Etiological factors of chronic pain syndrome in young adults with post-coronavirus disease 2019 condition.

PURPOSE: The coronavirus disease 2019 (COVID-19) generates long-term sequelae, but studies investigating patients with chronic pain syndrome (CPS) are limited. This study aimed to establish the etiological factors of CPS in patients with post-COVID-19 conditions. METHODS: This was a case-control retrospective study. The predictor variables were sex, diabetes mellitus, obesity (predisposing factors), unfavorable socioeconomic conditions, impaired rehabilitation (disabling factors), repeated exposure to COVID-19 (precipitating factor), home isolation, stress overload, fear of dying, admission to intensive care unit, prone positioning, and use of medications (reinforcing factors). The outcome variable was the presence of CPS. FINDINGS: This study included 120 individuals. Prolonged days of isolation (p = 0.005), fear (p < 0.001), stress overload (p < 0.001), and impaired rehabilitation (p = 0.003) were significantly associated with CPS. CONCLUSIONS: A significant relationship was found between prolonged days of isolation, fear, stress overload, impaired rehabilitation, and CPS. IMPLICATIONS FOR NURSING PRACTICE: The study findings can assist nurses by promoting their knowledge of the causes of CPS and supporting the care planning needs of patients with post-COVID-19 conditions, in addition to promoting the use of the NANDA-International taxonomy.

Models of Support for Caregivers and Patients with the Post-COVID-19 Condition: A Scoping Review.

BACKGROUND: In December 2019, an outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in the city of Wuhan, China. On 30 January 2020, the World Health Organization declared the outbreak a public health emergency of international concern. In October 2021, with the advancement of the disease, the World Health Organization defined the post-COVID-19 condition. The post-COVID-19 condition occurs in individuals with a history of probable or confirmed infection with SARS-CoV-2, usually 3 months after the onset of the disease. The chronicity of COVID-19 has increased the importance of recognizing caregivers and their needs. METHODS: We conducted a scoping review following international guidelines to map the models of support for caregivers and patients with the post-COVID-19 condition. The searches were conducted in electronic databases and the grey literature. The Population, Concept, and Context framework was used: Population: patients with the post-COVID-19 condition and caregivers; Concept: models of caregiver and patient support; and Context: post-COVID-19 condition. A total of 3258 records were identified through the electronic search, and 20 articles were included in the final sample. RESULTS: The studies approached existing guidelines and health policies for post-COVID-19 condition patients and support services for patients and home caregivers such as telerehabilitation, multidisciplinary care, hybrid models of care, and follow-up services. Only one study specifically addressed the home caregivers of patients with this clinical condition. CONCLUSIONS: The review indicates that strategies such as telerehabilitation are effective for training and monitoring the patient-family dyad, but the conditions of access and digital literacy must be considered.

Health literacy and adherence to the pharmacological treatment by people with arterial hypertension.

OBJECTIVE: To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension. METHODS: Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests. RESULTS: People with post-graduation, who were actively working and did not smoke, had better health literacy results. Elders and those who were retired or lived on government subsidies adhered better to the medication treatment. There was a correlation between the numerical dimension (rs=0.189; p=0.004) and the global health literacy result (r2=0.170; p=0.009) with the adherence. CONCLUSIONS: A better numerical and global understanding of health literacy was associated with better adherence to arterial hypertension medication treatment.

Evaluación de un juego educativo sobre salud cerebrovascular para personas con enfermedades crónicas: estudio cuasiexperimental / Avaliação de um jogo educacional sobre saúde cerebrovascular para pessoas com doenças crônicas: estudo quaseexperimental / Evaluation of an educational game on cerebrovascular health for people with chronic diseases: A quasi-experimental study

