Afrontamiento de enfermeras en Unidades de cuidados intensivos durante la pandemia: Una mirada interdisciplinaria / Coping de enfermeiros em unidades assistenciais terapia intensiva durante a pandemia: um olhar interdisciplinario / Coping of nurses in care units intensive care during the pandemic: An interdisciplinary look

Introduction: The COVID-19 pandemic, in its beginnings, caused a great impact with ahigh morbidity and mortality in which health teams, especially nursing, had to face great vitalorganizational changes in the way of caring. Objective: To understand from an interdisciplinaryperspective the coping of nurses in an Adult Intensive Care Unit of a public hospital in Valparaíso, Chile, when caring for people diagnosed with COVID-19 during the year 2020 of the pandemic. Methodology: Qualitative study with a narrative design, which convenience sampling allowed the selection of 8 nurses who participated voluntarily after signing the informed consent.The collection of information was carried out through a semi-structured interview recorded virtually by videoconference, with prior authorization from the hospital's Scientific Ethics Committee. Results: The stressors were identified: Seeing people die, fear of infecting others, organizational changes and the uncertainty about the disease. To deal with them, they had personal andenvironmental resources, using coping strategies focused on the problem and emotion, whichallowed them to adapt and focus the care of the person served. Conclusions: Nurses faced caring with emotional intelligence and resilience, which added to structural changes and the restructuring of their role, allowing them to adapt to overcome the contingency situation.(AU)

Introducción: La pandemia por COVID-19 en sus comienzos, causó un gran impactocon una elevada morbimortalidad en que los equipos de salud, especialmente enfermería, debieron enfrentar grandes cambios vitales, organizacionales y en la forma de cuidar. Objetivo: Comprender desde una mirada interdisciplinaria el afrontamiento de enfermeras de una Unidad deCuidados Intensivos del Adulto de un hospital público de Valparaíso, Chile, al cuidar personasdiagnosticadas con COVID-19 durante el año 2020 de la pandemia. Metodología: Estudio cualitativo de diseño narrativo, cuyo muestreo por conveniencia permitió seleccionar 8 enfermerasque participaron voluntariamente, previa firma del consentimiento informado. La recolección deinformación se realizó mediante una entrevista semiestructurada grabada de manera virtual porvideoconferencia, previa autorización del Comité Ético Científico del hospital. Resultados: Seidentificaron los estresores: Ver gente morir, temor a contagiar a otros, cambios organizacionalese incertidumbre ante la enfermedad; para afrontarlos, contaron con recursos personales y ambientales, utilizando estrategias de afrontamiento centradas en el problema y la emoción, lo queles permitió adaptarse y centrar el cuidado de la persona atendida. Conclusiones: Las enfermerasafrontaron el cuidado con inteligencia emocional y resiliencia, lo que sumado a cambios estructurales y la reestructuración de su rol, les permitió lograr la adaptación para superar la situaciónde contingencia.(AU)

Introdução: A pandemia de COVID-19 em seus primórdios, causou grande impactocom alta morbimortalidade onde as equipes de saúde principalmente a enfermagem, tiveram queenfrentar grandes mudanças vitais, organizacionais e na forma de cuidar. Objetivo: Compreender a partir de uma perspectiva interdisciplinar, o enfrentamento dos enfermeiros de uma Unidade de Terapia Intensiva Adulto de um hospital público de Valparaíso, Chile, ao cuidar de pessoas diagnosticadas com COVID-19 durante o ano de 2020 da pandemia. Metodologia: Estudoqualitativo de desenho narrativo, cuja amostragem por conveniência permitiu a seleção de 8 enfermeiros que participaram voluntariamente após assinatura do consentimento informado. A coleta de informações foi realizada por meio de entrevista semiestruturada gravada virtualmentepor videoconferência, com autorização prévia do Comitê de Ética Científica do hospital. Resultados: Foram identificados os estressores: Ver pessoas morrerem, medo de infectar outras pessoas, mudanças organizacionais e incerteza sobre a doença. Para lidar com eles, dispunham derecursos pessoais e ambientais, utilizando estratégias de enfrentamento centradas no problema ena emoção, o que lhes permitia adaptar e focar o cuidado da pessoa atendida. Conclusões: Osenfermeiros enfrentaram o cuidado com inteligência emocional e resiliência, o que somado àsmudanças estruturais e à reestruturação do seu papel, permitiu que se adaptassem para superara situação de contingência.(AU)

Beneficios del Zhineng Qigong en la salud holística de practicantes durante la COVID-19: aportes para enfermería / Benefícios do Zhineng Qigong na saúde holística dos profissionais durante a COVID-19: contribuições para a enfermagem / Benefits of Zhineng Qigong in the holistic health of practitioners during COVID- 19: contributions for nursing

