Effect of the transition program on self-care of patients with heart failure: a randomized clinical trial / Efecto del programa de transición en el autocuidado de pacientes con insuficiencia cardíaca: ensayo clínico aleatorizado / Efeito do programa de transição no autocuidado de pacientes com insuficiência cardíaca: ensaio clínico randomizado

ABSTRACT Objective: analyze the effect of transitional care on self-care, quality of life and knowledge of disease of patients admitted with heart failure. Method: this is a blind randomized clinical trial with 74 patients with heart failure in two quaternary hospitals in Rio de Janeiro-RJ between December 2017 and February 2020. The intervention group received transitional care with educational management by a nurse at the bedside from admission until hospital discharge and telephone consultation for 30 days after discharge. The control group received usual follow-up. The primary outcomes included maintenance skills, management and confidence in self-care, and the secondary outcomes included quality of life and knowledge of disease. Both were assessed using questionnaires validated for use in Brazil. Data were analyzed by repeated measures ANOVA. Results: the intervention group had higher scores for maintenance (74.3 vs 44.2; p<0.001) and self-care confidence (79.3 vs 56.4; p<0.001) and knowledge of disease (41.3 vs 27.5; p<0.001) and lower quality of life scores (42.1 vs 64.5; p<0.001) 30 days after discharge. Conclusion: transitional care was effective in improving quality of life, knowledge of disease, maintenance and confidence in self-care. This study was registered in the Brazilian Clinical Trials Registry, under RBR-2dpc6b.

RESUMEN Objetivo: analizar el efecto de los cuidados transicionales sobre el autocuidado, la calidad de vida e y el conocimiento de la enfermedad de pacientes hospitalizados con insuficiencia cardíaca. Método: ensayo clínico aleatorio ciego con 74 pacientes con insuficiencia cardíaca en dos hospitales cuaternarios de Río de Janeiro-RJ entre diciembre de 2017 y febrero de 2020. El grupo de intervención recibió cuidados de transición con manejo educativo por parte de una enfermera al lado de la cama desde el ingreso hasta el alta hospitalaria y Consulta telefónica durante 30 días después del alta. El grupo de control recibió el seguimiento habitual. Los resultados primarios incluyeron habilidades de mantenimiento, gestión y confianza en el autocuidado, y los resultados secundarios incluyeron calidad de vida y conocimiento de la enfermedad. Ambos fueron evaluados mediante cuestionarios validados para su uso en Brasil. Los datos fueron analizados mediante ANOVA de medidas repetidas. Resultados: el grupo de intervención tuvo puntuaciones más altas en mantenimiento (74,3 vs 44,2; p<0,001) y confianza en el autocuidado (79,3 vs 56,4; p<0,001) y conocimiento de la enfermedad (41,3 vs 27,5; p<0,001)y puntuaciones de calidad de vida más bajas (42,1 frente a 64,5; p<0,001) 30 días después del alta. Conclusión: la atención de transición fue eficaz para mejorar la calidad de vida, el conocimiento de la enfermedad, el mantenimiento y la confianza en el autocuidado. Estudio inscrito en el Registro Brasileño de Ensayos Clínicos, con el número RBR-2dpc6b.

RESUMO Objetivo: analisar o efeito do cuidado de transição no autocuidado, qualidade de vida e conhecimento da doença de pacientes hospitalizados com insuficiência cardíaca. Método: ensaio clínico randomizado cego com 74 pacientes com insuficiência cardíaca em dois hospitais quaternários do Rio de Janeiro-RJ, entre dezembro de 2017 e fevereiro de 2020. O grupo intervenção recebeu cuidados de transição com gerenciamento educativo por enfermeira, à beira do leito, desde a admissão até a alta hospitalar e consulta telefônica por 30 dias após a alta. O grupo controle recebeu acompanhamento usual. Os desfechos primários incluíram habilidades de manutenção, manejo e confiança no autocuidado, e os desfechos secundários, qualidade de vida e conhecimento da doença. Ambos foram avaliados por questionários validados para uso no Brasil. Os dados foram analisados pelo ANOVA de medidas repetidas. Resultados: o grupo intervenção apresentou maiores escores para manutenção (74,3 vs44,2; p<0,001) e confiança do autocuidado (79,3 vs56,4; p<0,001) e conhecimento da doença (41,3 vs27,5; p<0,001) e menores escores de qualidade de vida (42,1 vs64,5; p<0,001) em 30 dias após a alta. Conclusão: o cuidado de transição foi efetivo na melhora da qualidade de vida, conhecimento da doença, manutenção e confiança no autocuidado. Estudo registrado no Registro Brasileiro de Ensaios Clínicos, sob o número RBR-2dpc6b.

A Qualitative Study of the Limits and Possibilities of Integrating Palliative Care in Heart Failure.

Heart failure is a progressive condition with a high burden of symptoms and clinical decompensations that causes psychological and social suffering, poor quality of life, and limited life expectancy. Therefore, it requires palliative care to control symptoms and signs, but integrating it with clinical care is complicated. We aimed to discuss the limits and possibilities of integrating palliative care in heart failure. This was a qualitative descriptive study. Semi-structured qualitative interviews were carried out between July 2020 and July 2021. We applied the thematic content analysis and the SWOT matrix. Ethical principles were respected. Ten professionals from an Institute specializing in cardiovascular diseases in Rio de Janeiro, Brazil, participated in the study, including physicians, nurses, psychologist, and occupational therapist. We identified 4 categories related to intervening factors: the patient's profile, the emotional aspects of professionals facing these patients, the challenges to integrating and sustaining palliative care in practice, and the ways for assistance planning in this context. The existence of a specialized team, the palliative care commission, and the institutional palliative care protocol, aligned with the realistic perception of the assistance, organizational, political, and social problems, may promote the advancement of palliative care in heart failure.