Objetivo: evaluar la implementación de un juego educativo para el reconocimiento temprano de la enfermedad cerebrovascular aguda en personas con diabetes mellitus e hipertensión arterial. Materiales y métodos: estudio con diseño cuasiexperimental, tipo antes-después, realizado con un grupo de 213 adultos con hipertensión y/o diabetes, bajo la modalidad acción educativa, entre junio de 2018 y junio de 2020. Las sesiones de acción se realizaron en cuatro Unidades Básicas de Salud. Esta actividad se realizó en dos momentos: primero, la construcción y validación de una tecnología sanitaria en forma de juego educativo; segundo, la implementación de acciones. Resultados: la mayoría de los participantes eran mujeres (70,89%),con una edad media de 60,29 años. El 86,38% de los participantes logró reconocer tres o más signos y síntomas de accidente cerebrovascular y el 93,89% comenzó a identificar los principales factores de riesgo de esta enfermedad. Una gran proporción de los participantes presentaron un logro de aproximadamente 95% al realizar la posprueba. Sin embargo, no se registró una diferencia estadística significativa entre las medias obtenidas en los grupos durante la preprueba y la posprueba (p=0,9967). Conclusiones: la implementación del juego educativo propició un aumento en los puntajes obtenidos por los participantes sobre el reconocimiento temprano de la enfermedad cerebrovascular aguda y sus factores de riesgo, según muestran las evaluaciones realizadas antes y después del juego.

Objetivo: avaliar a implementação de um jogo educacional para reconhecer precocemente a doença cerebrovascular aguda em pessoas com diabetes mellitus e hipertensão arterial. Materiais e métodos: estudo com desenho quase experimental, do tipo antes e depois, realizado com 213 adultos com hipertensão e/ou diabetes, na modalidade de ação educativa, no período de junho de 2018 a junho de 2020. As sessões de ação foram realizadas em quatro Unidades Básicas de Saúde. Essa atividade foi realizada em dois momentos: primeiro, construção e validação de uma tecnologia em saúde na formade um jogo educacional; segundo, implementação de ações. Resultados: amaioria dos participantes erado sexo feminino (70,89%), com média de idade de 60,29 anos. Dos participantes,86,38% conseguiram reconhecer três ou mais sinais e sintomas de acidente vascular cerebral, assim como 93,89% passaram a identificar os principais fatores de risco para esta doença. A maioria dos participantes apresentou um aproveitamento de aproximadamente 95% ao realizar o pós-teste. No entanto, não houve diferença estatisticamente significativa entre as médias obtidas dos grupos no pré-teste e no pós-teste (p=0,9967). Conclusões: a implementação do jogo educacional levou a um aumento nas notas obtidas pelos participantes sobre o reconhecimento precoce da doença cerebrovascular aguda e de seus fatores de risco, entre as avaliações realizadas antes e depois do jogo.

Objective: To assess the implementation of an educational game for the early recognition of acute cerebrovascular disease in people with diabetes mellitus and hypertension. Materials and methods: Quasi-experimentalstudy, before-and-after type, conducted with 213 adults with hypertension and/or diabetes, under the educational action modality, from June 2018 toJune2020. The action sessions were carried out at fourBasic Health Units in two moments: first, construction and validation of a health technology in the form of an educational game; and second, the implementation of actions. Results:Most participants were women (70.89%),with a mean age of 60.29 years. Of the total number of individuals, 86.38% were able to recognize three or more signs and symptoms of stroke, while93.89% began to identify the main risk factors for this disease. A big share of the participants presented an achievement of approximately 95% when performing the post-test. However, there were no statistically significant differences between the means obtained between the groups during the pre-test and the post-test (p=0.9967). Conclusions: The implementation of the educational game led to an increase in the scores obtained by participants regarding the early recognition of acute cerebrovascular disease and its associated risk factors, as shown by the assessments performed before and after the game.

Challenges for maintaining surgical care practices in the COVID-19 pandemic: an integrative review.

OBJECTIVES: To present the knowledge produced on challenges of health services for maintaining surgical care practices in times of the COVID-19 pandemic. METHODS: This is an integrative literature review, performed with descriptors 'Operating rooms' and 'Coronavirus Infections' in the MEDLINE/PubMed Central, IBECS, LILACS, BDENF, Coleta SUS, BIGG, BINACIS, SciELO, PubMed, Science Direct, and Cochrane Library databases. RESULTS: Of the 405 studies analyzed, 27 met the inclusion criteria. The main challenges for surgical services during the pandemic were: (i) rearrangement of general practice in surgical units; (ii) administration and management of resources and elective surgeries; (iii) follow-up and control of preoperative patients to medium term; (iv) maintenance of patients' and health professionals' autonomy and mental health in this context; and (v) teaching health residents in the operating room. CONCLUSIONS: For surgical care services, the challenges caused by managing the high demand of patients in need of care resulted in the transfer of own resources to other units and the consequent hiring of professionals to meet the demand for these services due to the damming of postponed elective surgeries. This knowledge will allow us to propose strategies in decision making in this scenario, considering the new waves that may arise from this disease.

