Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants.

OBJECTIVE: To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. METHOD: Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). RESULTS: Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. CONCLUSION: Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants / Lactancia materna al alta y en la tercera etapa del Método Madre Canguro en recién nacidos prematuros hospitalizados / Aleitamento materno na alta e na terceira etapa do Método Canguru entre recém-nascidos prematuros hospitalizados

ABSTRACT Objective: To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. Method: Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). Results: Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. Conclusion: Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

RESUMEN Objetivo: Identificar el tipo de alimentación y analizar los factores sociodemográficos y clínicos asociados a la lactancia materna exclusiva al alta hospitalaria, en el primero y en la última visita de seguimiento de la tercera etapa del Método Madre Canguro entre los recién nacidos ingresados en la unidad canguro. Método: Estudio longitudinal y retrospectivo. Se incluyeron 186 neonatos en edad gestacional <37 semanas ingresados en la unidad canguro en 2018 y 2019. Datos recopilados de historias clínicas sometidas a análisis inferencial y modelo de regresión de Poisson (p < 0,05). Resultados: La tasa de lactancia materna exclusiva fue del 73,1% al alta, con descenso en la última visita de seguimiento (68,1%). Al alta hubo mayor probabilidad de lactancia materna exclusiva en madres más jóvenes, con mayor escolaridad, recién nacidos con mayor peso al nacer y que recibieron leche materna exclusiva durante la internación; en la primera visita de seguimiento, en una madre más joven y un recién nacido que recibió únicamente leche materna durante la hospitalización; y en la última visita de seguimiento, una madre joven, recién nacido que recibió sólo leche humana y con la primera succión del pecho en la unidad canguro. Conclusión: La mayoría de los recién nacidos hospitalizados en la segunda etapa del Método Madre Canguro fueron amamantados exclusivamente y presentaron factores maternos y médicos relacionados con la lactancia materna, que pueden ayudar a gestionar los desafíos del método y promover la lactancia materna.

RESUMO Objetivo: Identificar o tipo de alimentação e analisar os fatores sociodemográficos e clínicos associados ao aleitamento exclusivo na alta hospitalar, no primeiro e no último retorno da terceira etapa do Método Canguru entre neonatos internados na unidade canguru. Método: Estudo longitudinal e retrospectivo. Incluídos 186 neonatos com idade gestacional <37 semanas admitidos na unidade canguru em 2018 e 2019. Dados coletados do prontuário submetidos à análise inferencial e ao modelo de regressão Poisson (p < 0,05). Resultados: Taxa de aleitamento exclusivo foi de 73,1% na alta, com queda no último retorno (68,1%). Na alta, houve maior probabilidade de aleitamento exclusivo em mãe mais jovem, com escolaridade superior, neonato nascido com maior peso e que recebeu leite humano exclusivo durante internação; no primeiro retorno, em mãe mais jovem e neonato que recebeu apenas leite humano na internação; e no último retorno, mãe jovem, neonato que recebeu apenas leite humano e com primeira sucção na mama na unidade canguru. Conclusão: A maioria dos neonatos internados na segunda etapa do Método Canguru estava em aleitamento exclusivo e apresentou fatores maternos e clínicos relacionados ao aleitamento, podendo auxiliar no manejo dos desafios do método e na promoção da amamentação.

Conhecimento, Atitude e Prática de Gestantes Sobre Incontinência Urinária: Estudo Observacional / Knowledge, Attitude, and Practice of Pregnant Women About Urinary Incontinence: Observational Study / Conocimiento, Actitud y Práctica De Gestantes Sobre la Incontinencia Urinaria: Estudio Observacional

