Content analysis of NOC outcomes related to mechanical ventilation in people with COVID-19.

OBJECTIVE: To analyze the evidence of content validity of the Nursing Outcomes "Mechanical Ventilation Response: Adult" and "Mechanical Ventilation Weaning Response: Adult", for patients with severe COVID-19. METHOD: Methodological study developed in two stages: literature review to construct the definitions of the indicators and analysis of the evidence of content validity of the nursing outcomes by a focus group. RESULTS: All the conceptual and operational definitions developed for the 56 indicators were considered clear and precise. However, 17 indicators were excluded because they were deemed not to be relevant. The definitions of the magnitudes for 17 indicators of the Nursing Outcome "Mechanical Ventilation Response: Adult" and 22 indicators "Mechanical Ventilation Weaning Response: Adult" were thus constructed. CONCLUSION: The development of definitions and validation by experts makes the use of these outcomes and their indicators more understandable and precise, favoring their use in clinical practice and providing greater detail in assessment and recording.

Self-care Level of Adults With Arterial Hypertension in Outpatient Follow-up in Brazil: A Cross-sectional Study.

BACKGROUND: Self-care is essential for minimizing the long-term progression of hypertension (HTN) and improving global health outcomes. However, little is known about the predictors of HTN self-care among adults with HTN in Brazil. OBJECTIVE: The aim of this study was to evaluate the self-care practices and the association of sociodemographic and clinical factors of adults with HTN in Brazil. METHODS: This was a cross-sectional study conducted by telephone with 120 adults with HTN monitored in a specialized outpatient clinic of a teaching hospital. Sociodemographic and clinical information was collected by a questionnaire survey. Self-care was assessed by the Self-care of Hypertension Inventory version 2. Multiple regression and Kendall's correlation analyses were performed to determine possible predictors. RESULTS: Low levels of self-care were observed across maintenance, management, and confidence measures. A weak correlation was observed between self-care maintenance and education (-0.13), the time of diagnosis (0.16), and the number of medications (0.15); self-care management and family income (0.13) and cognitive function (0.17); and self-care confidence and systolic (-0.15) and diastolic (-0.18) blood pressure values and time of diagnosis (0.16). In multiple regression analysis, self-care confidence was a predictor of self-care maintenance ( ß = 0.30; 95% confidence interval, 0.10-0.36) and management ( ß = 0.20; 95% confidence interval, 0.03-0.46). CONCLUSION: Confidence was essential in the maintenance and management of self-care and is central to the control of HTN. Self-care interventions must consider the different aspects that may affect self-care, highlighting improving self-care confidence as a main goal.

Autogestão ineficaz de linfedema em mulheres mastectomizadas: análise de conceito / Autogestión ineficaz de linfedema en mujeres mastectomizadas: análisis de concepto / Ineffective self-management of lymphedema in mastectomized women: concept analysis

Resumo Objetivo Analisar o conceito de "autogestão ineficaz do linfedema" em mulheres mastectomizadas. Métodos Trata-se de uma análise do conceito proposto por Walker e Avant operacionalizada por meio de uma revisão integrativa da literatura, organizada em oito etapas e baseada nas seguintes questões norteadoras: Qual é a definição de autogestão ineficaz em mulheres mastectomizadas? Quais os antecedentes, atributos e consequências da autogestão ineficaz em mulheres mastectomizadas? Como a autogestão ineficaz de linfedema tem sido definida no contexto de mulheres que passaram por mastectomia? A busca de artigos foi realizada em cinco bases de dados eletrônicas, sem limite de data, no período de julho de 2022 a fevereiro de 2023. Resultados Foram identificados 30 antecedentes e 19 consequentes; os mais frequentes entre eles foram respectivamente os seguintes: falta de apoio familiar/social e diminuição da qualidade de vida. Os atributos definidores mais frequentemente identificados foram os seguintes: edema, inchaço no braço, sensação de peso no membro, dor, dormência e diminuição da função do membro. Foram ainda elaborados os casos modelo e contrário para auxiliar na decisão sobre o uso do conceito. Conclusão Os conceitos resultantes da análise contribuem para clarificar os termos e o desenvolvimento da linguagem na enfermagem, devendo ser validados por juízes e prática clínica para melhor aplicação na oncologia clínica.

Resumen Objetivo Analizar el concepto de "autogestión ineficaz de linfedema" en mujeres mastectomizadas. Métodos Se trata de un análisis del concepto propuesto por Walker y Avant, realizado mediante una revisión integradora de la literatura, organizado en ocho etapas y basado en las siguientes preguntas orientadoras: ¿Cuál es la definición de autogestión ineficaz en mujeres mastectomizadas? ¿Cuáles son los antecedentes, atributos y consecuencias de la autogestión ineficaz en mujeres mastectomizadas? ¿Cómo se define la autogestión ineficaz de linfedema en el contexto de mujeres que pasaron por una mastectomía? La búsqueda de artículos fue realizada en cinco bases de datos electrónicas, sin límite de fecha, en el período de julio de 2022 a febrero de 2023. Resultados Se identificaron 30 antecedentes y 19 consecuentes. El antecedente más frecuente fue falta de apoyo familiar/social y el consecuente, reducción de la calidad de vida. Los atributos definidores identificados más frecuentemente fueron los siguientes: edema, hinchazón en el brazo, sensación de peso en el miembro, dolor, adormecimiento y reducción de la función del miembro. Además, se elaboraron los casos modelo y contrarios para ayudar en la decisión sobre el uso del concepto. Conclusión Los conceptos resultantes del análisis contribuyen a clarificar los términos y el desarrollo del lenguaje en enfermería y deben ser validados por jueces y práctica clínica para una mejor aplicación en la oncología clínica.

