Clinical validation of nursing outcome mobility in patients with cerebrovascular accidents. / Validação clínica do resultado de enfermagem mobilidade em pacientes com acidente vascular cerebral.

OBJECTIVE: To clinically validate the nursing outcome Mobility in patients with cerebrovascular accidents. METHODS: Descriptive study, conducted in July 2011, with 38 outpatients, in northeastern Brazil. Data collection took place by evaluating two pairs of specialist nurses, where one pair used the instrument containing the constitutive and operational definitions of the indicators and magnitudes of the Mobility Outcome and the other pair without such definitions. RESULTS: When analyzing the evaluations among nurses, all indicators showed significant differences by the Friedman test (p <0.05). CONCLUSION: The constitutive and operational definitions submitted to the validation process provide greater accuracy in assessing the cerebrovascular accident patient's mobility state.

[Strategies for self-management support by patients with stroke: integrative review]. / Estratégias de autocuidado apoiado para pacientes com acidente vascular cerebral: revisão integrative.

OBJECTIVE: To analyze strategies for self-management support by patients with stroke in the light of the methodology of the five A's (ask, advice, assess, assist and arrange). METHODS: Integrative review conducted at the following databases CINAHL, SCOPUS, PubMed, Cochrane and LILACS. RESULTS: A total of 43 studies published between 2000 and 2013 comprised the study sample. All proposed actions in the five A's methodology and others were included. We highlight the Assist and Arrange, in which we added actions, especially with regard to the use of technological resources and joint monitoring between patients, families and professionals. No study included all five A's, which suggests that the actions of supported self-management are developed in a fragmented way. CONCLUSION: The use of five A's strategy provides guidelines for better management of patients with stroke with lower cost and higher effectiveness.

[Nursing diagnoses of urinary incontinence in patients with stroke]. / Diagnósticos de enfermagem de incontinência urinária em pacientes com acidente vascular cerebral.

OBJECTIVE: Identifying the prevalence of Stress urinary incontinence (SUI), Urge urinary incontinence (UUI), Functional urinary incontinence (FUI), Overflow urinary incontinence (OUI) and Reflex urinary incontinence (RUI) nursing diagnoses and their defining characteristics in stroke patients. METHOD: A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference. RESULTS: 92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%), followed by FUI (53.2%), RUI (50.0%), UUI (41.0%) and SUI (37.8%). Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified. CONCLUSION: The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.

Blood pressure variability in individuals with diabetes mellitus: a scoping review.

OBJECTIVES: to map methods and devices used to assess very short-, short-, medium-, and long-term pressure variability in adults with type 1 or 2 diabetes mellitus. METHODS: scoping review conducted in January and February 2021 in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase databases. Studies conducted within the last ten years analyzing pressure variability in adult and older patients with diabetes mellitus type 1 or 2 were included. Studies that used discontinued devices were excluded. RESULTS: the sample was composed of 25 articles published since 2017, with the majority developed in Japan (n=11); with the predominance of the oscillometric method (n=22); the most used devices were from the Omron® brand (n=14); the most detected type was long-term variability (n=10). CONCLUSIONS: we observed the increasing application of the oscillometric method for pressure variability analysis with various brands and models of automatic devices.

Cardiovascular risk and cardiovascular risk factors in adolescents.

OBJECTIVES: to identify cardiovascular risk and cardiovascular risk factors in adolescents and verify correlations between these variables and biochemical markers, and between blood pressure percentiles, Body Mass Index, and biochemical markers. METHODS: a cross-sectional study, conducted at a Brazilian school, from August to September 2019, including 205 participants who were interviewed. After the interview, anthropometric assessments, including weight, height, arm circumference, blood pressure checking, and blood collection for laboratory tests were performed. Descriptive and inferential analysis using the chi-square test was conducted. RESULTS: a total of 18.5% had blood pressure percentiles >95%, 25.4% were overweight, and 25.9% were at very high cardiovascular risk. Statistically significant associations were found between cardiovascular risk and sex, Body Mass Index and blood pressure percentiles, and between blood pressure percentiles and triglycerides. CONCLUSIONS: high prevalence of risk factors among school adolescents reinforces the need for interventions for cardiovascular risk reduction in this population.

Predictive factors of the nursing diagnosis sedentary lifestyle in people with high blood pressure.