Double Product and Autonomic Function as Predictors of Quality of Life in Heart Transplant Recipients: A Cross-Sectional Study.

INTRODUCTION: Heart rate control by the autonomic nervous system (ANS) is impaired in heart transplant (HT) recipients, leading to increased resting heart rate, metabolic demand, and fatigue, which can impair their quality of life (QoL). In this study, we hypothesized the association of hemodynamics and autonomic function as predictors of QoL in HT recipients. METHODS: This is a cross-sectional study conducted with HT recipients aged ≥ 18 years at ambulatorial accompaniment. Blood pressure was used for hemodynamics assessment, and heart rate variability (HRV) was used for ANS assessment. QoL was assessed by the 36-item Short Form Health Survey. The significance level was set as P≤0.05. RESULTS: Twenty-two volunteers were included in the study. Systolic blood pressure (SBP) and double product (DP) were significantly negatively associated with the physical functioning domain of QoL. DP, the number of consecutive normal RR interval differences > 50 ms (NN50), and the percentage of normal RR intervals that differed by > 50 ms from the adjacent interval (PNN50) exhibited negative association with the physical role domain. NN50 and PNN50 were significantly associated with bodily pain, social functioning, and emotional role domains. SBP was negatively associated with the vitality domain. Considering general and mental health domains, no variable demonstrated significant association. DP, NN50, and PNN50 were negatively associated with the total score of QoL. CONCLUSION: This study demonstrated DP and HRV as predictors of QoL in HT recipients. These innovative results can become a relevant therapeutic target for improving QoL in HT recipients prior to its deterioration.

Double Product and Autonomic Function as Predictors of Quality of Life in Heart Transplant Recipients: A Cross-Sectional Study

ABSTRACT Introduction: Heart rate control by the autonomic nervous system (ANS) is impaired in heart transplant (HT) recipients, leading to increased resting heart rate, metabolic demand, and fatigue, which can impair their quality of life (QoL). In this study, we hypothesized the association of hemodynamics and autonomic function as predictors of QoL in HT recipients. Methods: This is a cross-sectional study conducted with HT recipients aged ≥ 18 years at ambulatorial accompaniment. Blood pressure was used for hemodynamics assessment, and heart rate variability (HRV) was used for ANS assessment. QoL was assessed by the 36-item Short Form Health Survey. The significance level was set as P≤0.05. Results: Twenty-two volunteers were included in the study. Systolic blood pressure (SBP) and double product (DP) were significantly negatively associated with the physical functioning domain of QoL. DP, the number of consecutive normal RR interval differences > 50 ms (NN50), and the percentage of normal RR intervals that differed by > 50 ms from the adjacent interval (PNN50) exhibited negative association with the physical role domain. NN50 and PNN50 were significantly associated with bodily pain, social functioning, and emotional role domains. SBP was negatively associated with the vitality domain. Considering general and mental health domains, no variable demonstrated significant association. DP, NN50, and PNN50 were negatively associated with the total score of QoL. Conclusion: This study demonstrated DP and HRV as predictors of QoL in HT recipients. These innovative results can become a relevant therapeutic target for improving QoL in HT recipients prior to its deterioration.

Especialização em Gestão do Trabalho e da Educação na Saúde: uma análise do programa nacional / Specialization in Work Management and Health Education: an analysis of the national program

RESUMO Um dos propósitos do Componente III do Programa de Qualificação e Estruturação da Gestão do Trabalho e da Educação no SUS (ProgeSUS) foi o de oferecer cursos de Especialização em Gestão do Trabalho e da Educação na Saúde. Nesse sentido, o objetivo deste estudo foi o de analisar tal processo formativo no País, discutindo seus resultados e as perspectivas analíticas dos dirigentes nos diferentes níveis de coordenação a partir de análise qualitativa e quantitativa. Assim, valeu-se de registros da coordenação geral e da aplicação de questionário semiestruturado do qual se extraiu a análise sob a ótica dos coordenadores locais. No total, foram qualificados 1.471 gestores, sendo 557 no Nordeste, 301 no Norte, 236 no Sudeste, 224 no Centro-Oeste e 153 no Sul. Constatou-se a grande permanência dos alunos nos cargos de gestão; a aplicabilidade dos projetos de intervenção por eles elaborados; o eixo Gestão do Trabalho de maior evidência nas duas primeiras turmas, mas de igual interesse com a Gestão da Educação na terceira turma; e a necessidade de aprofundamento e aumento de carga horária em temas específicos nesses eixos. Essas informações constituem importantes subsídios para a formulação de políticas públicas que deem continuidade a esse processo de qualificação principalmente em vista da crescente terceirização dos vínculos dos trabalhadores da saúde e da gestão dos trabalhadores do SUS.

