Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.584
Filtrar
1.
Rev. enferm. UERJ ; 30: e63609, jan. -dez. 2022.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1361561

RESUMO

Objetivo: identificar a ocorrência de isolamento social e solidão e sua relação com fatores sociodemográficos e de saúde em graduandos de enfermagem no contexto da pandemia de COVID-19. Método: estudo transversal, descritivo e correlacional, desenvolvido com 147 estudantes de enfermagem que responderam um formulário eletrônico, contendo Questionário de caracterização, Escala de Solidão da Universidade de Califórnia e Escala de Depressão, Ansiedade e Estresse. Resultados: evidenciou-se a ocorrência de isolamento social percebido em 42,2% dos estudantes, e que, 8,8% dos estudantes apresentaram isolamento social conforme indicador rede de discussão, e 6,8% de acordo com o indicador de apoio social. Observou-se a solidão em 49,7% dos estudantes. Ambos foram associados com depressão, ansiedade e estresse, além de outras variáveis. Conclusão: identificou-se isolamento social e solidão e a relação destes com outras variáveis durante a pandemia de COVID-19, demandando intervenções por parte das instituições de ensino e dos formuladores de políticas de saúde.


Objective: to identify the occurrence of social isolation and loneliness and their relationship with sociodemographic and health factors in nursing undergraduates in the context of the COVID-19 pandemic. Method: in this cross-sectional, descriptive, correlational study, 147 nursing students answered an electronic form comprising a characterization questionnaire, the University of California Loneliness Scale and the Depression, Anxiety and Stress Scale. Results: perceived social isolation was found to occur in 42.2% of the students, and 8.8% experienced social isolation according to the discussion network indicator, and 6.8%, according to the social support indicator. Loneliness was observed in 49.7% of students. Both were associated with depression, anxiety and stress, and other variables. Conclusion: this study found isolation and loneliness and their relationship with other variables during the COVID-19 pandemic, requiring interventions by educational institutions and health policymakers.


Objetivo: identificar cómo ocurre el aislamiento social y la soledad y su relación con factores sociodemográficos y de salud en estudiantes de enfermería en el contexto de la pandemia de COVID-19. Método: estudio transversal, descriptivo y correlacional, desarrollado junto a 147 estudiantes de enfermería que respondieron un formulario electrónico, que contenía un cuestionario de caracterización, la Escala de Soledad de la Universidad de California y la Escala de Depresión, Ansiedad y Estrés. Resultados: resaltó la incidencia de aislamiento social percibido en el 42,2% de los estudiantes, y que el 8,8% de los estudiantes presentó aislamiento social según el indicador de red de discusión, y el 6,8% según el indicador de apoyo social. La soledad se verificó en el 49,7% de los estudiantes. Ambos fueron asociados con depresión, ansiedad y estrés, además de otras variables. Conclusión: se identificaron el aislamiento social y la soledad y su relación con otras variables durante la pandemia de COVID-19, requiriendo intervenciones por parte de las instituciones de enseñanza y de los formuladores de políticas de salud.

2.
Rev. enferm. UERJ ; 30: e63904, jan. -dez. 2022.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1361566

RESUMO

Objetivo: descrever os impactos da pandemia de COVID-19 para a saúde de enfermeiros. Método: trata-se de um estudo exploratório, descritivo, com abordagem qualitativa, realizado com dez enfermeiros das Estratégias de Saúde da Família de Murici- Alagoas. Os dados foram obtidos a partir de entrevista semiestruturada, submetidos à técnica de Análise de Conteúdo de Minayo. O referencial teórico utilizado foi a Teoria da adaptação de Callista Roy. Resultados: o medo do desconhecido, a necessidade de enfrentamento da situação tanto pessoal como profissionalmente, o medo de transmissão da COVID-19 para os familiares e a vivência do luto, foram identificados neste estudo. Conclusão: a exposição do profissional enfermeiro ao Coronavírus o leva a vulnerabilidade profissional e humana. Nesse contexto, é fundamental que haja acolhimento efetivo ao enfermeiro, tendo em vista que a base profissional é o cuidado. Então, para a qualidade na assistência as condições de trabalho precisam ser condizentes a sua função.


Objective: Objective: to describe the impacts of the COVID-19 pandemic on nurses' health. Method: in this exploratory, descriptive, qualitative study, data were obtained from semi-structured interviews of ten nurses from the Family Health Strategy in Murici, Alagoas state, and submitted to Minayo's Content Analysis technique, using Callista Roy's Theory of Adaptation as the theoretical frame of reference. Results: fear of the unknown, the need to meet the situation both personally and professionally, fear of transmitting COVID to family members, and the experience of grief were identified in this study. Conclusion: nurses' occupational exposure to the Coronavirus leads them to professional and human vulnerability. In this context, it is essential that nurses' health demands be well received and effectively met, considering that the basis of the profession is care. Accordingly, for quality care, working conditions need to be consistent with the nurses' function.