Introduction: There are some studies on the benefits of ZhiNeng QiGong, but still veryfew in the context of the COVID-19 pandemic and related to holistic care. Objective: To describe thebenefits of Zhineng Qigong in the comprehensive health of practicing adults during COVID-19.Method: Exploratory descriptive qualitative research. The sample was non-probabilistic for convenience, achieved by the saturation technique and data redundancy, 13 practitioners of the third International Certification of Zhineng Qigong participated, with prior informed consent. The information was collected by online interview and processed according to content analysis. Results: Fivecategories were found: physical health, mental health, social health, spiritual health and ecologicalhealth, where positive changes were found for strengthening and individual healing with irradiation towards their family and social environment. Conclusions: All Zhineng Qigong practitionersexperienced physical and emotional healing, improvements in their family and work relationships.Likewise, they feel vitality, inner peace, connection with the universe and nature. Most indicatedthat they did not contract COVID-19 because they improved their immune system andwith the practice.(AU)

Introducción: Existen algunos estudios sobre los beneficios de ZhiNeng QiGong, peroaún muy pocos en el contexto de la pandemia por la COVID-19 y relacionados con el cuidado holístico. Objetivo: Describir los beneficios de Zhineng Qigong en la salud integral de adultos practicantes durante la COVID-19. Método: Investigación cualitativa descriptiva exploratoria. La muestrafue no probabilística por conveniencia, lograda por técnica de la saturación y redundancia de datos,participaron 13 practicantes de disciplina incorporados en la tercera Certificación Internacional deZhineng Qigong, previo consentimiento informado. La información fue recolectada por entrevistaonline y procesada según el análisis de contenido. Resultados: Se encontraron cinco categorías: salud física, mental, social, espiritual y ecológica, donde en todas se encontró cambios positivos defortalecimiento y sanación individual con irradiación hacia su entorno familiar y social. Conclusiones: Todos los practicantes de Zhineng Qigong experimentaron sanación física y emocional, mejorasen sus relaciones familiares y laborales. Asimismo, sienten vitalidad, paz interior, conexión con eluniverso y la naturaleza. La mayoría indicaron que no contrajeron la COVID-19 porque con la práctica mejoraron su sistema inmunológico y la respiración.(AU)

Introdução: Existem alguns estudos sobre os benefícios do ZhiNeng QiGong, mas aindamuito poucos no contexto da pandemia de COVID-19 e relacionados ao cuidado holístico. Objetivo:Descrever os benefícios do Zhineng Qigong na saúde abrangente de adultos praticantes durante oCOVID-19. Método: Pesquisa qualitativa descritiva exploratória. A amostra foi não probabilísticapor conveniência, alcançada pela técnica de saturação e redundância de dados, 13 praticantes dadisciplina participaram da terceira Certificação Internacional de Zhineng Qigong, com consentimento prévio informado. As informações foram coletadas por entrevista online e processadas conforme análise de conteúdo. Resultados: Foram encontradas cinco categorias: saúde física, mental,social, espiritual e ecológica, onde foram encontradas mudanças positivas de fortalecimento e curaindividual com irradiação para o meio familiar e social em todos eles. Conclusões: Todos os praticantes de Zhineng Qigong experimentaram cura física e emocional, melhorias em suas relações familiares e de trabalho. Da mesma forma, eles sentem vitalidade, paz interior, conexão com o universo e a natureza. A maioria indicou que não contraiu COVID-19 porque, com a prática, seu sistema imunológico e sua respiração melhoraram.(AU)

Ensinamentos de Florence Nightingale resgatados na pandemia COVID-19: revisão integrativa / Las enseñanzas de Florence Nightingale rescatadas en la pandemia de Covid-19: revisión integradora / Florence Nightingale's teachings rescued in the COVID-19 pandemic: integrative review

Objetivo principal: Analizar en la literatura las enseñanzas de Florence Nightingale rescatadas en la pandemia COVID-19. Metodología: Revisión integrativa, realizada de abril a agosto de 2021, en bases de datos electrónicas Cumulative Index to Nursing and Allied Health Literature, Banco de Dados em Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System on-line via PubMed e Web of Science. Se incluyeron los estudios primarios, disponibles en su totalidad, sin restricciones de idioma. Se excluyeron los estudios que no detallaron las enseñanzas de Florence Nightingale sobre la pandemia de COVID-19. Resultados principales: Se seleccionaron y discutieron nueve artículos en dos categorías: hechos históricos de Florence Nightingale y Teachings of Florence Nightingale rescatados en la pandemia de COVID-19. Conclusión principal: Se encontraron similitudes entre la situación de salud vivida por Nightingale y la actual crisis de salud provocada por la pandemia COVID-19, lo que resaltó la relevancia de sus colaboraciones en el campo de la salud hasta la actualidad (AU)