ABSTRACT One of the purposes of component III of the SUS Work and Education Management Structuring and Qualification Program (ProgeSUS) was to offer specialization courses in Work Management and Health Education. The objective was to analyze this formative process in the country, punctuating its results and the analytical perspectives of the leaders at the different levels of coordination; from qualiquantitative analysis. It used records of the general coordination and the application of a semi-structured questionnaire in which the analysis was subtracted from the perspective of local coordinators. In total, 1,471 managers were qualified: 557 in the Northeast, 301 in the North, 236 in the Southeast, 224 in the Midwest and 153 in the South. It was verified: great permanence of the students in the management positions; applicability of the intervention projects prepared by them; the Labor Management axis of greater evidence in the first two classes, but of equal interest with the Education Management in the third class; and requiring deepening and increasing workload on specific topics in these axes. This information constitutes important subsidies for the formulation of public policies for the continuation of this qualification process, mainly due to the growing outsourcing of health workers 'labor relations and SUS workers' management.

Descriptive report of cases of congenital syndrome associated with Zika virus infection in the state of São Paulo, Brazil, from 2015 to 2017. / Descrição dos casos de síndrome congênita associada à infecção pelo ZIKV no estado de São Paulo, no período 2015 a 2017.

OBJECTIVE: to characterize cases of congenital syndrome associated with Zika virus infection (CZS) and other infectious etiologies, resident in the state of São Paulo, Brazil, from October 30, 2015, to June 30, 2017. METHODS: this was a descriptive study of suspected cases of CZS and other infectious etiologies notified on the Public Health Events Registry. RESULTS: 960 cases were investigated up to epidemiological week 26/2017, and 146 were confirmed for congenital infection; of these, 59 (40.4%) were confirmed for congenital infection without etiological identification and 87 (59.6%) with laboratory confirmation, of which 55 were congenital syndrome associated with Zika virus and 32 were congenital syndrome associated with other infectious agents. CONCLUSION: this study enabled the detection of 23.9% CZS cases among suspected cases of infectious etiology.

Association between quality of life and prognosis of candidate patients for heart transplantation: a cross-sectional study.

OBJECTIVE: to verify the association between the prognostic scores and the quality of life of candidates for heart transplantation. METHOD: a descriptive cross-sectional study with a convenience sample of 32 outpatients applying to heart transplantation. The prognosis was rated by the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM); and the quality of life by the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Pearson correlation test was applied. RESULTS: the correlations found between general quality of life scores and prognostic scores were (HFSS/MLHFQ r = 0.21), (SHFM/MLHFQ r = 0.09), (HFSS/KCCQ r = -0.02), (SHFM/KCCQ r = -0.20). CONCLUSION: the weak correlation between the prognostic and quality of life scores suggests a lack of association between the measures, i.e., worse prognosis does not mean worse quality of life and the same statement is true in the opposite direction.

Descrição dos casos de síndrome congênita associada à infecção pelo ZIKV no estado de São Paulo, no período 2015 a 2017 / Descripción de los casos de síndrome congénita asociada a la infección por el virus Zika en el estado de São Paulo, Brasil, en el período de 2015 a 2017 / Descriptive report of cases of congenital syndrome associated with Zika virus infection in the state of São Paulo, Brazil, from 2015 to 2017

Objetivo: caracterizar os casos de síndrome congênita associada à infecção pelo ZIKV (SCZ) e outras etiologias infeciosas, residentes no estado de São Paulo, Brasil, no período de 30 de outubro de 2015 a 30 de junho de 2017. Métodos: estudo descritivo dos casos suspeitos de SCZ e outras etiologias infecciosas notificados no Registro de Eventos em Saúde Pública. Resultados: foram investigados 960 casos até a semana epidemiológica 26/2017, sendo confirmados 146 para infecção congênita; destes, 59 (40,4%) foram confirmados para infecção congênita sem identificação etiológica e 87 (59,6%) com confirmação laboratorial, sendo 55 com SCZ e 32 com síndrome congênita associada a outros agentes infecciosos. Conclusão: este estudo permitiu detectar 23,9% de casos de SCZ entre os casos suspeitos de etiologia infecciosa.

Objetivo: caracterizar los casos sospechosos de síndrome congénita asociada a la infección por virus Zika (SCZ) y otras etiologías infecciosas residentes en el estado de São Paulo, Brasil, en el período de 30 de octubre de 2015 a 30 de junio de 2017. Métodos: estudio descriptivo de los casos sospechosos de síndrome congénita asociada a la infección por el virus Zika y otras etiologías infecciosas notificadas en el Registro de Eventos en Salud Pública. Resultados: se han investigado 960 casos hasta la semana epidemiológica 26/2017, siendo confirmados 146 para la infección congénita; de estos, 59 fueron confirmados para infección congénita sin identificación etiológica y 87 con identificación etiológica, siendo 55 síndrome congénita asociados al virus Zika y 32 síndrome congénita asociado a otros agentes infecciosos. Conclusión: este estudio permitió detectar una tasa del 23,9% de casos de SCZ entre los casos sospechosos de etiología infecciosa.

Objective: to characterize cases of congenital syndrome associated with Zika virus infection (CZS) and other infectious etiologies, resident in the state of São Paulo, Brazil, from October 30, 2015, to June 30, 2017. Methods: this was a descriptive study of suspected cases of CZS and other infectious etiologies notified on the Public Health Events Registry. Results: 960 cases were investigated up to epidemiological week 26/2017, and 146 were confirmed for congenital infection; of these, 59 (40.4%) were confirmed for congenital infection without etiological identification and 87 (59.6%) with laboratory confirmation, of which 55 were congenital syndrome associated with Zika virus and 32 were congenital syndrome associated with other infectious agents. Conclusion: this study enabled the detection of 23.9% CZS cases among suspected cases of infectious etiology.