Objetivo: describir los impactos de la pandemia de COVID-19 en la salud de enfermeros. Método: se trata de un estudio exploratorio, descriptivo, cuyo enfoque es cualitativo, realizado junto a diez enfermeros de las Estrategias de Salud Familiar de Murici-Alagoas. Los datos se basaron sobre una entrevista semiestructurada y fueron sometidos a la técnica de Análisis de Conteo de Minayo. El referencial teórico utilizado fue la Teoría de la adaptación de Callista Roy. Resultados: en este estudio se identificaron el miedo a lo desconocido, la necesidad de afrontar la situación tanto personal como profesionalmente, el temor a la transmisión del COVID-19 a los familiares y la experiencia del duelo. Conclusión: la exposición profesional de los enfermeros al Coronavirus los lleva a la vulnerabilidad profesional y humana. En este contexto, es fundamental que haya una acogida eficaz al enfermero, teniendo en cuenta que la base profesional es el cuidado. Por lo tanto, para que la asistencia sea de calidad, las condiciones de trabajo deben ser adecuadas a su función.

4.
Infectio ; 26(2): 137-144, Jan.-June 2022. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1356259

RESUMO

Resumen Objetivo: Sintetizar las características epidemiológicas y clínicas de los niños de COVID-19 con EK, KLD y MIS-C. Métodos: Se realizó una búsqueda en 4 bases de datos y preprints hasta el 31 de Mayo del 2021. Se incluyeron reportes/series de caso que evaluaron las caracte rísticas clínicas del EK, KLD o MIS-C en pacientes pediátricos con COVID-19. Resultados: Se incluyeron 16 estudios (seis informes de casos y diez series de casos, 367 pacientes en total, 58 pacientes con EK, 87 con KLD y 290 pacientes con MIS-C); con edades entre los 6 meses y los 10 años, y el 62% eran mujeres. Se observó COVID-19 positivo en 75,2%. Respecto a EK, KLD y MIS-C, las características clínicas repor tadas fueron compatibles con los cuadros diagnósticos estandarizados en el contexto de COVID-19. La duración de la hospitalización fue de 5 a 14 días para EK y de 4,3 a 13 para MIS-C. Once pacientes con MIS-C (2,8%) necesitaron ECMO. Seis pacientes con MIS-C fueron reportados muertos. Ocho estudios reportaron pacientes en la UCI. Conclusiones: EK o KLD puede asociarse a COVID-19 en niños, y pueden complicarse con MIS-C. El tiempo de hospitalización es prolongado si se presenta EK o KLD asociado a COVID-19 en niños.


Abstract Objective: To synthesize the epidemiological and clinical characteristics of COVID-19 children with MIS-C, KLD and EK. Methods: Databases and preprints were searched until May 31, 2021. Reports/case series that evaluated the clinical features of EK, KLD, or MIS-C in pediatric patients with COVID-19 were included. Results: Sixteen studies were included (six case reports and ten case series, 367 patients total, 58 patients with EK, 87 with KLD, and 290 patients with MIS-C); with ages ranging from 6 months to 10 years, and 62% were female. Positive COVID-19 was observed in 75.2%. Regarding EK, KLD and MIS-C, the reported clinical characteristics were compatible with the standardized diagnostic pictures in the context of COVID-19. The duration of hospitalization was 5 to 14 days for EK and 4.3 to 13 for MIS-C. Eleven patients with MIS-C (2.8%) needed ECMO. Eleven patients with MIS-C (2.8%) needed ECMO. Six patients with MIS-C were reported dead. Eight studies reported patients in the ICU. Conclusions: Children with COVID-19 develop EK or KLD, and can be complicated by MIS-C. Prevention, diagnosis, and treatment measures are needed.

5.
Infectio ; 26(2): 156-160, Jan.-June 2022. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1356262

RESUMO

Resumen Introducción: La mortalidad por SARS-COV-2 ha disminuido en diferentes países, pero no se ha evaluado si es igual en Colombia, o si se relaciona con las carac terísticas de los pacientes y tratamientos utilizados. Objetivo: Comparar la mortalidad por SARS-COV-2, en dos periodos de tiempo controlando por factores de riesgo asociados con mortalidad. Metodología: Estudio observacional, basado en una cohorte retrospectiva de pacientes con SARS-COV-2 atendidos en el Hospital Universitario San Ignacio, Bogotá (Colombia), desde el 19 de marzo al 12 de noviembre, 2020. Se comparó la tasa de mortalidad intrahospitalaria de los pacientes egresados antes y después del 21 de agosto de 2020 (primer pico de mortalidad en Colombia) y se analizó el impacto del momento de atención controlando por comorbilidades, severidad al ingreso y tratamiento recibido, usando un modelo de regresión logística. Resultados: 1399 pacientes (944 antes y 455 después del primer pico de mortalidad) fueron analizados. La tasa de mortalidad intrahospitalaria global fue similar en ambos periodos (17.6% vs 16.3%, p=0.539). En el análisis multivariado se encontró que la atención en el segundo periodo de tiempo se asoció a menor mortalidad (OR 0.66 IC95% 0.47; 0.93, p=0.018), a diferencia del aumento de la misma asociado a la edad (OR 1.06 IC95% 1.05; 1.07, p<0.001), sexo masculino (OR 1.84 IC95% 1.33; 2.54 p<0.001), cirrosis (OR 1.89 IC95% 1.24; 2.88, p=0.003), enfermedad renal (OR 1.36 IC95% 1.00; 1.83, p=0.043) y el uso de dexametasona (OR 1.53 IC95% 1.03; 2.28, p=0.031). Conclusiones: La tasa de mortalidad intrahospitalaria se redujo después del 21 de agosto durante la primera ola de la pandemia en Bogotá, posiblemente asociado a la mejoría en la capacidad de respuesta del sistema de salud en ese momento, o a un menor inoculo viral de los pacientes infectados. Estos hallazgos pueden cambiar con la saturación del sistema de salud.