OBJECTIVES: To verify the reproducibility of defining the characteristics and related factors in order to identify a sedentary lifestyle in patients with high blood pressure. DESIGN AND SAMPLE: A cross-sectional study. 310 patients diagnosed with high blood pressure. MEASURES: Socio-demographics and variables related to defining the characteristics and related factors of a sedentary lifestyle. The coefficient Kappa was utilized to analyze the reproducibility. The sensitivity, specificity, and predictive value of the defining characteristics were also analyzed. Logistic regression was applied in the analysis of possible predictors. RESULTS: The defining characteristic with the greatest sensitivity was demonstrates physical deconditioning (98.92%). The characteristics chooses a daily routine lacking physical exercise and verbalizes preference for activities low in physical activity presented higher values of specificity (99.21% and 95.97%, respectively). CONCLUSIONS: The following indicators were identified as powerful predictors (85.2%) for the identification of a sedentary lifestyle: demonstrates physical deconditioning, verbalizes preference for activities low in physical activity, and lack of training for accomplishment of physical exercise.

Development of middle-range theories in nursing.

OBJECTIVE: To identify in the literature how Middle-Range Theories (MRT) are being developed in Nursing. METHOD: Integrative review on the databases Lilacs (Latin American and Caribbean Literature in Health Sciences), Scopus, Cinahl (Cumulative Index to Nursing and Allied Health Literature), Web of Science and PubMed portal, using the keywords middle range theory and nursing, as well its Portuguese correspondents (Lilacs), and the Boolean operator AND. The sample included 25 articles. RESULTS: All articles presented concepts related to MRT. Most developed a synthesis picture. Some theories have formulated specific propositions, hypotheses, and names. Only 16 articles cited the methodological framework, while 22 used theories or models for theoretical foundation and 11 carried out literature reviews. FINAL CONSIDERATIONS: The development of MRT included the presentation of fundamental concepts, synthesis, propositions, hypotheses and specific name. The MRT is recognized as a way of developing knowledge to guide the nursing practice.

Social determinants of health and heart failure hospitalizations in Brazil. / Determinantes sociais em saúde e internações por insuficiência cardíaca no Brasil.

OBJECTIVE: To analyze the relationship between social determinants of health and heart failure hospitalizations in Brazil. METHOD: A retrospective ecological study, whose units of analysis were the cities of the Brazilian states. The outcome variable was heart failure hospitalization rate. The independent variables were Family Health Strategy coverager, federal transfer to Primary Care, expenditure on Primary Care, overlapping of the female population and age group above 60 years old. Regressive techniques were adopted for panel data, with estimation of weighted least squares by fixed effect. RESULTS: Twenty-six cities were analyzed. Hospitalization rates showed a non-uniform distribution between the areas, with lower median in the North and higher in the South. The regression model identified a relationship between hospitalization rates and Family Health Strategy coverage, federal transfer to Primary Care, and overlapping of the female population. CONCLUSION: Heart failure occurrence, a condition sensitive to Primary Care in Brazil, is influenced by social determinants of health represented by demographic, budgetary, and health service coverage factors.

Nurses' competencies in health promotion for homebound older people.

OBJECTIVE: to identify competencies related to health promotion targeting homebound older people, as they appear in the literature. METHOD: systematic review using the LILACS, Scopus, CINAHL, PubMed and Cochrane Library databases. The search was performed in November 2017. Selected articles were analyzed according to nine competency domains: enable change; advocate for health; mediate through partnership; communication; leadership; assessment; planning; implementation, and evaluation and research. RESULTS: nine clinical trials were included. All health promotion competency domains were identified in the reviewed research interventions, performed with homebound older people. CONCLUSION: studies showed that the employed treatments were beneficial for the homebound older population. Interventions based on health promotion competencies were positively identified, and are linked to an effective and high-quality health care practice.

Efeitos do adalimumabe, clindamicina e/ou rifampicina no tratamento da hidradenite supurativa: um protocolo de revisão sistemática / Effects of adalimumab, clindamycin, and/or rifampicin in the treatment of hidradenitis suppurativa: a systematic review protocol