Health Interventions for Preventing Climate-Sensitive Diseases: Scoping Review.

Climate variations cause public health problems, but the literature is still scarce on studies involving health interventions against climate-sensitive diseases. The objective of this review was to identify health interventions for the prevention of such diseases. We conducted a scoping review using the JBI Methodology. Six large research databases were searched (PubMed, Scopus, Web of Science, Lilacs, Embase, and Cochrane). The following inclusion criterion was used: studies addressing health interventions to prevent climate-sensitive diseases or consequences of climate on people's health. The exclusion criteria consisted of thesis, dissertations, conference proceedings, studies with unclear information/methodology, and studies not addressing climate-related health interventions. No language or date restrictions were applied. Of 733 studies identified and screened by title and abstract, 55 studies underwent full-text screening, yielding 13 studies for review. The health interventions identified were classified into three levels of management. The macro level included the use of epidemiological models, renewable energy, and policies sensitive to climate change. The meso level comprised interventions such as the creation of environmental suitability maps, urban greening, chemoprophylaxis, water security plans, and sanitation projects, among other measures. Some interventions are at the intersection, such as educational campaigns and the modification of artificial larvae sites. Finally, the micro level contained interventions such as the inspection of window screens and the use of light-colored clothing and repellents. The health interventions at the macro, meso, and micro levels and the intersection may serve as a basis for public managers to implement appropriate interventions against climate-sensitive diseases.

Accuracy of the defining characteristics of the nursing diagnosis hypothermia in patients on hemodialysis.

OBJECTIVE: to analyze the accuracy of the defining characteristics of hypothermia in patients on hemodialysis. METHODS: a diagnostic accuracy study was assembled within a cross-sectional study with 124 patients from two dialysis centers. A latent class model was used for data analysis. RESULTS: the nursing diagnosis hypothermia was present in 13 (10.48%) study participants. The most prevalent defining characteristics were hypoxia (100%), decrease in blood glucose level (83.1%), hypertension (65.3%), piloerection (45.2%), and skin cool to touch (41.1%). The defining characteristics acrocyanosis (99.96%) and cyanotic nail beds (99.98%) had a high sensitivity. Acrocyanosis (91.8%), skin cool to touch (64.8%), and peripheral vasoconstriction (91.8%) had high specificity. CONCLUSION: specific and sensitive indicators of hypothermia work as good clinical indicators for confirming this diagnosis in patients on hemodialysis. The study findings can assist nurses in their clinical reasoning for a correct inference of hypothermia.

Assessment of Neurological Status in Patients with Cerebrovascular Diseases through the Nursing Outcome Classification: A Methodological Study.

Nurses play an important role in healthcare, and the Nursing Outcomes Classification is a key tool for the standardization of care. This study aims to validate the nursing outcome "Neurological Status" for patients with cerebrovascular diseases. A methodological study was performed in four phases. In Phase 1, the relevance of the indicators was evaluated by seven specialists and the modified kappa coefficient and content validity index were calculated. In Phase 2, conceptual and operational definitions were formulated. In addition, their content was validated with a focus group in Phase 3. In Phase 4, the results were applied in clinical practice and convergence with the National Institute of Health Stroke Scale was verified. The reliability was measured by Cronbach's alpha. Of the 22 initial indicators, 6 were excluded. The focus group suggested changes in the definitions and the exclusion of two indicators. In Phase 4, only 13 indicators were validated due to the impossibility of measuring intracranial pressure. A strong correlation between the two scales and agreement among all the indicators were observed. Following the specialists' review, the nursing outcome was reliable and clinically validated with 13 indicators: consciousness, orientation, language, central motor control, cranial sensory and motor function, spinal sensory and motor function, body temperature, blood pressure, heart rate, eye movement pattern, pupil size, pupil reactivity, and breathing pattern.