Association between quality of life and prognosis of candidate patients for heart transplantation: a cross-sectional study / Associação entre qualidade de vida e prognóstico de pacientes candidatos ao transplante cardíaco: estudo transversal / Asociación entre calidad de vida y pronóstico de pacientes candidatos al trasplante cardíaco: estudio transversal

ABSTRACT Objective: to verify the association between the prognostic scores and the quality of life of candidates for heart transplantation. Method: a descriptive cross-sectional study with a convenience sample of 32 outpatients applying to heart transplantation. The prognosis was rated by the Heart Failure Survival Score (HFSS) and the Seattle Heart Failure Model (SHFM); and the quality of life by the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Pearson correlation test was applied. Results: the correlations found between general quality of life scores and prognostic scores were (HFSS/MLHFQ r = 0.21), (SHFM/MLHFQ r = 0.09), (HFSS/KCCQ r = -0.02), (SHFM/KCCQ r = -0.20). Conclusion: the weak correlation between the prognostic and quality of life scores suggests a lack of association between the measures, i.e., worse prognosis does not mean worse quality of life and the same statement is true in the opposite direction.

RESUMO Objetivo: verificar a associação entre os escores de prognóstico e a qualidade de vida de pacientes candidatos ao Transplante Cardíaco. Método: estudo transversal descritivo, com amostra de conveniência formada por 32 pacientes ambulatoriais candidatos ao transplante cardíaco. O prognóstico foi classificado pelo Heart Failure Survival Score (HFSS) e pelo Seattle Heart Failure Model (SHFM); e a qualidade de vida pelo Minnesota Living With Heart Failure Questionnaire (MLHFQ) e pelo Kansas City Cardiomyopathy Questionnaire (KCCQ). Aplicou-se o teste de correlação de Pearson. Resultados: as correlações encontradas entre os escores gerais dos instrumentos de qualidade de vida e os escores de prognósticos foram (HFSS/MLHFQ r = 0,21), (SHFM/MLHFQ r = 0,09), (HFSS/KCCQ r = -0,02), (SHFM/KCCQ r = -0,20). Conclusão: a correlação fraca entre os escores de prognóstico e de qualidade de vida sugere a não associação entre as medidas, ou seja, pior prognóstico não significa pior qualidade de vida e o mesmo ocorre no sentido inverso.

RESUMEN Objetivo: verificar la asociación entre los puntajes del pronóstico y la calidad de vida de pacientes candidatos al Trasplante Cardíaco. Método: estudio transversal descriptivo, con una muestra de conveniencia formada por 32 pacientes de ambulatorios candidatos al trasplante cardíaco. El pronóstico fue clasificado por el Heart Failure Survival Score (HFSS) y por el Seattle Heart Failure Model (SHFM) y la calidad de vida por el Minnesota Living With Heart Failure Questionnaire (MLHFQ) y por el Kansas City Cardiomyopathy Questionnaire (KCCQ). Se aplicó el test de correlación de Pearson. Resultados: las correlaciones encontradas entre los puntajes generales de los instrumentos de calidad de vida y los puntajes de pronósticos fueron (HFSS/MLHFQ r = 0,21), (SHFM/MLHFQ r = 0,09), (HFSS/KCCQ r = -0,02), (SHFM/KCCQ r = -0,20). Conclusión: la correlación débil entre los puntajes de pronóstico y de calidad de vida sugiere la no asociación entre las medidas, o sea, peor pronóstico no significa peor calidad de vida y el mismo ocurre en el sentido inverso.

Impacto do monitoramento telefônico em pacientes com insuficiência cardíaca: ensaio clínico randomizado / Impact of telephone monitoring on patients with heart failure: a randomized clinical trial

Resumo Objetivo Analisar o autocuidado e o conhecimento em pacientes com insuficiência cardíaca monitorados por contato telefônico e analisar a correlação do conhecimento com o autocuidado. Métodos Ensaio clínico randomizado, realizado em uma clínica especializada, no período de abril de 2015 a dezembro de 2015. Foram monitorados e randomizados 36 pacientes no Grupo Controle (17) ou no Grupo Intervenção (19). Ambos os grupos participaram do monitoramento convencional, compreendendo três atendimentos (Basal; 2° mês; 4° mês); no Grupo Intervenção houve associação do monitoramento telefônico por meio de um guia padronizado. Foram utilizados os Questionários de Conhecimento e de Autocuidado para avaliação dos desfechos primários e secundários. Resultados Houve diferença no conhecimento (12,7±1,7 vs. 10,8±2,2; p=0,009) e autocuidado (25,4±6,6 vs. 29,5±4,8; p=0,04) no 4° mês; correlação negativa entre os escores do conhecimento e autocuidado no 2° mês (r=-0,48; p=0,03). Conclusão O monitoramento convencional combinado ao monitoramento telefônico mostra-se eficaz no 4° mês com a melhoria do conhecimento e autocuidado de pacientes com insuficiência cardíaca e correlação significativa desses desfechos no 2° mês.