Objetivo:avaliar o conhecimento, a atitude e a prática (CAP) de gestantes sobre incontinência urinária (IU), identificar a prevalência de IU durante a gestação, avaliar seu impacto na qualidade de vida (QV) e identificar os fatores associados ao CAP inadequados em relação à IU. Metodologia: Estudo observacional realizado de maio a novembro de 2019 na cidade de Fortaleza, Ceará. Utilizaram-se dois instrumentos para coleta de dados: um para avaliação sociodemográfica, obstétrica e de perdas urinárias e outro para avaliação do CAP sobre IU. Resultados: Participaram 237 gestantes. A prevalência de IU foi de 49,3% e observou-se baixo impacto na QV. A maioria apresentou conhecimento (89,6%) e prática inadequados tanto para prevenir (89,2%) quanto para tratar (78,8%) a IU. Identificaram-se baixos percentuais de acerto relacionados ao conhecimento sobre fatores de risco (46,8%), prevenção (43,8%) e tratamento da IU (42,8%). Apesar disso, a atitude foi considerada adequada para a maioria das mulheres (98,5%). Ausência de orientação sobre o preparo do períneo para o parto durante o pré-natal (p = 0,019), baixa escolaridade (p < 0,001), casos mais leves de IU (p = 0,027) e gestação de alto risco (p = 0,004) associaram-se a prática inadequada. Conclusão: o conhecimento sobre causas, prevenção e tratamento da IU é insuficiente e interfere no manejo dessa condição.perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objectives:To assess the knowledge, attitude and practice (KAP) of pregnant women about urinary incontinence (UI), identify the prevalence of UI, assess its impact on quality of life (QoL) and identify factors associated with inadequate KAP in relation to UI. Methodology: Observational study carried out from May to November 2019 in the city of Fortaleza, Ceará, Brazil. Two instruments were used for data collection: one for sociodemographic, obstetric and urinary loss assessment and another for KAP assessment on UI. Results: 237 pregnant women participated. The prevalence of UI was 49.3% and a low impact on QoL was observed. Most had knowledge (89.6%) and inadequate practice both to prevent (89.2%) and to treat (78.8%). Low percentages of correct answers were identified related to knowledge about risk factors (46.8%), prevention (43.8%) and treatment of UI (42.8%). Despite this, the attitude was considered adequate for most women (98.5%). Absence of guidance on preparation of the perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objetivos:evaluar el conocimiento, la actitud y la práctica (CAP) de las gestantes sobre la incontinencia urinaria (IU), identificar la prevalencia de la IU, evaluar su impacto en la calidad de vida (CV) e identificar los factores asociados a una PAC inadecuada en relación con la IU. Metodología: estudio observacional realizado de mayo a noviembre de 2019 en la ciudad de Fortaleza/CE. Se utilizaron dos instrumentos para la recolección de datos: uno para la evaluación sociodemográfica, obstétrica y de pérdidas urinarias y otro para la evaluación del CAP en la IU. Resultados: Participaron 237 gestantes. La prevalencia de IU fue del 49,3% y se observó un bajo impacto en la CV. La mayoría tenía conocimiento (89,6%) y práctica inadecuada tanto para prevenir (89,2%) como para tratar (78,8%). Se identificaron bajos porcentajes de aciertos relacionados con el conocimiento sobre factores de riesgo (46,8%), prevención (43,8%) y tratamiento de la IU (42,8%). A pesar de ello, la actitud fue considerada adecuada por la mayoría de las mujeres (98,5%). La ausencia de orientación sobre la preparación del perineo para el parto durante el control prenatal (p = 0,019), la baja escolaridad (p < 0,001), los casos más leves de IU (p = 0,027) y el embarazo de alto riesgo (p = 0,004) se asociaron con una atención inadecuada. práctica. Conclusión: el conocimiento sobre las causas, la prevención y el tratamiento de la IU es insuficiente e interfiere con el manejo de esta condición.

Brazilian Portuguese translation, cross-cultural adaptation, and content validation of the pediatric lower urinary tract symptom score.

BACKGROUND: Early screening instruments for professionals are important to reduce the cost and time of diagnosing pediatric lower urinary tract dysfunction. This study aimed to translate, cross-culturally adapt, and validate pediatric lower urinary tract symptom scores. METHODS: This methodological study was conducted in 2019 in two phases: translation and cross-cultural adaptation, and content validation. In the first phase, we used translators, specialists, and 30 parents of children with voiding dysfunction. In the second phase, validation was performed by 11 pediatric urology specialists. FINDINGS: The instrument was translated and adapted to Brazilian Portuguese and presented an excellent level of verbal comprehension. Further, the instrument presented a good content validity index >0.8 for all items, except for the nomenclature and clarity of two items, as indicated by the Cronbach's alpha value of 0.75 for internal consistency. DISCUSSION: The final version showed semantic, idiomatic, experiential, and conceptual equivalence with the original instrument, indicating that it is adequate for other assessments of psychometric qualities. PRACTICE IMPLICATIONS: The translation and adaptation of an important instrument for diagnosing lower urinary tract dysfunction in children to other countries helps nurses identify the disease early and monitor the treatment.

Validation of Visual Prostate Symptom Score (VPSS) in Brazilian Sample Population.

PURPOSE: The aim of the study was to evaluate the reliability and validity of the Visual Prostate Symptom Score (VPSS), its correlation with the International Prostate Symptom Score (IPSS), and the time required and need for help when completing the instrument. We also aimed to identify variables associated with difficulty completing these instruments. DESIGN: Longitudinal, prospective correlational study. SUBJECTS AND SETTING: The target population was Brazilian men from different cities within the state of São Paulo with lower urinary tract symptoms followed in urological consultation at a university hospital during October 2017. The sample comprised 59 patients with a mean age of 66.53 years. METHODS: Reliability of the VPSS was evaluated using a test-retest approach and its convergent validity with the IPSS. Cronbach α coefficient was also calculated. Both questionnaires were self-administered and, in case of difficulty of comprehension, assistance was provided. RESULTS: Mean completion time of the IPSS was 6.56 minutes and for VPSS was 5.02 minutes. The variables skin color and educational level were associated with the difficulty in completing the IPSS and for comprehending meaning of the VPSS pictograms. Internal consistency evaluated using Cronbach α coefficient was 0.74 for IPSS and 0.15 for VPSS, respectively. Test-retest reliability testing revealed that both instruments had a high intraclass correlation index (>0.75). There was a significant correlation between the health-related quality of life (QoL) scores of the 2 instruments (0.71, P = .0001) and between the total score of each instrument with its corresponding QoL score. CONCLUSION: Although time for response of the VPSS was shorter and it demonstrated good test-retest reliability, it more frequently required help to answer. The VPSS showed low internal consistency and low correlation with the IPSS (except for the QoL item).