Educação em saúde na prevenção de quedas para idosos com hipertensão / Health education for fall prevention in older adults with hypertension / Educación en salud en la prevención de caídas en ancianos con hipertensión

Objetivo: relatar a experiência de ações educativas sobre a prevenção de quedas em idosos com hipertensão arterial. Método: relato de experiência sobre encontros educativos acerca da prevenção de quedas, realizados para 36 idosos com hipertensão arterial, acompanhados pela atenção primária, no interior cearense. Durante os encontros, utilizou-se do jogo adaptado "Não deixe a vovó cair". Além disso, houve a confecção de fôlderes e cartazes para fornecer as informações de forma mais ilustrativa. Resultados: a aplicação do jogo estimulou os idosos a refletirem sobre situações inadequadas no ambiente domiciliar que podem ser adaptadas para evitar quedas. Alguns idosos apresentaram dificuldades cognitivas, quando solicitados a identificarem os fatores de riscos presentes em cada cômodo da casa, mas, após os exemplos do cotidiano, foram capazes de entender as situações do jogo. Com as orientações, os idosos puderam compreender a relevância dos fatores que favorecem o risco de quedas. Conclusão: a educação em saúde é uma potencial estratégia para realização de atividades educativas sobre a prevenção de quedas em idosos com hipertensão arterial. Para isso, torna-se importante a utilização de metodologias lúdicas, como jogos e materiais que proporcionem a fixação das orientações, a exemplo dos fôlderes. Descritores: Idoso; Hipertensão; Acidente por Quedas; Fatores de Risco; Educação em Saúde.(AU)

Objective: to report the experience of using educational actions for fall prevention in older adults with arterial hypertension. Method: this is an experience report on educational meetings about fall prevention carried out with 36 older adults with arterial hypertension accompanied by primary care in the countryside of Ceará. The adapted game "Do not let grandma fall" was used during the meetings. In addition, folders and posters were made to provide illustrative information. Results: it was noticed that the game stimulated the older adults to reflect on inappropriate situations in their home environment that can be adapted to prevent falls. Some older adults had cognitive difficulties when asked to identify the risk factors present in each room of the house, but after the examples, they were able to understand the game situations. With the guidelines, the older adults could understand the relevance of the factors that favor the risk of falls. Conclusion: it is concluded that health education is a potential strategy to prevent falls in older adults with arterial hypertension. Therefore, it is important to use playful methodologies such as games and materials that provide guidelines for fall prevention, such as folders.(AU)

Objetivo: relatar la experiencia de acciones educativas sobre prevención de caídas en ancianos con hipertensión arterial. Método: relato de experiencia sobre encuentros educativos sobre prevención de caídas, realizados con 36 ancianos con hipertensión arterial, acompañados por atención primaria, en el interior de Ceará. Durante las reuniones se utilizó el juego adaptado "Que no se caiga la abuela". Además, se realizaron carpetas y carteles para brindar información de una manera más ilustrativa. Resultados: la aplicación del juego animó a los ancianos a reflexionar sobre situaciones inapropiadas en el ambiente domiciliario que pueden ser adaptadas para prevenir caídas. Algunos ancianos tenían dificultades cognitivas cuando se les pedía que identificaran los factores de riesgo presentes en cada habitación de la casa, pero, tras los ejemplos cotidianos, lograban comprender las situaciones del juego. Con las orientaciones, los ancianos lograron comprender la relevancia de los factores que favorecen el riesgo de caídas. Conclusión: la educación en salud es una estrategia potencial para la realización de actividades educativas sobre la prevención de caídas en ancianos con hipertensión arterial. En consecuencia, es importante utilizar metodologías lúdicas, como juegos y materiales que sirvan de marco de pautas, como carpetas.(AU)

Ineffective health management in people with type 2 diabetes.

PURPOSE: To analyze the Nursing Diagnosis Ineffective Health Management in people with type 2 diabetes. METHODS: Cross-sectional correlational study conducted with 112 patients from August 2018 to April 2019 in a primary healthcare facility, Ceará, Brazil. Used a structured interview and a form created by the authors specifically for the study. Descriptive and inferential statistics were used in the data analysis. FINDINGS: The Nursing Diagnosis Ineffective Health Management was present in 63.4% of the patients. The defining characteristics with the highest prevalence were difficulty with prescribed regimen (61.6%) and failure to include a treatment regimen in daily living (60.7%). The following significant associations were found: gender and failure to take action to reduce risk factors (P = 0.003), medication and difficulty with prescribed regimen (P = 0.003), and high blood pressure and ineffective choices in daily living for meeting health goals (P = 0.005). The following defining characteristics were associated with the presence of Ineffective Health Management: difficulty with prescribed regimen (P = 0.001), failure to take action to reduce risk factors (P = 0.008), ineffective choices in daily living for meeting health goals (P = 0.001), and failure to include the treatment regimen in daily living (P = 0.001). CONCLUSIONS: The Nursing Diagnosis Ineffective Health Management had a high prevalence in the sample. Its defining characteristics are associated with the nursing diagnosis itself and with sociodemographic and clinical variables. IMPLICATIONS FOR NURSING PRACTICE: Ineffective Health Management should be considered a priority for developing and implementing nursing care for people with type 2 diabetes, especially in primary health care settings.