Objective: To analyze in the literature leassons of Florence Nightingale redeemed in the COVID-19 pandemic. Methods: Integrative review, carried out from april to august 2021 in electronic databases Cumulative Index to Nursing and Allied Health Literature, Banco de Dados em Enfermagem, Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System on-line via PubMed and Web of Science. Primary studies, available in full, without language restriction were included. were exclued Studies that do not detail Florence Nightingale's teachings in the COVID-19 pandemic. Results: Nine articles were selected and discussed in two categories: Historical feats of Florence Nightingale and Teachings of Florence Nightingale rescued in the COVID-19 pandemic. Conclusions: Similarities were found between the health status experienced by Nightingale and the current public health crisis caused by the COVID-19 pandemic, which highlighted the relevance of his collaborations in the field of health up to the present day (AU)

Objetivo: Analisar na literatura os ensinamentos de Florence Nightingale resgatados na pandemia COVID-19. Metodologia: Revisão integrativa, realizada no período de abril a agosto de 2021, nas bases eletrônicas Cumulative Index to Nursing and Allied Health Literature, Banco de Dados em Enfermagem, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Medical Literature Analysis and Retrieval System on-line via PubMed e Web of Science. Incluiu-se estudos primários, disponíveis na íntegra, sem restrição de idioma. Excluiu-se estudos que não detalhavam os ensinamentos de Florence Nightingale na pandemia COVID-19. Resultados principais: Selecionaram-se nove artigos que foram discutidos em duas categorias: Feitos históricos de Florence Nightingale e Ensinamentos de Florence Nightingale resgatados na pandemia COVID-19. Conclusões principais: Constatou-se semelhanças entre a situação sanitária vivenciada por Nightingale com a atual crise de saúde causada pela pandemia COVID-19, o que evidenciou a relevância de suas colaborações para o campo da saúde até os dias atuais (AU)

Gestión humanizada en una UCI en tiempos de COVID-19 / Humanized management at an ICU in times of COVID-19

Desde el inicio de la pandemia de la COVID-19 se han planteado numerosas situaciones que la mayoría de la población no había vivido nunca. Los trabajadores sanitarios se han encontrado en un contexto para el que no estaban preparados y que ha supuesto numerosas consecuencias psicológicas, las cuales deben ser tratadas para evitar problemas futuros. Una de las unidades que ha sufrido más presión asistencial en estos tiempos de pandemia es la de los cuidados intensivos, donde el paciente con infección por COVID pasa largos periodos debatiéndose entre la vida y la muerte. Ante esta situación se planteó como objetivo establecer una serie de medidas que ayudaran a mejorar la salud psicológica de los trabajadores de la salud y analizar los problemas surgidos, así como plantear medidas adecuadas para paliarlos. Dichas medidas tuvieron una buena aceptación por parte de los trabajadores, y no supusieron un sobrecoste a la institución, obteniéndose un mayor compromiso por parte de los profesionales, gestionando de forma humanizada, guiando las actuaciones a partir de las experiencias de HUGES (Humanizando la gestión sanitaria), que aboga por comenzar la humanización por la gestión y estableciendo medidas basadas en un liderazgo efectivo de los mandos enfermeros.(AU)

Since the start of the COVID-19 pandemic, many situations have arisen that most of the population had not experienced before. Healthcare workers have found themselves in a setting for which they were not prepared, and which has entailed many psychological consequences, that must be treated in order to prevent future problems. One of the units that has experienced a high care load pressure in these pandemic times is Intensive Care, where patients infected with COVID will spend long periods fighting for their lives. Faced with this scenario, the objective was to establish a series of measures that would help to improve the psychological health of healthcare workers, and to analyze the problems that appeared, as well as to establish the adequate measures to alleviate them. Said measures were well accepted by workers, and did not represent an excess cost for the institution; there was an increase in commitment by professionals, through humanized management, and guiding their actions based on the HUGES (humanizing the health management) experiences, which advocates starting the humanizing process from management, and determining measures based on an effective leadership by nursing managers.(AU)

Experiencia de Atención Comunitaria en residencias de ancianos durante la primera ola de la pandemia COVID-19 / Experience in Community Care in nursing homes during the first wave of the COVID-19 pandemic

La COVID-19 ha producido muchas muertes en las residencias geriátricas. El compromiso de las enfermeras/os y médicos de Atención Primaria (AP) con la población que atienden hacía indispensable realizar acciones comunitarias para mejorar la atención de estas personas.El objetivo general fue implementar el “Plan de Acción para la Gestión de Personas en el Ámbito Residencial y la Asistencia Sanitaria en Situación de Pandemia por COVID-19” de la Generalitat de Cataluña y adecuarlo a las necesidades concretas en los centros atendidos. La intervención fue realizada por enfermeras y médicas de AP en dos residencias de ancianos de un núcleo urbano de Barcelona entre marzo y mayo de 2020. Constó de tres etapas: 1) Valoración: las dos residencias atendían 41 residentes (78,6% mujeres; edad media 84,5 años). El 100% tenía patología crónica, el 41,5% presentaba dependencia total, un 21,9% dependencia grave y el 26,8% tenía deterioro cognitivo. Un 63,4% estaba asintomático. Se identificaron carencias de material, infraestructuras y conocimientos. 2) Acciones de coordinación: desinfección de residencias por el servicio de bomberos y toma de muestras PCR que fueron negativas en el 100% de residentes y positivas en cuatro cuidadoras. 3) Taller de educación sanitaria para personal con trato directo a las personas residentes.Las residencias se mantuvieron libres de COVID-19 hasta el momento del inicio de la desescalada a finales de mayo de 2020. Se mantuvo la relación posterior con las residencias. La intervención comunitaria puede haber contribuido a la falta de casos de contagio de trabajadoras y personas residentes.(AU)