Barreiras e facilitadores da implementação do pré-natal em grupo: um protocolo de scoping review / Barriers and facilitators to the implementation of group prenatal care: a scoping review protocol

OBJETIVO: Mapear modelos de Pré-Natal em Grupo (PNG) para identificar barreiras, facilitadores, desafios de implementação e manutenção do PNG. MÉTODO: Este protocolo descreve uma Scoping Review desenvolvida de acordo com a metodologia do Joanna Briggs Institute (JBI). A questão de pesquisa que norteia esta revisão é: "Quais são os modelos de PNG existentes, as barreiras, facilitadores e desafios na implementação e manutenção desses modelos?". A busca será conduzida em oito bases de dados e incluirá a pesquisa em literatura cinzenta. O software Rayyan será utilizado para gerenciar a seleção dos artigos. Dois revisores realizarão a avaliação do título e resumo dos artigos de forma independente. Aqueles que atenderem aos critérios de inclusão serão selecionados para a leitura completa. Em caso de divergências, um terceiro revisor será consultado para resolver as discordâncias. A síntese dos dados será realizada de forma descritiva, com um resumo narrativo dos resultados apresentado em tabelas, descrevendo como esses resultados se relacionam com o objetivo e a questão de pesquisa.

OBJECTIVE: To map group prenatal care (GPC) models to identify barriers, facilitators, implementation challenges, and maintenance of GPC. MÉTODO: This protocol describes a scoping review conducted using the methodology outlined by the Joanna Briggs Institute (JBI). The research question guiding this review is: "What are the existing GPC models, barriers, facilitators, and challenges in implementing and sustaining these models?". The search will be conducted in eight databases and include gray literature searches. Rayyan software will be used to manage the article selection process. Two reviewers will independently assess the title and abstract of the articles. Those that meet the inclusion criteria will be selected for full-text reading. A third reviewer will be consulted to resolve disagreements in case of discrepancies. Data synthesis will be performed descriptively, with a narrative summary of the results presented in tables, describing how these results relate to the objective and research question.

Form for planning and elaborating high fidelity simulation scenarios: A validation study.

Every human being has the right to safe, dignified and harm-free care in health institutions. High fidelity simulation has been used in teaching for the training and continuing education of health professionals to promote quality, safe and humanized patient care. Elaborating scenarios is an important phase to provide a simulation-based experience, and is relevant in the teaching-learning process. The objective of this study was to validate the content and applicability of the High Fidelity Simulation Scenario Planning and Development Form and its Operational Manual. The form could be used to development of scenarios to medicine, nursing, physiotherapy and as well as other specialties in the healthcare. This was a methodological validation study of the form and its manual content by experts in simulation and its feasibility, conducted in two phases: Phase 1: eight experts were selected using the "snowball" sampling technique to validate the content measured by the content validity index; Phase 2 (test): the form and its operational manual validated by the experts were made available to 28 participants in order to elaborate scenarios for the feasibility assessment and participation in the focus group. All items in the form and in the operational manual reached a content validity index above 0.80. The total content validity index was 0.98. The evaluation of the usability of the instruments carried out by the participants reached a percentage above 96.43% in all alternatives except for the item "It was easy to use the form to build your scenario" (75%). Eight participants were present in the focus group. Focus group discussions were categorized into completeness, practicality and usefulness according to comments and suggestions. The form and its operational manual proved to be valid instruments.

Nursing Process in the Brazilian context: reflection on its concept and legislation.

OBJECTIVES: to reflect on the global understanding of the Nursing Process concept, with emphasis on the Brazilian context. METHODS: a reflection article, aligned with the vision and expertise of researchers who are members of the Nursing Process Research Network. RESULTS: the reflection is presented in two main topics: The evolution of Systematization of Nursing Care X Nursing Process concepts and its consonance with national and international practices, and Brazilian legislation; The Nursing Process concept realignment in Brazilian legislation in line with current care, teaching and research practices. Final Considerations: the reflections were oriented to the Nursing Process' conceptual, normative and legal issues, including elements of its historical evolution, and, with that, pointed to the need to modify the Brazilian regulation on the Nursing Process.

Translation and Cross-Cultural Adaptation of the System Usability Scale to Brazilian Portuguese / Tradução e adaptação transcultural da System Usability Scale para o português do Brasil / Traducción y adaptación transcultural de la System Usability Scale al portugués de Brasil

Objective: To adapt culturally the System Usability Scale to Brazilian Portuguese and assess its internal consistency and structural construct validity. Materials and methods: This methodological study of a measurement instrument's cultural adaptation included the initial translation, the translations' synthesis, the back-translation, the evaluation by a committee of eight experts, testinh with a sample of 100 students, who evaluated the usability of the WhatsApp application, and the evaluation of structural construct validity by exploratory factor analysis. Results: The judges validated the Brazilian version of the System Usability Scale in the second round. It was revealed that, following the structural construct validation, the version had a unidimensional structure and an acceptable level of reliability (Cronbach's alpha of 0.76). Besides, in the usability test, no suggestions for change were made. Conclusions: It is worth noting that the Brazilian version of this scale was semantically, idiomatically, conceptually, and culturally equivalent to the original English version and showed adequate reliability and structural construct validity.