PROPÓSITO: analisar o diagnóstico de Enfermagem Controle Ineficaz da Saúde em pessoas com diabetes mellitus tipo 2. MÉTODOS: estudo observacional do tipo transversal, realizado com 112 pacientes, no período de agosto de 2018 a abril de 2019, em uma Unidade de Atenção Primária à Saúde, Ceará, Brasil. Utilizou-se entrevista estruturada e instrumento de coleta específico, construído pelos pesquisadores. Os dados obtidos receberam tratamento descritivo e inferencial. ACHADOS: atestou-se a prevalência do diagnóstico de enfermagem Controle Ineficaz da Saúde em 63,4% dos pacientes. As principais características definidoras do diagnóstico de enfermagem presentes foram: dificuldade com o regime prescrito (61,6%) e falha em incluir o regime de tratamento na vida diária (60,7%). Estão associadas estatisticamente às variáveis sexo e falha em agir para reduzir fatores de risco (P = 0,003), medicação e dificuldade com o regime prescrito (P = 0,003), hipertensão arterial e escolhas na vida diária ineficazes para atingir as metas de saúde (P = 0,005) e as seguintes características definidoras com o diagnóstico de enfermagem Controle Ineficaz da Saúde: dificuldade com o regime prescrito (P = 0,001), falha em agir para reduzir fatores de risco (P = 0,008), escolhas na vida diária ineficazes para atingir as metas de saúde (P = 0,001) e falha em incluir o regime de tratamento na vida diária (P = 0,001). CONCLUSÕES: o diagnóstico de enfermagem Controle Ineficaz da Saúde teve prevalência majoritária nos pacientes avaliados e suas características definidoras estão associadas ao diagnóstico de enfermagem, às variáveis sociodemográficas e clínicas. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: o diagnóstico de enfermagem Controle Ineficaz da Saúde deve ser considerado como prioritário para a elaboração e implementação do plano de cuidados de enfermagem às pessoas com diabetes mellitus tipo 2 em acompanhamento na atenção primária à saúde. PALAVRAS-CHAVE: Enfermagem; Diagnóstico de enfermagem; Processo de enfermagem; Doença crônica; Diabetes Mellitus.

Accuracy of the clinical indicators for Readiness for enhanced health management.

PURPOSE: to analyze accuracy measures of the clinical indicators of Readiness for enhanced health management in patients with arterial hypertension and/or diabetes mellitus METHODS: prospective diagnostic accuracy study conducted with 359 patients with hypertension and/or diabetes mellitus, followed up in primary healthcare. Stratified random sampling was used to recruit participants. An assessment form was applied with sociodemographic data, health conditions, and information related to the clinical indicators under investigation. Sensitivity, specificity, predictive values, and likelihood ratios were analyzed FINDINGS: the sample was composed of 359 participants. The prevalence of Readiness for enhanced health management was 93.8%. There was a statistically significant association between the diagnosis and age under 60 years (p < 0.001), having only one chronic condition (p < 0.001), having normal blood pressure (p = 0.017) and blood glucose (p = 0.013) values, and having a nonsedentary (p = 0.026) and nonalcoholic (p = 0.044) lifestyle. All clinical indicators had high predictive values in predicting the nursing diagnosis under investigation. The indicator expresses desire to enhance management of symptoms was the most sensitive (99.7%) and specific (100%). The indicator expresses desire to enhance management of prescribed regimens was also highly specific (100%) CONCLUSION: all clinical indicators were accurate in predicting Readiness for enhanced health management IMPLICATIONS FOR NURSING PRACTICE: knowing which clinical indicators and sociodemographic/clinical characteristics best predict Readiness for enhanced health management, nurses in primary care can better plan nursing interventions and direct their goals.

Effects of the nursing intervention Fall prevention in older adults with arterial hypertension using NANDA-I, NIC, and NOC.

