Implementation of routine venous thromboembolism prophylaxis during neoadjuvant chemotherapy for patients with ovarian cancer.

OBJECTIVE: To compare the venous thromboembolism (VTE) rate in patients with ovarian cancer undergoing neoadjuvant chemotherapy before and after implementing routine thromboprophylaxis. METHODS: This is a quasi-experimental pre-post study evaluating the VTE rate in patients with ovarian cancer who received neoadjuvant chemotherapy following a quality improvement initiative of routine thromboprophylaxis within a single healthcare system that started in January 2017. Patients were excluded if VTE was diagnosed before initiating chemotherapy. Patient factors and perioperative variables of interest were investigated for their association with VTE through univariate and multivariate models. RESULTS: Of the 136 patients in the pre-implementation group, 3.7% (n = 5) received thromboprophylaxis. Of the 154 patients in the post-implementation group, 65.6% (n = 101) received thromboprophylaxis. Provider compliance varied from 51% in 2019 to 79.3% in 2021. The overall rate of VTE, from the start of chemotherapy to the end of treatment, was 21.3% (n = 29) pre- and 8.4% (n = 13) in the post-implementation group (p < 0.01). There was no difference in major bleeding events between groups (0% vs. 0.68%, p = 0.63). On univariate analysis, thromboprophylaxis (OR 0.19; 95% CI 0.07-0.52) and post-implementation period (OR 0.34; 95% CI 0.17-0.69) were associated with a decreased risk of any VTE during primary treatment. On multivariate analysis, only thromboprophylaxis remained significantly associated with reduced VTE rates (aOR 0.19; 95% CI 0.07-0.53). CONCLUSION: Routine thromboprophylaxis during neoadjuvant chemotherapy is associated with reduced risk of VTE throughout primary treatment and is not associated with increased bleeding events.

The Impact of Spontaneous versus Indicated Preterm Birth on Neonatal Outcomes among Extremely Premature Neonates.

OBJECTIVE: This study aimed to investigate whether neonatal morbidity differs in spontaneous compared with indicated preterm births in extremely premature neonates. STUDY DESIGN: This is a retrospective cohort study including births ≤28 weeks at a single institution from 2011 to 2020. Births were categorized as either medically indicated or spontaneous preterm deliveries. The primary outcome was inhospital mortality and serious morbidity in survivors. t-tests, Fisher's exact tests, chi-square tests, and logistic regression models were utilized as appropriate. p < 0.05 was significant. RESULTS: Two hundred and twenty-seven births were included, with two-thirds representing spontaneous births (65.6%, 149/227) and one-third categorized as medically indicated births (34.4%, 78/227). Inhospital mortality was more common in the spontaneous preterm birth group (p = 0.04), while inhospital morbidity did not significantly vary between the medically indicated and spontaneous birth groups (p = 0.32). There was no difference in inhospital morbidity or mortality by maternal race. In multivariate models of inhospital morbidity and mortality, gestational age was the only significant predictor of adverse outcomes. CONCLUSION: Despite inhospital mortality being more common in spontaneous preterm births, inhospital mortality and significant morbidity are best accounted for by gestational age alone. KEY POINTS: · Inhospital death is more common in spontaneous preterm births.. · Perinatal outcomes do not differ on the basis of racial/ethnic group.. · Gestational age is the best predictor of inhospital morbidity and mortality..

Infrastructure for hand hygiene in a teaching hospital. / Infraestrutura para higienização das mãos em um hospital universitário.

OBJECTIVE: To evaluate the hospital infrastructure and the knowledge of the coordinators about the unit structure for hand hygiene. METHODS: Descriptive cross-sectional design study carried out in a teaching hospital in the South of Brazil, in the period between December 2016 and January 2017. Eighteen inpatient care units were evaluated, and 16 coordinators were interviewed. We used the questionnaire of the World Health Organization multimodal strategy on the structure of the units for hand hygiene. It was used descriptive statistics. RESULTS: All the units had alcohol-based sanitizers, and 93.8% of the dispensers were substituted when they got empty. The difficulties observed were the lack of illustrating posters, the location of sinks and dispensers of alcohol-based hand sanitizers in some nursing infirmarys, and the fact that there were few dispensers at hand reach near the patient's bed. CONCLUSIONS: We concluded that there were protocols for hand hygiene, and professionals were instructed about it. There were gaps in the inpatient units, such as the presence of inadequate sinks and taps.

Ergonomic risks and musculoskeletal pain in hospital cleaning workers: Convergent Care Research with mixed methods.

OBJECTIVE: to analyze exposure to ergonomic risks and the occurrence of musculoskeletal pain in workers in the Hospital Cleaning Service. METHOD: Convergent Care Research, with data production designed using mixed methods, implemented with 149 hospital cleaning workers. The methodological strategy of the convergent parallel project was employed, using observation, photographic records, questionnaires and convergence groups. The results were integrated through joint display. Data analysis with descriptive and inferential statistics and content analysis. RESULTS: the mixing of data highlighted the multifactorial nature of exposure to ergonomic risks (uncomfortable work postures; repetitive movements; prolonged orthostatism; use of equipment not adapted to the psychophysiological needs of workers) and musculoskeletal pain in the population investigated. The latter was prevalent in the lumbar spine, ankles or feet, wrists or hands, thoracic spine and shoulders. The concept of ergonomic risk was expanded and was influenced by the psychosocial aspects of work. CONCLUSION: the workers investigated are exposed to modifiable multifactorial ergonomic risks related to musculoskeletal pain. It is possible to promote innovations and teaching-learning actions to minimize them, such as the continuing education program, collectively constructed with recommendations for improvements.