Abstract Introduction: Mortality secondary to SARS-COV 2 has decreases around the world, however this has not been evaluated in Colombia neither has the correlation between patient characteristics or treatments. Objective: To compare the mortality due to SARS-COV-2, in two periods of time, controlling risk factors associated with mortality. Methodology: Observational retrospective cohort study of patients with SARS- COV-2 treated at the San Ignacio University Hospital in Bogotá (Colombia), from March 19 to November 12, 2020. The in-hospital mortality rate of patients discharged before and after August 21, 2020 (surge mortality in Colombia) was com pared. The impact of the moment of attention was analyzed controlled by comorbidities, severity at admission and treatment received using a bivariate and multivariate logistic regression model. Results: 1399 patients (944 before and 455 after August 21) were analyzed. The overall in-hospital mortality rate was similar at both times (17.6%vs16.3percentage, p=0.539). In the multivariate analysis, it was found that the moment of attention was associated with lower mortality (OR 0.66 95% CI0.47;0.93,p=0.018), in contrast to its increase associated with age (OR 1.06 95% CI 1.05;1.07,p=<0.001), male sex (OR 1.84 95%CI 1.33;2.54,p=<0.001), cirrhosis (OR1.89 95%CI 1.24;2.88, p=0.003), kidney disease (OR 1.36 95% CI1.00;1.83,p=0.043) and the use of dexamethasone (OR1.53 95%CI 1.03;2.28,p=0.031). Conclusions: The in-hospital mortality rate fell after August 21 during the first wave of the pandemic in Bogotá-Colombia, possibly associated with an improvement in response capacity, or a lower viral inoculum of infected patients. These findings may change with the saturation of the health system

6.
Recurso na Internet em Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48775

RESUMO

Considerando las pautas de la ciencia abierta, en el marco de la ciencia ciudadana, la BVS Enfermería Internacional ha establecido una serie de iniciativas dentro del alcance de su Red para sistematizar y difundir materiales convencionales y no convencionales en desarrollo o ya producidos sobre el desempeño de la Enfermería en la pandemia de COVID-19. Estas iniciativas conforman el esfuerzo para crear la Vitrine Nursing Now en alianza con el Ministerio de Salud de Brasil y BIREME / OPS / OMS, que, desde el surgimiento de la pandemia, se ha desarrollado a un ritmo más rápido. Entre las acciones que ya están en marcha están la creación del Grupo de Trabajo - GT Editorial Enfermagem y COVID, un grupo interinstitucional con la participación de BIREME, cuyo objetivo es analizar la relevancia, la calidad técnica y científica de los materiales producidos en la región; el establecimiento de un flujo de recepción de contribuciones, selección, indexación de artículos científicos publicados por las revistas BDENF y LILACS; destacado para materiales de divulgación y otros materiales, en la página de BVS Enfermería y publicación en redes sociales y EN EMERGENCIA, la creación de VITRINE ENFERMAGEM E COVID-19. La Vitrine Enfermagem e COVID-19 tiene como objetivo sistematizar y difundir la literatura técnico-científica de enfermería, así como documentos e iniciativas que expresan la participación de la enfermería en el manejo de COVID-19, a través de la investigación y la producción científica y permitir el intercambio de investigadores. La producción de materiales con el tema es vasta. La dinámica de la pandemia hace que la información se cambie rápidamente. Por lo tanto, fue propuesto construir estrategias de búsqueda para recuperar artículos científicos indexados y documentos técnicos y todavia, buscar activamente materiales no convencionales (videos, materiales didácticos, guías, recomendaciones, materiales de información, sitios web, cursos en línea, entre otros) para su selección de acuerdo con Criterios BDNF y LILACS, indexación y difusión en la Vitrina y redes sociales de BVS Enfermería. / Considerando as diretrizes da ciência aberta, no marco da ciência cidadã, a BVS Enfermería Internacional estabeleceu uma série de iniciativas no âmbito da sua Rede para sistematizar e difundir materiais convencionais e não-convencionais em desenvolvimento ou já produzidos sobre a atuação da Enfermagem na pandemia da COVID-19. Essas iniciativas compõem o esforço de criação da Vitrine Nursing Now em parceria com o Ministério da Saúde do Brasil e BIREME/OPAS/OMS que, desde a emergência da pandemia, está sendo desenvolvida em ritmo mais acelerado. Entre as ações já em curso destacam-se a criação do Grupo de Trabalho - GT Editorial Enfermagem e COVID, um grupo interinstitucional com participação da BIREME, cuja finalidade é analisar a pertinência, qualidade técnica e científica dos materiais produzidos na região; o estabelecimento de um fluxo de recebimento de contribuições, seleção, indexação de artigos científicos publicados por revistas das bases BDENF e LILACS; destaque para as matérias de divulgação e outros materiais, na página da BVS Enfermería e postagem nas redes sociais; e, EM CARÁTER EMERGENCIAL a criação da VITRINE ENFERMAGEM E COVID-19. A Vitrine Enfermagem e COVID-19 tem por objetivos sistematizar e difundir a literatura técnico-científica de enfermagem, bem como documentos e iniciativas que expressam a participação da enfermagem no enfrentamento da COVID-19, por meio da pesquisa e da produção científica e possibilitar o intercâmbio e compartilhamento de pesquisadores. A produção de materiais com a temática é vasta. A dinâmica da pandemia faz com que informações sejam modificadas de forma rápida. Assim, foi proposta a construção de estratégias de busca para recuperação de artigos científicos e documentos técnicos indexados e a busca ativa de materiais não convencionais (vídeos, materiais didáticos, guias, recomendações, materiais informativos, sites, cursos online entre outros) para seleção segundo critérios BDNF e LILACS, indexação e divulgação na vitrine e nas redes sociais da BVS Enfermería. Se espera que contribuya a facilitar el acceso de los profesionales y estudiantes de enfermería, así como a mejorar su producción.