PURPOSE: To measure the effects of the NIC intervention fall prevention on the magnitude of the NANDA-I Risk for falls' risk factors and of NOC indicators related to falls in older adults with arterial hypertension. BACKGROUND: Nurses can use nursing taxonomies to provide effective care in preventing falls in specific populations. METHODS: Clinical, randomized, open, parallel, and multicenter trial following the CONSORT recommendations for nonpharmacological trials. The clinical trial was registered. The research was conducted with 118 older adults allocated to intervention and control groups and matched by sex and age. The intervention was conducted in the participants' homes in three different moments and consisted of nursing activities belonging to the NIC Fall prevention and implemented with the aid of a protocol with operational definitions. FINDINGS: Three months after the intervention, there was a significant intergroup difference in the frequency of Risk for falls and of the following factors/conditions: cluttered environment, unfamiliar setting, exposure to unsafe weather-related condition, insufficient anti-slip material in the bathroom, history of falls, acute illness, orthostatic hypotension, hearing impairment, and impaired vision. There was also a positive change in the magnitude of the following NOC indicators: risk control, cognitive orientation, knowledge: fall prevention, safe home environment, comfort level, vision compensation behavior, and leisure participation. CONCLUSIONS: The NIC intervention Fall prevention was effective in modifying risk factors belonging to Risk for falls and NOC indicators related to falls in older adults. IMPLICATIONS FOR NURSING PRACTICE: The tested intervention is important and should be instituted, mainly by nurses from primary care services who make home visits to older adults.

Accuracy of the defining characteristics of the nursing diagnosis hypothermia in patients on hemodialysis / Exactitud de las características definitorias del diagnóstico de enfermería hipotermia en pacientes en hemodiálisis / Acurácia das características definidoras do diagnóstico de enfermagem hipotermia em pacientes em hemodiálise

ABSTRACT Objective: to analyze the accuracy of the defining characteristics of hypothermia in patients on hemodialysis. Methods: a diagnostic accuracy study was assembled within a cross-sectional study with 124 patients from two dialysis centers. A latent class model was used for data analysis. Results: the nursing diagnosis hypothermia was present in 13 (10.48%) study participants. The most prevalent defining characteristics were hypoxia (100%), decrease in blood glucose level (83.1%), hypertension (65.3%), piloerection (45.2%), and skin cool to touch (41.1%). The defining characteristics acrocyanosis (99.96%) and cyanotic nail beds (99.98%) had a high sensitivity. Acrocyanosis (91.8%), skin cool to touch (64.8%), and peripheral vasoconstriction (91.8%) had high specificity. Conclusion: specific and sensitive indicators of hypothermia work as good clinical indicators for confirming this diagnosis in patients on hemodialysis. The study findings can assist nurses in their clinical reasoning for a correct inference of hypothermia.

RESUMEN Objetivo: analizar la exactitud de las características definitorias de la hipotermia en pacientes en hemodiálisis. Métodos: estudio de exactitud diagnóstica, con diseño transversal, realizado con 124 pacientes de dos centros de diálisis. Se utilizó un modelo de clases latentes para el análisis de datos. Resultados: el diagnóstico de enfermería hipotermia estuvo presente en 13 (10,48%) participantes del estudio. Las características definitorias más prevalentes fueron hipoxia (100%), reducción de la glucosa en sangre (83,1%), hipertensión (65,3%), piloerección (45,2%) y piel fría al tacto (41,1%). Las características definitorias de acrocianosis (99,96%) y lechos ungueales cianóticos (99,98%) mostraron alta sensibilidad. La acrocianosis (91,8%), la piel fría al tacto (64,8%) y la vasoconstricción periférica (91,8%) mostraran alta especificidad. Conclusión: los indicadores específicos y sensibles de hipotermia son buenos indicadores clínicos para confirmar este diagnóstico en pacientes en hemodiálisis. Los resultados del estudio pueden ayudar a las enfermeras a inferir correctamente la hipotermia.

RESUMO Objetivo: analisar a acurácia das características definidoras de hipotermia em pacientes em hemodiálise. Métodos: estudo de acurácia diagnóstica, com delineamento transversal, realizado com 124 pacientes de dois centros de diálise. Um modelo de classe latente foi utilizado para a análise de dados. Resultados: o diagnóstico de enfermagem hipotermia esteve presente em 13 (10,48%) participantes do estudo. As características definidoras mais prevalentes foram hipóxia (100%), redução da glicemia sanguínea (83,1%), hipertensão (65,3%), piloereção (45,2%) e pele fria ao toque (41,1%). As características definidoras acrocianose (99,96%) e leitos ungueais cianóticos (99,98%) apresentaram alta sensibilidade. Acrocianose (91,8%), pele fria ao toque (64,8%) e vasoconstrição periférica (91,8%) apresentaram alta especificidade. Conclusão: os indicadores específicos e sensíveis de hipotermia são bons indicadores clínicos para confirmar esse diagnóstico em pacientes em hemodiálise. Os resultados deste estudo podem auxiliar os enfermeiros em seu raciocínio clínico para uma inferência correta de hipotermia.