[Job stress in agents at the socio-educational service centers in the state of Rio Grande do Sul]. / Estresse no trabalho em agentes dos centros de atendimento socioeducativo do Rio Grande do Sul.

The study was both to understand the association of work stress, socio-demographic and labor characteristics, habits and working conditions of the Socio-educational agents in the state of Rio Grande do Sul Brazil. It was a cross-sectional study with 881 agents of the Socio-educational Service Centers in the state of Rio Grande do Sul. The Brazilian version of the Job Stress Scale for assessment of work stress has been applied. Were classified in a situation of high strain 19.2% of the agents. The following factors were related to job stress, the need for counseling lack of leisure time, day shift work, dissatisfaction with the workplace, the need for absence from work due to health problems and insufficient scale work. There is a need to further research working conditions and execution of Occupational Health Service acting in order to minimize the effects of psychological demands at work of a socio-educational agent

Association between Moral Distress and Burnout Syndrome in university-hospital nurses.

OBJECTIVE: to analyze the association between moral distress and Burnout Syndrome among nurses in a university hospital. METHOD: descriptive, analytical study conducted with 269 nurses working in a university hospital located in Rio Grande do Sul, Brazil. Data were collected in person in 2019 by previously trained collectors. A sociodemographic and employment questionnaire, the Brazilian Scale of Moral Distress in Nurses and the Maslach Burnout Inventory were applied. Descriptive and analytical statistical analysis was used. RESULTS: an association was identified between moral distress intensity and frequency and its dimensions with Burnout Syndrome and its dimensions. Nurses with low professional achievement and high emotional exhaustion showed a higher prevalence of moral distress. CONCLUSION: an association between moral distress and Burnout Syndrome, as well as between their dimensions, was evidenced. The results suggest the need to investigate urgent interventions to mitigate the situations and manifestations of moral distress and Burnout Syndrome by developing strategies for workers' health.

Elaboration and validity of the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias.

OBJECTIVE: to elaborate and validate the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias. METHODS: a methodological study, developed in three stages: instrument structuring through documentary research and researchers' expertise; instrument validity with a panel of 11 expert judge nurses; and instrument final composition. RESULTS: the instrument, after validity by experts, consisted of 30 items, divided into the content (26 items) and appearance (four items) domains. In the initial instrument validity process, 11 items were modified and seven were withdrawn, as they had a percentage of agreement below 0.80. The instrument showed excellent internal consistency, with values greater than 0.90 in its psychometric criteria. CONCLUSION: the instrument produced and validated aimed at assessing research methodological models for technological development showed good reliability, and may contribute to the methodological rigor of technological development research in nursing.

Urinary metabolites as a predictive marker for perinatal depression: A secondary analysis of the mothers, Omega-3 & Mental Health Study.

Background: Perinatal depression has been associated with unfavorable pregnancy and childhood development outcomes; however, no objective markers exist to identify perinatal mood disorders. We investigated whether metabolites in maternal urine during pregnancy can predict increased depressive symptoms in late pregnancy and postpartum among pregnant women at risk for perinatal depression. Methods: We evaluated metabolomic markers in urine collected at 12-20 and 34-36 weeks' gestation. We analyzed 49 urinary metabolites using ion pairing reversed-phase liquid chromatography-mass spectrometry. Depressive symptom severity was identified using Beck Depression Inventory (BDI) scores from 105 participants at 12-20 and 34-36 weeks' gestation, and 6-8 weeks' postpartum. Mixed model repeated measures analysis evaluated associations between changes in maternal urinary metabolites and BDI scores across pregnancy. Results: Increases in urinary xanthine and hypoxanthine were positively associated with increases in maternal depressive symptoms throughout pregnancy (p = 0.03 and 0.02, respectively). This finding did not persist after false discovery rate correction. None of the urinary metabolites examined were significantly associated with development of postpartum depressive symptoms. Limitations: This study is an exploratory secondary biologic sample analysis from a trial whose sample size was determined by a different primary outcome and expected effect size, which may have limited statistical power to detect associations between urinary metabolites, depressive symptoms, and mood trajectory over time. Conclusions: Increasing concentrations of xanthine and hypoxanthine were associated with increasing depressive symptoms throughout pregnancy. Further research is needed to evaluate the utility of these metabolic markers in identifying women at risk for perinatal depressive symptoms.

Psychometric evaluation of the Resilience at Work Scale (RAW Scale - Brazil).

OBJECTIVES: to analyze the validity of the Resilience at Work Scale (RAW Scale - Brazil), 25 and 20-item versions, based on its internal structure (dimensional and correlation), with professors and health workers from a public university in southern Brazil. METHODS: methodological study, developed in 2018, with 526 participants. For psychometric tests, the following were used: Confirmatory Factor Analysis; composite reliability, and convergent validity against the Engagement at work; Occupational self-efficacy; Overall resilience; General Health Questionnaire; and Social support at work scales. RESULTS: both versions had factor loadings > 0.30, adequate fit indices and satisfactory composite reliability. In both versions, strong and direct correlations with general Resilience and Self-efficacy were evidenced; moderate and direct with social Engagement and Support; and moderate and inverse with General Health. CONCLUSIONS: the RAW Scale 25 and 20 - Brazil meets the validity requirements with potential for assessing resilience at work within the studied context.