OBJETIVO: Avaliar a efetividade, segurança, níveis de dor e qualidade de vida associados ao uso de adalimumabe, clindamicina e/ou rifampicina no tratamento da hidradenite supurativa. MÉTODO: Serão incluídos estudos do tipo coorte prospectiva e retrospectiva, ensaios clínicos randomizados e de equivalência, bem como análises econômicas realizadas com adultos diagnosticados com hidradenite supurativa, que tenham utilizado pelo menos uma das seguintes alternativas terapêuticas: adalimumabe, clindamicina ou rifampicina. Os estudos devem abordar um ou mais desfechos, tais como contagem de abscessos e/ou nódulos, presença de nódulos inflamatórios, níveis de dor, qualidade de vida, segurança e custos. As bases de dados consultadas serão: Medical Literature Analysis and Retrieval System Online (MEDLINE, Interface OVID), Excerpta Medica DataBASE (EMBASE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL, interface EBSCO), Psychological Abstracts (PsycINFO, interface EBSCO), Web of Science (WoS) e Source-Neutral Abstract and Citation Database (Scopus). Os processos de triagem, seleção e extração serão conduzidos por pesquisadores independentes e previamente treinados. O risco de viés será avaliado por meio dos instrumentos Risk of Bias 2.0 e ROBINS-I. Os resultados serão combinados em uma síntese qualitativa e quantitativa, com a realização de análises de especificidade e subgrupos.

OBJECTIVE: To evaluate the efficacy, safety, pain, and quality of life associated with the use of adalimumab, clindamycin, and/or rifampicin in the treatment of hidradenitis suppurativa. METHOD: Prospective and retrospective cohort studies randomized clinical trials and equivalence studies, and economic analyses, conducted in adults diagnosed with hidradenitis suppurativa who have used at least one of the following therapeutic alternatives: adalimumab, clindamycin, or rifampicin, will be included. Studies should address one or more outcomes such as abscess and/or nodule counts, presence of inflammatory nodules, pain levels, quality of life, safety, and cost. Databases consulted will include Medical Literature Analysis and Retrieval System Online (MEDLINE, OVID interface), Excerpta Medica DataBASE (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL, EBSCO interface), Psychological Abstracts (PsycINFO, EBSCO interface), Web of Science (WoS), and Source-Neutral Abstract and Citation Database (Scopus). Screening, selection, and extraction processes will be conducted by independent and previously trained researchers. The risk of bias will be assessed using the Risk of Bias 2.0 and ROBINS-I tools. Results will be summarized in a qualitative and quantitative synthesis, including specificity and subgroup analyses.

[Quality of life and perception of illness among individuals with high blood pressure]. / Qualidade de vida e percepção da doença entre portadores de hipertensão arterial.

This study aimed to investigate quality of life in individuals with arterial hypertension and to associate the results with the patients' perceived severity of illness. The sample included 113 patients with arterial hypertension followed up in a clinic in Fortaleza, Ceará State, Brazil, from May to August 2002, using an international scale for assessing quality of life, the SF-36. Of the entire sample of patients, 77% were women, a large proportion were over 50 years of age, living with family, and with some kind of occupation. Assessment with the SF-36 showed compromised quality of life in different domains, although patients viewed their illness as not serious, and curable. These circumstances can interfere in follow-up of their illness over time, which can in turn jeopardize their quality of life. In conclusion, use of the SF-36 to assess individuals with arterial hypertension produced significant results, indicating generally compromised quality of life. According to these results, hypertension jeopardizes the patients' social and physical dimensions, but this situation can be changed by the provision of qualified services.

Cuff dimension for children and adolescents: a study in a northeastern Brazilian city.

The goal of this study was to measure the arm circumferences (AC) and appropriated cuff sizes for children and adolescents and to relate these dimensions to specific age ranges. This is a cross-sectional study, developed in Fortaleza, Ceará, Brazil, with 596 people between 6 and 17 years old. The AC was measured at the midpoint between the olecranon and the acromion. The selected cuff width followed the recommended ratio of 40% the AC. The more suitable cuff sizes were 7x14 cm, 8x16 cm and 9x18 cm, at 19.8%, 26.5% and 25%, respectively. A statistically significant association between AC and age range was found in both genders, as well as between the cuff and the age range, showing that the 7x14 cm (38.9%) and 8x16 cm (29.6%) cuffs were more suitable for children, and 8x16 cm (23.7%) and 9x18 cm (36.1 %) cuffs were better for adolescents. Adequate cuffs were concluded to be different from the standard cuffs used for children and adolescents.

Serial album validation for promotion of infant body weight control.