Assuntos
COVID-19 , Pandemias , COVID-19/enfermagem , Infecções por Coronavirus , SARS-CoV-2 , Cuidados de Enfermagem
7.
Recurso na Internet em Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48776

RESUMO

En este aclamado año de 2020 para la profesión de la enfermería, esta vitrina de conocimientos tiene por objeto destacar y sistematizar la producción científica sobre la fuerza de trabajo de la enfermería en América Latina & Caribe, que incluye: la infometría; las innovaciones, inventos y tecnologías; las intervenciones de enfermería; la enfermería y la salud mundial; la educación en materia de enfermería; el protagonismo de los estudiantes y otras cuestiones emergentes como la respuesta a la COVID-19; y la enfermería en cifras en América Latina. Así pues, en el marco del bicentenario de Florence Nightingale y de la conmemoración del año de la enfermería, buscamos con esta vitrina contribuir a la visibilidad de la Enfermería en el campo de la producción técnica y científica, destacando los contenidos relevantes y el papel de la enfermería en América Latina y el Caribe. Para más detalles sobre la construcción del la Vitrine y las metodologías utilizadas para los contenidos destacados, acceda a los Términos de Referencia. Esta iniciativa tiene una alianza con el Ministerio de Salud de Brasil y BIREME / OPS / OMS. Nesse tão aclamado ano de 2020 para a profissão da Enfermagem, essa vitrine do conhecimento tem como objetivo destacar e sistematizar a produção científica sobre a força do trabalho da enfermagem na América Latina & Caribe, incluindo: infometria; inovações, invenções e tecnologias; intervenções da enfermagem; enfermagem e a saúde global; educação em enfermagem; protagonismo estudantil e outros temas emergentes como o enfrentamento da COVID-19; e a enfermagem em números na América Latina. Assim, tendo como pano de fundo a comemoração dos 200 anos de Florence Nightingale e a comemoração do ano da enfermagem, buscamos com essa vitrine contribuir para a visibilidade da Enfermagem no campo da produção técnica e científica destacando conteúdos relevantes e o protagonismo da enfermagem na América Latina & Caribe. Para maior detalhamento sobre a construção da vitrine e metodologias utilizadas para os destaques de conteúdos, acesse o Termo de Referência. Essa iniciativa tem parceria com o Ministério da Saúde do Brasil e BIREME/OPAS/OMS.


Assuntos
Recursos Humanos , Enfermagem , Mão de Obra em Saúde , Recursos Humanos de Enfermagem , Enfermeiras e Enfermeiros
8.
J Emerg Nurs ; 2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35501167

RESUMO

BACKGROUND: The aim of this study was to examine the content, reliability, popularity, and quality of YouTube videos for patients learning how to self-administer subcutaneous low molecular weight heparin injections. METHODS: A systematic review of YouTube videos was conducted on August 20, 2021, using the keywords of "Low-molecular-weight heparin injection," "Enoxaparin injection," "Heparin injection," "Dalteparin injection," and "Tinzaparin injection." Two independent emergency physicians evaluated included videos separately with 5 different score systems (1- Journal of American Medical Association Score, 2-The Video Power Index, 3- Global Quality Scale, 4- Modified 5 Point DISCERN, 5- Total Comprehensiveness Score). RESULTS: Of 458 videos, a total of 161 unique videos were included. Of these, 94 (58.4%) were classified as useful and 67 (41.6%) as containing misleading information. The total number of views was 6,245,284 in useful information videos. DISCERN score (median 4, P < .001), Global Quality Score (median 4, P < .001), Journal of American Medical Association Score (median 4, P < .001), and Total Comprehensiveness Score (median 6, P < .001) were higher in the Useful Information Group. CONCLUSIONS: Nurse and physician prescreening and prescoring the accuracy and quality of specific low molecular weight heparin injection self-administration videos before recommending YouTube to patients is warranted. Policies to limit the spread of health misinformation through credibility scoring and evaluation are needed on social media sites such as YouTube.

