Validation of telesimulation in the care of late preterm newborns with hypoglycemia for nursing students.

OBJECTIVE: To develop and validate a telesimulation scenario for nursing students in the care of late preterm infants with hypoglycemia. METHODS: A methodological study conducted between August 2021 and May 2022 in a virtual environment involved constructing and validating the scenario with 10 experts, and testing it with 10 students. The content validity index assessed validity, with a threshold of 80% or higher, and suggestions were analyzed using semantic approximation. RESULTS: Validation confirmed the appropriateness of all 14 scenario items, with an overall index of 97.8% and clarity and relevance indices of 98.5%. During testing, the overall index was 99.7%, with the "resources" item receiving the lowest score. Adjustments were made to objectives, technical terms, resources, and target audience based on feedback. CONCLUSION: Telesimulation is a widely accepted educational technology for training nursing students, with potential to enhance teaching quality and neonatal care.

Capecitabine-induced oral mucosal hyperpigmentation associated with hand-foot syndrome - A literature review

Abstract Background Capecitabine (Xeloda®) is a cytotoxic, antimetabolite chemotherapeutic agent. Its most common adverse events are diarrhea, hand-foot syndrome (HFS), hyperbilirubinemia, hyperpigmentation, fatigue, abdominal pain, and other gastrointestinal effects. HFS or palmar-plantar erythrodysesthesia (PPE) is an adverse reaction resulting from therapy with chemotherapeutic agents, classified into three degrees. Hyperpigmentation, as an adverse effect of capecitabine, can occur in different locations and with different patterns. The skin, nails and oral mucosal membrane can be affected. Objective The objective of this study was to report and discuss oral hyperpigmentation associated with HFS caused by the use of capecitabine, which is still poorly described in the literature. Methodology A literature review was carried out using the online databases PubMed, Scielo, BVS, Lilacs, Medline, BBO and Google Scholar, associating the descriptors "Capecitabine", "Pigmentation Disorders", "Oral mucosa", "Cancer" and "Hand-Foot Syndrome", which were related and used to exemplify, discuss and report the exposed clinical case. Results This case report corroborates the literature regarding the incidence in females and black skin persons like this patient who was affected by HFS when undergoing antineoplastic therapy with capecitabine and presented hyperpigmentation of the hands, feet and oral mucosa. On the oral mucosa, the hyperpigmented spots were diffuse, showing a blackish color and irregular edges. Their pathophysiology remains unknown. Study limitations Few articles citing capecitabine-associated pigmentation. Conclusions It is hoped that this study may contribute to the identification and correct diagnosis of hyperpigmentation in the oral cavity, as well as call attention to the adverse effects related to capecitabine.

Capecitabine-induced oral mucosal hyperpigmentation associated with hand-foot syndrome - A literature review.

BACKGROUND: Capecitabine (Xeloda®) is a cytotoxic, antimetabolite chemotherapeutic agent. Its most common adverse events are diarrhea, hand-foot syndrome (HFS), hyperbilirubinemia, hyperpigmentation, fatigue, abdominal pain, and other gastrointestinal effects. HFS or palmar-plantar erythrodysesthesia (PPE) is an adverse reaction resulting from therapy with chemotherapeutic agents, classified into three degrees. Hyperpigmentation, as an adverse effect of capecitabine, can occur in different locations and with different patterns. The skin, nails and oral mucosal membrane can be affected. OBJECTIVE: The objective of this study was to report and discuss oral hyperpigmentation associated with HFS caused by the use of capecitabine, which is still poorly described in the literature. METHODOLOGY: A literature review was carried out using the online databases PubMed, Scielo, BVS, Lilacs, Medline, BBO and Google Scholar, associating the descriptors "Capecitabine", "Pigmentation Disorders", "Oral mucosa", "Cancer" and "Hand-Foot Syndrome", which were related and used to exemplify, discuss and report the exposed clinical case. RESULTS: This case report corroborates the literature regarding the incidence in females and black skin persons like this patient who was affected by HFS when undergoing antineoplastic therapy with capecitabine and presented hyperpigmentation of the hands, feet and oral mucosa. On the oral mucosa, the hyperpigmented spots were diffuse, showing a blackish color and irregular edges. Their pathophysiology remains unknown. STUDY LIMITATIONS: Few articles citing capecitabine-associated pigmentation. CONCLUSIONS: It is hoped that this study may contribute to the identification and correct diagnosis of hyperpigmentation in the oral cavity, as well as call attention to the adverse effects related to capecitabine.