Objetivo: realizar a adaptação cultural da System Usability Scale para a língua portuguesa do Brasil e avaliar a sua consistência interna e a validade estrutural de constructo. Materiais e método: trata-se de um estudo metodológico, de adaptação cultural de instrumento de medida, que contemplou a tradução inicial, a síntese das traduções, a retrotradução, a avaliação por comitê de oito especialistas, o teste com uma amostra de 100 estudantes, que avaliaram a usabilidade do aplicativo WhatsApp, e a avaliação da validade de constructo estrutural por análise fatorial exploratória. Resultados: validou-se a versão brasileira da System Usability Scale pelos juízes na segunda rodada. Revela-se que, após a validação de constructo estrutural, a versão apresentou estrutura unidimensional e nível aceitável de confiabilidade (alfa de Cronbach de 0,76). Acrescenta-se que, no teste de usabilidade, não houve sugestão de mudança. Conclusões: informa-se que a versão brasileira dessa escala apresentou equivalência semântica, idiomática, conceitual e cultural com a versão original em inglês, bem como adequada confiabilidade e validade de constructo estrutural.

Objetivo: realizar la adaptación cultural de la System Usability Scale al idioma portugués, variante brasileña, y evaluar su consistencia interna y su validez de constructo estructural. Materiales y métodos: se trata de un estudio metodológico de adaptación cultural de un instrumento de medición, que contempló traducción inicial, síntesis de traducciones, retrotraducción, evaluación por ocho expertos, prueba con una muestra de 100 estudiantes, quienes evaluaron la usabilidad de la aplicación WhatsApp, y evaluación de la validez de constructo estructural mediante análisis factorial exploratorio. Resultados: los expertos en la segunda ronda validaron la versión brasileña de la System Usability Scale. Se reveló que, luego de la validación de constructo, la versión presentó una estructura unidimensional y un nivel aceptable de confiabilidad (alfa de Cronbach de 0,76). Además, en la prueba de usabilidad, no hubo sugerencia de cambio. Conclusiones: se informa que la versión brasileña de la escala presentó equivalencia semántica, idiomática, conceptual y cultural con la versión original en inglés, así como una confiabilidad y validez de constructo estructural adecuadas.

Nursing Process in the Brazilian context: reflection on its concept and legislation / Proceso de Enfermería en el contexto brasileño: reflexión sobre su concepto y legislación / Processo de Enfermagem no contexto brasileiro: reflexão sobre seu conceito e legislação

ABSTRACT Objectives: to reflect on the global understanding of the Nursing Process concept, with emphasis on the Brazilian context. Methods: a reflection article, aligned with the vision and expertise of researchers who are members of the Nursing Process Research Network. Results: the reflection is presented in two main topics: The evolution of Systematization of Nursing Care X Nursing Process concepts and its consonance with national and international practices, and Brazilian legislation; The Nursing Process concept realignment in Brazilian legislation in line with current care, teaching and research practices. Final Considerations: the reflections were oriented to the Nursing Process' conceptual, normative and legal issues, including elements of its historical evolution, and, with that, pointed to the need to modify the Brazilian regulation on the Nursing Process.

RESUMEN Objetivos: reflexionar sobre la comprensión global del concepto de Proceso de Enfermería, con énfasis en el contexto brasileño. Métodos: ensayo reflexivo, alineado con la visión y experiencia de investigadores integrantes de la Red de Investigación del Proceso de Enfermería. Resultados: la reflexión se presenta en dos temas principales: La evolución de los conceptos de Sistematización de la Atención de Enfermería X Proceso de Enfermería y su consonancia con las prácticas nacionales e internacionales, y la legislación brasileña; La realineación del concepto de Proceso de Enfermería en la legislación brasileña de acuerdo con las prácticas actuales de atención, enseñanza e investigación. Consideraciones Finales: las reflexiones se orientaron a las cuestiones conceptuales, normativas y legales del Proceso de Enfermería, incluyendo elementos de su evolución histórica, y, con eso, apuntaron para la necesidad de cambiar la regulación brasileña sobre el Proceso de Enfermería.

RESUMO Objetivos: refletir sobre a compreensão global do conceito de Processo de Enfermagem, com ênfase no contexto brasileiro. Métodos: ensaio reflexivo, alinhado à visão e expertise de pesquisadores membros da Rede de Pesquisa em Processo de Enfermagem. Resultados: a reflexão se apresenta em dois tópicos principais: A evolução dos conceitos de Sistematização da Assistência de Enfermagem X Processo de Enfermagem e a sua consonância com as práticas nacional e internacional, e a legislação brasileira; Realinhamento do conceito Processo de Enfermagem na legislação brasileira em consonância com as práticas assistenciais, de ensino e pesquisa atuais. Considerações Finais: as reflexões se orientaram às questões conceituais, normativas e legais do Processo de Enfermagem, incluindo elementos de sua evolução histórica, e, com isso, apontaram para a necessidade da modificação da regulamentação brasileira sobre o Processo de Enfermagem.

Knowledge, attitude and practice about hypertensive gestational syndrome among pregnant women: a randomized clinical trial / Conocimiento, actitud y práctica sobre el síndrome hipertensivo gestacional entre mujeres embarazadas: ensayo clínico aleatorizado / Conhecimento, atitude e prática sobre síndrome hipertensiva gestacional entre gestantes: ensaio clínico randomizado