OBJECTIVE: to validate the content and appearance of a serial album for children aged from 7 to 10 years addressing the topic of prevention and control of body weight. METHOD: methodological study with descriptive nature. The validation process was attended by 33 specialists in educational technologies and/or in excess of infantile weight. The agreement index of 80% was the minimum considered to guarantee the validation of the material. RESULTS: most of the specialists had a doctoral degree and a graduate degree in nursing. Regarding content, illustrations, layout and relevance, all items were validated and 69.7% of the experts considered the album as great. The overall agreement validation index for the educational technology was 0.88. Only the script-sheet 3 did not reach the cutoff point of the content validation index. Changes were made to the material, such as title change, inclusion of the school context and insertion of nutritionist and physical educator in the story narrated in the album. CONCLUSION: the proposed serial album was considered valid by experts regarding content and appearance, suggesting that this technology has the potential to contribute in health education by promoting healthy weight in the age group of 7 to 10 years.

Association between follow-up in health services and antihypertensive medication adherence.

OBJECTIVE: To analyze the association between the characteristics of follow-up in health services and adherence to antihypertensive medication in patients with cardiovascular disease. METHOD: Analytical study carried out with 270 patients suffering from hypertension and hospitalized due to cardiovascular complications. Data collection occurred between November 2015 and April 2016, involving sociodemographic variables, presence of self-reported diabetes, accessibility and use of health services, blood pressure levels and medication adherence (analyzed through the Morisky-Green Test). RESULTS: The rate of adherence to antihypertensive therapy was 63.0%. Enrollment in the Hiperdia program had no statistical significance to medication adherence. People who attended at least between 4 and 6 nursing consultations throughout the data collection period (p = 0.02) had better adherence. CONCLUSION: The study's findings provide support for the reorientation of health services and their public policies towards improving adherence to antihypertensive therapeutics.

Cardiovascular adverse events associated with oral antineoplastic therapy.

OBJECTIVE: To identify in the literature the cardiovascular adverse events resulting from oral antineoplastic therapy. METHOD: Integrative review of the literature through the SCOPUS, Scientific Electronic Library Online (SciELO), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE) databases. The antineoplastic, cardiotoxicity, cardiovascular system and adverse reaction descriptors were used in Portuguese, English and Spanish. We selected 23 articles published between 1985 and 2015. RESULTS: Twenty studies were related to cardiac events and eleven to peripheral vascular events. The most frequent adverse cardiac events were reduced left ventricular ejection fraction, myocardial infarction, changes in the electrocardiogram, heart failure and angina, whereas peripheral vascular events were hypertension and thromboembolism. CONCLUSION: Oral antineoplastic therapy is associated with different adverse events, including cardiac and peripheral vascular events.

Influence of socio-demographic characteristics in the self-care of people with heart failure.

OBJECTIVE: To determine the influence of socio-demographic characteristics in the self-care of people with heart failure (HF). METHOD: Cross-sectional, analytical study, held in three private hospitals in Fortaleza, Ceará, Brasil, with 57 hospitalized patients. The data were collected through a demographic characterization form and a self-care assessment scale and were analyzed with inferential statistics, using mean comparison tests. RESULTS: Self-care was best assessed in people with higher education level, higher household income and in a relationship. CONCLUSION: The socio-demographic characteristics influenced seven self-care practices: dietary control; monitoring of body weight; effort in labor activities; knowledge about HF; up-to-date vaccination record; leisure activities; and family and social support network with strong bonds. The higher prevalence of answers indicating satisfactory self-care practices among the patients occurred in the areas of health promotion and tolerance to stress.

Blood pressure variability in individuals with diabetes mellitus: a scoping review / Variabilidad de la presión arterial en individuos con diabetes mellitus: revisión del área / Variabilidade da pressão arterial em indivíduos com diabetes mellitus: revisão de escopo

ABSTRACT Objectives: to map methods and devices used to assess very short-, short-, medium-, and long-term pressure variability in adults with type 1 or 2 diabetes mellitus. Methods: scoping review conducted in January and February 2021 in MEDLINE, Web of Science, CINAHL, LILACS, PubMed, and Embase databases. Studies conducted within the last ten years analyzing pressure variability in adult and older patients with diabetes mellitus type 1 or 2 were included. Studies that used discontinued devices were excluded. Results: the sample was composed of 25 articles published since 2017, with the majority developed in Japan (n=11); with the predominance of the oscillometric method (n=22); the most used devices were from the Omron® brand (n=14); the most detected type was long-term variability (n=10). Conclusions: we observed the increasing application of the oscillometric method for pressure variability analysis with various brands and models of automatic devices.