9.
J Adv Nurs ; 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35502140
10.
Nurse Educ ; 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35503104

RESUMO

BACKGROUND: Continued restrictions imposed on face-to-face learning related to the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) pandemic resulted in a decision to permanently transition a graduate nursing education advanced assessment course from a hybrid to an online learning modality. PURPOSE: The purpose of this article is to describe the transition of the physical examination skills lab from face-to-face to online, compare advanced practice nursing student performance outcomes, and evaluate faculty satisfaction and student satisfaction and confidence in learning. METHODS: A retrospective comparison design was used to evaluate student outcomes. Surveys were used to evaluate faculty satisfaction and student satisfaction and confidence. RESULTS: Academic performance, including the psychomotor performance proficiency of advanced assessment skills, was comparable between the modalities. Students were satisfied with and confident in their learning of skills. Faculty support online delivery despite increased workload. CONCLUSIONS: Continued use of the online learning modality for teaching advanced physical examination skills is warranted.

11.
Med Clin (Engl Ed) ; 158(6): 265-269, 2022 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-35492427

RESUMO

Introduction: D-dimer levels are elevated in COVID 19 and they correlate to the levels of other inflammatory markers such us ferritin, fibrinogen and C-reactive protein. It may be possible to correct D-dimer value in function of inflammatory markers, thus identifying patients at higher risk of venous thromboembolism (VTE). Our objectives are estimating a corrected value of plasma D-dimer as a linear function of ferritin, C-reactive protein and fibrinogen and stablishing a cut-off point of high probability of VTE. Patients and methods: Age and sex matched case-control study of all patients diagnosed with COVID 19 and VTE between March and May 2020 in a tertiary hospital in Madrid (Spain). Using linear regression, the best predictive model will be estimated and residual D-dimer values will be obtained and analyzed using ROC curves to determine its discriminative performance. Results: Thirty-eight cases and seventy-six controls were included. There was 63.2% of men and mean age was 68.2. D-dimer was best predicted by a linear model including fibrinogen, ferritin and C-reactive protein. Using residual values, the optimal cutoff point was 2165 ng/mL, with a sensitivity of 57.9% and specificity of 98.7%. Conclusion: It is possible to estimate a D-dimer corrected value in function of ferritin, C-reactive protein and fibrinogen. Using the observed and estimated value we can obtain a residual value that performs well as a screening method to detect patients who would benefit for further VTE diagnostic testing.


Introducción: El dímero-D está elevado en la COVID-19 y se correlacionan con los niveles de otros marcadores inflamatorios como ferritina, fibrinógeno y proteína C reactiva. Cabe la posibilidad de corregir el dímero-D en función de dichos marcadores inflamatorios, identificando así los pacientes con mayor riesgo de enfermedad tromboembólica venosa (ETV). Nuestros objetivos son estimar un valor corregido de dímero-D como función lineal de ferritina, proteína C reactiva y fibrinógeno, y establecer un punto de corte de alta probabilidad de ETV. Pacientes y métodos: Estudio de casos y controles emparejados por sexo y edad de todos los pacientes diagnosticados con COVID-19 y ETV entre marzo y mayo de 2020 en un hospital terciario de Madrid, España. Mediante regresión lineal, se estima el mejor modelo predictivo y se obtiene el valor residual de dímero-D. Este se analizará con curvas ROC para determinar su capacidad discriminativa. Resultados: Se incluyeron 38 casos y 76 controles. Había un 63,2% de varones y la edad media fue de 68,2 años. El valor de dímero-D fue predicho por un modelo que incluyó fibrinógeno, ferritina y proteína C reactiva. Usando los valores residuales, el punto de corte óptimo estimado de 2.165 ng/ml, con una sensibilidad del 57,9% y una especificidad del 98,7%. Conclusiones: Es posible estimar un valor corregido de dímero-D en función de ferritina, fibrinógeno y proteína C reactiva. Usando el valor observado y estimado podemos obtener un valor residual que funciona bien como método de cribado para detectar pacientes que podrían beneficiarse de más estudios diagnósticos de la ETV.

12.
Med Clin (Engl Ed) ; 158(6): 251-259, 2022 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-35492428

RESUMO

Objective: To analyse susceptibility/risk of suffering COVID-19 among adults with distinct underlying medical conditions. Methods: Population-based cohort study involving 79,083 individuals ≥50 years old in Tarragona (Southern Catalonia, Spain). Baseline cohort characteristics (demographic, pre-existing comorbidities, chronic medications and vaccinations history) were established at study start (01/03/2020) and primary outcome was laboratory-confirmed COVID-19 occurred among cohort members throughout 01/03/2020-30/06/2020. Risk of suffering COVID-19 was evaluated by Cox regression, estimating multivariable hazard ratios (HRs) adjusted for age/sex and pre-existing comorbidities. Results: Across study period, 536 laboratory-confirmed COVID-19 cases were observed (mean incidence: 39.5 cases per 100,000 persons-week). In multivariable-analysis, increasing age/years (HR: 1.01; 95% CI: 1.00-1.02), nursing-home (HR: 20.19; 95% CI: 15.98-25.51), neurological disease (HR: 1.35; 95% CI: 1.03-1.77), taking diuretics (HR: 1.39; 95% CI: 1.10-1.75), antiplatelet (HR: 1.36; 95% CI: 1.05-1.76) and benzodiazepines (HR: 1.24; 95% CI: 1.00-1.53) increased risk; conversely, taking angiotensin-converting-enzyme inhibitors (HR: 0.78; 95% CI: 0.61-1.00), angiotensin-receptor-blockers (HR: 0.70; 95%CI: 0.51-0.96) and statins (HR: 0.75; 95% CI: 0.58-0.96) were associated with reduced risk. Among community-dwelling individuals, pre-existing cancer, renal and cardiac disease appeared also related with an increased risk, whereas influenza vaccination was associated with reduced risk. Conclusion: In a setting with relatively low incidence of COVID-19 across the first wave of pandemic period, increasing age, nursing-home residence and multiple comorbidities appear predisposing for COVID-19 among middle-aged/older adults. Conversely, statins, angiotensin-receptor blockers/inhibitors and influenza vaccination were related with decreased risk.