ABSTRACT Objective: to evaluate knowledge, attitude and practice about Gestational Hypertensive Syndrome among pregnant women, after an educational intervention. Method: a controlled, randomized and longitudinal clinical trial, related to the Knowledge, Attitude and Practice survey on Gestational Hypertensive Syndrome complications, carried out with 120 pregnant women at a public maternity hospital in Fortaleza-CE, Brazil. Data collection was performed at three moments and the pregnant women were separated into two groups with 60 participants each. For quantitative comparisons, the Student's t test or the Mann-Whitney's test were applied. To study qualitative associations, the Chi-square or Fisher's exact tests were employed. Results: adequate assessment of knowledge, attitude and practice was identified in the intervention group, on the seventh and thirtieth days after the intervention (p<0.05), with an increased chance of adequate knowledge on the seventh (Odds Ratio=6.63 - Confidence Interval: 3.5-12.55) and on the thirtieth (Odds Ratio=6.25 - Confidence Interval: 3.13-12.50) days. In this group, the attitude was adequate on the seventh (Odds Ratio=6.11 - Confidence Interval: 3.28-11.39) and on the thirtieth (Odds Ratio=6.44 - Confidence Interval: 3.49-11.89) days. The practice was also adequate on the seventh (Odds Ratio=3.73 - Confidence Interval: 2.21-6.28) and on the thirtieth (Odds Ratio=4.91 - Confidence Interval: 2.90-8.32) days. Conclusion: the pregnant women who participated in the educational intervention presented more adequacy in relation to knowledge, attitude and practice, when compared to those in the control group. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos, REBEC) RBR-8wyp8j

RESUMEN Objetivo: evaluar el conocimiento, la actitud y la práctica sobre el Síndrome Hipertensivo Gestacional entre mujeres embarazadas, después de una intervención educativa. Método: ensayo clínico controlado, aleatorizado y longitudinal, relacionado con la encuesta de Conocimiento, Actitud y Práctica sobre complicaciones del Síndrome Hipertensivo Gestacional, realizado con 120 mujeres embarazadas en una maternidad pública de Fortaleza-CE, Brasil. La recolección de datos tuvo lugar en tres momentos y se separó a las mujeres embarazadas en dos grupos de 60 participantes cada uno. Para las comparaciones cuantitativas, se aplicó la prueba t de Student o la de Mann-Whitney. Para estudiar las asociaciones cualitativas, se empleó la prueba de Chi-cuadrado o la prueba exacta de Fisher. Resultados: se identificó una evaluación adecuada del conocimiento, la actitud y la práctica en el grupo intervención, a los siete y treinta días posteriores a las intervenciones (p<0,05), con un incremento en la probabilidad de conocimiento adecuado al día siete (Odds Ratio=6,63 - Intervalo de Confianza: 3,5-12,55) y al día treinta (Odds Ratio=6,25 - Intervalo de Confianza: 3,13 - 12,50). En este grupo, la actitud fue adecuada al día siete (Odds Ratio=6,11 - Intervalo de Confianza: 3,28 -11,39) y al día treinta (Odds Ratio=6,44 - Intervalo de Confianza: 3,49-11,89). La práctica también resultó adecuada al día siete (Odds Ratio=3,73 - Intervalo de Confianza: 2,21-6,28) y al día treinta (Odds Ratio=4,91 - Intervalo de Confianza: 2,90-8,32). Conclusión: las mujeres embarazadas que participaron en la intervención educativa presentaron más adecuación en relación con el conocimiento, la actitud y la práctica, en comparación las participantes del grupo control. Registro Brasileño de Ensayos Clínicos (REBEC) RBR-8wyp8j

RESUMO Objetivo: avaliar conhecimento, atitude e prática sobre Síndrome Hipertensiva Gestacional entre gestantes, após intervenção educativa. Método: ensaio clínico controlado, randomizado e longitudinal, relacionado ao inquérito Conhecimento, Atitude e Prática sobre complicações da Síndrome Hipertensiva Gestacional, realizado em maternidade pública de Fortaleza-CE, Brasil, com 120 gestantes. A coleta de dados foi realizada em três momentos e as gestantes separadas em dois grupos com 60 participantes cada. Para comparações quantitativas, aplicou-se o teste t de Student ou Mann-Whitney. Para estudar associações qualitativas, empregou-se o teste Qui-quadrado ou exato de Fisher. Resultados: identificou-se avaliação adequada do conhecimento, da atitude e prática no grupo intervenção, no sétimo e trigésimo dia pós-intervenção (p<0,05), com aumento de chance para o conhecimento adequado no sétimo (Odds Ratio=6,63 - Intervalo de Confiança: 3,5-12,55) e no trigésimo dia (Odds Ratio=6,25 - Intervalo de Confiança: 3,13 - 12,50). Neste grupo, a atitude foi adequada no sétimo (Odds Ratio= 6,11 - Intervalo de Confiança: 3,28-11,39) e no trigésimo dia (Odds Ratio=6,44 - Intervalo de Confiança: 3,49-11,89). Prática também adequada no sétimo (Odds Ratio=3,73 - Intervalo de Confiança: 2,21-6,28) e trigésimo dia (Odds Ratio=4,91 - Intervalo de Confiança: 2,90-8,32). Conclusão: as gestantes que participaram da intervenção educativa apresentaram mais adequabilidade em relação ao conhecimento, à atitude e prática, quando comparadas às participantes do grupo controle. Registro Brasileiro de Ensaios Clínicos (REBEC) RBR-8wyp8j

Recomendações clínicas para prevenir e tratar a retenção urinária pós-parto / Clinical recommendations to prevent and treat postpartum urinary retention