COVID-19 has caused many deaths in geriatric homes. The commitment by female Primary Care doctors and nurses with the population they manage made it essential to conduct community actions in order to improve the care for these persons.The general objective was to implement the “Plan of Action for Managing Persons in the Nursing Home Setting and Healthcare during the COVID-19 Pandemic” of the Government of Catalonia, and to adapt it to the specific needs in the centres managed. The intervention was conducted by female Primary Care nurses and doctors, in two nursing homes from an urban area of Barcelona between March and May, 2020. It consisted of three stages: 1) Assessment: Both nursing homes cared for 41 persons (78.6% were female; mean age: 84.5 years). Of these, 100% had a chronic condition, 41.5% presented total dependence, 21.9% presented severe dependence, and 26.8% suffered cognitive deterioration; 63.4% of them were asymptomatic. Lack of materials, infrastructures, and knowledge were detected. 2) Coordination actions: Disinfection of nursing homes by the Fire Department, and extraction of PCR samples, which tested negative in 100% of patients and positive in four caregivers. 3) Health Education Workshop for staff in direct contact with the persons living in the nursing home.Nursing homes stayed free of COVID-19 until the start of de-escalation by the end of May, 2020. Subsequent contact was maintained with nursing homes. Community intervention might have contributed to the lack of infection cases among workers and persons living in the nursing homes.(AU)

Hospitalización a domicilio y en hotel medicalizado durante la primera ola de la pandemia por COVID-19: caso clínico / Hospitalization at home and in medicalized hotels during the first wave of the COVID-19 pandemic: a case report

La pandemia de COVID-19 ha generado que el sistema sanitario realice ajustes y cambios para hacer frente a la emergencia sanitaria y tenga en cuenta otras modalidades asistenciales como la hospitalización a domicilio (HaD). Durante la primera ola de la pandemia de 2020 el equipo HaD, multidisciplinario y transversal, del Hospital Clínic de Barcelona atendió pacientes COVID-19 y no COVID-19 en domicilio y también se encargó de la gestión de un hotel medicalizado.Se presenta el caso de un paciente ingresado en HaD con diagnósticos de prostatitis aguda y COVID-19 durante la primera ola de la pandemia que fue atendido en ambos entornos.Este caso clínico ejemplifica la importancia de la continuidad asistencial. El equipo de HaD, experto y entrenado en la realización de visitas domiciliarias, se ha adaptado a la nueva situación de pandemia, prestando atención y cuidados de calidad.(AU)

The COVID-19 pandemic has led the health system to make adjustments and changes in order to face the healthcare emergency, and to consider other healthcare modalities such as hospitalization at home (HaH). During the first wave of the pandemic in 2020, the HAH multidisciplinary and cross-sectional team of the Hospital Clínic of Barcelona managed at home COVID-19 patients as well as non-COVID-19 patients, and was also in charge of managing a medicalized hotel.We present the case of a patient admitted to HaH with diagnoses of acute prostatitis and COVID-19 during the first wave of the pandemics, who was managed in both settings.This case report is an example of the importance of continuity of care. The HaH team, experienced and trained on conducting home visits, has adapted to the new pandemic situation, providing quality care for patients.(AU)

Noticia singular. 2020, el verdadero año de las enfermeras / Singular news. 2020, the true year of the nurses

Era 2019 cuando, en la celebración de la 72ª Asamblea Mundial de la Salud celebrada en Ginebra, se acordó declarar por unanimidad que el 2020 sería el Año Internacional de la Enfermera y la Matrona. Una proclamación que el director general de la Organización Mundial de la Salud (OMS), Tedros Adhanom, acogió con alegría argumentando que la OMS se enorgullecía de esta proposición porque “estas dos profesiones son invaluables para la salud e las personas en todas partes. Sin enfermeras y matronas no lograremos los Objetivos de Desarrollo Sostenible ni la cobertura sanitaria universal”.(AU)

Efectos psicológicos de la pandemia covid 19 en el personal del ámbito sanitario / Psychological effects of the covid19 pandemic on healthcare professionals