Objetivo: Analizar incidencia y riesgo/susceptibilidad de sufrir la COVID-19 en adultos según distintas condiciones médicas preexistentes. Métodos: Cohorte de base poblacional que incluyó 79.083 personas ≥50 años en Tarragona. Características basales de la cohorte (edad/sexo, comorbilidades, medicaciones crónicas) se establecieron a 01-03-2020 y se registraron todos los casos de COVID-19 confirmada ocurridos en miembros de la cohorte hasta el 30-06-2020. Para estimación de riesgos se realizó regresión de Cox, con cálculo de hazard ratio (HR) ajustados por edad, sexo y comorbilidad. Resultados: Se observaron 536 casos confirmados de COVID-19 (incidencia media: 39,5 casos por 100.000 personas-semana). En análisis multivariante, edad/años (HR: 1,01; IC el 95%: 1,00-1,02; p = 0,050), estar institucionalizado/residencia (HR: 20,19; IC 95%: 15,98-25,51; p<0,001), enfermedad neurológica (HR: 1,35; IC el 95%: 1,03-1,77), diuréticos (HR: 1,39; IC 95%: 1,10-1,75), antiagregantes plaquetarios (HR: 1,36; IC 95%: 1,05-1,76) y benzodiacepinas (HR: 1,24; IC 95%: 1,00-1,53) se asociaron con un riesgo aumentado de la COVID-19 analizando la totalidad de la cohorte; contrariamente, medicación IECA (HR: 0,78; IC el 95%: 0,61-1,00), ARA-II (HR: 0,70; IC el 95%: 0,51-0,96) y estatinas (HR: 0,75; IC el 95%: 0,58-0,96) se asociaron con menor riesgo. Entre personas no institucionalizadas, cáncer, nefropatía y cardiopatía se asociaron con mayor riesgo y vacunación antigripal con menor riesgo. Conclusión: En un área con relativamente baja incidencia de COVID-19, edad, institucionalización y múltiples comorbilidades aumentaron el riesgo/susceptibilidad de sufrir la COVID-19. Contrariamente, estatinas, inhibidores del sistema renina-angiotensina y vacunación antigripal se asociaron con menor riesgo.

13.
Front Public Health ; 10: 758156, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35493392

RESUMO

Background: The unpredictable and variable nature of COVID-19 and the lack of healthcare resources has led to inadequate care for patients. This study aimed to explain the causes of missed nursing care during the COVID-19 pandemic from the perspective of Iranian nurses. Method: This qualitative study was conducted using semi-structured interviews with 14 nurses caring for patients with COVID-19 in three hospitals in Iran. Sampling was performed by the purposive method. Data were analyzed using the conventional content analysis method. The interviews were first recorded and transcribed, and then the data were analyzed using the Elo and Kyngas method. Data management was done with MAXQDA software version 10. To achieve trustworthiness, the criteria presented by Lincoln and Guba were used. Findings: A total of 14 nurses participated in the study. The mean age of participants was 31.85 ± 4.95 years, and the mean number of years of work experience was 7.71 ± 4.44. Eleven participants were women. Among all participants, nine had a bachelor's degree and five had a master's degree. Four nurses had fixed shifts, while ten nurses had rotating shifts. The causes of missed nursing care were categorized into 4 groups. The category "unfulfilled care" comprised the reasons for forgetting care, neglecting care, arbitrary elimination of care, and compulsory elimination of care. The category of "care at improper time" consisted of interference of the care in patients' daily activities and interference with other healthcare providers' activities. The "incomplete cares" category comprised failure to complete the care period in hospital, interruption in care, and discontinuance of care after patient discharge. The last category, "incorrect care," consisted of providing care regardless of the nursing process, providing care by unqualified professionals, and providing trial-and-error care. Conclusion: This study illustrates an understanding of the causes of missed nursing care during the COVID-19 pandemic from the perspective of nurses. The increasing demand for care caused by the pandemic and problems in the work environment has led to the failure of nurses to provide complete, correct care and sometimes miss parts of care to patients. Therefore, nursing policymakers and managers should develop and implement appropriate care protocols and instructions to minimize missed nursing care.