RESUMEN Objetivos: mapear métodos y dispositivos utilizados para evaluación de la variabilidad presórica de cortísimo, corto, mediano y largo plazo en adultos con diabetes mellitus tipo 1 o 2. Métodos: revisión del área realizada en enero y febrero de 2021 en las bases de datos MEDLINE, Web of Science, CINAHL, LILACS, PubMed y Embase. Incluidos estudios, realizados en los últimos diez años, que analizaron la variabilidad presórica en pacientes adultos y ancianos con diabetes mellitus tipo 1 o 2. Excluidos estudios que utilizaron dispositivos descontinuados. Resultados: la muestra fue compuesta por 25 artículos, publicados desde 2017, con mayoría desarrollada en Japón (n=11); predominancia del método oscilométrico (n=22); los dispositivos más utilizados fueron de la marca Omron® (n=14); el tipo de variabilidad más detectada fue la de largo plazo (n=10). Conclusiones: observado el creciente uso del método oscilométrico para análisis de la variabilidad presórica, presentando variedad de marcas y modelos de dispositivos automáticos.

RESUMO Objetivos: mapear métodos e dispositivos utilizados para avaliação da variabilidade pressórica de curtíssimo, curto, médio e longo prazo em adultos com diabetes mellitus tipo 1 ou 2. Métodos: revisão de escopo realizada nos meses de janeiro e fevereiro de 2021 nas bases de dados MEDLINE, Web of Science, CINAHL, LILACS, PubMed e Embase. Incluíram-se estudos, realizados nos últimos dez anos, que analisaram a variabilidade pressórica em pacientes adultos e idosos com diabetes mellitus tipo 1 ou 2. Excluíram-se estudos que utilizaram dispositivos descontinuados. Resultados: a amostra foi composta por 25 artigos, publicados a partir de 2017, com maioria desenvolvida no Japão (n=11); predominância do método oscilométrico (n=22); os dispositivos mais utilizados foram da marca Omron® (n=14); o tipo de variabilidade mais detectada foi a de longo prazo (n=10). Conclusões: observou-se o crescente uso do método oscilométrico para análise da variabilidade pressórica, apresentando variedade de marcas e modelos de dispositivos automáticos.

Influence of hormonal contraceptives and the occurrence of stroke: integrative review.

OBJECTIVE:: To identify scientific evidence regarding the influence of hormonal contraceptive use and the occurrence of stroke. METHOD:: Integrative review of the literature, through database search using the descriptors "contraceptive agents", "contraceptive devices", "contraceptives, Oral" and "Stroke". Original studies in Portuguese, Spanish and English, published in full and available online were included. Studies that did not answer our guiding questions and duplicated studies were excluded. RESULTS:: Women using combined oral contraceptives have higher risk of stroke, even with a lower hormonal dosage and different types of progestogen, regardless of the duration of use. The use of contraceptives associated with smoking, hypertension, migraine, hypercholesterolemia, obesity and sedentary lifestyle increases the chance of stroke. Contraceptive patch and vaginal ring are associated to increased risk. CONCLUSION:: Use of combined hormonal contraceptives, except for the injectable and the transdermal ones, increases the chance of occurrence of the event. Progestogen-only contraceptives were considered safe. OBJETIVO:: Identificar evidências científicas acerca da influência do uso de anticoncepcionais hormonais na ocorrência do acidente vascular cerebral (AVC). MÉTODO:: Revisão integrativa da literatura, com pesquisa em bases de dados, utilizando os descritores "contraceptive agents", "contraceptive devices", "contraceptives, Oral" e "stroke". Foram incluídos artigos originais nos idiomas português, espanhol e inglês, publicados na íntegra e disponíveis eletronicamente. Foram excluídos artigos que não respondiam às questões norteadoras e repetidos. RESULTADOS:: Usuárias de anticoncepcional oral combinado apresentam risco maior de AVC, mesmo com dosagem hormonal menor e diferentes tipos de progestágeno, independente do tempo de uso. A presença associada de tabagismo, hipertensão arterial, enxaqueca, hipercolesterolemia, obesidade e sedentarismo aumenta a chance desse desfecho. Adesivo anticoncepcional e anel vaginal são relacionados ao aumento desse risco. CONCLUSÃO:: A exposição aos anticoncepcionais hormonais combinados aumenta a chance de ocorrência do evento, exceto o injetável e o transdérmico. Os exclusivos de progestágeno foram considerados seguros.