Abstract Objective To analyze the concept of "ineffective self-management of lymphedema" in mastectomized women. Methods This is an analysis of the concept proposed by Walker and Avant, operationalized through an integrative literature review, organized into eight stages, and based on the following guiding questions: What is the definition of ineffective self-management in mastectomized women? What are the antecedents, attributes, and consequences of ineffective self-management in mastectomized women? How has ineffective self-management of lymphedema been defined in the context of women who have undergone mastectomy? The search for articles was carried out in five electronic databases, with no date limit, from July 2022 to February 2023. Results Antecedents (30) and consequents (19) were identified. Among them, the most frequent were the following, respectively: lack of family and/or social support and decreased quality of life. The most frequently identified defining attributes were the following: edema, swelling in the arm, feeling of heaviness in the limb, pain, numbness, and reduced function of the limb. Model and contrary cases were also designed to help decide on the use of the concept. Conclusion The concepts resulting from the analysis contribute to clarifying the terms and development of language in nursing, and should be validated by judges and clinical practice for better application in clinical oncology.

Magnitude of risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil: A population-based study.

AIM OF THE STUDY: Estimate the magnitude and factors associated with risk factors for chronic noncommunicable diseases in adolescents and young adults in Brazil. METHODS: Cross-sectional study that analyzed data from the 2019 National Health Survey. The population of interest was adolescents and young adults aged 15 to 24 years. Data were collected through individual interviews during home visits. Dependent variables included major risk factors for chronic noncommunicable diseases. Demographic and socioeconomic characteristics were used as independent variables. Multiple Poisson regression models were used to assess the relationship between independent variables and risk factors. RESULTS: A total of 10,460 individuals (5,001 men and 5,459 women) were included. Regardless of sex, the most prevalent risk factors were insufficient fruit and vegetable consumption (92.6%) and leisure-time physical inactivity (43.3%). The prevalence rates of tobacco smokers, alcohol consumption once a month or more, and alcohol abuse were 8.9%, 28.7%, and 18.5%, respectively. Regular consumption of soft drinks and/or artificial juices was described by 17.2%. The prevalence of overweight was 32.5%. Young adults, males, and individuals with lower educational levels, of black race/skin color, with lower household income, and residents of urban areas had a higher prevalence for most risk factors. Differences in the determinants were found for some factors. Inequalities between Brazilian regions were recorded for seven of the nine factors analyzed. The most socioeconomically developed regions had the highest prevalence of most risk factors. The high magnitude of risk factors indicates a potential increase in the burden of chronic noncommunicable diseases in a future scenario for Brazil.

Symptoms of Depression in the Postpartum Period: Targeting Maternal Mental Health in the Perinatal Period.

This cross-sectional study aimed to examine the relationship between postpartum depression symptoms, anxiety, and stress during the postpartum period. A total of 101 women were assessed using the Depression, Anxiety and Stress Scale (DASS-21) and the Edinburgh Postnatal Depression Scale (EPDS) within 14 days after delivery. Multivariate regression analysis revealed that paid work, tobacco use, and stress symptoms were significantly associated with a higher incidence of postpartum depression symptoms. These results underscore the importance of comprehensive prenatal care and effective postpartum follow-up to address maternal mental health and prevent adverse outcomes for both mothers and children.

Decreased cardiac output: an integrative review.

OBJECTIVE: to identify, in the scientific literature, the defining characteristics and contributing factors (related factors, associated conditions and populations at risk) for nursing diagnosis decreased cardiac output. METHOD: an integrative literature review, conducted between September and October 2020, with an update in March 2022, in the MEDLINE via PubMed, LILACS, SciELO, CINAHL and EMBASE databases. Using acronym PEO, studies published in the last 10 years in Portuguese, English and Spanish were included. A descriptive analysis was carried out to present the elements mapped in the literature. RESULTS: analysis of 31 articles identified different elements, highlighting 4 new related factors: hyperglycemic stress, prone position, left lateral position, sleep deprivation. Individuals with a history of cardiovascular disease and males were identified as possible populations at risk. FINAL CONSIDERATIONS: the elements for decreased cardiac output, identified in the literature, add evidence that justifies the permanence of this diagnosis in the NANDA-I classification.

Evaluation of the effectiveness of nursing interventions in research from Brazilian postgraduation programs.

PURPOSE: The purpose of this study was to evaluate research from Brazilian postgraduate students who provide evidence of effectiveness for Nursing Interventions Classification (NIC). METHODS: We conducted a literature review study of thesis and dissertations available in the Brazilian Digital Library of Dissertations and Theses (D/T) in May 2021 regardless of the year they were conducted. In those studies that did not utilize the NIC in the effectiveness evaluation, the cross-mapping methodology was employed between NIC and the interventions used by the authors of the studies. RESULTS: Using a systematic process, we identified 91 studies. Twenty-seven met a priori inclusion and exclusion criteria. We found an increase in studies that focused on nursing interventions in the last 10 years (n = 19), a large proportion of clinical trials (n = 16), and the majority of articles from the Southeast region of Brazil (n = 20). The areas of focus were adult and elderly care, and with a special interest in the behavioral domain (n = 11). Two sensitivity criteria were identified in all D/T (n = 27), and each study presented evidence of effectiveness of a minimum of three criteria simultaneously. CONCLUSIONS: Based on the effectiveness criteria, the Brazilian scientific production in postgraduate programs carried out by nurses provides evidence of the effectiveness for NIC nursing interventions. IMPLICATIONS FOR NURSING PRACTICE: It is recommended to conduct further research that uses the NIC in the planning, conduct, and evaluation of interventions, based on effectiveness criteria of nursing sensitivity.