Abstract Objective To analyze self-care and knowledge in patients with heart failure who were monitored telephonically, and to analyze the correlation of knowledge with self-care. Methods It was a randomized clinical trial, performed in a specialized clinic from April of 2015 to December of 2015. Thirty-six patients were monitored and randomized, with 17 in the control group and 19 in the intervention group. Both groups participated in the conventional monitoring, which included three visits (initial, second and fourth month); the intervention group was associated with telephone support by means of a standardized guide. The Knowledge and Self-Care Questionnaires were used to evaluate the primary and secondary outcomes. Results Difference in knowledge (12.7±1.7 vs. 10.8±2.2, p=0.009) and self-care (25.4±6.6 vs. 29.5±4.8, p=0. 04) were identified in the fourth month; and there was a negative correlation between knowledge and self-care scores in the second month (r =-0.48; p=0.03). Conclusion The conventional management combined with telephone monitoring was effective in the 4th month with improved knowledge and self-care of patients with heart failure and a significant correlation of these outcomes in the second month.

[Evaluation of the cold chain for vaccine conservation in primary healthcare centers in the South and Midwest regions of São Paulo city, Brazil, in 2011-2012]. / Avaliação da rede de frio para conservação de vacinas em unidades básicas de saúde das regiões Sul e Centro-Oeste do município de São Paulo em 2011-2012.

OBJECTIVE: to assess the cold chain capacity, health workers' immunobiological product conservation knowledge and practices in Primary Healthcare Centers (PHC) in São Paulo city, Brazil. METHODS: this descriptive study included 24 randomly selected PHC in the South and Midwest regions of the city; between December 2011 and July 2012, we interviewed the health workers on their vaccine conservation knowledge/practice and observed the local infrastructure, using a form developed for this project; we assigned points to items of the form and classified each PHC as sufficient, regular or insufficient. RESULTS: most of the 24 PHC evaluated were administered by Social Organizations; all of them had vaccine storage chambers; 5 PHC reported using their maximum storage capacity; 9 PHC were classified as having sufficient knowledge/practice and 15 as having regular knowledge/practice. CONCLUSION: in these PHC, cold chain utilization was close to its maximum capacity; many health workers did not have basic knowledge about vaccine conservation.

Acute cellular rejection and HLA mismatch in heart transplantation: insights from a developing country.

The notable evolution of heart transplant (HTX) has paralleled the capacity of diagnosing rejection and, consequently, initiating timely treatment. Acute cellular rejection, diagnosed by endomyocardial biopsy, is the most frequent in the first 6 months after HTX. HLA matching is not routinely performed in HTX due to the absence of consensus regarding its usefulness. However, the use of HLA typing might be underscored if it could predict an increased risk of rejection. Therefore, the aim of this study was to evaluate, at a public cardiology center in Brazil, the association between HLA mismatches and the incidence of acute cellular rejection in the first 6 months after HTX. Data were obtained from hospital records and from the National Transplant System. Overall, there was no association between the number of HLA mismatches and the frequency of acute cellular rejection, but there was a tendency toward a higher incidence of rejection with HLA-DR incompatibility.

Avaliação da rede de frio para conservação de vacinas em unidades básicas de saúde das regiões Sul e Centro-Oeste do município de São Paulo em 2011-2012 / Evaluation of the cold chain for vaccine conservation in primary healthcare centers in the South and Midwest regions of São Paulo city, Brazil, in 2011-2012 / Evaluación de la cadena de frío para la conservación de vacunas en Unidades Básicas de Salud de las regiones Sur y Medio-Oeste de São Paulo en 2011-2012

OBJETIVO: avaliar capacidade da rede de frio (RF), conhecimento dos profissionais e práticas de conservação de imunobiológicos em unidades básicas de saúde (UBS) do município de São Paulo. MÉTODOS: estudo descritivo envolvendo amostra randômica de 24 UBS das regiões Sul e Centro-Oeste do município; de dezembro de 2011 a julho de 2012, foram entrevistados profissionais quanto ao conhecimento/prática em conservação de vacinas e observou-se a infraestrutura local, utilizando-se formulário desenvolvido para o projeto, sobre cujos itens atribuíram-se pontos e classificou-se cada UBS - suficiente, regular e insuficiente. RESULTADOS: a maioria das 24 UBS avaliadas era administrada por organizações sociais; todas possuíam câmaras de vacinas, cinco referiram utilizar sua capacidade máxima de armazenamento, nove UBS foram classificadas como de conhecimento/prática suficiente e 15 como de conhecimento/prática regular. CONCLUSÃO: a utilização da RF nessas UBS estava próxima da capacidade máxima; muitos profissionais não tinham conhecimentos básicos sobre conservação de vacinas.

OBJECTIVE: to assess the cold chain capacity, health workers' immunobiological product conservation knowledge and practices in Primary Healthcare Centers (PHC) in São Paulo city, Brazil. METHODS: this descriptive study included 24 randomly selected PHC in the South and Midwest regions of the city; between December 2011 and July 2012, we interviewed the health workers on their vaccine conservation knowledge/practice and observed the local infrastructure, using a form developed for this project; we assigned points to items of the form and classified each PHC as sufficient, regular or insufficient. RESULTS: most of the 24 PHC evaluated were administered by Social Organizations; all of them had vaccine storage chambers; 5 PHC reported using their maximum storage capacity; 9 PHC were classified as having sufficient knowledge/practice and 15 as having regular knowledge/practice. CONCLUSION: in these PHC, cold chain utilization was close to its maximum capacity; many health workers did not have basic knowledge about vaccine conservation.