Validation of telesimulation in the care of late preterm newborns with hypoglycemia for nursing students / Validación de la telesimulación en el cuidado del recién nacido prematuro tardío con hipoglucemia para estudiantes de enfermeira / Validação de telessimulação no cuidado ao recém-nascido prematuro tardio com hipoglicemia para estudantes de enfermagem

ABSTRACT Objective: To develop and validate a telesimulation scenario for nursing students in the care of late preterm infants with hypoglycemia. Methods: A methodological study conducted between August 2021 and May 2022 in a virtual environment involved constructing and validating the scenario with 10 experts, and testing it with 10 students. The content validity index assessed validity, with a threshold of 80% or higher, and suggestions were analyzed using semantic approximation. Results: Validation confirmed the appropriateness of all 14 scenario items, with an overall index of 97.8% and clarity and relevance indices of 98.5%. During testing, the overall index was 99.7%, with the "resources" item receiving the lowest score. Adjustments were made to objectives, technical terms, resources, and target audience based on feedback. Conclusion: Telesimulation is a widely accepted educational technology for training nursing students, with potential to enhance teaching quality and neonatal care.

RESUMEN Objetivo: Desarrollar y validar un escenario de telesimulación para estudiantes de enfermería en el cuidado de recién nacidos prematuros tardíos con hipoglucemia. Métodos: Estudio metodológico virtual entre agosto de 2021 y mayo de 2022, con construcción y validación del escenario por 10 expertos y prueba con 10 estudiantes. Se utilizó un índice de validez de contenido con umbral del 80% o superior y se analizaron sugerencias mediante aproximación semántica. Resultados: Validación confirmó la adecuación de los 14 elementos del escenario, con un índice general del 97.8% y claridad y pertinencia del 98.5%. En la prueba del escenario, el índice general fue del 99.7%, con "recursos" obteniendo la puntuación más baja. Se ajustaron objetivos, términos técnicos, recursos y público objetivo según comentarios recibidos. Conclusión: Telesimulación es una tecnología educativa ampliamente aceptada para formación de estudiantes de enfermería, con potencial para mejorar la calidad de la enseñanza y el cuidado neonatal.

RESUMO Objetivo: Elaborar e validar um cenário de telessimulação para estudantes de enfermagem no cuidado ao prematuro tardio com hipoglicemia. Métodos: Estudo metodológico, realizado entre agosto de 2021 e maio de 2022, em ambiente virtual envolvendo construção e validação de conteúdo com 10 especialistas e teste do cenário com 10 estudantes. Foi utilizado índice de validade de conteúdo igual ou superior a 80% e análise de sugestões por aproximação semântica. Resultados: Na validação, os 14 itens do cenário foram considerados adequados, com índice geral de 97,8% e 98,5% para clareza e pertinência, respectivamente. No teste do cenário, o índice foi de 99,7%, sendo que o item "recursos" obteve o menor escore. Foram realizados ajustes nos objetivos, termos técnicos, recursos e público-alvo. Conclusão: A telessimulação é uma tecnologia educacional viável e aceita na capacitação de estudantes de enfermagem e com potencial para melhorar a qualidade do ensino e da assistência neonatal.

Two devices to facilitate the perception of pelvic floor muscle contraction in the sitting position in women with urinary incontinence: comparative analysis / Dois dispositivos facilitadores de percepção da contração do assoalho pélvico na posição sentada em mulheres com incontinência urinária: análise comparativa / Dos herramientas que facilitan la percepción de la contracción del suelo pélvico en posición sentada de mujeres con incontinencia urinaria: un análisis comparativo

ABSTRACT The use of support devices may facilitate the perception of pelvic floor muscle (PFM) contraction, which is difficult to be performed. Therefore, this study aimed to compare the perception of PFM contraction in the sitting position during the use of two different support devices on women with PFM dysfunction. This is a cross-sectional study performed with 37 women with stress or mixed urinary incontinence (UI). All women performed three free PFM contractions sitting on a chair, followed by three contractions using each support device (sand pads and a cylindrical foam, which provide sciatic and perineal support, respectively). Women scored the perception of PFM contraction from 1 to 5, as well as the perception of facilitation of contraction (higher grades show better results) and discomfort (higher grades show more discomfort) when compared with free contraction. The cylindrical foam presented similar results to sand pads for the perception of PFM contraction (2.84±1.61 vs. 3.19±1.43; p=0.34) and facilitation of contraction (3.38±1.34 vs. 3.19±1.54; p=0.61), as well as for their discomfort (1.83±1.23 vs. 1.5±1.16; p=0.20). Of all women, 57% preferred sand pads. Thus, both sand pads (sciatic support) and the cylindrical foam (perineal support) improved the perception of PFM contraction and facilitation of contraction in the sitting position of women with PFM dysfunction when compared with sitting with no device. The two devices presented no difference between them.