Ineffective health management in people with hypertension: Accuracy study.

PURPOSE: To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension. METHODS: This is a cross-sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability. RESULTS: Ineffective health management is probably present in 37.5% of people with hypertension. 'Failure to include treatment regimen in daily living' was the clinical indicator with the highest sensitivity value, and 'failure to take action to reduce risk factor' had the highest specificity value. CONCLUSIONS: Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario. IMPLICATIONS FOR NURSING PRACTICE: This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing.

Cardiovascular risk factors in the elderly: a 10-year follow-up survival analysis.

AIMS: Cardiovascular risk factors present a high prevalence and have an impact on the morbimortality of the elderly; however, studies evaluating the impact of cardiovascular risk factors in the elderly have had short follow-up times and have not allowed specific analyses of the effects of these factors in the aged population, including how they affect the survival of the elderly. This study aimed to analyse the survival of elderly individuals living in the community, considering the presence of cardiovascular risk factors. METHODS AND RESULTS: A prospective 10-year follow-up was initiated in 2008 with a cohort of 418 elderly people living in a community in Central Brazil. The Kaplan-Meier method and the Cox proportional hazards model were used to examine the association between survival and cardiovascular risk factors. The mean age of the participants was 70.6 (±7.1) years; most participants were hypertensive (81.6%) and participated in irregular physical activity (44%), and 43.3% smoked. After a mean follow-up of 8.38 (±2.82) years, 59.3% had survived and 34.1% had died; among the deaths, 14.1% were due to cardiovascular causes. Age [hazard ratio (HR) 1.067, 95% confidence interval (CI) 1.027-1.109], hypertension (HR 3.178, 95% CI 1.144-8.826), and smoking (HR 2.235, 95% CI 1.253-3.987) were confirmed as risk factors for reduced survival, whereas physical activity was a protective factor (HR 0.456, 95% CI 0.206-1.007). CONCLUSION: The results from this study highlight the need for educational policies towards hypertension and smoking prevention among elderly people, and participation in physical activity needs to be encouraged.

Decreased cardiac output: an integrative review / Disminución del gasto cardíaco: revisión integradora / Débito cardíaco diminuído: revisão integrativa

ABSTRACT Objective: to identify, in the scientific literature, the defining characteristics and contributing factors (related factors, associated conditions and populations at risk) for nursing diagnosis decreased cardiac output. Method: an integrative literature review, conducted between September and October 2020, with an update in March 2022, in the MEDLINE via PubMed, LILACS, SciELO, CINAHL and EMBASE databases. Using acronym PEO, studies published in the last 10 years in Portuguese, English and Spanish were included. A descriptive analysis was carried out to present the elements mapped in the literature. Results: analysis of 31 articles identified different elements, highlighting 4 new related factors: hyperglycemic stress, prone position, left lateral position, sleep deprivation. Individuals with a history of cardiovascular disease and males were identified as possible populations at risk. Final considerations: the elements for decreased cardiac output, identified in the literature, add evidence that justifies the permanence of this diagnosis in the NANDA-I classification.

RESUMEN Objetivo: identificar, en la literatura científica, las características definidoras y los factores contribuyentes (factores relacionados, condiciones asociadas y poblaciones de riesgo) para el diagnóstico de enfermería de gasto cardíaco disminuido. Método: revisión integrativa de la literatura, realizada entre septiembrey octubre de 2020, con actualización en marzo de 2022, en las bases de datos MEDLINE vía PubMed, LILACS, SciELO, CINAHL y EMBASE. Utilizando la sigla PEO, se incluyeron estudios publicados en los últimos 10 años en portugués, inglés y español. Se realizó un análisis descriptivo para presentar los elementos mapeados en la literatura. Resultados: el análisis de 31 artículos identificó diferentes elementos, con énfasis en 4 nuevos factores relacionados: estrés hiperglucémico, posición prona, posición lateral izquierda, privación del sueño. Las personas con antecedentes de enfermedad cardiovascular y los hombres se identificaron como posibles poblaciones en riesgo. Consideraciones finales: los elementos para gasto cardíaco disminuido, identificados en la literatura, suman evidencias que justifican la permanencia de este diagnóstico en la clasificación NANDA-I.