Conjoined twins: an obstetrician's guide to prenatal care and delivery management.

OBJECTIVE: Obstetricians infrequently encounter conjoined twins. Much of the clinical care literature focuses on postnatal management from a neonatology and pediatric surgery perspective; guidance on obstetrical management is limited. We outline steps for prenatal evaluation, obstetrical care, and delivery planning. STUDY DESIGN: Experiences with two cases of conjoined twins. RESULTS: We identified several points throughout the planning, delivery, and postnatal process that are important to highlight for optimizing clinical outcome, patient safety, and parental satisfaction. CONCLUSION: After diagnosis, patients should be referred to a center experienced in the management of conjoined twins. Specialists in fields including maternal fetal medicine, pediatric surgery, neonatology, and radiology play a vital role in the management of these patients. Early referral allows for timely family counseling and decision-making. Prenatal evaluation beyond the first trimester should include a detailed ultrasound, fetal echocardiogram, and fetal MRI. 3D printed life-sized models can improve delivery planning and patient understanding.

Auriculotherapy and reducing chronic musculoskeletal pain: integrative review.

OBJECTIVES: to describe the scientific evidence on the use of auriculotherapy to reduce chronic musculoskeletal pain in adults and the elderly. METHODS: integrative literature review conducted in the Latin American and Caribbean Health Sciences, SciVerse Scopus and MEDLINE databases (via National Library of Medicine), in March 2019, with no time frame. RESULTS: 14 original scientific articles were analyzed, 64.3% of which were classified with level of evidence 2. All productions show the benefit of auriculotherapy in reducing chronic musculoskeletal pain, especially in the lumbar spine (42.9%). The treatment was developed in one or more sessions, using semi-permanent needles (42.9%) and electro-auriculotherapy (21.4%). CONCLUSIONS: auriculotherapy was effective in reducing chronic musculoskeletal pain, showing itself as an alternative to be used for the promotion and recovery of individuals' health.

Guidance for Evaluation and Management of Blunt Abdominal Trauma in Pregnancy.

Blunt abdominal trauma is the leading type of traumatic injury in pregnancy, with motor vehicle crashes, falls, and assault being the most common etiologies. Several adverse outcomes can occur in pregnancy, including placental abruption, preterm labor and preterm delivery, uterine rupture, and pelvic fracture. Understanding and integration of key anatomic and physiologic changes in pregnancy are key when evaluating a pregnant trauma patient. Pregnant women should be managed in a medical center with the ability to provide adequate care to both trauma patients-the pregnant woman and fetus. Multiple clinical providers are usually involved in the care of pregnant trauma patients, but obstetric providers should play a central role in the evaluation and management of a pregnant trauma patient given their unique training, knowledge, and clinical skills. An algorithm for management of trauma in pregnancy should be used at all sites caring for pregnant women. An alignment of policies within each system optimizes appropriate triage, integration of care, management, and monitoring of pregnant trauma patients and their fetuses. Ensuring effective protocols for prehospital and hospital treatment, as well as thorough training of involved health care providers, is essential in ensuring that optimal care is provided.

Ergonomic risks and musculoskeletal pain in hospital cleaning workers: Convergent Care Research with mixed methods / Riesgos ergonómicos y dolor musculoesquelético en trabajadores de limpieza hospitalaria: Investigación Convergente Asistencial con métodos mixtos / Riscos ergonômicos e dor musculoesquelética em trabalhadores de limpeza hospitalar: Pesquisa Convergente Assistencial com métodos mistos

Objective: to analyze exposure to ergonomic risks and the occurrence of musculoskeletal pain in workers in the Hospital Cleaning Service. Method: Convergent Care Research, with data production designed using mixed methods, implemented with 149 hospital cleaning workers. The methodological strategy of the convergent parallel project was employed, using observation, photographic records, questionnaires and convergence groups. The results were integrated through joint display. Data analysis with descriptive and inferential statistics and content analysis. Results: the mixing of data highlighted the multifactorial nature of exposure to ergonomic risks (uncomfortable work postures; repetitive movements; prolonged orthostatism; use of equipment not adapted to the psychophysiological needs of workers) and musculoskeletal pain in the population investigated. The latter was prevalent in the lumbar spine, ankles or feet, wrists or hands, thoracic spine and shoulders. The concept of ergonomic risk was expanded and was influenced by the psychosocial aspects of work. Conclusion: the workers investigated are exposed to modifiable multifactorial ergonomic risks related to musculoskeletal pain. It is possible to promote innovations and teaching-learning actions to minimize them, such as the continuing education program, collectively constructed with recommendations for improvements.