OBJETIVO: Analizar los efectos psicológicos que la actual pandemia de coronavirus (covid19) está teniendo en los profesionales del ámbito sanitario. MÉTODOS: Estudio descriptivo de corte transversal en una muestra de 1150 profesionales del ámbito sanitarios, seleccionados al azar. Las mediciones y los resultados se explicaron con el modelo teórico el Diferencial Semántico propuesto por Osgood. RESULTADOS: Se ha encontrado que, en general, el personal del ámbito sanitario se siente muy desprotegido, con miedo y estresado. Confieren más miedo al autocontagio que al contagio de otros. Perciben su trabajo como eficaz, beneficioso, activo, útil y flexible, y simultáneamente se siente amable, afectivo, sincero, cálido y discreto. Encontramos que las enfermeras, y después los técnicos en cuidados enfermeros se sienten más útiles, valientes, importantes y sinceras que otras categorías sanitarias, entre las que figuran los y las médicos/as. Las emociones que sentían el personal sanitario están fuertemente influidas por la orientación política que tuvieran. CONCLUSIÓN: El estudio realizado sobre el efecto psicológico de la actual pandemia en los profesionales del ámbito sanitario aporta diferencias significativas en función de la profesión, el contrato laboral, el sexo y la orientación política de los entrevistados

OBJECTIVE: To analyze the psychological effects that the current coronavirus pandemic (covid19) is having on healthcare professionals. METHODS: Descriptive cross-sectional study in a sample of 1,150 healthcare professionals, randomly selected. Measurements and results were explained with the theoretical model of the Semantic Differential proposed by Osgood. RESULTS: It has been found that, in general, healthcare professionals feel very unprotected, afraid and stressed. They were more afraid of self-contagion than of others. They perceived their work as effective, beneficial, active, useful and flexible, and at the same time, they feel kind, affective, sincere, warm and discreet. We found that nurses, and later, nurse care technicians feel more useful, brave, important, and sincere than other healthcare categories, including physicians. The emotions that the health personnel felt were strongly influenced by their political orientation. CONCLUSION: The study carried out on the psychological effect of the current pandemic on health professionals provides significant differences depending on the profession, the employment contract, the sex and the political orientation of the interviewees

ENECOVID: una experiencia de mejora profesional / ENECOVID: An experience of profesional improvement

En el Centro de Salud El Doctoral, perteneciente al Área de Salud de Gran Canaria, seis enfermeras de Atención Primaria fueron las encargadas de atender a los requerimientos de las 133 familias que participaron en el Estudio Nacional de Seroprevalencia (ENECOVID) dirigido por el Instituto de Salud Carlos III y el Ministerio de Sanidad. En las tres fases del estudio comentadas en este trabajo se atendieron un total de 702 participantes. En la primera fase se valoró a un total de 203 personas, 251 en la segunda y 248 en la tercera fase. Los participantes en su mayoría fueron adultos, siendo el número total de niños atendidos 84. La participación por sexos fue igual (50% hombres y 50% mujeres). Para dar una respuesta adecuada al estudio, dentro del centro, se creó un circuito con puntos de entrada, espera e información a los participantes, donde se les explicaba el objetivo y la dinámica del mismo, y formalizaban el consentimiento informado antes de acceder a las consultas destinadas a su desarrollo. La experiencia de las enfermeras en la investigación ENECOVID redundó en la cohesión del grupo de trabajo, mejoró la destreza en el manejo del paciente con infección por SARS-CoV-2, aumentó la seguridad a la hora de utilizar los equipos de protección individual y repercutió en la capacidad de abordar un gran volumen de participantes sin mermar la calidad de los cuidados.(AU)

At the Doctoral Health Centre, belonging to the Gran Canaria Healthcare Area, six Primary Care nurses were in charge of meeting the requirements of the 133 families included in the National Seroprevalence Study (ENECOVID) conducted by the Instituto de Salud Carlos III and the Ministry of Health. During the three stages of the study discussed in this article, 702 participants were managed in total. In the first stage, 203 persons were evaluated, 251 in the second, and 248 in the third stage. The majority of participants were adult, and the total number of children included was 84. There was equal participation by gender (50% men and 50% women). In order to provide an adequate response to the study, a circuit was created within the centre, with entry, waiting, and information points for participants, where the objective and the dynamics of the study were explained to them, and they completed their informed consent forms before having access to the relevant consultations. The experience of nurses in the ENECOVID research resulted in the cohesion of the work team, improved the skills regarding the management of patients infected with SARS-CoV-2, increased safety at the time of using individual protection equipment, and had a positive impact on the ability to address a great volume of participants without reducing the quality of care.(AU)

COVID-19: la necesidad de enfermeras de práctica avanzada en el cuidado de la salud

Lo que hemos aprendido del COVID-19: La necesidad de enfermeras de práctica avanzada en el cuidado de la salud. What we have learned from COVID-19: The need of Advanced Practice Nurses in Health Care.