RESUMO Objetivo: identificar, na literatura científica, as características definidoras e fatores contribuintes (fatores relacionados, condições associadas e populações em risco) para o diagnóstico de enfermagem débito cardíaco diminuído. Método: revisão integrativa da literatura, conduzida entre setembro e outubro de 2020, com atualização em março de 2022, nas bases de dados MEDLINE via PubMed, LILACS, SciELO, CINAHL e EMBASE. Com uso do acrônimo PEO, foram incluídos estudos publicados nos últimos 10 anos em português, inglês e espanhol. Realizouse análise descritiva para apresentar os elementos mapeados na literatura. Resultados: análise de 31 artigos identificou diferentes elementos, com destaque para 4 novos fatores relacionados: estresse hiperglicêmico, posição prona, posição lateral esquerda, privação do sono. Indivíduos com história de doença cardiovascular e do sexo masculino foram apontados como possíveis populações em risco. Considerações finais: os elementos para débito cardíaco diminuído, identificados na literatura, agregam evidências que justificam a permanência desse diagnóstico na classificação da NANDA-I.

Fatores sociodemográficos e clínicos associados à ansiedade em mulheres hipertensas: estudo transversal / Factores sociodemográficos y clínicos asociados a la ansiedad en mujeres hipertensas: estudio transversal / Sociodemographic and clinical factors associated with anxiety in hypertensive women: a cross-sectional study

Resumo Objetivo Verificar a prevalência da ansiedade e sua associação com os fatores sociodemográficos e clínicos em mulheres com hipertensão arterial sistêmica. Métodos Estudo transversal com 258 mulheres com hipertensão arterial sistêmica diagnosticada há pelo menos seis meses e que eram atendidas no ambulatório de Hipertensão Arterial de uma instituição pública voltada ao ensino, pesquisa e assistência na cidade de São Paulo. O instrumento continha dados sociodemográficos, clínicos e de hábitos de vida e foi preenchido por meio de uma entrevista. A ansiedade foi avaliada pelo inventário de Ansiedade Traço e classificada em baixa, moderada, elevada e muito elevada. A avaliação da associação entre os fatores sociodemográficos e clínicos com o nível de ansiedade foi realizada pelos testes de associação e regressão logística simples multinomial, considerando o nível de significância de 5%. Resultados Identificou-se que 70,5% apresentavam ansiedade moderada e 19,4% elevada. Na regressão logística multinomial simples identificou-se que quanto maior a idade maior a chance de ansiedade elevada (p=0,01; Odds Ratio =1,09), as mulheres sem companheiro tinham maiores chances de ansiedade elevada (p=0,02, Odds Ratio =3,19) e com o aumento da renda mensal familiar menor foi a chance de ansiedade elevada (p=0,04, Odds Ratio =0,99). Conclusão Houve alta prevalência de ansiedade moderada na população estudada e a ausência de companheiro foi o fator que melhor explicou o fenômeno de ansiedade. Os enfermeiros devem propor intervenções, principalmente para estas pessoas, com o intuito de reduzir tal sentimento.

Resumen Ocurrencias Verificar la prevalencia de la ansiedad y su relación con los factores sociodemográficos y clínicos en mujeres con hipertensión arterial sistémica. Métodos Estudio transversal con 258 mujeres con hipertensión arterial sistémica diagnosticadas hace seis meses por lo menos y que habían sido atendidas en consultorios externos de Hipertensión Arterial de una institución pública orientada a la educación, investigación y atención en la ciudad de São Paulo. El instrumento contenía datos sociodemográficos, clínicos y de hábitos de vida y fue completado mediante una encuesta. La ansiedad fue evaluada mediante el inventario de rasgos de ansiedad y clasificada como baja, moderada, alta o muy alta. La evaluación de la relación entre los factores sociodemográficos y clínicos con el nivel de ansiedad fue realizada con la prueba de asociación y regresión logística simple multinominal, con un nivel de significación de 5 %. Resultados Se identificó que el 70,5 % presentó ansiedad moderada y el 19,4 % alta. En la regresión logística multinomial simple se identificó que, cuanto mayor era la edad, mayor era la probabilidad de ansiedad alta (p=0,01; Odds Ratio =1,09), las mujeres sin compañero tenían mayores probabilidades de ansiedad alta (p=0,02, Odds Ratio =3,19) y con el aumento de los ingresos familiares mensuales, la probabilidad de ansiedad alta fue menor (p=0,04, Odds Ratio =0,99). Conclusión Se observó una alta prevalencia de ansiedad moderada en la población estudiada y la ausencia de compañero fue el factor que mejor explicó el fenómeno de ansiedad. Los enfermeros deben proponer intervenciones, principalmente para estas personas, con el objetivo de reducir ese sentimiento.

Abstract Objective To verify the prevalence of anxiety and its association with sociodemographic and clinical factors in women with hypertension. Method This is a cross-sectional study with 258 women with hypertension diagnosed for at least six months and who were treated at the hypertension outpatient clinic of a public institution dedicated to teaching, research and care in the city of São Paulo. The instrument contained sociodemographic, clinical and lifestyle data and was completed through an interview. Anxiety was assessed by the State-Trait Anxiety inventory and classified as low, moderate, high and very high. The assessment of the association between sociodemographic and clinical factors with anxiety level was performed using association tests and simple multinomial logistic regression, considering a significance level of 5%. Results It was found that 70.5% had moderate anxiety and 19.4% had high anxiety. In the simple multinomial logistic regression, it was identified that the older the age, the greater the chance of high anxiety (p=0.01; Odds Ratio =1.09), women without a partner were more likely to have high anxiety (p=0.02, Odds Ratio =3.19), and with increasing monthly family income, the chance of high anxiety was lower (p=0.04, Odds Ratio =0.99). Conclusion There was a high prevalence of moderate anxiety in the population studied and the absence of a partner was the factor that best explained the anxiety phenomenon. Nurses should propose interventions, especially for these people, in order to reduce this feeling.