OBJETIVO: evaluar la cadena de frío (CF), el conocimiento de los profesionales y las prácticas de conservación de vacunas en unidades básicas de salud (UBS) de São Paulo-SP, Brasil. MÉTODOS: estudio descriptivo de una muestra aleatoria de 24 UBS en las regiones Sur y Centro-Oeste del municipio; de diciembre del 2011 a julio del 2012, fueron entrevistados profesionales con respecto a sus conocimientos y prácticas en la conservación de vacunas, concomitantementese observó la infraestructura, utilizando un formulario desarrollado para el proyecto; atribuyéndose un puntaje específico para cada ítem, clasificamos las UBS como suficientes, regulares o insuficientes. RESULTADOS: la mayoría de las 24 UBS eran administradas por organizaciones sociales; todos tenían cámaras de vacunas; cinco informaron usar su capacidad máxima de almacenamiento; 9 UBS fueron clasificadas como suficientes y 15 como regulares. CONCLUSIÓN: la utilización de la CF en estas UBS estaba próxima al máximo; muchos profesionales no tenían conocimientos básicos acerca de conservación de vacunas.

Diagnósticos de Enfermagem em crianças com cardiopatias congênitas: mapeamento cruzado / Nursing diagnoses in children with congenital heart disease: cross mapping

Objetivo Identificar Diagnósticos de Enfermagem da NANDA International a partir dos termos encontrados nos registros de Enfermagem de crianças com cardiopatias congênitas hospitalizadas e verificar associação entre estes termos e os Diagnósticos de Enfermagem mapeados. Métodos Estudo observacional, transversal desenvolvido por mapeamento dos termos nos registros de Enfermagem de crianças hospitalizadas de até 2 anos com cardiopatia congênita. A associação entre os termos e os Diagnósticos de Enfermagem mais frequentes foi avaliada pelo teste t de Student ou qui quadrado. Resultados Nos 82 registros analisados, os Diagnósticos de Enfermagem mais frequentes foram Risco de infecção (81,7%), Troca de gases prejudicada (46,3%) e Intolerância à atividade (36,6%). O termo “cianótico” e “hipocorado” tiveram relação estatisticamente significativa com o diagnóstico Troca de gases prejudicada. Conclusão Observou-se que os termos registrados em prontuários de crianças com cardiopatias congênitas permitiram a identificação dos Diagnósticos de Enfermagem da NANDA International, além da verificação das associações.

Objective To identify the NANDA International nursing diagnoses from the terms found in the nursing records of hospitalized children with congenital heart defects, and verify the association between these terms and the mapped nursing diagnoses. Methods Observational and cross sectional study, developed by mapping of the terms in the nursing records of hospitalized children up to two years of age with congenital heart disease. The association between the terms and the most frequent nursing diagnoses were evaluated using the Student’s t-test or chi-square. Results The most frequent nursing diagnoses in the 82 records analyzed were: risk for infection (81.7%), impaired gas exchange (46.3%) and activity intolerance (36.6%). The terms “cyanotic” and “pallor” had significant associations with the diagnosis, impaired gas exchange. Conclusion The terms recorded in the records of children with congenital heart disease allowed for the identification of NANDA International nursing diagnoses, in addition to verification of associations.

Body language in health care: a contribution to nursing communication.

OBJECTIVE: to classify body language used in nursing care, and propose "Body language in nursing care" as an analytical category for nursing communication. METHOD: quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions. RESULTS: sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches. CONCLUSION: nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classified body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.

Expressões corporais no cuidado: uma contribuição à Comunicação da Enfermagem / Expresiones del cuerpo en la atención: un aporte el concepto de Comunicación en Enfermería / Body language in health care: a contribution to nursing communication

RESUMOObjetivo:tipificar expressões dos corpos no processo de comunicação, durante o cuidado de enfermagem e propor “Expressões dos corpos no cuidado de enfermagem” como uma das categorias analíticas para a Comunicação da Enfermagem.Método:pesquisa quantitativa com observação sistemática de 21 e 43 situações de cuidado, com 21 integrantes da equipe de dois hospitais. Categorias empíricas: expressões sonoras, faciais, visuais e corporais.Resultados:as expressões sonoras ressaltaram o riso. As faciais destacadas foram de satisfação e felicidade. As visuais destacaram contato do olhar com os integrantes. As corporais mais frequentes foram movimentos de cabeça e toque indistinto.Conclusão:integrantes da equipe usaram expressões de seus corpos para se aproximar dos pacientes, esclarecer suas necessidades e planejar o cuidado. O estudo tipificou expressões dos corpos características do cuidado humanizado que envolvem além de questões técnicas, as não técnicas para a Comunicação da Enfermagem.