Assuntos
COVID-19 , Adulto , COVID-19/epidemiologia , Feminino , Hospitais , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pandemias , Pesquisa Qualitativa
14.
J Patient Exp ; 9: 23743735221092602, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35493440

RESUMO

The purpose of the study was to examine the experiences of patients undergoing emergency surgery during the Covid-19 pandemic. In-depth semi-structured interviews were conducted with 15 patients. Data analysis was performed using MAXQDA 20 software, and the descriptive and relational analysis method was used in the analysis of the data. Three themes were defined in the study: (a) Categories of the theme of corporate obligation: Corporate protective precautions, Covid-19 related training, individual protective precautions, and preoperative preparation; (b) Categories of the theme of challenging dilemma related to surgery: psychological factors and the difficulties of surgery in the pandemic; and (c) Categories of the theme of development of professional values: Communication with health workers, support, professionalism, and patient-institute trust relationship. We determined in the study that participants had positive and negative deep experiences. In the relational analysis, participants expressed opinions about trust in hospital staff and health workers, as well as about professionalism, environmental hygiene, physical distance, and mask necessity. The results of this study could help nurses identify the needs of patients undergoing emergency surgery during the Covid-19 pandemic, including informing and training about the surgery and discharge process, healthy communication, and psychological support.

15.
SAGE Open Nurs ; 8: 23779608221094108, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35493543

RESUMO

Objective: The aim of our study was to describe specialist nurses' experiences with the helicopter transport of patients critically ill with COVID-19. Method: Our study followed a descriptive qualitative design anchored in the naturalistic paradigm and was based on qualitative content analysis. The study followed the consolidated criteria for reporting qualitative research. Results: Six semi-structured interviews were conducted with specialist nurses who have cared for patients critically ill with COVID-19 during helicopter transport. The analysis of the interviews resulted in three themes-designing new routines before transport, working under new conditions and post-transport and reflections-with 11 categories. The goal of the intensive care transport of patients with COVID-19 was twofold: to prevent the spread of infection by using personal protective equipment and to prevent the contamination of the helicopter. Conclusion: For the nurses, working in personal protective equipment created a feeling of distance from patients that compromised patient-nurse intimacy. Our results suggest that ensuring the sufficiency of equipment required in the event of major accidents and pandemics is critical.

16.
SAGE Open Nurs ; 8: 23779608221094547, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35493546

RESUMO

Introduction: Lockdowns due to the COVID-19 pandemic radically changed nursing education. Along with social isolation, the transition to distance education affected the well-being of students in several countries, particularly Portugal and Spain. Objectives: To identify which variables are predictors of psychological well-being for Portuguese and Spanish nursing students during mandatory lockdowns. Methods: A multicenter, cross-sectional, descriptive, correlational study involving a sample of 1075 students (944 women, mean age 22.46 + /-4.95 years). Data were collected from an online questionnaire which applied the following scales: Perceived Stress Scale (α = .820); Brief COPE-14 Subscales (α = .430 < 0.930); Well-being Manifestations Measure Scale (α = .940); Herth Hope Index (α = .850). A multiple regression model was created to predict the psychological well-being of nursing students. Results: The following predictor variables were identified in the model of the psychological well-being of students during the COVID-19 pandemic: perceived stress (ß = .405; p ≤ .001); hope (ß = .404; p ≤ .001); and the mechanisms of active coping (ß = .405; p ≤ .001), planning (ß = .097; p ≤ .001), and positive reinterpretation (ß = .053; p = .12). These five variables predicted 62.0% of the nursing students' psychological well-being (R 2 = .620; F = 350.82; p ≤ .001). Conclusion: Promoting students' mental health is essential, especially in periods of great adversity, such as a pandemic. Our results lead the way for the design and validation of an intervention program that addresses the five variables identified as predictors of students' psychological well-being.

17.
Indian J Psychiatry ; 64(2): 151-158, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35494318

RESUMO

Background: Care of COVID-19 patients has been shown to affect the mental health of healthcare personnel (HCP), however, there is little data reflecting psychological health of HCP in India. Aims: The present study was undertaken to assess the prevalence of psychological outcomes and its association with various sociodemographic and occupational factors among the HCP in India. Methodology: A cross-sectional, online survey, using snowball sampling method was conducted between June 1, 2020, and June 22, 2020. The HCP working in COVID-19 designated hospitals across India were invited to participate. Patient Health Questionnaire-4 and 19-item stress-related questionnaire were used to evaluate symptoms of overall anxiety, depression, COVID-19 infection specific anxiety, exhaustion, and workload. Results: In this cross-sectional study with 2334 HCP from 27 states and 7 union territories of India; 17.9% of participants had depression, 18.7% had overall anxiety, 26.5% had exhaustion, 30.3% reported heavy workload, and 25.4% had COVID-19 infection-specific anxiety, respectively. The HCP working in states with higher caseload was a common risk factor for overall anxiety (odds ratio [OR], 1.7; P < 0.001), depression (OR, 1.6; P < 0.001), COVID-19 infection-specific anxiety (OR, 2.5; P < 0.001), exhaustion (OR, 3.1; P < 0.001), and heavy workload (OR, 2.6; P < 0.001). Nurses were more at risk for depression (OR, 2.2; P < 0.001), anxiety specific to COVID-19 infection (OR, 1.3; P = 0.034), and heavy workload (OR, 2.9; P < 0.001); while doctors were more at risk for overall anxiety (OR, 2.0; P = 0.001) and exhaustion (OR, 3.1; P < 0.001). Conclusions: Frontline workers, specifically nurses and doctors, and those working in states with high COVID-19 caseload are more at risk for adverse psychological outcomes. The relatively less prevalence compared with other countries, is perhaps a reflection of measures undertaken, including early lockdown, ensuring better all-round preparedness and social norms.