Clinical indicators of the nursing diagnosis ineffective health management: Systematic review and meta-analysis.

BACKGROUND: Nursing diagnoses should reasonably represent global nursing practice phenomena, organizing indicators in their clinical structure that represent different scenarios and populations. However, few studies have summarized the evidence of these indicators, mainly for behavioral diagnoses. AIM: This systematic review aimed to identify the best clinical indicators (CI) to determine the presence or absence of the nursing diagnosis "Ineffective Health Management" (IHM). METHOD: A systematic review with meta-analysis was utilized. Six electronic databases were consulted to retrieve studies that identified the nursing diagnosis IHM, with at least one CI. The period of data collection was between September and October 2020. The research group independently conducted the selection, quality assessment, data extraction, and analysis of all included studies. Fixed-effect measures and meta-analyses summarized sensitivity, specificity measures, and diagnostic odds ratios using the statistical software R. The preferred reporting items for systematic reviews and meta-analyses and standards for reporting studies of diagnostic accuracy guidelines were used to guide this review, and quality assessment of diagnostic accuracy studies was used for the critical appraisal of the methodological quality of the included studies. RESULTS: The systematic review included 11 studies on people with chronic conditions, the elderly, and pregnant women. The analyzed four CI showed diagnostic odds ratios statistically higher than the unit value, highlighting the "Failure to include the treatment regimen in daily living" (DOR = 45.53; CI = 10.1, 205.6). LINKING EVIDENCE TO ACTION: Overall, findings showed that all CI of the IHM nursing diagnosis had good sensitivity, specificity, and diagnostic odds ratio measures to identify their presence correctly. These findings can contribute to better accuracy in nurses' decision-making process, providing indicators to infer the IHM nursing diagnosis early in different population spectra based on the best measures of diagnostic accuracy.

Effect of simulation on stress, anxiety, and self-confidence in nursing students: Systematic review with meta-analysis and meta-regression.

INTRODUCTION: Simulation is a promising strategy in health education, with evidence of importance for learning, but the available systematic reviews are still inconclusive about the effect of the strategy on stress, anxiety, and self-confidence of nursing students, which impact the adherence to and sustainment of this strategy. Thus, better evidence is needed of the impact of simulation on these competences, essential for health professional education. OBJECTIVE: To evaluate the effect of simulation-based experiences on stress, anxiety, self-confidence and learning of undergraduate nursing students compared to conventional teaching strategies or no intervention. DESIGN: Systematic review with meta-analysis and meta-regression. DATA SOURCES: The databases used included: CENTRAL, CINAHL, Embase®, ERIC, LILACS, MEDLINE, PsycINFO®, SCOPUS and Web of Science. Additional searches occurred in PQDT Open (ProQuest), BDTD, Google Scholar and journals with a specific scope in clinical simulation. REVIEW METHODS: This study was conducted by the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Experimental and quasi-experimental studies that compared the effects of simulation on stress, anxiety, and self-confidence of nursing students were included. Study selection and data extraction steps were performed independently by two reviewers. Critical appraisal of the studies was managed by means of the risk of bias tools RoB 2 and ROBINS-I, and quality of evidence by means of the GRADE tool. Data summarization was performed by qualitative synthesis with descriptive analysis and quantitative synthesis by meta-analytic methods and meta-regression. RESULTS: Sixty-two studies were included covering an overall sample of 4570 undergraduate nursing students. When comparing simulation with other teaching strategies, simulation showed small effect size for anxiety (d = -0.33; 95% CI: -0.66-0.002; p = 0.051) and medium effect size for self-confidence (d = 0.71; 95% CI: 0.46-0.95; p < 0.001); there was no difference in the effect-size for stress (d = 0.04; 95% CI:-0.91-0.99; p = 0.90). Subgroup analyses showed an effect of methodological characteristics of the studies on students' anxiety and self-confidence. A positive relationship between self-confidence and learning was identified by meta-regression (p = 0.018; R2 = 20.96%). CONCLUSION: Simulation is an effective strategy for reducing anxiety and increasing self-confidence compared to conventional teaching strategies. Results are still inconclusive for stress. The use of simulation-based experiences in nursing education obtains positive results on anxiety and self-confidence in students, providing support for its implementation in undergraduate curricula to improve the education of qualified nurses. REGISTRATION NUMBER: CRD42020206077. TWEETABLE ABSTRACT: Simulation is an effective teaching strategy for reducing anxiety and increasing self-confidence in learning.

Ineffective health management: A systematic review and meta-analysis of related factors.

PURPOSE: A standardized language system can support the elaboration of clinical guidelines by matching information from similar patterns of response to people. To identify the factors that are related to a higher likelihood of an ineffective health management nursing diagnosis. METHODS: We conduct a systematic review and meta-analysis. An electronic search was conducted in MEDLINE databases via PubMed, Web of Science, SciELO, CINAHL, SCOPUS, and Embase between October and November 2020. Descriptive data were extracted from each article. The odds ratios for each etiological factor related to ineffective health management were directly extracted from the articles or calculated from the data described in the articles. The analysis of the measurements of exposure and the magnitude of the effect was performed using the statistical software R, and a forest plot was constructed for each etiological factor. FINDINGS: Ten studies were included, and 15 related factors were recovered from the primary studies. The factors that significantly increased the likelihood of an ineffective health management nursing diagnosis were insufficient knowledge of the therapeutic regimen, perceived barriers, powerlessness, economic disadvantage, and difficulty managing complex treatment regimens. No effect was verified with the following factors: decision conflict, family pattern of healthcare, and inadequate number of cues to action. CONCLUSION: Factors related to a higher likelihood of ineffective health management may be the focus of early and targeted nursing interventions, contributing to an improved quality of care. CLINICAL RELEVANCE: Understanding exposure to these factors can improve diagnostic reasoning at different population levels.

