Psychometric Properties of the Brazilian Version of the Nurses' Knowledge of High-Alert Medications Scale: A Pilot Study.

BACKGROUND AND PURPOSE: High-alert medication is considered to be a medication that presents a high risk of causing significant patient harm when used erroneously and its consequences can be fatal. The Nurses' Knowledge of High-Alert Medication scale (NKHAM) is a tool available to evaluate the knowledge of nurses in practice about this issue. AIM: This pilot study aimed to measure the reliability and known-groups validity of the Brazilian version of the NKHAM. METHODS: This pilot psychometric study was carried out at the Faculty of Nursing and University Hospital of the University of Campinas, São Paulo, Brazil. Forty nursing students and 44 registered nurses working in complex clinical or surgical settings completed a sociodemographic questionnaire and the Brazilian version of the NKHAM. The Kuder-Richardson 20 (KR-20) coefficient and Mann-Whitney test were used to establish reliability and known-groups validity. A significance level of ≤ 0.05 was adopted for all the analyses. RESULTS: Analyses demonstrated preliminary acceptable reliability scores of 0.55 and 0.60 in domains A and B of NKHAM, respectively. A significant difference was found between the nursing students' and the registered nurses' knowledge of high-alert medications, demonstrating the scale's ability to discriminate between the two groups. IMPLICATIONS FOR PRACTICE: Although this is pilot study, results suggest that the Brazilian version of the NKHAM might be a reliable and valid tool to measure nurses' knowledge of high-alert medications.

Psychometric Performance of the Brazilian Version of the Diabetes Distress Scale in Patients With Diabetes Mellitus Type 2.

BACKGROUND AND PURPOSE: Assessing the stress of patient with diabetes requires reliable and valid instruments. This study evaluated the measurement properties of the Brazilian version of the Diabetes Distress Scale (B-DDS). METHODS: This cross-sectional study enrolled 139 patients with Type 2 diabetes mellitus (DM2) receiving outpatient treatment. Reliability and construct validity were estimated through convergent validity and confirmatory factor analysis. RESULTS: Evidence of reliability was obtained-Cronbach alpha = .87 and intraclass correlation coefficient (ICC) = .93. Significant positive correlations of moderate-to-strong magnitudes were observed between the dimensions of the DDS and the total score of the PAID; the confirmatory factor analysis supported the four dimensions of the original instrument. CONCLUSIONS: The B-DDS is reliable and valid for evaluation of the stress related to diabetes mellitus.

Influence of cyclosporine on the occurrence of nephrotoxicity after allogeneic hematopoietic stem cell transplantation: a systematic review.

Cyclosporine, a drug used in immunosuppression protocols for hematopoietic stem cell transplantation that has a narrow therapeutic index, may cause various adverse reactions, including nephrotoxicity. This has a direct clinical impact on the patient. This study aims to summarize available evidence in the scientific literature on the use of cyclosporine in respect to its risk factor for the development of nephrotoxicity in patients submitted to hematopoietic stem cell transplantation. A systematic review was made with the following electronic databases: PubMed, Web of Science, Embase, Scopus, CINAHL, LILACS, SciELO and Cochrane BVS. The keywords used were: "bone marrow transplantation" OR "stem cell transplantation" OR "grafting, bone marrow" AND cyclosporine OR cyclosporin OR "risk factors" AND "acute kidney injury" OR "acute kidney injuries" OR "acute renal failure" OR "acute renal failures" OR "nephrotoxicity". The level of scientific evidence of the studies was classified according to the Oxford Centre for Evidence Based Medicine. The final sample was composed of 19 studies, most of which (89.5%) had an observational design, evidence level 2B and pointed to an incidence of nephrotoxicity above 30%. The available evidence, considered as good quality and appropriate for the analyzed event, indicates that cyclosporine represents a risk factor for the occurrence of nephrotoxicity, particularly when combined with amphotericin B or aminoglycosides, agents commonly used in hematopoietic stem cell transplantation recipients.