COVID-19: the need of advanced practice nurses in health care

What we have learned from COVID-19: The need of Advanced Practice Nurses in Health Care. Lo que hemos aprendido del COVID-19: La necesidad de enfermeras de práctica avanzada en el cuidado de la salud.

Processo de enfermagem para pacientes com manifestações respiratórias da COVID-19 / Nursing process for patients with respiratory manifestations of COVID-19 / Proceso de enfermería para pacientes del COVID-19 con manifestaciones respiratorias

Objetivo: discutir sobre o Processo de Enfermagem diante dos aspectos clínicos respiratórios da COVID-19. Método: trata-se de um estudo qualitativo, descritivo, informativo que partiu de uma revisão narrativa da literatura, documentos da Organização Mundial da Saúde e das taxonomias aplicadas ao Processo de Enfermagem North American Nursing Diagnosis Association, Nursing Interventions Classification e Nursing Outcomes Classification. Realizou-se uma busca bibliográfica de artigos científicos que abordassem o tema na Biblioteca Virtual de Saúde e Biblioteca Virtual SciELO. Utilizaram-se descritores como: Coronavírus OR COVID-19 AND pessoal da saúde OR Enfermagem. Resultados: informa-se que diante da clínica apresentada, os principais diagnósticos são: Hipertermia, Padrão respiratório ineficaz e Troca de gases prejudicada. Ressalta-se que, para isso, são necessárias as intervenções de Enfermagem, as quais terão como resultado esperado a temperatura normalizada, conforto e padrão respiratório normal e a melhora na troca de gases. Conclusão: reconhece-se a importância do Processo de Enfermagem, o qual possibilita reconhecer as necessidades do paciente e atuar diretamente neles, identificando aqueles que forem prioritários e fortificando o cunho científico da profissão, padronizando uma linguagem própria e facilitando a comunicação entre os enfermeiros do mundo. (AU)

Objective: to discuss the Nursing Process in view of the respiratory clinical aspects of COVID-19. Method: It is a qualitative, descriptive, informative study that started with a narrative review of literature, World Health Organization documents and taxonomies applied to the Nursing Process North American Nursing Diagnosis Association, Nursing Interventions Classification and Nursing Outcomes Classification. A bibliographic search of scientific articles addressing the topic was conducted in the Virtual Health Library and the SciELO Virtual Library. Descriptors such as: Coronavirus OR COVID-19 AND health personnel OR Nursing were used. Results: it is informed that in view of the clinic presented, the main diagnoses are: Hyperthermia, ineffective respiratory pattern and impaired gas exchange. It is important to emphasize that, for that, it is necessary the nursing interventions, which will have as an expected result the normalized temperature, comfort and normal respiratory pattern and the improvement in gas exchange. Conclusion: recognizes the importance of the Nursing Process, which makes it possible to recognize the needs of the patient and act directly on them, identifying those that are priority and fortifying the scientific nature of the profession, standardizing its own language and facilitating communication among nurses worldwide.(AU)

Objetivo: discutir el Proceso de Enfermería ante los aspectos clínico-respiratorios del COVID-19. Método: se trata de un estudio cualitativo, descriptivo e informativo que se inició con una revisión narrativa de la literatura, los documentos de la Organización Mundial de la Salud y las taxonomías aplicadas al Proceso de Enfermería North American Nursing Diagnosis Association, Nursing Interventions Classification y Nursing Outcomes Classification. Se realizó una búsqueda bibliográfica de artículos científicos que abordaron el tema en la Biblioteca Virtual en Salud y Biblioteca Virtual SciELO. Se utilizaron descriptores como: Coronavirus o COVID-19 y personal de salud o Enfermería. Resultados: se informa que, a la vista de la clínica presentada, los principales diagnósticos son: Hipertermia, Patrón respiratorio ineficaz y Alteración del intercambio gaseoso. Se enfatiza que, para ello, son necesarias intervenciones de Enfermería, las cuales tendrán el resultado esperado de temperatura normalizada, confort y patrón respiratorio normal y mejora en el intercambio de gases. Conclusión: se reconoce la importancia del Proceso de Enfermería, que permite reconocer las necesidades del paciente y actuar directamente sobre ellas, identificando aquellas que son prioritarias y fortaleciendo el carácter científico de la profesión, estandarizando el lenguaje propio y facilitando la comunicación entre enfermeros en el mundo.(AU)

Hospital physical therapy management in pediatric patients with covid-19: case reports / Manejo da fisioterapia no âmbito hospitalar no paciente pediátrico com covid-19: relato de casos