Educational interventions in improving quality of life for hypertensive people: integrative review / Intervenciones educativas en el mejoramiento de la calidad de vida de hipertensos: revisión integradora / Intervenções educativas na melhora da qualidade de vida de hipertensos: revisão integrativa

ABSTRACT Objective: to evaluate the effectiveness of educational interventions in improving the quality of life of people with arterial hypertension. Method: an integrative literature review which included studies that conducted educational interventions aimed at the hypertensive public to improve quality of life. The search was performed in the following databases: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO and CINAHL, without restriction of language, date and sample size. For this, the following descriptors were crossed: "hipertensão" (hypertension), "educação em saúde" (health education) and "qualidade de vida" (quality of life). 619 articles were retrieved and after the selection and analysis process, a total of 10 made up this review. Data extraction and analysis were performed with the help of validated instruments and the result summarized. Results: Most studies were developed on a quasi-experimental basis, using generic instruments to measure quality of life with significant improvement after educational interventions, with group technology being the most used educational strategy. Just one study used a specific instrument to evaluate hypertensive patients. Conclusion: these results may direct the interventions to be implemented by health professionals in managing arterial hypertension. Further investigations are needed to identify and verify the most effective interventions for hypertensive patients, considering heterogeneous profiles and aiming at improving quality of life.

RESUMO Objetivo: evaluar la eficacia de las intervenciones educativas en el mejoramiento de la calidad de vida de personas con hipertensión arterial. Método: revisión integradora de la literatura que incluyó estudios que han realizado intervenciones educativas direccionadas al público hipertenso con el objetivo de mejorar su calidad de vida. La búsqueda se realizó en las bases de datos MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sin restricción de idioma, fecha ni tamaño de muestra. A tal efecto, se utilizaron los descriptores "hipertensión", "educación en salud" y "calidad de vida". Se tomaron 619 artículos y luego de un proceso de selección y análisis esta revisión se compone de un total de 10. La extracción y el análisis de datos se realizaron con el auxilio de instrumentos validados e se procedió a la síntesis de los resultados. Resultados: la mayor parte de los estudios se desarrolló con carácter casi experimental mediante el uso instrumentos genéricos para medir la calidad de vida, con significativa mejoría después de realizadas las intervenciones educativas, siendo la tecnología grupal la estrategia educacional más utilizada. Apenas un estudio utilizó un instrumento específico para la evaluación de hipertensos. Conclusión: estos resultados pueden direccionar las intervenciones que deben llevarse a cabo por profesionales de la salud en el manejo de la presión arterial. Es necesario profundizar las investigaciones para identificar y verificar las intervenciones más eficientes en pacientes hipertensos, considerando perfiles heterogéneos a fin de mejorar su calidad de vida.

RESUMO Objetivo: avaliar a efetividade de intervenções educativas na melhora da qualidade de vida de pessoas com hipertensão arterial. Método: revisão integrativa da literatura que incluiu estudos que realizaram intervenções educacionais direcionadas ao público hipertenso com vistas à melhora da qualidade de vida. Busca realizada nas bases de dados: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sem restrição de idioma, data e tamanho amostral. Para tal, cruzaram-se os descritores: "hipertensão", "educação em saúde" e "qualidade de vida". Foram resgatados 619 artigos e após o processo de seleção e análise, um total de 10 compuseram esta revisão. A extração e análise dos dados foram realizadas com auxílio de instrumentos validados e o resultado sumarizado. Resultados: a maioria dos estudos foi desenvolvida em caráter quase experimental, utilizando-se de instrumentos genéricos para mensuração da qualidade de vida com melhora significativa após a realização de intervenções educativas, sendo a tecnologia grupal a estratégia educacional mais utilizada. Apenas um estudo utilizou instrumento específico para avaliação em hipertensos. Conclusão: estes resultados podem direcionar as intervenções a serem implementadas por profissionais de saúde no manejo da hipertensão arterial. Futuras investigações são necessárias para identificar e verificar as intervenções mais eficazes aos pacientes hipertensos, considerando perfis heterogêneos e visando à melhora da qualidade de vida.

Brazilian Nursing Process Research Network contributions for assistance in the COVID-19 pandemic.

OBJECTIVE: to describe the theoretical construction process of nursing process support documents in COVID-19 care scenarios. METHODS: an experience report of the joint activity of the Brazilian Nursing Process Research Network (Rede de Pesquisa em Processo de Enfermagem) composed of Higher Education and Health Institution researchers in Brazil. RESULTS: five instruments were organized collectively, involving the elements of nursing practice (nursing diagnoses, outcomes and interventions) in assistance for community; for patients (with suspected or mild, moderate, and critical COVID-19 and residents in Nursing Homes); for nursing workers' health support, also subsidizing registration and documentation during the COVID-19 pandemic. FINAL CONSIDERATIONS: valuing the phenomena manifested by families/communities, patients and health professionals is essential for early detection, intervention, and prevention of diseases.