Objetivo: analizar la exposición a riesgos ergonómicos y la ocurrencia de dolor musculoesquelético en trabajadores del Servicio de Limpieza Hospitalaria. Método: investigación Convergente Asistencial, con producción de datos diseñada mediante métodos mixtos, realizada con 149 trabajadores de limpieza hospitalaria. Se utilizó la estrategia metodológica del proyecto paralelo convergente, basada en observación, registros fotográficos, cuestionarios y grupos de convergencia. Los resultados se integraron mediante joint display . Análisis de datos con estadística descriptiva e inferencial y análisis de contenido. Resultados: la combinación de datos puso de relieve la naturaleza multifactorial de la exposición a riesgos ergonómicos (posturas de trabajo incómodas; movimientos repetitivos; ortostatismo prolongado; uso de equipos no adaptados a las necesidades psicofisiológicas de los trabajadores) y al dolor musculoesquelético en la población investigada. Este último prevalecía en la columna lumbar, tobillos o pies, puños o manos, columna torácica y hombros. El concepto de riesgo ergonómico se amplió y estuvo influenciado por los aspectos psicosociales del trabajo. Conclusión: los trabajadores investigados están expuestos a riesgos ergonómicos multifactoriales modificables relacionados con el dolor musculoesquelético. Es posible promover innovaciones y acciones de enseñanza-aprendizaje para minimizarlos, como el programa de educación continua, construido colectivamente con recomendaciones de mejora.

Objetivo: analisar a exposição aos riscos ergonômicos e a ocorrência de dor musculoesquelética em trabalhadores do Serviço Hospitalar de Limpeza. Método: pesquisa Convergente Assistencial, sendo a produção de dados delineada com métodos mistos, realizada com 149 trabalhadores de limpeza hospitalar. Utilizou-se a estratégia metodológica do projeto paralelo convergente, baseada em observação, registros fotográficos, questionários e grupos de convergência. Os resultados foram integrados por meio de joint display . Análise de dados com estatística descritiva e inferencial e análise de conteúdo. Resultados: a mixagem dos dados evidenciou o caráter multifatorial da exposição aos riscos ergonômicos (posturas de trabalho desconfortáveis; movimentos repetitivos; ortostatismo prolongado; utilização de equipamentos não adaptados às necessidades psicofisiológicas dos trabalhadores) e à dor musculoesquelética na população investigada. Esta última foi prevalente na coluna lombar, tornozelos ou pés, punhos ou mãos, coluna torácica e ombros. O conceito de risco ergonômico foi ampliado e sofreu influência dos aspectos psicossociais do trabalho. Conclusão: os trabalhadores investigados estão expostos aos riscos ergonômicos multifatoriais modificáveis relacionados à dor musculoesquelética. É possível promover inovações e ações de ensino-aprendizagem para minimizá-los, como o programa de educação continuada, construído coletivamente com recomendações de melhorias.

Translation and cross-cultural adaptation of resilience at work scale into brazilian portuguese / Traducción y adaptación transcultural de resilience at work scale para el portugués de brasil / Tradução e adaptação transcultural da resilience at work scale para o português do brasil

ABSTRACT Objective: to translate and cross-culturally adapt the Resilience at Work Scale for the Brazilian context. Method: Methodological study comprising the stages of conceptual, item, semantic, and operational equivalences. Resilience at Work Scale is composed of 25 items (long version) and 20 items (short version), rated on a seven-point Likert scale. A test-retest was applied to a sample of 45 educators and health workers. Quadratic weighted Kappa and intraclass correlation were used. Result: The adaptation of the 25 items followed the phases of translation, back translation, external assessment, expert committee, pre-tests, test-retest reliability, and equivalence between the original and adapted versions. Two items initially showed less than 90% comprehensibility, but satisfactory results were obtained in a new pre-test after adjustments. The overall Intraclass correlation coefficient was 0.83. Conclusion: The final version of the Resilience at Work Scale 25-Brasil was properly adapted to the Brazilian culture to measure resilience at work. It is an Emancipatory Technology as it enables the implementation of knowledge that contributes to thinking, reflecting, and acting in the face of the individual or collective health-disease continuum.

RESUMEN Objetivo: realizar la traducción y adaptación transcultural de la Resilience at Work Scale para el contexto brasileño. Método: estudio metodológico, en el cual fueron realizadas las etapas de equivalencia conceptual, de ítems, de semántica y operacional. La Resilience at Work Scale es una escala Likert de siete puntos, compuesta por 25 ítems en su versión larga y 20 ítems en la versión corta. El test-retest fue aplicado a una muestra de 45 docentes y trabajadores de la salud. Para esta evaluación, se utilizó el coeficiente Kappa ponderado con ponderación cuadrática y correlación intraclase. Resultados: la adaptación de los 25 ítems de la RAW siguió las fases de traducción, retrotraducción, evaluación externa, comité de especialistas, pre-pruebas y confiabilidad test-retest, verificando las equivalencias entre el instrumento original y el adaptado. Inicialmente, dos ítems presentaron clareza inferior a 90%. Ellos fueron reajustados y un nuevo pretest indicó un resultado satisfactorio. El coeficiente de correlación intraclase general de la RAW fue de 0,83. Conclusión: la versión final de la Resilience at Work Scale 25-Brasil se mostró promisora y con adaptación adecuada a la cultura brasileña para medir la resiliencia en el trabajo. Se trata de una Tecnología Emancipadora, ya que posibilita concretizar conocimientos que contribuye en lo que se refiere a pensar, reflexionar y actuar delante de un proceso de salud/enfermedad, sea este individual o colectivo.