Health literacy and adherence to the pharmacological treatment by people with arterial hypertension / Alfabetización en salud y adhesión al tratamiento farmacológico de personas con hipertensión arterial / Letramento em saúde e adesão ao tratamento farmacológico de pessoas com hipertensão arterial

ABSTRACT Objective: To analyze the association between health literacy and the adherence to the pharmacological treatment of Brazilians with arterial hypertension. Methods: Cross-sectional study with 234 participants who responded an on-line sociodemographic and clinical characterization questionnaire, in addition to evaluation of health literacy and of the adherence to their pharmacological treatment. Data were analyzed using descriptive statistics and difference and correlation tests. Results: People with post-graduation, who were actively working and did not smoke, had better health literacy results. Elders and those who were retired or lived on government subsidies adhered better to the medication treatment. There was a correlation between the numerical dimension (rs=0.189; p=0.004) and the global health literacy result (r2=0.170; p=0.009) with the adherence. Conclusions: A better numerical and global understanding of health literacy was associated with better adherence to arterial hypertension medication treatment.

RESUMEN Objetivo: Analizar relación entre alfabetización en salud y adhesión al tratamiento farmacológico de brasileños con hipertensión arterial. Métodos: Estudio transversal, desarrollado con 234 participantes, que respondieron una encuesta online de caracterización sociodemográfica, clínica, evaluación de la alfabetización en salud y de la adhesión al tratamiento farmacológico. Los datos fueron analizados con estadística descriptiva y testes de diferencia y correlación. Resultados: Personas con postgrado, que trabajabany no tabaquistas obtuvieron mejores resultados de alfabetización en salud. Ancianos yjubilados/pensionistas presentaron mejor adhesión al tratamiento medicamentoso. Hubo correlación entre la dimensión numérica (rs = 0,189; p = 0,004) yel resultado global de alfabetización en salud (rs = 0,170; p = 0,009) con la adhesión. Conclusiones: Mejor comprensión numérica y global de alfabetización en salud estuvieron relacionados a mejores resultados de adhesión al tratamiento medicamentoso de la hipertensión arterial.

RESUMO Objetivo: Analisar a associação entre o letramento em saúde e a adesão ao tratamento farmacológico de brasileiros com hipertensão arterial. Métodos: Estudo transversal, desenvolvido com 234 participantes, que responderam um questionário on-line de caracterização sociodemográfica, clínica, avaliação do letramento em saúde e da adesão ao tratamento farmacológico.Os dados foram analisados com estatística descritiva e testes de diferença e correlação. Resultados: Pessoas com pós-graduação, que trabalhavam e não tabagistas obtiveram melhores resultados de letramento em saúde. Idosos e aposentados/pensionistas apresentaram melhor adesão ao tratamento medicamentoso. Houve correlação entre a dimensão numérica (rs=0,189; p=0,004) e o resultado global de letramento em saúde (rs = 0,170; p=0,009) com a adesão. Conclusões: Melhor compreensão numérica e global de letramento em saúde estiveram associados a melhores resultados de adesão ao tratamento medicamentoso da hipertensão arterial.

Prácticas de cuidado de enfermería en el escenario de los países de lengua portuguesa / Nursing health care practices in the Práticas de cuidados de enfermagem no cenário dos países de língua portuguesa / Nursing health care practices in the scenario of Portuguese-speaking countries

Care is essential for men from birth to death and nursing permeates this whole processsince it participates from the search for the best evidence-based health care practices to theexecution of this care. These practices are present in the reception, in the construction andestablishment of intersubjective bonds, and in qualified listening, aspects that constitute theelements inherent to the constitution of holistic care. Nursing is inserted in this care since it is ascience committed to improving this care based on evidence-based practices. This uniquecontribution from nursing affects and transforms the reality of health in several countries,including those of the Portuguese language.(AU)