Health education: the effectiveness of interventions in patients with heart failure.

OBJECTIVES: To evaluate the effectiveness of NIC interventions "Teaching: Disease Process", "Health Education" and "Cardiac Care" in the improvement of NOC results in individuals with Heart Failure (HF), and the Nursing Diagnosis (ND) "Ineffective Health Control". METHODS: Retrospective cohort, conducted at a Health Education in Nursing outpatient clinic. Fourteen patients with HF had follow-up for one year in six bimonthly consultations. The effectiveness of interventions was verified through the change of the result scores through the Friedman's Non-Parametric Test and Analysis of Non-Parametric Variance for repeated measures. The level of significance was 5%. RESULTS: The interventions were implemented in consultations in a variety of activities. There was a significant improvement in the result scores until the fourth visit (p<0.001). CONCLUSIONS: The interventions were effective in improving outcomes in patients with HF and Ineffective Health Control.

Brazilian Nursing Process Research Network contributions for assistance in the COVID-19 pandemic / Contribuciones de la Red de Investigación en Proceso de Enfermería para la asistencia en la pandemia de COVID-19 / Contribuições da rede de pesquisa em processo de enfermagem para assistência na pandemia de COVID-19

ABSTRACT Objective: to describe the theoretical construction process of nursing process support documents in COVID-19 care scenarios. Methods: an experience report of the joint activity of the Brazilian Nursing Process Research Network (Rede de Pesquisa em Processo de Enfermagem) composed of Higher Education and Health Institution researchers in Brazil. Results: five instruments were organized collectively, involving the elements of nursing practice (nursing diagnoses, outcomes and interventions) in assistance for community; for patients (with suspected or mild, moderate, and critical COVID-19 and residents in Nursing Homes); for nursing workers' health support, also subsidizing registration and documentation during the COVID-19 pandemic. Final considerations: valuing the phenomena manifested by families/communities, patients and health professionals is essential for early detection, intervention, and prevention of diseases.

RESUMEN Objetivo: describir el proceso de construcción teórica de los documentos de respaldo del Proceso de Enfermería en los escenarios de asistencia al COVID-19. Métodos: es un relato de experiencia de la actividad conjunta de la Red de Investigación de Procesos de Enfermería, formada por investigadores de las Instituciones de Educación Superior y Salud de Brasil. Resultados: se organizaron cinco instrumentos de manera colectiva, involucrando elementos de la práctica de enfermería (diagnósticos, resultados e intervenciones de enfermería) en el cuidado comunitario; al paciente (sospechoso o con COVID-19 leve y moderado, crítico y residente en Hogares para Ancianos); y apoyo a la salud del trabajador de enfermería, subsidiando además el registro y documentación durante la pandemia de COVID-19. Consideraciones finales: valorar los fenómenos manifestados por las familias/comunidades, pacientes y profesionales de la salud es fundamental para su identificación temprana, intervención y prevención de enfermedades.

RESUMO Objetivo: descrever o processo de construção teórica dos documentos de apoio ao Processo de Enfermagem nos cenários de atendimento à COVID-19. Métodos: trata-se de um relato de experiência da atividade conjunta da Rede de Pesquisa em Processo de Enfermagem, formada por pesquisadores de Instituições de Ensino Superior e de Saúde do Brasil. Resultados: cinco instrumentos foram organizados coletivamente, envolvendo os elementos da prática de enfermagem (diagnósticos, resultados e intervenções de enfermagem) na assistência à comunidade; ao paciente (suspeito ou com COVID-19 leve e moderada, crítico e residente em Instituições de Longa Permanência para Idosos); e ao suporte à saúde do trabalhador de enfermagem, subsidiando igualmente o registro e a documentação durante a pandemia de COVID-19. Considerações finais: valorizar os fenômenos manifestados por famílias/comunidades, pacientes e profissionais de saúde é essencial para sua identificação precoce, intervenção e prevenção de agravos.

Health education: the effectiveness of interventions in patients with heart failure / Educación para la salud: la efectividad de las intervenciones en pacientes con insuficiencia cardíaca / Educação em saúde: efetividade das intervenções em pacientes com insuficiência cardíaca

ABSTRACT Objectives: To evaluate the effectiveness of NIC interventions "Teaching: Disease Process", "Health Education" and "Cardiac Care" in the improvement of NOC results in individuals with Heart Failure (HF), and the Nursing Diagnosis (ND) "Ineffective Health Control". Methods: Retrospective cohort, conducted at a Health Education in Nursing outpatient clinic. Fourteen patients with HF had follow-up for one year in six bimonthly consultations. The effectiveness of interventions was verified through the change of the result scores through the Friedman's Non-Parametric Test and Analysis of Non-Parametric Variance for repeated measures. The level of significance was 5%. Results: The interventions were implemented in consultations in a variety of activities. There was a significant improvement in the result scores until the fourth visit (p<0.001). Conclusions: The interventions were effective in improving outcomes in patients with HF and Ineffective Health Control.

