI). Caregivers' burden was assessed through the Caregiver Burden Scale (CBS). RESULTS: Twenty-six caregivers were assessed, all mothers, aged 18-42years. Five provided child care and engaged in paid work. Regarding functional independence, 23.1% of the children were classified as needing supervision, 23.1% moderate assistance, 42.3% maximal assistance, and 11.5% total assistance. Median value for the overall CBS was 27.0 (22.0-53.0). The mean global CBS score was 1.42 and the mean PEDI score was 1.95. Correlations between PEDI and CBS scores were very close to zero. CONCLUSIONS: We found no association between the functional independence of children with myelomeningocele from 0 to 7years old and the burden of informal caregivers. PRACTICE IMPLICATIONS: The effect of functional independence of children with myelomeningocele may be balanced by the caregivers' resilience so that caregivers' burden is not dependent upon the child's independence.

Risk for falls among community-dwelling older people: systematic literature review. / Risco de quedas em idosos residentes na comunidade: revisão sistemática da literatura.

OBJECTIVE: To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International. METHOD: A systematic literature review based on research using the following platforms: EBSCOHost®, CINAHL and MEDLINE, from December 2010 to December 2014. The descriptors used were (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors. RESULTS: The sample comprised 62 studies and 50 risk factors have been identified. Of these risk factors, only 38 are already listed in the classification. CONCLUSIONS: Two new categories of risk factors are proposed: psychological and socio-economical. New fall risk factors for the community-dwelling elderly have been identified, which can contribute to the updating of this nursing diagnosis of the Taxonomy II of NANDA International.

Clinical indicators of sexual dysfunction in pregnant women: integrative literature review.

OBJECTIVE: to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women. METHOD: it is an integrative literature review, with research in databases using the keywords "sexual*", "pregnan*" and "function*". Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded. RESULTS: sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International. CONCLUSION: clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.

Indicadores clínicos de disfunção sexual em mulheres grávidas: revisão integrativa de literatura / Indicadores clínicos de disfunción sexual en mujeres embarazadas: revisión integradora de literatura / Clinical indicators of sexual dysfunction in pregnant women: integrative literature review

RESUMO Objetivo: identificar os indicadores clínicos do diagnóstico de enfermagem disfunção sexual em mulheres grávidas. Método: revisão integrativa da literatura, com pesquisa em bases de dados, utilizando os descritores "sexual*", "pregnan*" e"function*". Foram incluídos estudos com resumo disponível para análise, referentes a grávidas com idade igual ou superior a 18 anos, escritos em português, francês, espanhol e inglês, com data de publicação entre 2010 e 2014. Foram excluídos estudos que reportassem grávidas com patologia associada. Resultados: a disfunção sexual na grávida é consistente na literatura. Foram identificadas nove características definidoras e 16 fatores relacionados, alguns não classificados na NANDA Internacional. Conclusão: indicadores clínicos podem ser adicionados ao diagnóstico de enfermagem de modo a favorecer um diagnóstico acurado e intervenções efetivas na vigilância da gravidez como um período de vivência sexual saudável.

RESUMEN Objetivo: identificar los indicadores clínicos del diagnóstico de enfermería disfunción sexual en mujeres embarazadas. Método: revisión integradora de la literatura, con investigación en bases de datos, utilizando las palabras clave "sexual*", "pregnan*" y "function*". Fueron incluidos estudios con resumen disponible para análisis, referentes a embarazadas con edad igual o superior a 18 anos, escritos en português, francés, espanol e inglés, con fecha de publicación entre 2010 y 2014. Fueron excluidos estudios que reportasen embarazadas con patología asociada. Resultados: la disfunción sexual en la embarazada es consistente en la literatura. Fueron identificadas nueve características definidoras y 16 factores relacionados, algunos no clasificados en la NANDA Internacional. Conclusión: indicadores clínicos pueden ser agregados al diagnóstico de enfermería de modo a favorecer un diagnóstico preciso e intervenciones efectivas en la vigilancia del embarazo como un período de vivencia sexual sana.

ABSTRACT Objective: to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women. Method: it is an integrative literature review, with research in databases using the keywords "sexual*", "pregnan*" and "function*". Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded. Results: sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International. Conclusion: clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.

Risco de quedas em idosos residentes na comunidade: revisão sistemática da literatura / Riesgo de caídas de los ancianos residentes en la comunidad: revisión sistemática de la literatura / Risk for falls among community-dwelling older people: systematic literature review

RESUMO Objetivo Identificar fatores de risco de queda em idosos residentes na comunidade para atualização da taxonomia II da NANDA Internacional. Método Revisão sistemática da literatura, com pesquisa na plataforma EBSCOHost®, na CINAHL e MEDLINE, no período de dezembro de 2010 a dezembro de 2014. Utilizaram-se os descritores (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors. Resultados Obteve-se uma amostra de 62 estudos e um total de 50 fatores de risco, dos quais, apenas 38 estão presentes na classificação. Conclusões São propostas duas novas categorias de fatores: os psicológicos e socioeconômicos. Foram identificados novos fatores de risco de queda dos idosos residentes na comunidade, o que contribui para a atualização deste diagnóstico na taxonomia II da NANDA Internacional.

RESUMEN Objetivo Identificar los factores de riesgo de caídas en los ancianos residentes en la comunidad. Método Revisión sistemática de la literatura. La búsqueda fue realizada en plataforma EBSCOHost®, en CINAHL y MEDLINE, entre diciembre de 2010 y diciembre de 2014. Los descriptores utilizados fueron (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND (Nurs*) AND (Fall Risk Factors). Resultados Fueron seleccionados 62 artículos en los cuales se identificaron 50 factores de riesgo, de los que apenas 38 están presentes en la NANDA Internacional. Conclusiones Se proponen dos nuevas categorías de factores: los psicológicos y los socioeconómicos. Se identificaron nuevos factores de riesgo de caídas en los ancianos residentes en la comunidad, lo que contribuyó para la actualización de la taxonomía II NANDA Internacional.

ABSTRACT Objective To identify the risk factors for falls of the community-dwelling elderly in order to update the Taxonomy II of NANDA International. Method A systematic literature review based on research using the following platforms: EBSCOHost®, CINAHL and MEDLINE, from December 2010 to December 2014. The descriptors used were (Fall* OR Accidental Fall) AND (Community Dwelling OR Community Health Services OR Primary health care) AND (Risk OR Risk Assessment OR Fall Risk Factors) AND (Fall* OR Accidental Fall) AND (Community Dwelling OR older) AND Nurs* AND Fall Risk Factors. Results The sample comprised 62 studies and 50 risk factors have been identified. Of these risk factors, only 38 are already listed in the classification. Conclusions Two new categories of risk factors are proposed: psychological and socio-economical. New fall risk factors for the community-dwelling elderly have been identified, which can contribute to the updating of this nursing diagnosis of the Taxonomy II of NANDA International.