Spray skin protectant versus standard moisturiser in the prevention of radiodermatitis in patients with anal canal and rectal cancer: A randomised clinical trial.

The evidence on products for the prevention of radiodermatitis is limited. The primary objective was to analyse the effectiveness of the spray skin protectant 'non-burning barrier film' in the prevention of radiodermatitis with moist desquamation in patients with the anal canal and rectal cancer followed in nursing consultations compared to a standardised moisturiser based on Calendula officinalis and Aloe barbadensis. Single-blind randomised clinical trial. The study was performed in a hospital in Rio de Janeiro, Brazil, with 63 patients undergoing anal canal and rectal cancer treatment, randomised into one of the following two groups: an experimental group, which used a spray skin protectant and a control group, which used a moisturiser. Data were collected using an initial and subsequent evaluation form and were assessed using descriptive and inferential analyses. Participants who used the spray skin protectant had a lower chance of presenting radiodermatitis with moist desquamation and a longer time without this outcome when compared to the control group. The overall incidence of radiodermatitis was 100%, with 36.5% being severe. Furthermore, 17.5% of participants discontinued radiotherapy due to radiodermatitis. There were no differences between the groups regarding the severity of radiodermatitis and the number of patients who discontinued radiotherapy. The skin protectant was effective in preventing radiodermatitis with moist desquamation amongst patients with anal canal and rectal cancer.

Elaboration and validation of an ICNP® terminology subset for patients with acute myocardial infarction.

OBJECTIVE: To elaborate a terminological subset for the International Classification for Nursing Practice (ICNP®) for patients with acute myocardial infarction using the Activities of Living Model. METHOD: A methodological study which followed the guidelines of the International Nursing Council and was based on theoretical framework of the Activities of Living Model for its elaboration. Content validation was performed by 22 nursing specialists. RESULTS: Twenty-two (22) diagnoses and 22 nursing outcomes were elaborated. Of these, 17 nursing diagnosis statements and 17 nursing outcome statements presented Content Validity Index (CVI) ≥ 0.80. Of the 113 elaborated nursing interventions, 42 reached a CVI ≥ 0.80, and 51 interventions made up the terminological subset after the expert suggestions. CONCLUSION: The ICNP® was suitable for use with the Activities of Living Model, having compatible terms with those used in clinical nursing practice, and valid for construction of the terminological subset for patients with acute myocardial infarction and most likely to facilitate clinical nursing judgment.

ICNP® terminology subset for care of women and children experiencing breastfeeding. / Subconjunto terminológico da CIPE® para assistência à mulher e à criança em processo de amamentação.

OBJECTIVE: To describe the development of a terminology subset of the International Classification for Nursing Practice for care of women and children in process of breastfeeding. METHOD: Methodological study developed in six stages according to the guidelines recommended by the International Council of Nurses. RESULTS: Seventy-four nursing diagnoses/outcomes and 213 nursing interventions were performed and classified according to the theoretical model Interactive Theory of Breastfeeding. CONCLUSION: The subset is expected to safely and systematically steer nurses that work in this area, promoting the implementation of the nursing process and quality of care, focusing on women, children and families that are experiencing the breastfeeding process.

V diagram as a tool for analytical integration of theoretical, conceptual, and methodological knowledge in health care. / O diagrama V como ferramenta de integração analítica de conhecimentos teórico-conceituais e metodológicos na saúde.

OBJECTIVE: To produce a reflection on the ability of the V diagram to integrate theoretical, conceptual, and methodological knowledge obtained from complex, non-explicitly identifiable systems, models, and theories. METHODS: Reflection study with an analytical characteristic. RESULTS: The V Diagram is presented as an instrument that can ensure an integrated analysis between theoretical and conceptual knowledge (worldview and philosophy, theories, principles, constructs, and concepts), and the analysis or production of methodological knowledge (data records, transformations, knowledge assertions, and value assertions). Examples are related to the Unified Health System (SUS), and care in Psychosocial Care Centers for Alcohol and Drugs. CONCLUSIONS: V diagram is an instrument capable of producing an integrated analysis of the knowledge contained in productions linked to complex and non-explicitly identifiable models and theories as a theoretical model, theory or framework applying deductive and inductive procedures.

Breastfeeding experience of women after mammoplasty. / Experiência de amamentação de mulheres após mamoplastia.