RESUMEN Objetivos: Evaluar la efectividad de las intervenciones NIC "Enseñanza: Proceso de Enfermedad", "Educación para la Salud" y "Cuidados Cardíacos" en la mejora de resultados NOC en individuos con insuficiencia cardíaca (IC) y el diagnóstico de enfermería (DE) "Control Ineficaz de la Salud". Métodos: Ccohorte retrospectivo conducido en un ambulatorio de enfermería de educación para la Salud. Se incluyeron 14 pacientes con IC acompañados durante un año, en seis consultas presenciales bimestrales. La efectividad de las intervenciones fue verificada por medio del cambio de los escores de los resultados, con uso de las Pruebas no paramétricas de Friedman y Análisis de Variancia no Paramétrica para medidas repetidas. El nivel de significancia adoptado fue del 5%. Resultados: Llas intervenciones fueron implementadas en las consultas con variación de las actividades. Se observó una mejoría significativa de los resultados obtenidos hasta la cuarta consulta (p <0,001). Conclusiones: Llas intervenciones fueron efectivas en la mejora de los resultados en pacientes con IC y Control Ineficaz de la Salud.

RESUMO Objetivos: Avaliar a efetividade das intervenções NIC "Ensino: Processo de Doença", "Educação em Saúde" e "Cuidados Cardíacos" na melhora de resultados NOC em indivíduos com Insuficiência Cardíaca (IC), e o Diagnóstico de Enfermagem (DE) "Controle Ineficaz da Saúde". Métodos: Coorte retrospectivo, conduzido num ambulatório de enfermagem de Educação em Saúde. Foram incluídos 14 pacientes com IC acompanhados durante um ano em seis consultas presenciais bimestrais. A efetividade das intervenções foi verificada por meio da mudança dos escores dos resultados por meio dos Testes Não-Paramétricos de Friedman e Análise de Variância Não-Paramétrica para medidas repetidas. O nível de significância adotado foi de 5%. Resultados: As intervenções foram implementadas nas consultas com variação das atividades. Houve melhora significativa dos escores dos resultados até a quarta consulta (p<0,001). Conclusões: As intervenções foram efetivas na melhora dos resultados em pacientes com IC e no Controle Ineficaz da Saúde.

Health education: the effectiveness of interventions in patients with heart failure / Educación para la salud: la efectividad de las intervenciones en pacientes con insuficiencia cardíaca / Educação em saúde: efetividade das intervenções em pacientes com insuficiência cardíaca

ABSTRACT Objectives: To evaluate the effectiveness of NIC interventions "Teaching: Disease Process", "Health Education" and "Cardiac Care" in the improvement of NOC results in individuals with Heart Failure (HF), and the Nursing Diagnosis (ND) "Ineffective Health Control". Methods: Retrospective cohort, conducted at a Health Education in Nursing outpatient clinic. Fourteen patients with HF had follow-up for one year in six bimonthly consultations. The effectiveness of interventions was verified through the change of the result scores through the Friedman's Non-Parametric Test and Analysis of Non-Parametric Variance for repeated measures. The level of significance was 5%. Results: The interventions were implemented in consultations in a variety of activities. There was a significant improvement in the result scores until the fourth visit (p<0.001). Conclusions: The interventions were effective in improving outcomes in patients with HF and Ineffective Health Control.

RESUMEN Objetivos: Evaluar la efectividad de las intervenciones NIC "Enseñanza: Proceso de Enfermedad", "Educación para la Salud" y "Cuidados Cardíacos" en la mejora de resultados NOC en individuos con insuficiencia cardíaca (IC) y el diagnóstico de enfermería (DE) "Control Ineficaz de la Salud". Métodos: Ccohorte retrospectivo conducido en un ambulatorio de enfermería de educación para la Salud. Se incluyeron 14 pacientes con IC acompañados durante un año, en seis consultas presenciales bimestrales. La efectividad de las intervenciones fue verificada por medio del cambio de los escores de los resultados, con uso de las Pruebas no paramétricas de Friedman y Análisis de Variancia no Paramétrica para medidas repetidas. El nivel de significancia adoptado fue del 5%. Resultados: Llas intervenciones fueron implementadas en las consultas con variación de las actividades. Se observó una mejoría significativa de los resultados obtenidos hasta la cuarta consulta (p <0,001). Conclusiones: Llas intervenciones fueron efectivas en la mejora de los resultados en pacientes con IC y Control Ineficaz de la Salud.

RESUMO Objetivos: Avaliar a efetividade das intervenções NIC "Ensino: Processo de Doença", "Educação em Saúde" e "Cuidados Cardíacos" na melhora de resultados NOC em indivíduos com Insuficiência Cardíaca (IC), e o Diagnóstico de Enfermagem (DE) "Controle Ineficaz da Saúde". Métodos: Coorte retrospectivo, conduzido num ambulatório de enfermagem de Educação em Saúde. Foram incluídos 14 pacientes com IC acompanhados durante um ano em seis consultas presenciais bimestrais. A efetividade das intervenções foi verificada por meio da mudança dos escores dos resultados por meio dos Testes Não-Paramétricos de Friedman e Análise de Variância Não-Paramétrica para medidas repetidas. O nível de significância adotado foi de 5%. Resultados: As intervenções foram implementadas nas consultas com variação das atividades. Houve melhora significativa dos escores dos resultados até a quarta consulta (p<0,001). Conclusões: As intervenções foram efetivas na melhora dos resultados em pacientes com IC e no Controle Ineficaz da Saúde.