RESUMENObjetivo:tipificar expresiones de los cuerpos en el proceso de comunicación durante la atención de enfermería y proponer “Expresiones de los cuerpos en los cuidados de enfermería” como una categoría analítica para la comunicación de Enfermería.Método:investigación cuantitativa con observación sistemática de 21 y 43 situaciones de cuidado, con 21 miembros del equipo de enfermería de los hospitales. Categorías empíricas: expresiones faciales, sonido, visual y corporal.Resultados:Las expresiones sonoras destacaran el risa. Las expresiones faciales destacadas eran de satisfacción y felicidad. Las visuales destacaran contato de mirar con los integrantes. Las expresiones corporales eran movimientos de la cabeza y el tacto más frecuentes indistintas.Conclusión:los miembros del equipo usan las expresiones con el cuidado de sus cuerpos están más cerca de los pacientes, para aclarar sus necesidades y planear los cuidados. Las expresiones de los cuerpos tipificou el cuidado humanizado, que implican, además de las cuestiones técnicas y las no técnicas para una comunicación de la Enfermería.

ABSTRACTObjective:to classify body language used in nursing care, and propose “Body language in nursing care” as an analytical category for nursing communication.Method:quantitative research with the systematic observation of 21:43 care situations, with 21 members representing the nursing teams of two hospitals. Empirical categories: sound, facial, eye and body expressions.Results:sound expressions emphasized laughter. Facial expressions communicated satisfaction and happiness. Eye contact with members stood out in visual expressions. The most frequent body expressions were head movements and indistinct touches.Conclusion:nursing care team members use body language to establish rapport with patients, clarify their needs and plan care. The study classifi ed body language characteristics of humanized care, which involves, in addition to technical, non-technical issues arising from nursing communication.

Diagnósticos, intervenções e resultados de enfermagem para criança com cardiopatia congênita: revisão integrativa / Diagnosticos, intervenciones y resultados de enfermería para ninô con cardiopatía congénita: revision integratíva / Diagnoses, interventions and nursing results for child with congenital heart disease: integrative revision

Objective: correlate the diagnoses, intervention and nursing results standardization before the knowledge produced in the literature, as a way to express the actions interrelated and systematized to the child with congenital heart disease. Method: the integrative revision was used as methodology, realized in the data bases: Lilacs, PubMed, Bdenf and Cuiden. Results: were selected 19 articles; being 4 about nursing diagnoses; 01 about nursing outcomes; 11 about nursing interventions and 3 about nursing diagnoses, interventions and outcomes in children with congenital heart disease. Conclusions: it was verified that few studies showed the steps of the interrelated nursing process. It is necessary to increase the researches in the nursing area in pediatric cardiology to deepen the knowledge and, consequently, improve the practice.

Objetivo: correlacionar à padronização de diagnósticos, intervenções e resultados de enfermagem frente ao conhecimento produzido na literatura, como forma de expressar as ações inter-relacionadas e sistematizadas à criança com cardiopatia congênita. Método: foi utilizada como metodologia a revisão integrativa, realizada nas bases de dados: Lilacs, PubMed, Bdenf e Cuiden. Resultados: foram selecionados 19 artigos, sendo 04 sobre diagnósticos de enfermagem; 01 sobre resultados de enfermagem; 11 sobre intervenções de enfermagem e 03 sobre diagnósticos, intervenções e resultados de enfermagem em crianças com cardiopatias congênitas. Conclusão: verificou-se que poucos estudos demonstraram as etapas do processo de enfermagem inter-relacionadas. É necessário aumentar as pesquisas na área de assistência de enfermagem em cardiologia pediátrica para aprofundar o conhecimento e, consequentemente, melhorar a prática.

Objetivo: correlacionar la padronización de diagnósticos, intervenciones y resultados de enfermería frente al conocimiento producido en la literatura, como forma de expresar las acciones interrelacionadas y sistematizadas al niño con cardiopatía congénita. Método: se ha utilizada como metodología la revisión integratíva, realizada en las bases de datos: Lilacs, PubMed, Bdenf y Cuiden. Resultados: fueronseleccionados 19 artículos, siendo 04 sobre los diagnósticos de enfermería, 01 sobre resultados de enfermería; 11 sobre intervenciones de enfermería y 03 sobre diagnósticos, intervenciones y resultados de enfermería en niños con cardiopatías congénitas. Conclusión: se ha verificado que pocos estudios demostraron las etapas del proceso de enfermería interrelacionadas. Es necesario aumentar las pesquisas en el área de asistencia de enfermería en cardiología pediátrica profundizar el conocimiento y, consecuentemente, mejorar la práctica.

Adaptação transcultural brasileira do “Family caregiver-specific quality of life scale”: estudo metodológico / Adaptación transcultural brasileña del “Family caregiver-specific quality of life scale”: estudio metodológico / Brazilian transcultural adaptation of the “Family caregiver-specific quality of life scale”: a methodological study

To perform a transcultural adaptation of the Family Caregiver-Specific Quality of Life Scale to be used in Brazil. Method: A simple, easily applicable questionnaire was applied, composed of 16 questions, subdivided into the physical, psychological, social and spiritual domains, which was originally tested on a population composed of caregivers for heart failure patients. In this methodological study, the process of adaptation involved the translation, synthesis of translations, back translation and a committee of evaluators. Results: After the translation process, the committee of evaluators suggested some changes to the questionnaire that were authorized by its original author. Discussion: The questionnaire was considered pertinent to Brazilian culture, and to adequately represent the target-population, as well as presenting a good semantic equivalence between the final version in Portuguese and the original version. Conclusion: The instrument has proven to be sufficiently adequate to be used in the general population, and it has also been psychometrically validated...