RESUMO Objetivo: realizar a tradução e adaptação transcultural da Resilience at Work Scale para o contexto brasileiro. Método: estudo metodológico, em que foram executadas as etapas da equivalência conceitual, de itens, semântica e operacional. A Resilience at Work Scale é uma escala Likert de sete pontos, composta por 25 itens em sua versão longa e 20 itens na versão curta. O teste-reteste foi aplicado a uma amostra de 45 docentes e trabalhadores da saúde. Para esta avaliação, utilizou-se o coeficiente Kappa ponderado com ponderação quadrática, e correlação intraclasse. Resultados: a adaptação dos 25 itens da Resilience at Work Scale pautou-se nas fases tradução, retrotradução, avaliação externa, comitê de especialistas, pré-testes e confiabilidade teste-reteste, verificando as equivalências entre o instrumento original e o adaptado. Dois itens, inicialmente, apresentaram clareza inferior a 90%. Eles foram reajustados e novo pré-teste indicou resultado satisfatório. O coeficiente de correlação intraclasse geral da Resilience at Work Scale foi de 0,83. Conclusão: a versão final da Resilience at Work Scale 25 - Brasil mostrou-se promissora e com adaptação adequada à cultura brasileira para mensuração da resiliência no trabalho. Trata-se de uma Tecnologia Emancipatória, pois possibilita concretizar conhecimentos que contribuem quanto ao pensar, ao refletir e ao agir diante de um processo de saúde/doença, seja individual ou coletivo.

Competências do enfermeiro no cuidado a pacientes com acidente vascular cerebral elegíveis à terapia trombolítica / Competencias de enfermería en el cuidado de personas con accidente cerebrovascular elegibles para terapia trombolítica / Nursing competencies in the care of patients with stroke who are eligible for thrombolytic therapy

Resumo Introdução: O acidente vascular cerebral isquêmico tem como tratamento a terapia trombolítica, aplicada ainda na fase aguda, promovendo melhora importante nas sequelas acarretadas por este agravo. Considerando a complexidade da terapia trombolítica, torna-se necessário que os enfermeiros compreendam suas competências para auxiliar no cuidado. Objetivo: Identificar evidências científicas acerca das competências do enfermeiro no cuidado a pacientes com acidente vascular cerebral elegíveis à terapia trombolítica. Metodologia: Revisão integrativa composta por seis etapas em seis etapas (elaboração da questão, busca na literatura, coleta de dados, análise, discussão e apresentação da revisão), realizada nas bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase e CINAHL. A busca foi realizada entre agosto e setembro de 2022 adotando como critérios de inclusão estudos primários; gratuitos, disponíveis eletronicamente na íntegra; nos idiomas inglês, português e espanhol. Foram obtidos inicialmente 2.830 estudos, os quais passaram por uma seleção, onde foram incluídos aqueles que atendiam os critérios previamente estabelecidos. Resultados: Com base nos doze estudos incluídos nesta revisão identificaram-se competências voltadas à três atividades do cuidado: gestão do cuidado como trabalho em equipe, códigos, fluxos e protocolos, assistência ao paciente antes, durante e após a utilização da terapia trombolítica e educação em saúde para equipe, pacientes e familiares. Conclusão: Os achados desta revisão puderam evidenciar as competências do enfermeiro no cuidado aos pacientes elegíveis a terapia trombolítica, as quais perpassam diferentes áreas de atuação do enfermeiro. Para este estudo prevaleceram as competências assistências, seguida por competências gerenciais.

Resumen Introducción: El accidente cerebrovascular isquémico se trata con terapia trombolítica, aplicada incluso en la fase aguda, que promueve una mejoría significativa de las secuelas provocadas por este padecimiento. Considerando la complejidad de la terapia trombolítica, es necesario que las personas profesionales de enfermería comprendan sus competencias para ayudar en el cuidado. Objetivo: Identificar evidencias científicas sobre las competencias del personal de enfermería en el cuidado de pacientes con accidente cerebrovascular elegibles para terapia trombolítica. Metodología: Revisión integradora que consta de seis etapas (elaboración de la pregunta, búsqueda bibliográfica, recolección de datos, análisis, discusión y presentación de la revisión), realizada en las bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase y CINAHL. La búsqueda se realizó entre agosto y septiembre de 2022. Los criterio de inclusión fueron: estudios primarios, gratuito, disponible electrónicamente en su totalidad, en inglés, portugués y español. Inicialmente se obtuvieron 2830 estudios, los cuales fueron sometidos a un proceso de selección, que incluyó aquellos que cumplían con los criterios previamente establecidos. Resultados: A partir de los doce estudios incluidos en esta revisión, se identificaron competencias centradas en tres actividades asistenciales: gestión del cuidado como trabajo en equipo, códigos, flujos y protocolos, atención a pacientes antes, durante y después del uso de la terapia trombolítica y educación en salud para personal, pacientes y familias. Conclusión: Los hallazgos de esta revisión pudieron resaltar las competencias de las personas profesionales en enfermería en el cuidado de personas elegibles para terapia trombolítica, que abarcan diferentes áreas de actuación del personal de enfermería. Para este estudio, prevalecieron las habilidades asistenciales, seguidas de las competencias gerenciales.