A retenção urinária pós-parto (RUPP) é considerada um distúrbio urinário e embora não esteja associada à mortalidade, sua morbidade é significativa. Acredita-se que diretrizes pré-estabelecidas, somadas aos achados do exame físico puerperal, possam dar suporte à prática clínica do profissional e, consequentemente, preservam a autonomia estrutural e funcional do sistema urinário da mulher. Assim, o objetivo deste estudo é estabelecer consenso entre especialistas acerca de uma proposta de recomendações clínicas baseadas em evidências para prevenir e tratar a RUPP. Trata-se de estudo descritivo-exploratório, de natureza quantitativa, desenvolvido por meio da técnica Delphi. Foi elaborada uma proposta inicial com 48 recomendações clínicas baseadas em evidências, distribuídas em três domínios. A primeira rodada do Painel Delphi foi composta por 19 especialistas, a segunda por 16 especialistas e a terceira por 13 especialistas. Ao final do Painel Delphi, 27 (56,3%) recomendações obtiveram consenso superior a 90%. Dessas, nove (33,3%) visavam a prevenção da RUPP evidente e oculta, e pertenciam ao Domínio ­ 1, nove (33,3%) visavam o tratamento da RUPP evidente e oculta, e pertenciam ao Domínio ­ 2 e nove (33,3%) visavam a reeducação da bexiga na RUPP persistente e pertenciam ao Domínio ­ 3. Considera-se que as recomendações aprovadas por meio deste consenso apoiam a tomada de decisão dos profissionais diante dos riscos inerentes de RUPP, que pode causar, em função hiperdistensão da bexiga, danos irreversíveis ao músculo detrusor, assim como infecções recorrentes do trato urinário e dificuldade de eliminação urinária permanente.

Postpartum urinary retention (PPUR) is considered a urinary disorder and although it is not associated with mortality, its morbidity is significant. It is believed that pre-established guidelines, added to the findings of the puerperal physical examination, can support a professional's clinical practice and, consequently, preserve the structural and functional autonomy of the woman's urinary system. Thus, the aim of this study is to establish a consensus among experts on a proposal for evidence-based clinical recommendations to prevent and treat PPUR. This is a descriptive-exploratory study, of a quantitative nature, developed using the Delphi technique. An initial proposal was elaborated with 48 evidence-based clinical recommendations, distributed into three domains. The first round of the Delphi Panel consisted of 19 experts, the second of 16 experts, and the third of 13 experts. At the end of the Delphi Panel, 27 (56.3%) recommendations obtained a consensus greater than 90%. Of these, nine (33.3%) aimed at preventing overt and hidden PPUR, and belonged to Domain ­ 1, nine (33.3%) aimed at treating overt and hidden PPUR and belonged to Domain ­ 2, and nine (33.3%) aimed at bladder reeducation in persistent PPUR and belonged to Domain - 3. It is considered that the recommendations approved through this consensus support the decision-making of professionals in the face of the inherent risks of PPUR, which can cause overdistension of bladder function, irreversible damage to the detrusor muscle, as well as recurrent urinary tract infections and difficulty in permanent urinary elimination.

A Brazilian Portuguese translation, cultural adaptation and validation of the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) health-related quality of life (HRQOL) scale.

INTRODUCTION: The health-related quality of life (HRQOL) of patients with tachyarrhythmia can be negatively influenced by the clinical manifestations. The evaluation of HRQOL with validated instruments can provide valuable information that will contribute to clinical decision-making and treatment. In Brazil, however, there is no available scale that evaluates HRQOL in different types of arrhythmia. The purpose of this study was to adapt the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia-HRQOL scale (ASTA-HRQOL scale) to the Brazilian culture, and to assess the psychometric properties of the adapted questionnaire. METHODS: The study used a methodological process of cultural adaptation based on international literature guidelines. The analyses were performed with 172 participants, 32 for cultural adaptation and 140 for psychometric validation. Calculation included analysis of reliability by Cronbach's α coefficient, construct validity with convergent validity using the WHOQOL-BREF questionnaire and by the Spearman correlation coefficient, Average Variance Extracted, and assessment of confirmatory factor analysis. RESULTS: The translation and adaptation processes showed a satisfactory degree of comprehension and applicability (93% reported them to be easy to understand). Confirmatory factor analysis indicated exclusion of one item from the mental scale, but after qualitative analysis the item was retained. The items presented adequate internal consistency (Cronbach's alpha coefficient = 0.88), and an inverse correlation of moderate magnitude with the physical domain (rho = -0.63) and with the mental domain (rho = -0.58) of the WHOQOL-BREF. CONCLUSIONS: The Brazilian Portuguese version of the ASTA-HRQOL scale, the ASTA-Br-HRQOL scale, can be a valuable tool for use in clinical practice and research.

Análise de questionários para a avaliação de pacientes com arritmias cardíacas / Analysis of questionnaires for the assessment of patients with cardiac arrhythmias / Análisis de cuestionario para la evaluación de pacientes con arritmia cardíaca