18.
Indian J Psychiatry ; 64(2): 120-129, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35494325

RESUMO

Aim of the Study: There is currently no meta-synthesis focused on the lived experiences of health-care providers during COVID-19. This meta-synthesis adds to evidence-based literature with an in-depth exploration of how health-care providers responded to the COVID-19 crisis. Materials and Methods: The meta-synthesis approach was used for the extraction and synthesis of data. Results: Fifteen qualitative research articles were identified and analyzed; the majority of which were done in China 7 (48%) and Iran 6 (40%). The total sample size was 383, and the majority of the samples were nurses 282 (74%). Three overarching themes identified were "It is my duty," "I am exhausted and about to fall," and "I have overcome it." The subthemes were professional responsibility, challenges faced, the unexpected burden at work, self-coping and reflection, hospital support, government support, and social support. Conclusion: The recommendations for the policy-makers, put forward by the current study are; designing and engineering effective personal protective equipment (lightweight protective suit with long-lasting durable diapers and face masks with a portal for drinking juice or water), rostering minimal working hours, live-in care facilities, exclusion of pregnant and sick health care providers during an epidemic assignment and frequent outbreak training sessions for all department staff.

19.
Artigo em Inglês | MEDLINE | ID: mdl-35494413

RESUMO

Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in China and subsequently spread worldwide. In Japan, many clusters occurred during the first wave in 2020. We describe the investigation of an early outbreak in a Tokyo hospital. Methods: A COVID-19 outbreak occurred in two wards of the hospital from April to early May 2020. Confirmed cases were individuals with laboratory-confirmed SARS-CoV-2 infection linked to Wards A and B, and contacts were patients or workers in Wards A or B 2 weeks before the index cases developed symptoms. All contacts were tested, and cases were interviewed to determine the likely route of infection and inform the development of countermeasures to curb transmission. Results: There were 518 contacts, comprising 472 health-care workers (HCWs) and 46 patients, of whom 517 were tested. SARS-CoV-2 infection was confirmed in 42 individuals (30 HCWs and 12 patients). The proportions of SARS-CoV-2 infections in HCWs were highest among surgeons, nurses, nursing assistants and medical assistants. Several HCWs in these groups reported being in close proximity to one another while not wearing medical masks. Among HCWs, infection was thought to be associated with the use of a small break room and conference room. Discussion: Nosocomial SARS-CoV-2 infections occurred in two wards of a Tokyo hospital, affecting HCWs and patients. Not wearing masks was considered a key risk factor for infection during this outbreak; masks are now a mandated countermeasure to prevent the spread of SARS-CoV-2 infection in hospital settings.


Assuntos
COVID-19 , Infecção Hospitalar , COVID-19/epidemiologia , COVID-19/prevenção & controle , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Hospitais , Humanos , Japão/epidemiologia , Pandemias/prevenção & controle , Quartos de Pacientes , SARS-CoV-2 , Tóquio/epidemiologia
20.
Cureus ; 14(3): e23604, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35494937

RESUMO

Sickle cell disease is an autosomal recessive disorder resulting in the substitution of CTG by CAG in the sixth codon of the beta-globin gene. As a result of this, the hydrophilic glutamic acid residue is replaced by hydrophobic valine residue, leading to the formation of hemoglobin tetramer HBS. This alteration in the beta-globin chain makes the red blood cells prone to sickling, especially in the presence of risk factors such as stress, hypoxia, and infection. These sickled red blood cells have the tendency to adhere to the endothelium and lead to vessel occlusion and distal tissue ischemia. The recent coronavirus disease 2019 (COVID-19) outbreak has impacted millions across the globe, putting individuals with co-morbidities at particularly high risk, and patients with sickle cell disease are no exception. We present the case of a 47-year-old African American male presenting to the emergency department with subjective fevers and a two-day history of pain in the arms, legs, and chest. A diagnosed case of sickle cell disease, the patient was on hydromorphone for pain management but ran out of his medications a few weeks before presentation. On examination, the patient was saturating well with mild tenderness upon palpation of the arms, legs, and chest. On complete blood count, the patient had a hemoglobin of 11.3 g/dL and a white cell count of 13.1 x10(3)/mcL. The patient had a normal mean corpuscular volume with reticulocytosis, hypochromia, ovalocytosis, poikilocytosis, polychromasia, and target cells. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) was positive. The chest X-ray did not reveal any significant findings. He was admitted to the medicine floor for the management of sickle cell crisis and was placed under airborne and droplet precautions. The patient was started on hydromorphone for pain management and intravenous fluid hydration. On the second day of admission, the patient reported increasing shortness of breath. He was saturating 90% on room air and 94% on 2 liters of supplemental oxygen. The white blood cell count increased to 18.42 x10(3)/mcL and the chest X-ray revealed reticular densities with patchy alveolar opacities in the left lung. Given the decline in respiratory status, the patient was started on remdesivir. Over the course of his hospital stay, the patient's pain and respiratory status improved, with the patient saturating 97% on room air. He was discharged home with instructions to follow isolation precautions for at least two weeks, folic acid, and adequate pain management. An appointment was also scheduled for the patient to follow with a sickle cell nurse practitioner upon discharge.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...