ABSTRACT Objective: To report the physiotherapeutic management of two pediatric cases with COVID-19 admitted in a reference state hospital to treat the disease in Porto Alegre, Southern Brazil. Cases description: Case 1, female, 10-month-old child, pre-existing chronic disease, hospitalized since birth, mechanical ventilation dependency via tracheotomy, progressed with hypoxemia, requiring oxygen therapy, and increased ventilator parameters, and a diagnosis of COVID-19 was confirmed. Airway clearance and pulmonary expansion maintenance therapies were performed. During hospitalization, the child acquired cephalic control, sitting without support, rolling, holding, and reaching objects. Recommendations were provided to a family member to maintain motor development milestones. Case 2, male, nine years old, previous psychiatric disease and obesity, showed worsening of the sensory state, requiring intensive care and invasive mechanical ventilation, with the diagnosis of SARS-Cov-2 infection. The physical therapy was performed to maintain airway clearance, pulmonary expansion, and early mobilization, showing ventilatory improvement during the intensive care hospitalization and successfully extubated after 17 days. The physical therapy evolved from passive to resistive exercises during the hospitalization, and the patient was able to walk without assistance at discharge, with the same previous functional status. Comments: The COVID-19 showed different manifestations in both cases. Physical therapy treatment was essential to maintain and to recover the functional status of the patients. Future studies are needed to improve the understanding of disease course and its functional consequences to offer an efficient treatment to pediatric patients with COVID-19.

RESUMO Objetivo: Relatar as condutas fisioterapêuticas dos dois casos de pacientes pediátricos com COVID-19 internados em hospital de referência estadual em Porto Alegre para tratamento da doença. Descrição dos casos: Caso 1, sexo feminino, 10 meses de idade com doença crônica preexistente, internada desde o nascimento, utilizava ventilação mecânica via traqueostomia, evoluiu com hipoxemia, necessidade de oxigenoterapia e aumento dos parâmetros ventilatórios, sendo confirmada COVID-19. Foram realizadas técnicas de desobstrução brônquica e manutenção da expansão pulmonar. Além disso, a criança durante a internação adquiriu controle cefálico, sedestação sem apoio, rolar e alcance de objetos e durante infecção por coronavírus foram passadas orientações ao familiar para manutenção dos marcos motores adquiridos. Caso 2, sexo masculino, 9 anos, com doença psiquiátrica prévia e obesidade, evoluiu com quadro de rebaixamento do sensório e necessidade de tratamento intensivo, sendo o paciente colocado em ventilação mecânica invasiva na chegada à unidade e confirmada a infecção por SARS-CoV-2. Realizou fisioterapia para desobstrução brônquica, reexpansão pulmonar e mobilização precoce, apresentando melhora ventilatória ao longo da internação, e após 17 dias foi extubado com sucesso. Evoluiu de cinesioterapia passiva para assistida e resistida na internação pediátrica, conseguindo deambular sem auxílio, e teve alta hospitalar com condição funcional prévia à internação hospitalar. Comentários: A COVID-19 apresentou-se de forma distinta nos casos, todavia a fisioterapia foi essencial para a manutenção e recuperação do quadro funcional dos pacientes. Estudos futuros são necessários para melhor compreensão do curso da doença e suas repercussões funcionais, a fim de traçar um tratamento eficiente para os pacientes pediátricos acometidos pela COVID-19.

Neumonía bilateral por SARS-CoV2: evolución radiográfica / SARS-CoV2 bilateral pneumonia: chest X-ray evolution

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[Nursing Experience Caring for a COVID-19 Patient With Hearing Loss].

The focus of this article is on a male patient with hearing loss who was diagnosed with COVID-19 after returning to Taiwan from overseas. Due to the severe pneumonia infiltration, the patient received the clinical-trial treatment Remdesivir. In addition to facing the isolation and new-drug-related anxieties of the patient, the medical team faced difficulties in communicating effectively with the patient and in helping him through the isolation period. During the period of hospitalization (March 14th to April 13th, 2020), the author used Roy's adaptation model to perform a nursing assessment, which confirmed that the patient faced the following problems: (1) ineffective breathing pattern related to COVID-19, (2) impaired verbal communication related to hearing impairment, and (3) social isolation related to the isolation experience and the communication barrier with healthcare workers. During the nursing care process, the author helped the patient receive the antiviral treatment and taught him how to do diaphragmatic breathing in a comfortable, recumbent position to improve his breathing pattern. To reduce the difficulty of communication, the author made a pile of cards with common care-related words, provided pen and paper to write, and used a mobile-phone-based social-networking application to communicate with the patient. The author used writing to communicate with the patient and learned some simple signs from him to enable interaction. Moreover, the intervention helped him adapt to the isolation and treatment protocols to reach holistic nursing care. Based on this experience, the author suggests that hospitals cooperate with sign language organizations to teach healthcare workers simple communication skills, including sign language and cards to provide more complete care for patients with hearing loss during hospitalization.

[Experience Caring for a Severe COVID-19 Patient With ARDS in the Intensive Care Unit].