RESUMO O uso de dispositivos de suporte pode auxiliar na percepção da contração dos músculos do assoalho pélvico (AP). O objetivo deste estudo foi, comparar na posição sentada, a percepção da contração dos músculos do AP durante o uso de dois tipos diferentes de dispositivos, em mulheres com disfunção dos músculos do AP. Para tanto, foi realizado um estudo transversal com 37 mulheres com incontinência urinária (IU) de esforço ou mista. Primeiro as participantes faziam três contrações livres dos músculos do AP sem o uso de dispositivos, sentadas em uma cadeira. Em seguida, faziam três contrações utilizando cada um dos dois dispositivos: almofadas de areia e uma espuma cilíndrica, que forneciam apoio isquiático e perineal, respectivamente. As pacientes atribuíram nota de 1 a 5 para a percepção que tiveram da contração dos músculos do AP, da facilitação da contração (quanto maior a nota, melhor o resultado) e do desconforto com o dispositivo (quanto maior a nota, maior o desconforto) em comparação às contrações livres. Como resultados principais, verificou-se que o uso da almofada cilíndrica foi similar ao das almofadas de areia para a percepção da contração dos músculos do AP (2,84±1,61 vs. 3,19±1,43; p=0,34), e da facilitação da contração (3,38±1,34 vs. 3,19±1,54; p=0,61), assim como do desconforto (1,83±1,23 vs. 1,5±1,16; p=0,20). Entre as participantes, 57% relataram preferir as almofadas de areia. Concluiu-se que em mulheres com incontinência urinária, tanto as almofadas de areia (apoio isquiático) quanto a espuma cilíndrica (apoio perineal) melhoraram a percepção da contração e facilitaram a contração dos músculos do assoalho pélvico na posição sentada, não havendo, no entanto, diferença entre os dispositivos.

RESUMEN Las herramientas de apoyo pueden ayudar en la percepción de la contracción de los músculos del suelo pélvico (SP), que no siempre es fácil de obtener su medición. El objetivo de este estudio fue comparar si dos tipos diferentes de herramientas ayudan a las mujeres con disfunción muscular del SP a contraer estos músculos en posición sentada. Para ello, se realizó un estudio transversal con 37 mujeres con incontinencia urinaria (IU) de esfuerzo o mixta. Primero, las participantes realizaron tres contracciones libres de los músculos del SP sentadas en una silla, sin el uso de herramientas de apoyo. Luego, realizaron tres contracciones utilizando cada uno de los dos dispositivos de apoyo: almohadillas de arena y espuma cilíndrica, que brindan apoyo isquiático y perineal, respectivamente. Las participantes deberían asignar una puntuación de 1 a 5 cuanto a su percepción de la contracción muscular del SP, de la facilitación de la contracción (cuanto mayor sea la puntuación, mejor será el resultado) y la incomodidad con la herramienta (cuanto mayor sea la puntuación, mayor será la incomodidad) en comparación con las contracciones libres. Los principales resultados encontrados apuntan que el uso de la almohadilla cilíndrica fue similar al de las almohadillas de arena en cuanto a su percepción de la contracción de los músculos del SP (2,84±1,61 vs. 3,19±1,43; p=0,34), y la facilitación de la contracción (3,38±1,34 vs. 3,19±1,54; p=0,61), así como la incomodidad (1,83±1,23 vs. 1,5±1,16; p=0,20). El 57% de las participantes informó preferir las almohadillas de arena. Se concluyó que tanto las almohadillas de arena (apoyo isquiático) como la espuma cilíndrica (apoyo perineal) mejoraron la percepción y la facilitación de la contracción muscular del SP en posición sentada de mujeres con disfunción muscular del SP en comparación con la ausencia de la herramienta, sin embargo, hay no hubo diferencia entre las herramientas.