ABSTRACT Introduction: Ischemic stroke is treated with thrombolytic therapy, applied even in the acute phase, promoting a significant improvement in the after-effects caused by this condition. Considering the complexity of thrombolytic therapy, it is necessary for nurses to understand the skills required to assist in care. Objective: To identify scientific evidence about the competencies of nurses in the care of patients with stroke who are eligible for thrombolytic therapy. Methodology: An integrative review consisting of six stages (elaboration of the question, literature review, data collection, analysis, discussion, and presentation), conducted in MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase, and CINAHL databases. The search was carried out between August and September 2022 using primary studies as the inclusion criteria: free of charge, fully available electronically, published in English, Portuguese, or Spanish. Initially, 2.830 studies were obtained, which underwent a selection process that included only those studies that met the previously established criteria. Results: Based on the twelve studies included in this review, competencies focused on three care activities were identified: care management such as teamwork; codes; flows and protocols; patient care before, during, and after the use of thrombolytic therapy; and education health education for staff, patients, and families. Conclusion: The findings of this review highlighted the nurses' competencies in the care of patients eligible for thrombolytic therapy, which encompass different areas of the nurse's work. For this study, assistance competencies prevailed, followed by management competencies.

Elaboration and validity of the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias / Elaboración y validación del Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias / Elaboração e validação do Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias

ABSTRACT Objective: to elaborate and validate the Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias. Methods: a methodological study, developed in three stages: instrument structuring through documentary research and researchers' expertise; instrument validity with a panel of 11 expert judge nurses; and instrument final composition. Results: the instrument, after validity by experts, consisted of 30 items, divided into the content (26 items) and appearance (four items) domains. In the initial instrument validity process, 11 items were modified and seven were withdrawn, as they had a percentage of agreement below 0.80. The instrument showed excellent internal consistency, with values greater than 0.90 in its psychometric criteria. Conclusion: the instrument produced and validated aimed at assessing research methodological models for technological development showed good reliability, and may contribute to the methodological rigor of technological development research in nursing.

RESUMEN Objetivo: elaborar y validar el Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias. Métodos: estudio metodológico, desarrollado en tres etapas: estructuración de instrumentos a través de la investigación documental y la pericia de los investigadores; validación del instrumento con un panel de 11 enfermeros jueces expertos; y composición final del instrumento. Resultados: el instrumento, después de la validación por especialistas, constó de 30 ítems, divididos en los dominios contenido (26 ítems) y apariencia (cuatro ítems). En el proceso de validación del instrumento inicial, se modificaron 11 ítems y se retiraron siete, por tener un porcentaje de concordancia inferior a 0,80. El instrumento mostró una excelente consistencia interna, con valores superiores a 0,90 en sus criterios psicométricos. Conclusión: el instrumento producido y validado para evaluar modelos metodológicos de investigación para el desarrollo tecnológico mostró buena confiabilidad, y puede contribuir al rigor metodológico de la investigación en desarrollo tecnológico en enfermería.

RESUMO Objetivo: elaborar e validar o Instrumento para Avaliação de Modelos metodológicos voltados ao Desenvolvimento de Tecnologias. Métodos: estudo metodológico, desenvolvido em três etapas: estruturação do instrumento por meio de pesquisa documental e da expertise dos pesquisadores; validação do instrumento com painel de 11 enfermeiros juízes especialistas; e composição final do instrumento. Resultados: o instrumento, após a validação por especialistas, foi composto por 30 itens, divididos entre os domínios conteúdo (26 itens) e aparência (quatro itens). No processo de validação do instrumento inicial, 11 itens sofreram modificação e sete foram retirados, pois apresentaram percentual de concordância inferior a 0,80. O instrumento apresentou ótima consistência interna, com valores superiores a 0,90 em seus critérios psicométricos. Conclusões: o instrumento produzido e validado voltado à avaliação de modelos metodológicos de pesquisa para o desenvolvimento tecnológico apresentou boa confiabilidade, podendo contribuir no rigor metodológico das pesquisas de desenvolvimento tecnológico em enfermagem.

Association between Moral Distress and Burnout Syndrome in university-hospital nurses / Associação do Sofrimento Moral e Síndrome de Burnout em enfermeiros de hospital universitário / Asociación del Sufrimiento Moral y Síndrome de Burnout en enfermeros de un hospital universitario

Abstract Objective: to analyze the association between moral distress and Burnout Syndrome among nurses in a university hospital. Method: descriptive, analytical study conducted with 269 nurses working in a university hospital located in Rio Grande do Sul, Brazil. Data were collected in person in 2019 by previously trained collectors. A sociodemographic and employment questionnaire, the Brazilian Scale of Moral Distress in Nurses and the Maslach Burnout Inventory were applied. Descriptive and analytical statistical analysis was used. Results: an association was identified between moral distress intensity and frequency and its dimensions with Burnout Syndrome and its dimensions. Nurses with low professional achievement and high emotional exhaustion showed a higher prevalence of moral distress. Conclusion: an association between moral distress and Burnout Syndrome, as well as between their dimensions, was evidenced. The results suggest the need to investigate urgent interventions to mitigate the situations and manifestations of moral distress and Burnout Syndrome by developing strategies for workers' health.