Realizar adaptação transcultural do Family Caregiver-Specific Quality of Life Scale para uso no Brasil. Método: O questionário é simples, de fácil aplicação, composto por 16 questões subdivididas nos domínios físico, psicológico, social e espiritual, tendo sido validado originalmente em uma população de cuidadores de pacientes com insuficiência cardíaca. Neste estudo metodológico, o processo de adaptação envolveu a tradução, síntese das traduções, retrotradução e comitê de juízes. Resultados: Após as etapas de tradução, o comitê de juízes sugeriu modificações no questionário que foram autorizadas pela autora do questionário original Discussão: O questionário foi considerado pertinente à cultura brasileira e seus itens adequados quanto à sua capacidade de representar à população-alvo, além de apresentar boa equivalência semântica entre a versão final em português e a original. Conclusão: O instrumento mostrou-se adequado para ser utilizado na população e está sendo validado psicometricamente...

Realizar la adaptación transcultural del Family Caregiver-Specific Quality of Life Scale para usarlo en Brasil. Método: El cuestionario es simple, de fácil aplicación, compuesto por 16 cuestiones subdivididas en los temas físicos, psicológicos, social y espiritual habiendo sido validado originalmente en una población de cuidadores de pacientes con insuficiencia cardíaca. En este estudio metodológico, el proceso de adaptación involucró la traducción, síntesis de traducciones, retro traducción y un comité de jueces. Resultados: Después de las etapas de traducción, el comité de jueces sugirió modificaciones en el cuestionario que fueron autorizadas por la autora del cuestionario original. Discusión: El cuestionario se consideró pertinente a la cultura brasileña y sus elementos adecuados en relación a su capacidad de representar la población a la cual está destinado, además de presentar buena equivalencia semántica entre la versión final en portugués y la original. Conclusión: El instrumento resultó adecuado para ser utilizado en la población y se está validando psicométricamente...

Finitude e a doação de órgãos na visão dos enfermeiros: estudo descritivo / Finitud y la donación de órganos en la visión de los enfermeros: estudio descriptivo / Death and organ donation from the point of view of nurses: a descriptive study

To describe the point of view of nurses regarding the moment of death in the process of organ donation in an intensive care unit of a transplant hospital. Method: This is a descriptive, qualitative study, performed with fifteen nurses working in intensive care. Alceste software was used to treat the data collected, which identified the category "ontological dimension of caring due to the moment of death in the process of organ donation and harvesting". Results: During their practice nurses experience a dialectic relationship between the act of donation and facing death through the nursing care provided to the potential donor and his family. Discussion: The process of dying comes up against on a daily basis, when nurses have to deal with the unknown, and face the daily fear of fighting against the possibility of death. Conclusion: There is a need to rethink/review standards, to reconsider the educational background of nursing staff, and to demystify institutional truths when dealing with the unknown...

Descrever a visão dos enfermeiros acerca da finitude no processo de doação de órgãos em unidade de terapia intensiva de um hospital transplantador. Método: Estudo descritivo, qualitativo, desenvolvido com quinze enfermeiros de terapia intensiva. Utilizou-se o software Alceste no tratamento dos dados, do qual emergiu a categoria dimensão ontológica do cuidado frente à finitude no processo de doação e captação de órgãos. Resultados: Os enfermeiros vivenciam em sua prática uma dialética entre a ação da doação e o lidar com a finitude através do cuidado de enfermagem prestado ao potencial doador e família. Discussão: O processo de finitude confronta-se com limitações no cotidiano, onde os enfermeiros apresentam dificuldades em lidar com o incógnito, o medo diário de lutar contra a realidade da morte. Conclusão: Há necessidade de repensar/rever conceitos, a formação e desmitificar verdades institucionais no lidar com o desconhecido...

Describir la visión de los enfermeros acerca de la finitud en el proceso de donación de órganos en la unidad de terapia intensiva de un hospital trasplantador. Método: Estudio descriptivo, cualitativo, desarrollado con quince enfermeros de terapia intensiva. Se utilizó el software Alceste en el tratamiento de los datos, del cual emergió la categoría dimensión ontológica del cuidado frente a la finitud en el proceso de donación y captación de órganos. Resultados: Los enfermeros vivencian en su práctica una dialéctica entre la acción de la donación y el lidiar con la finitud a través del cuidado de enfermería prestado al potencial donante y familia. Discusión: El proceso de finitud se confronta con limitaciones en lo cotidiano, donde los enfermeros presentan dificultades en lidiar con el incógnito, el miedo diario de luchar contra la realidad de la muerte. Conclusión: Hay necesidad de repensar/revisar conceptos, la formación y desmitificar verdades institucionales en el lidiar con lo desconocido...

Terms of nursing: human responses of children hospitalized with heart disease: a cross-sectional study

Aim: To describe the clinical characteristics from the terms found in the nursing and medical records of children hospitalized with congenital heart disease. Method: This was a cross-sectional study conducted in a public hospital. The data from 82 records were analyzed by two expert pediatric cardiology nurses. There was consensus and agreement after individual analysis of the 100 records. Results: The records were of nurslings (91.5%), mostly male (54.9%). The most common terms were "cyanotic" (80.5%) and "respiratory effort" (79.3%). Discussion: The terms used were related to changes in the supply of oxygen and blood flow, suggesting that the cardiocirculatory pathophysiological aspects guide the nursing needs and planning care. Conclusion: The records highlight the color of the skin, the respiratory pattern and hemodynamic aspect as the central points of nursing care with regard to this group of patients...