OBJECTIVE: To describe and interpret the experience of breastfeeding among women who underwent mammoplasty surgery prior to motherhood. METHOD: A descriptive, qualitative study developed with women attended at a Human Milk Bank between 2014 and 2015. Data analysis was based on the content analysis method and supported by the Interactive Theory of Breastfeeding. RESULTS: 13 women participated in the study. Four categories emerged: 1) Success (or lack thereof) in Exclusive Breastfeeding: influence of maternal and child biological conditions; 2) Maternal feelings: perception about breastfeeding; 3) Decision making on the continuity of breastfeeding or the use of formula; 4) The role of health professionals in protecting, promoting and supporting breastfeeding: Information (or lack thereof) on the implications of the surgery. CONCLUSION: Unfavorable biological conditions of the women who underwent mammoplasty generated unsuccessful experiences in exclusive breastfeeding and limited their decision-making, despite their desire to breastfeed.

Benchmarking mobile applications for the health of people with Diabetes Mellitus.

OBJECTIVE: to map the content and features of mobile applications on the management of Diabetes Mellitus and their usability on the main operating systems. METHOD: benchmarking research. The mapping of apps, content, and resources on the Play Store and App Store platforms was based on an adaptation of the Joanna Briggs Institute's scoping review framework. For the usability analysis, the apps were tested for two weeks and the System Usability Scale instrument was used, with scores between 50-67 points being considered borderline, between 68-84, products with acceptable usability and above 85, excellent user acceptance and, for the analysis, descriptive statistics. RESULTS: the most prevalent contents were capillary blood glucose management, diet, oral drug therapy, and insulin therapy. As for resources, diaries and graphs were the most common. With regard to usability, two apps were considered to have excellent usability; 34, products with acceptable usability; 29, the resource may have some flaws but still has acceptable usability standards and 6, with flaws and no usability conditions. CONCLUSION: the content and resources of mobile applications address the fundamental points for managing Diabetes Mellitus with user-friendly resources, with usability acceptable to users and have the potential to assist in the management of Diabetes Mellitus in patients' daily lives.

Brazilian nursing specific situation, middle and micro-range theories: a bibliometric study.

OBJECTIVES: to map the nursing theories developed in stricto sensu graduate programs in nursing in Brazil. METHODS: a bibliometric study, carried out on the Coordination for the Improvement of Higher Education Personnel Theses and Dissertations Portal in October 2023. The controlled descriptors "Nursing Theory" and "Nursing Models" and the uncontrolled descriptors "Theories" and "Middle-Range Theory" were used. Selected studies were cataloged for analysis, which was conducted by the study authors, who have a doctoral degree and expertise in research on nursing theories. RESULTS: thirty-nine nursing theories were mapped, with a predominance of middle-range theories (79.5%), focusing on nursing diagnostic concepts and use of the theoretical-methodology strategy of theoretical-causal validity. CONCLUSIONS: the study identified nursing theories developed in Brazil, recognizing trends, development strategies, theorized objects of disciplinary interest and investments necessary for practical application in Brazilian contexts.

Geropalliative Caring Model analysis and assessment according to Fawcett's criteria.

OBJECTIVES: To analyze and assess Lee Geropaliative Caring Model according to Fawcett's criteria. METHOD: A theoretical-reflective study about the Geropaliative Caring Model. The analysis resulted in a detailed review of the scope, context and content of a situation-specific theory, in order to determine aspects related to nursing practice and research, and assessment addressed the concrete concepts developed in theory, their significance, internal consistency, parsimony, testability and empirical and pragmatic adequacy in nursing as a discipline. RESULTS: Based on the analysis, a situation-specific theory was used based on the science of care and aimed at caring for older adults undergoing palliation and their families, structured into four fields, namely: (1) aligning care; (2) keeping safe; (3) comforting body/mind/spirit; and (4) facilitating transitions. FINAL CONSIDERATIONS: The analyzed and assessed theory leads to a structure that includes well-defined, delimited and interrelated concepts, based on the science of care as a grand theory that allowed Geropaliative Care Model derivation.

Contributions of representing the elements of nursing practice in the ISO 18.104:2023 standard: a theoretical study.

OBJECTIVE: To reflect on the contributions of representing nursing practice elements in the ISO 18.104:2023 standard. METHOD: This is a theoretical study with standard analysis. Categorical structures were described to represent nursing practice in terminological systems and contributions identified in the parts of the version were analyzed. RESULTS: There is innovation in the inclusion of nurse sensitive outcomes, nursing action, nursing diagnosis explanation as an indicator of nursing service demand and complexity of care, representation of concepts through mental maps and suggestion of use of restriction models for nursing actions. It describes that the Nursing Process is constituted by nursing diagnosis, nursing action and nurse sensitive outcomes. FINAL CONSIDERATIONS: Indicating a nursing diagnosis as an indicator will bring benefits for knowledge production and decision-making. Although care outcomes are not exclusive responses to nursing action, the modifiable attributes of a nursing diagnosis generate knowledge about clinical practice, nursing action effectiveness and subjects of care' health state. There is coherence in understanding the Nursing Process concept evolution.