Resumo Objetivo: analisar a associação entre sofrimento moral e síndrome de Burnout em enfermeiros de hospital universitário. Método: estudo descritivo-analítico, realizado com 269 enfermeiros atuantes em um hospital universitário localizado no Rio Grande do Sul, Brasil. A coleta de dados ocorreu de maneira presencial no ano de 2019 por coletadores previamente capacitados. Aplicaram-se questionário sociodemográfico e laboral, Escala Brasileira de Distresse Moral em Enfermeiros e o Inventário Maslach de Burnout. Empregou-se análise estatística descritiva e analítica. Resultados: identificou-se associação entre intensidade e frequência de sofrimento moral e suas dimensões com a síndrome de Burnout e suas dimensões. Enfermeiros em baixa realização profissional e alta exaustão emocional apresentaram prevalências mais elevadas para sofrimento moral. Conclusão: evidenciou-se a associação entre sofrimento moral e síndrome de Burnout bem como entre suas dimensões. Os resultados sinalizam a necessidade de investigar intervenções urgentes para amenizar as situações e as manifestações do sofrimento moral e a síndrome de Burnout, elaborando estratégias para a saúde dos trabalhadores.

Resumen Objetivo: analizar la asociación entre sufrimiento moral y síndrome de Burnout en enfermeros de un hospital universitario. Método: estudio descriptivo y analítico, realizado en 269 enfermeros que actuaban en un hospital universitario localizado en el estado de Rio Grande del Sur, en Brasil. La recogida de datos se realizó de manera presencial en el año de 2019 por colectores previamente capacitados. Se aplicaron el cuestionario sociodemográfico y laboral, la Escala Brasileña de Estrés Moral en Enfermeros y el Inventario Maslach de Burnout. Se empleó el análisis estadístico descriptivo y analítico. Resultados: se identificó asociación entre intensidad y frecuencia de sufrimiento moral y sus dimensiones con el síndrome de Burnout y sus dimensiones. Los enfermeros que tuvieron baja realización profesional y alta extenuación emocional, presentaron prevalencias más elevadas para el sufrimiento moral. Conclusión: se evidenció asociación entre sufrimiento moral y síndrome de Burnout así como entre sus dimensiones. Los resultados señalan la necesidad urgente de investigar intervenciones para amenizar las situaciones y las manifestaciones del sufrimiento moral y el síndrome de Burnout, elaborando estrategias para la salud de los trabajadores.

Incidence and Timing of Thromboembolic Events in Patients With Ovarian Cancer Undergoing Neoadjuvant Chemotherapy.

OBJECTIVE: To identify the incidence and timing of venous thromboembolism as well as any associated risk factors in patients with ovarian, fallopian tube, or primary peritoneal cancer undergoing neoadjuvant chemotherapy. METHODS: We conducted a retrospective cohort study of patients diagnosed with ovarian, fallopian tube, and primary peritoneal cancer and receiving neoadjuvant chemotherapy from January 2009 to May 2014 at a single academic institution. The timing and number of venous thromboembolic events for the entire cohort were categorized as follows: presenting symptom, during neoadjuvant chemotherapy treatment, after debulking surgery, and during adjuvant chemotherapy. RESULTS: Of the 125 total patients with ovarian cancer undergoing neoadjuvant chemotherapy, 13 of 125 patients (10.4%, 95% confidence interval [CI] 6.1-17.2%) had a venous thromboembolism as a presenting symptom and were excluded from further analysis. Of the 112 total patients at risk, 30 (26.8%, 95% CI 19.3-35.9%) experienced a venous thromboembolism. Based on the phase of care, 13 (11.6%, 95% CI 6.8-19.1%) experienced a venous thromboembolism during neoadjuvant chemotherapy, six (5.4%, 95% CI 2.4-11.5%) developed a postoperative venous thromboembolism, and 11 (9.9%, 95% CI 5.5-17%) developed a venous thromboembolism during adjuvant chemotherapy. Two of the four patients with clear cell histology developed a venous thromboembolism in this cohort. CONCLUSION: Overall new diagnosis of venous thromboembolism was associated with one fourth of the patients undergoing neoadjuvant chemotherapy for ovarian cancer with nearly half of these diagnosed during chemotherapy cycles before interval debulking surgery. Efforts to reduce venous thromboembolism so far have largely focused on the postoperative period. Additional attention to venous thromboembolic prophylaxis during chemotherapy (neoadjuvant and adjuvant) in this patient population is warranted in an effort to decrease the rates of venous thromboembolism.

Psychometric evaluation of the Resilience at Work Scale (RAW Scale - Brazil) / Evaluación psicométrica de la Escala de Resiliencia Laboral (RAW Scale - Brasil) / Avaliação psicométrica da Escala de Resiliência no Trabalho

ABSTRACT Objectives: to analyze the validity of the Resilience at Work Scale (RAW Scale - Brazil), 25 and 20-item versions, based on its internal structure (dimensional and correlation), with professors and health workers from a public university in southern Brazil. Methods: methodological study, developed in 2018, with 526 participants. For psychometric tests, the following were used: Confirmatory Factor Analysis; composite reliability, and convergent validity against the Engagement at work; Occupational self-efficacy; Overall resilience; General Health Questionnaire; and Social support at work scales. Results: both versions had factor loadings > 0.30, adequate fit indices and satisfactory composite reliability. In both versions, strong and direct correlations with general Resilience and Self-efficacy were evidenced; moderate and direct with social Engagement and Support; and moderate and inverse with General Health. Conclusions: the RAW Scale 25 and 20 - Brazil meets the validity requirements with potential for assessing resilience at work within the studied context.