Objetivo: analisar questionários de avaliação de sintomas e de Qualidade de Vida Relacionada à Saúde em pacientes com taquiarritmias. Método: trata-se de um estudo bibliográfico, bibliográfico, tipo revisão integrativa de artigos originais, sem limite temporal, nas bases de dados MEDLINE, CINAHL, Scopus, Embase e Web of Science, e na Biblioteca Virtual em Saúde, utilizando os descritores "Arritmias Cardíacas"; "Taquicardia Supraventricular"; "Taquicardia Ventricular"; "Fibrilação Atrial"; "Qualidade de Vida"; "Sintomas" e "Questionário". Realizou-se a análise descritiva dos dados que se apresentam em forma de figuras. Resultados: encontraram-se 14 estudos referentes a 11 questionários, sendo que a maioria avalia somente um aspecto, sintomas ou QVRS e apenas em pacientes com Fibrilação Atrial e somente um tem maior abrangência e avalia sintomas e QVRS em diversas formas de taquiarritmias supraventriculares e ventriculares. Conclusão: identificou-se, por meio da revisão integrativa, que existem vários questionários disponíveis para a avaliação de pacientes com taquiarritmias, porém, somente um abrange tanto sintomas quanto QVRS em taquiarritmias supraventriculares e ventriculares. Acrescenta-se que a utilização desses instrumentos por enfermeiros e demais profissionais da saúde é importante para uma adequada avaliação dos pacientes com arritmias.(AU)

Objective: to analyze questionnaires for the assessment of symptoms and Health-related Quality of Life in patients with tachyarrhythmias. Method: It is a bibliographic, bibliographic, integrative review type study of original articles, without time limit, in the MEDLINE, CINAHL, Scopus, Embase and Web of Science databases, and in the Virtual Health Library, using the descriptors "Cardiac Arrhythmias"; "Supraventricular Tachycardia"; "Ventricular Tachycardia"; "Atrial Fibrillation"; "Quality of Life"; "Symptoms" and "Questionnaire". The descriptive analysis of the data presented in the form of figures was carried out. Results: 14 studies were found referring to 11 questionnaires, the majority evaluating only one aspect, symptoms or HRQL and only in patients with Atrial Fibrillation and only one has a greater scope and evaluates symptoms and HRQL in several forms of supraventricular and ventricular tachyarrhythmias. Conclusion: It was identified, through the integrative review, that there are several questionnaires available for the assessment of patients with tachyarrhythmias, but only one covers both symptoms and HRQL in supraventricular and ventricular tachyarrhythmias. It is added that the use of these instruments by nurses and other health professionals is important for a proper assessment of patients with arrhythmias.(AU)

Objetivo: analizar cuestionarios para evaluar síntomas y calidad de vida relacionada con la salud en pacientes con taquiarritmias. Método: se trata de un estudio bibliográfico, tipo revisión integradora de artículos originales, sin límite de tiempo, en las bases de datos MEDLINE, CINAHL, Scopus, Embase y Web of Science, y en la Biblioteca Virtual en Salud, utilizando las palabras clave " Arritmia cardíaca "; "Taquicardia supraventricular"; "Taquicardia ventricular"; "Fibrilación auricular"; "Calidad de vida"; "Síntomas" y "Cuestionario". Se realizó un análisis descriptivo de los datos presentados en forma de figuras. Resultados: se encontraron 14 estudios referidos a 11 cuestionarios, la mayoría de los cuales evalúan solo un aspecto, síntomas o CVRS y solo en pacientes con Fibrilación Auricular y solo uno es más completo y evalúa síntomas y CVRS en diversas formas de taquiarritmias supraventriculares y ventriculares. Conclusión: se identificó, a través de la revisión integradora, que existen varios cuestionarios disponibles para la evaluación de pacientes con taquiarritmias, sin embargo, solo uno cubre tanto la sintomatología como la CVRS en taquiarritmias supraventriculares y ventriculares. Se agrega que el uso de estos instrumentos por parte de enfermeros y otros profesionales de la salud es importante para una adecuada evaluación de los pacientes con arritmias.(AU)

Instrumento sobre conhecimento, atitude e prática de gestantes acerca da síndrome hipertensiva gestacional / Instrument about knowledge, attitudes, and practices of pregnant women about the hypertensive disease of pregnancy

RESUMO Objetivo elaborar e validar instrumento para avaliação do conhecimento, da atitude e prática de gestantes acerca da síndrome hipertensiva gestacional. Métodos pesquisa metodológica, com desenvolvimento e validação de instrumento sobre conhecimento, atitude e prática de gestantes em relação à síndrome. As etapas do delineamento foram: elaboração, validação de conteúdo e análise semântica com o público-alvo. Resultados para elaboração do instrumento, adotaram-se os itens: definição, classificação, sinais e sintomas, fatores de risco, consequências, prevenção e tratamento da síndrome hipertensiva gestacional. Mediante construção, este foi submetido à validação por especialistas, e as dimensões do instrumento apresentaram Índice de Validade de Conteúdo total de 0,85, sendo 0,89 para pertinência; 0,81, para clareza; e 0,86, para abrangência. A variável atitude foi inferior a 0,8 em todas as dimensões. Conclusão o material foi considerado válido e poderá ser utilizado para direcionar intervenções educativas, com vistas a prevenir surgimento ou complicações da síndrome.

ABSTRACT Objective to elaborate and validate an instrument to evaluate the knowledge, attitudes, and practices of pregnant women regarding the hypertensive disease of pregnancy. Methods methodological research, to develop and validate an instrument about the knowledge, attitudes, and practices of pregnant women regarding said disease. The stages of the design were: elaboration, content validation, and semantic analysis with the target audience. Results to elaborate the instrument, the following items were adopted: definition, classification, signs and symptoms, risk factors, consequences, prevention and treatment of the hypertensive disease of pregnancy. The instrument was submitted to a validation by specialists. Its dimensions presented a Content Validity Index of 0.85, 0.89 for pertinence, 0.81 for clarity, and 0.86 for scope. The variable attitudes was below 0.8 in all dimensions. Conclusion the instrument was considered to be valid and can be used to direct educational interventions, aimed to prevent the disease or its complications from surfacing.