Cardiovascular risk and cardiovascular risk factors in adolescents / Risco cardiovascular e fatores de risco cardiovascular em adolescentes / Riesgo cardiovascular y factores de riesgo cardiovascular en adolescentes

ABSTRACT Objectives: to identify cardiovascular risk and cardiovascular risk factors in adolescents and verify correlations between these variables and biochemical markers, and between blood pressure percentiles, Body Mass Index, and biochemical markers. Methods: a cross-sectional study, conducted at a Brazilian school, from August to September 2019, including 205 participants who were interviewed. After the interview, anthropometric assessments, including weight, height, arm circumference, blood pressure checking, and blood collection for laboratory tests were performed. Descriptive and inferential analysis using the chi-square test was conducted. Results: a total of 18.5% had blood pressure percentiles >95%, 25.4% were overweight, and 25.9% were at very high cardiovascular risk. Statistically significant associations were found between cardiovascular risk and sex, Body Mass Index and blood pressure percentiles, and between blood pressure percentiles and triglycerides. Conclusions: high prevalence of risk factors among school adolescents reinforces the need for interventions for cardiovascular risk reduction in this population.

RESUMO Objetivos: identificar o risco cardiovascular e os fatores de risco cardiovascular em adolescentes e verificar correlações entre essas variáveis e marcadores bioquímicos, e entre percentis de pressão arterial, Índice de Massa Corporal e marcadores bioquímicos. Métodos: estudo transversal, realizado em escola brasileira, de agosto-setembro de 2019, incluindo 205 participantes que foram entrevistados. Após a entrevista, foram realizadas avaliações antropométricas, incluindo peso, altura, circunferência do braço, aferição da pressão arterial e coleta de sangue. Foi realizada análise descritiva e inferencial por meio do Teste do Qui-Quadrado. Resultados: 18,5% apresentavam percentis de pressão arterial>95%, 25,4% com sobrepeso e 25,9% com risco cardiovascular muito alto. Foram encontradas associações estatisticamente significativas entre risco cardiovascular e sexo, Índice de Massa Corporal e percentis de pressão arterial e entre percentis de pressão arterial e triglicérides. Conclusões: a alta prevalência de fatores de risco em adolescentes escolares reforça a necessidade de intervenções para redução do risco cardiovascular nessa população.

RESUMEN Objetivos: identificar riesgo cardiovascular y factores de riesgo cardiovascular en adolescentes y verificar las correlaciones entre estas variables y marcadores bioquímicos, y entre percentiles de presión arterial, Índice de Masa Corporal y marcadores bioquímicos. Métodos: estudio transversal, realizado en una escuela brasileña, de agosto a septiembre de 2019, que incluyó a 205 participantes que fueron entrevistados. Después de la entrevista, se realizaron evaluaciones antropométricas que incluyeron peso, talla, perímetro del brazo, medición de la presión arterial y extracción de sangre para pruebas de laboratorio. El análisis descriptivo e inferencial se realizó mediante la prueba de chi-cuadrado. Resultados: el 18,5% tenía percentiles de presión arterial>95%, el 25,4% tenía sobrepeso y el 25,9% tenía un riesgo cardiovascular muy alto.Se encontraron asociaciones estadísticamente significativas entre el riesgo cardiovascular y el sexo, el Índice de Masa Corporal y los percentiles de presión arterial, y entre los percentiles de presión arterial y los triglicéridos. Conclusiones: la alta prevalencia de factores de riesgo en estudiantes adolescentes refuerza la necesidad de intervenciones para reducir el riesgo cardiovascular en esta población.

Historical evolution of the concept environment proposed in the Roy Adaptation Model.

The concern for the development of concepts becomes even more important when we report to its use in Nursing theories, in which some concepts are considered central, such as person, environment, health and nursing. This study aims to discuss the historical evolution of the environment concept used in the Roy Adaptation Model. The method of analysis the study was based on is the evolutionary conceptual analysis of the concept Environment of the Roy Adaptation Model. According to the research results, Environment is introduced as the second major concept in the Roy Adaptation Model. In this theorist's interpretation of the environment, we notice her interest in surpassing the mechanistic point of view upon which the first version of the model was based. The approach of the concept of interaction between people and groups seems to represent an improvement, influenced by the current thoughts that are preeminent in nursing.