El cuidado es fundamental para el hombre desde el nacimiento hasta la muerte y laenfermería permea todo este proceso ya que participa desde la búsqueda de las mejores prácticasde atención en salud basadas en evidencias hasta la ejecución de este cuidado. Estas prácticasestán presentes en la recepción, en la construcción y establecimiento de vínculos intersubjetivosy en la escucha calificada, aspectos que constituyen los elementos inherentes a la constitución delcuidado holístico. La enfermería se inserta en este cuidado ya que es una ciencia comprometidacon la mejora de este cuidado a partir de prácticas basadas en evidencias. Esta contribución únicade la enfermería afecta y transforma la realidad de la salud en varios países, incluidos los delengua portuguesa.(AU)

O cuidado é essencial para o homem desde o nascimento até a morte e a enfermagempermeia todo esse processo, pois participa desde a busca das melhores práticas de atenção à saúdebaseadas em evidências até a execução desse cuidado. Essas práticas estão presentes noacolhimento, na construção e estabelecimento de vínculos intersubjetivos e na escuta qualificada,aspectos que constituem os elementos inerentes à constituição do cuidado holístico. Aenfermagem está inserida nesse cuidado por ser uma ciência comprometida com a melhoria dessecuidado com base em práticas baseadas em evidências. Essa contribuição ímpar da enfermagemafeta e transforma a realidade da saúde em diversos países, inclusive os de língua portuguesa.(AU)

Analysis of the Nursing Diagnosis Risk for Falls in Older Adults with Hypertension.

OBJECTIVES: To analyze the Nursing Diagnosis risk for falls indicators in aged with hypertension and to verify the association of this diagnosis with sociodemographic variables and antihypertensive agents used by the aged. METHODS: Analytical study, cross-sectional with quantitative approach. It was carried out in three health units in the city of Redenção, Ceará, Brazil, in the Brazilian Northeast. A total of 153 elderly subjects participated in the study. Statistical analysis was performed using Fisher's exact test, Pearson's chi-square test and multinomial logistic regression of variables that presented association with the Nursing Diagnosis. RESULTS: Use of throw rugs, difficulties with gait, acute illness (p = .004), age greater than or equal to 65 years and impaired vision were associated with the Nursing Diagnosis risk for falls (00155). The work situation (retired) was the only sociodemographic variable that had a significant association with the risk for falls. Antihypertensive agents were not associated with the diagnosis. CONCLUSION: Age greater than or equal to 65 years, use of throw rugs, difficulties with gait, acute illness, and impaired vision can be useful to infer the risk for falls and to confirm their presence in the aged with hypertension. IMPLICATIONS FOR NURSING PRACTICE: This study provides data that can help nurses in the process of inferring the diagnosis risk for falls in the aged with hypertension, which streamlines the planning and implementation of preventive interventions.

OBJETIVOS: analisar os elementos estruturais do Diagnóstico de Enfermagem Risco de quedas em idosos com hipertensão arterial e verificar a associação desse diagnóstico com variáveis sociodemográficas e agentes anti-hipertensivos utilizados pelos idosos. MÉTODOS: estudo analítico, transversal com abordagem quantitativa. Foi realizado em três unidades de saúde do município de Redenção, no Nordeste brasileiro. Um total de 153 idosos participaram deste estudo. A análise estatística foi pelo teste exato de Fisher, qui-quadrado de Pearson e a regressão logística multinominal de variáveis que apresentaram associação com o Diagnóstico de Enfermagem. RESULTADOS: uso de tapetes soltos, dificuldades na marcha, doença aguda (p = 0,004), idade maior ou igual a 65 anos e visão prejudicada foram associados ao Diagnóstico de Enfermagem Risco de quedas (00155). A situação de trabalho (aposentado) foi a única variável sociodemográfica que teve associação significante com o Risco de quedas. Os agentes anti-hipertensivos não foram associados ao diagnóstico. CONCLUSÃO: a idade maior ou igual a 65 anos, uso de tapetes soltos, dificuldades na marcha, doença aguda e visão prejudicada podem ser úteis para inferir o Diagnóstico de Enfermagem Risco de quedas e para confirmar sua presença em idosos com hipertensão arterial. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: este estudo fornece dados que podem ajudar o enfermeiro no processo de inferência do diagnóstico Risco de quedas em idosos com hipertensão arterial, o que agiliza o planejamento e a implementação de intervenções preventivas.