Construção e validação de cenário para telessimulação no manejo do prematuro tardio com hipoglicemia para graduandos em enfermagem / Construction and validation of a scenario for telesimulation in the management of late preterm infants with hypoglycemia for undergraduate nursing students

Introdução: A hipoglicemia neonatal é uma das principais comorbidades relacionadas a recém- nascidos pré-termo tardio (RNPT-T), nascidos entre 34 e 36 semanas e 6 dias de gestação. Neste contexto, o ensino do cuidado visa preparar futuros enfermeiros para atuar na prevenção, identificação e tratamento precoce a fim de evitar complicações e internação prolongada. Com a pandemia de Covid-19, e consequente fechamento das universidades para atividades presenciais, a telessimulação obteve notoriedade no ensino de enfermagem. Esta modalidade da simulação utiliza ambientes virtuais como as plataformas de videoconferência para unir alunos e educadores de diferentes localidades, para fins de educação, avaliação e capacitação. Assim como na simulação presencial, a construção do cenário e sua posterior validação de conteúdo por especialistas constitui-se etapas essenciais para o alcance de resultados de aprendizagem. Apesar de se encontrar na literatura artigos sobre telessimulação, há poucos estudos de validação principalmente nesta temática. Diante do exposto, elaborou-se a seguinte questão: o cenário de telessimulação no manejo do RNPT-T com hipoglicemia neonatal é válido quanto ao seu conteúdo para o ensino de enfermagem? Objetivo: propor um cenário de telessimulação para acadêmicos de enfermagem no manejo do RNPT-T com hipoglicemia neonatal. Método: estudo metodológico que ocorreu em três etapas: construção do cenário, validação de conteúdo por juízes especialistas e testagem por acadêmicos de enfermagem. Foi realizado em ambiente virtual no período de agosto de 2021 e maio de 2022. A versão inicial do telecenário foi constituída de 14 itens, de acordo com os padrões da International Nursing Association of Clinical Simulation and Learning (2021) e o protocolo de atenção ao recém-nascido do Ministério da Saúde (BRASIL, 2014). A validação contou com 10 juízes especialistas e a testagem com 10 acadêmicos. O cenário foi testado em dois encontros síncronos na plataforma de videoconferência Microsoft Teams®. Os dados obtidos foram armazenados no banco de dados da Microsoft Excel® e exportados para o Software SPSS® versão 22.0, na qual foram analisados a concordância por meio do cálculo do Índice de Validade de Conteúdo (IVC), considerando uma taxa igual ou superior a 80%. As sugestões dos juízes especialistas e acadêmicos de enfermagem foram categorizados por aproximação semântica e as consideradas pertinentes foram incluídas. O estudo foi submetido e aprovado pelo Comissão de Pesquisa, mediante submissão à Plataforma Brasil (CAEE: 48816721.7.0000.5347). O registro do consentimento dos participantes ocorreu a partir da assinatura do Termo de Consentimento Livre e Esclarecido. Resultados: a concordância entre os juízes especialistas para os 14 itens do cenário foi superior a 90%, sendo considerada satisfatória. Tendo como índice geral 97,8% e 98,5% para clareza e pertinência, respectivamente. Os acadêmicos de enfermagem avaliaram o telecenário como adequado quanto ao objetivo, organização, linguagem, aparência e motivação, em 100% na maioria dos itens. Apenas o terceiro item do bloco aparência ("Os recursos utilizados no cenário são atrativos") obteve avaliação igual a 90% e uma concordância geral de 99,4%. Conclusão: o cenário de telessimulação foi desenvolvido e considerado válido por contemplar escores acima do adotado para esta pesquisa (IVC>=80%). As sugestões dos juizes especialistas conferiram maior clareza aos objetivos de aprendizagem e a adequação de termos técnicos. A testagem possibilitou o ajustamento de recursos audiovisuais e do público-alvo. O cenário de telessimulação poderá contribuir no capacitação de estudantes de enfermagem no cuidado ao RNPT-T, grupo tão representativo entre os nascimentos prematuros. Outras pesquisas são necessárias para avaliar o impacto desta ferramenta na aprendizagem e desempenho de acadêmicos de enfermagem no cuidado ao RNPT-T.