Content analysis of nursing diagnoses related to urinary incontinence. / Análise de conteúdo dos diagnósticos de enfermagem relacionados à incontinência urinária.

OBJECTIVE: To analyze the content of nursing diagnoses related to urinary incontinence according to NANDA International and others identified in the literature. METHOD: Methodological study conducted with judges who were experts in urinary dysfunctions and nursing diagnosis. The analysis included diagnoses of Stress Urinary Incontinence, Urgency Urinary Incontinence, Functional Urinary Incontinence, Urinary Incontinence due to Neurogenic Detrusor Overactivity (previously denominated Reflex Urinary Incontinence in NANDA International's taxonomy), Mixed Urinary Incontinence, and Transient Urinary Incontinence. Wilcoxon test was applied and Content Validity Index ≥ 0.85 was considered appropriate. RESULTS: Fifty-one judges participated in this study. The judges recommended modifications in elements of all diagnoses (inclusion, exclusion or change of previous element type). CONCLUSION: The four diagnoses analyzed in NANDA International's taxonomy are recommended to be maintained with modifications; inclusion of nursing diagnoses Mixed and Transient Urinary Incontinence is also recommended.

Socioeconomic, demographic and obstetric profile of pregnant women with Hypertensive Syndrome in a public maternity.

OBJECTIVE: To describe the socioeconomic, demographic and obstetric profile of pregnant women with Gestational Hypertensive Syndrome. METHODS: A descriptive and correlational study, conducted in Maternity School Assis Chateaubriand, with 120 pregnant women, through a questionnaire analyzed by descriptive and analytical statistics. RESULTS: most women had chronic hypertension (60.83%). Regarding the socioeconomic and demographic profile, most pregnant women had a mean age of 30.9 ± 6.9 years, were Catholic, brown skin color, employed, in stable unions, complete high school education, and income of up to R$ 954.00. Regarding the obstetric profile, their Body Mass Index was up to 66, slightly elevated blood pressure, an average of five prenatal consultations, two pregnancies, one delivery and no abortions. Women with chronic hypertension were older (p = 0.0024), had lower gestational age (p = 0.0219) and a higher number of abortions (p = 0.0140). CONCLUSIONS: Pregnant women are overweight/obese, with a mean age of 30.9 years and are socially vulnerable. Pregnant women with chronic hypertension are older and have a higher number of abortions.

Competitive neural layer-based method to identify people with high risk for diabetic foot.

BACKGROUND AND OBJECTIVE: To automatically identify patients with diabetes mellitus (DM) who have high risk of developing diabetic foot, via an unsupervised machine learning technique. METHODS: We collected a new database containing 54 known risk factors from 250 patients diagnosed with diabetes mellitus. The database also contained a separate validation cohort composed of 73 subjects, where the perceived risk was annotated by expert nurses. A competitive neuron layer-based method was used to automatically split training data into two risk groups. RESULTS: We found that one of the groups was composed of patients with higher risk of developing diabetic foot. The dominant variables that described group membership via our method agreed with the findings from other studies, and indicated a greater risk for developing such a condition. Our method was validated on the available test data, reaching 71% sensitivity, 100% specificity, and 90% accuracy. CONCLUSIONS: Unsupervised learning may be deployed to screen patients with diabetes mellitus, pointing out high-risk individuals who require priority follow-up in the prevention of diabetic foot with very high accuracy. The proposed method is automatic and does not require clinical examinations to perform risk assessment, being solely based on the information of a questionnaire answered by patients. Our study found that discriminant variables for predicting risk group membership are highly correlated with expert opinion.

Mothers mothering in prison: an experience report of the nursing care project.

OBJECTIVES: to report the experience of designing and implementing the nursing care project with mothers and babies in prison. METHODS: this is an experience report about the nursing care project with mothers and children in prison, having as a guiding axis Winnicottian concepts about the mother-baby relationship. RESULTS: nursing consultations were held in childcare, thematic conversation circles and the manufacture of artifacts to encourage child development, as well as women's health care. The positive impact of the project has made it a health education program. FINAL CONSIDERATIONS: elaborating the nursing care project encouraged other ways of providing care and implementing it, using Winnicottian concepts. It is recommended that training institutions consider the prison and the individuals there as a field in the learning process of health professionals.

Locus of control, knowledge, attitude and practice for contraception among adolescents.

OBJECTIVES: to assess the relation of the locus of control with the adolescents' knowledge, attitude and practice (KAP). METHODS: this is a cross-sectional study with 1,192 high school students. Data were collected using the KAP questionnaire and the Levenson locus of control scale and analyzed by descriptive statistics, Mann-Whitney U test and Kruskal-Wallis H test. RESULTS: Women presented higher Externality Powerful Others locus of control than man (p=0.0015) and adolescents over 17, higher Externality Chance locus of control (p=<0.0001). Students who used contraceptive methods at the first contraceptive method had higher Externality Powerful Others (p=0.0107) and those who used coitus interruptus, had higher Externality Chance (p=0.0013). Internality was inversely proportional to the practice in relation to the dimensions of the locus of control. CONCLUSIONS: The dimensions of the locus of control were related to some contraceptive practices, but little or no relation to knowledge and attitude.