RESUMEN Objetivos: analizar evidencia de validez basada en estructura interna (dimensional y de correlación) de la Escala de Resiliencia Laboral (RAW Scale - Brasil), versiones 25 y 20 ítems, con docentes y trabajadores de salud de una universidad pública del Sur brasileño. Métodos: estudio metodológico, desarrollado en 2018, con 526 participantes. En las pruebas psicométricas, se utilizaron: Análisis Factorial Confirmatorio; confiabilidad compuesta y validez convergente con Compromiso laboral; Autoeficacia ocupacional; Resiliencia general; Encuesta General de Salud; y Apoyo social laboral. Resultados: las dos versiones presentaron cargas factoriales > 0,30, índices de ajuste adecuados y confiabilidad compuesta satisfactoria. En las dos versiones, evidenciadas correlaciones fuerte y directa con Resiliencia general y Autoeficacia; moderada y directa con Compromiso y Apoyo social; y moderada e inversa con Salud general. Conclusiones: la RAW Scale 25 y 20 - Brasil atiende a los requisitos de validez, con potencial para la evaluación de resiliencia laboral en el contexto estudiado.

RESUMO Objetivos: analisar a evidência de validade baseada na estrutura interna (dimensional e de correlação) da Escala de Resiliência no Trabalho (RAW Scale - Brasil), versões 25 e 20 itens, com docentes e trabalhadores da saúde de uma universidade pública do Sul do Brasil. Métodos: estudo metodológico, desenvolvido em 2018, com 526 participantes. Nos testes psicométricos, utilizaram se: Análise Fatorial Confirmatória; confiabilidade composta e validade convergente com Engajamento no trabalho; Autoeficácia ocupacional; Resiliência geral; Questionário Geral de Saúde; e Apoio social no trabalho. Resultados: as duas versões apresentaram cargas fatoriais > 0,30, índices de ajuste adequados e confiabilidade composta satisfatória. Nas duas versões, evidenciaram-se correlações forte e direta com Resiliência geral e Autoeficácia; moderada e direta com Engajamento e Apoio social; e moderada e inversa com Saúde geral. Conclusões: a RAW Scale 25 e 20 - Brasil atende aos requisitos de validade, com potencial para a avaliação de resiliência no trabalho no contexto estudado.

Estratégia Saúde da Família: qualidade de vida de pessoas idosas / Family health strategy: quality of life of older people

Objetivo: Avaliar a qualidade de vida de idosos pertencentes ao território de uma Estratégia Saúde da Família do município de Santiago, Rio Grande do Sul. Método: Estudo transversal, descritivo, de abordagem quantitativa, desenvolvido com 239 idosos a partir dos 60 anos, através da aplicação do questionário sociodemográfico e WHOQOL bref. Resultados: A maioria dos idosos são do sexo feminino, com média de idade de 71 anos, casados, aposentados, com baixa escolaridade, renda intermediária, hipertensos, ativos e utilizam o serviço da ESF. Por meio do WHOQOL bref constatou-se uma qualidade de vida boa em todos os domínios (físico, psicológico, relações sociais e meio ambiente). Os escores do domínio físico diferem significativamente dos demais. Conclusão: A qualidade de vida geral dos idosos contemplando todos os domínios foi avaliada como boa. Estes dados representam subsídios para os profissionais da atenção básica promoverem ações de promoção da qualidade de vida de idosos. (AU)

Objective: To evaluate the quality of life of elderly people belonging to the territory of a Family Health Strategy in the city of Santiago, Rio Grande do Sul. Method: Cross-sectional, descriptive, quantitative approach, developed with 239 elderly from 60 years old, through the application of sociodemographic questionnaire and WHOQOL bref. Results: Most of the elderly are female, with an average age of 71 years, married, retired, with low education, intermediate income, hypertensive, active and use the ESF service. Through the WHOQOL bref a good quality of life was found in all domains (physical, psychological, social relations and environment). Physical domain scores differ significantly from the others. Conclusion: The general quality of li (AU)

Objetivo: Evaluar la calidad de vida de los ancianos que pertenecen al territorio de una Estrategia de Salud Familiar en la ciudad de Santiago, Rio Grande do Sul. Método: enfoque transversal, descriptivo, cuantitativo, desarrollado con 239 ancianos mayores de 60 años, mediante la aplicación de cuestionarios sociodemográficos y WHOQOL bref. Resultados: la mayoría de los ancianos son mujeres, con una edad promedio de 71 años, casados, jubilados, con baja educación, ingresos intermedios, hipertensos, activos y utilizan el servicio ESF. A través del WHOQOL bref se encontró una buena calidad de vida en todos los dominios (físico, psicológico, relaciones sociales y medio ambiente). Los puntajes del dominio físico difieren significativamente de los demás. Conclusión: La calidad de vida general de los ancianos con todos los dominios se evaluó como buena. Estos datos representan subsidios para que los profesionales de atención primaria promuevan acciones para promover la calidad de vida de los ancianos. (AU)