Introduction: neonatal hypoglycemia is one of the main comorbidities related to late preterm newborns (PT), born between 34 and 36 weeks and 6 days of gestation. In this context, the teaching of care aims to prepare future nurses to act in prevention, identification and early treatment in order to avoid complications and prolonged hospitalization. With the Covid-19 pandemic, and the consequent closure of universities for face-to-face activities, telesimulation gained notoriety in nursing education. This type of simulation uses virtual environments such as videoconferencing platforms to unite students and educators from different locations for education, assessment and training purposes. As in the face-to-face simulation, the construction of the scenario and its subsequent content validation by specialists are essential steps to achieve learning outcomes. Although articles on telesimulation are found in the literature, there are few validation studies, especially on this topic. In view of the above, the following question was elaborated: is the telesimulation scenario in the management of PT with neonatal hypoglycemia valid in terms of its content for nursing education? Objective: to propose a telesimulation scenario for nursing students in the management of PT with neonatal hypoglycemia. Method: methodological study that took place in three stages: scenario construction, content validation by expert judges and testing by nursing students. It was carried out in a virtual environment between August 2021 and May 2022. The initial version of the telescenario consisted of 14 items, according to the standards of the International Nursing Association of Clinical Simulation and Learning (2021) and the care protocol for the patient. newborn from the Ministry of Health (BRASIL, 2014). Validation was performed by 10 expert judges and testing by 10 academics. The scenario was tested in two synchronous meetings on the Microsoft Teams® video conferencing platform. The data obtained were stored in the Microsoft Excel® database and exported to the SPSS® software version 22.0, in which the agreement was analyzed by calculating the Content Validity Index (CVI), considering a rate equal to or greater than 80%. The suggestions of expert judges and nursing students were categorized by semantic approximation and those considered relevant were included. The study was submitted and approved by the Research Committee, through submission to Plataforma Brasil (CAEE: 48816721.7.0000.5347). The participants' consent was registered after signing the Free and Informed Consent Form. Results: the agreement between the expert judges for the 14 items of the scenario was higher than 90%, being considered satisfactory. Having as a general index 97.8% and 98.5% for clarity and relevance, respectively. Nursing students evaluated the telescenario as adequate in terms of objective, organization, language, appearance and motivation, at 100% in most items. Only the third item in the appearance block ("The resources used in the scenario are attractive") obtained an evaluation equal to 90% and an overall agreement of 99.4%. Conclusion: the telesimulation scenario was developed and considered valid for contemplating scores above those adopted for this research (CVI>=80%). The expert judges' suggestions provided greater clarity to the learning objectives and the adequacy of technical terms. Testing made it possible to adjust audiovisual resources and the target audience. The telesimulation scenario may contribute to the training of nursing students in the care of PT, a very representative group among premature births. Further research is needed to assess the impact of this tool on the learning and performance of nursing students in the care of PT.

A guide to physiotherapy in urogynecology for patient care during the COVID-19 pandemic.

INTRODUCTION AND AIM: Physiotherapy in urogynecology faces challenges to safely continuing its work, considering the adoption of social distancing measures during the COVID-19 pandemic. Some guidelines have already been published for urogynecology; however, no specific documents have been produced on physiotherapy in urogynecology. This article aimed to offer guidance regarding physiotherapy in urogynecology during the COVID-19 pandemic. METHODS: A group of experts in physiotherapy in women's health performed a literature search in the Pubmed, PEDro, Web of Science and Embase databases and proposed a clinical guideline for physiotherapy management of urogynecological disorders during the COVID-19 pandemic. This document was reviewed by other physiotherapists and a multidisciplinary panel, which analyzed the suggested topics and reached consensus. The recommendations were grouped according to their similarities and allocated into categories. RESULTS: Four categories of recommendations (ethics and regulation issues, assessment of pelvic floor muscle function and dysfunction, health education and return to in-person care) were proposed. Telephysiotherapy and situations that need in-person care were also discussed. Regionalization is another topic that was considered. CONCLUSION: This study provides some guidance for continuity of the physiotherapist's work in urogynecology during the COVID-19 pandemic, considering the World Health Organization recommendations and the epidemiological public health situation of each region. Telephysiotherapy can also be used to provide continuity of the care in this area during the COVID-19 pandemic, opening new perspectives for physiotherapy in urogynecology.

Implementation of a lesson plan model in the nursing laboratory: strengthening learning.

OBJECTIVE: To describe the experience of implementing a lesson plan model for skills training as a learning tool in undergraduate nursing. METHOD: An experience report on the implementation of a structured plan model for skills training in a nursing laboratory at a public university in southern Brazil. The activities were developed between May/2018 and April/2019. RESULTS: The implementation process was divided into stages: literature review, work process, division of tasks, validation, pilot test, reformulation, dissemination and use. There was a growing link between professors and the laboratory staff regarding planning and management of classes, as well as the improvement of logistics for the organization of materials and simulators. CONCLUSION: The implementation of lesson plans represented an important contribution to the qualification of the teaching and learning process for students and professors.