The author's experience caring for a patient with COVID-19 whose condition deteriorated rapidly into a critical illness in the negative pressure room of the intensive care unit is described in this article. The onset of severe acute respiratory distress syndrome led this patient to receive endotracheal intubation with mechanical ventilation and subsequent extracorporeal membrane oxygenation for life support. He was isolated in the negative air pressure room in the intensive care unit for infection control for this emerging respiratory infectious disease. This patient was also confronted with emotional pressures arising from the general uncertainty regarding the progress of this novel disease and from being isolated from the outside world. The care period was from April 5th to May 12th, 2020. The data was collected through direct care, written conversations, physical communication, observation, medical record reviews, diagnosis reports, and nursing assessments of physical, psychological, social, and spiritual distress. The health problems of this patient were identified as gas exchange disorder, infection, anxiety, and other problems. Our chest physiotherapy team comprised nurses, physicians, and respiratory therapists. After administering individualized treatments, including monitoring vital signs and installing an external life support system, the lung consolidation and lung collapse problems of the patient improved, allowing the ventilator to be removed. To address the patient's psychological problems, we used a humanoid diagram and whiteboard drawing as communication tools to explain to the patient the reasons for and functions of the different tubes on his body to reduce his anxiety and maintain the safe use of these tubes. Moreover, bedside care was replaced by mobile phone video and phone calls, allowing the patient to communicate with family members, which reduced his isolation-related anxiety and enhanced his compliance with treatment and care protocols. This experience supports the benefit of installing two-way video devices and viewing monitors in negative pressure rooms in the ICU to facilitate effective communications between patients, patient family members, and the medical team to reduce patient-perceived anxiety and social isolation. This case report provides a reference demonstrating a patient-centered caring model for treating COVID-19 patients in the ICU.

Desafios da enfermagem em uma unidade de transplantes ante a Covid-19 / Nursing challenges in a transplant unit in the face of Covid-19 / Retos de la enfermería en una unidad de trasplante frente a Covid-19

Objetivo: Conhecer a percepção dos enfermeiros que atuam em uma unidade de transplantes sobre os desafios de sua atuação ante a COVID-19. Método: Estudo descritivo e exploratório, com abordagem qualitativa, desenvolvido em uma unidade de transplantes de um hospital referência do Ceará, entre março e junho de 2020, por meio de entrevista. Os dados foram analisados pelo software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ). Posteriormente, foi realizada a análise fatorial por correspondência (AFC) e gerada uma nuvem de palavras para a qual foram consideradas as evocações que apareceram com maior frequência. Resultados: Participaram do estudo 14 enfermeiros, a maioria do sexo feminino. O conteúdo analisado foi categorizado em três classes: organização do fluxo de atendimento de casos suspeitos, equipamento de proteção individual no contexto da pandemia da COVID-19, o emocional ante a pandemia. Conclusão: Constatou-se que os enfermeiros sofrem ante as fragilidades relacionadas ao momento vivenciado, pois estão sendo cotidianamente desafiados a se adaptarem às mudanças em suas rotinas de trabalho.

Objective: To understand how nurses who work in a transplant unit perceive the challenges of their role in the face of COVID-19. Method: This is an exploratory, descriptive, qualitative study conducted through interviews in the transplant unit of a reference hospital in Ceará, Northeastern Brazil, between March and June 2020. Data were analyzed in the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ). Subsequently, we performed a correspondence factor analysis (CFA) and generated a word cloud, taking into account the evocations with higher frequency. Results: Fourteen nurses participated in the study, most of them women. The content analyzed was categorized into three classes: organization of the care flow for suspected cases, personal protection equipment in the COVID-19 pandemic context, emotional state in the face of the pandemic. Conclusion: We found that nurses are suffering due to fragilities related to the moment they are experiencing, as they are daily challenged to adapt to changes in their work routines.

Objetivo: Conocer la percepción de los enfermeros que laboran en una unidad de trasplante sobre los desafíos de su desempeño ante el COVID- 19. Método: Estudio descriptivo y exploratorio, con abordaje cualitativo, desarrollado en una unidad de trasplante de un hospital de referencia en Ceará, entre marzo y junio de 2020, mediante entrevista. Los datos fueron analizados por el software IRAMUTEQ (Interface de R pour les Analyses Multimensionnelles de Textes et de Questionnaires). Posteriormente, se realizó el Análisis Factorial por Correspondencia (AFC) y se generó un Word Cloud para el que se consideraron las evocaciones que aparecían con mayor frecuencia. Resultados: participaron del estudio 14 enfermeras, la mayoría mujeres. El contenido analizado se categorizó en tres clases: Organización del Flujo de Servicios de Casos Sospechosos, Equipo de Protección Personal en el Contexto de la Pandemia de COVID-19, La Emocional Frente a la Pandemia. Conclusión: Se encontró que los enfermeros padecen las debilidades relacionadas con el momento vivido, ya que diariamente se enfrentan al desafío de adaptarse a los cambios en sus rutinas laborales.

El valor de las enfermeras en tiempos de COVID: una mirada desde la Salud Pública / The value of nurses in times of COVID: a Public Health perspective

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