Toward a theorizing strategy with components of terminologies, classifications, and nursing theories.

PURPOSE: This article describes a theorizing strategy that integrates the components of classifications or terminologies with elements of grand or middle-range theories. METHODS: The source of metatheoretical data to support the strategy was the levels of theories by Dickoff et al. (1968). Terminological data sources were professional classifications and terminologies. FINDINGS: The authors synthesized data and philosophical, metatheoretical, theoretical, and terminological knowledge from primary sources on the subject to construct arguments and demonstrate suitable links. CONCLUSIONS: The proposal presented in this article of a strategy for building theories integrates theories and classifications or standardized nomenclatures. It applies levels of theorization: scrutiny of phenomena, description, conceptualization, naming, relationship, modeling, and operationalization to achieve higher levels of explanatory, predictive, and prescriptive properties on generated theory. IMPLICATIONS FOR NURSING PRACTICE: The implications for practice and research are connected to the theorizing strategy proposed in this article. We assume that using professional language at all levels of theorization can ensure that the concepts generated are closer to clinical practice.

Architectural accessibility and perception of falls of elderly people in the peridomicile: mixed method.

OBJECTIVE: To describe contents, structure and origin of social representations about falls by elderly people, the peridomiciliary structural conditions that predispose to falls, and to relate the implications of these empirical evidence on the routine of the elderly in the architectural context. METHOD: Convergent mixed method by triangulation. Qualitative approaches(structural, n=195 and procedural, n=40of the Theory of Social Representations) and quantitative (descriptive sectional, n=183) were used. Elderly people enrolled in primary care were interviewed at home in 2018. Analysis techniques: categorical-thematic, prototypical, statistical, and deductive according to Leininger. RESULTS: Categories of analysis: 1) Peridomicile: fall scenario and 2) Aging and vulnerability: risk of falls in peridomicile. The following environmental characteristics were precursors to falls: uneven floors, holes, unevenness and objects in the pathway. Feelings and behaviors allocated in the possible central core are associated, justifying falls, and determining their causes. CONCLUSION: There was an association between the peridomiciliary architectural environment and the predictive characteristics of the risk of falls.

Nursing microtheory in the prevention of delirium in older adult in the intensive care unit. / Microteoría de enfermería en la prevención del delirium en personas mayores en la unidad de cuidados intensivos.

OBJECTIVE: to describe a microtheory for nursing care in the prevention of delirium in older adult in the intensive care unit. METHOD: prescriptive theoretical research, based on substruction. Roy's Adaptation Model constructs were deduced and data from the phenomenon of nursing care in the prevention of delirium in older adult in intensive care were induced, based on an integrative literature review. RESULTS: the microtheory has a theoretical and operational system and a model of care. In the theoretical system, Roy's focal and contextual stimulus constructs were used. From them, the concepts of focal and contextual care and the variable adaptive response to prevention were elaborated. From the relational statements, four axioms, two postulates, eight propositions and an epistemic assumption were elaborated. TWO EMPIRICAL INDICATORS WERE ESTABLISHED IN THE OPERATING SYSTEM: the Confusion Assessment Method for Intensive Care Units and the demographic/clinical history of the older adult. Subsequently, two transformational statements, four hypotheses and the model of care represented in figure were produced. CONCLUSION: the microtheory produced prescribes care in the prevention of delirium in older adult in intensive care, through a construct of interest to nursing, and allows interceptions for the development of instruments that guide nursing activities.

Systematization of Nursing Care: how did the concept mature?

OBJECTIVES: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility. METHODS: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019. RESULTS: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes. CONCLUSIONS: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

Body image of women during breastfeeding: analysis supported by nursing theory.

OBJECTIVE: To describe and interpret a woman's perception of her body image during the breastfeeding process. METHOD: Descriptive qualitative study conducted at a university hospital in the Southeast region, Brazil. Forty-three puerperal women who were breastfeeding were interviewed. The interviews were submitted to lexical analysis using the IRAMUTEQ software and interpreted based on the Interactive Theory of Breastfeeding. RESULTS: Women report dissatisfaction with changes in body image during breastfeeding. But they also value and want to keep breastfeeding because of the benefits for the child. Finally, several women express the desire to perform plastic surgery in the future because of these body changes. CONCLUSION: The woman's perception of her body image as satisfactory/unsatisfactory indicates that body changes cover the breastfeeding process with feelings of ambiguity.Body changes are perceived by women in a personal, subjective and complex way.

"Readiness for enhanced healthy aging" nursing diagnosis: Content validation by experts.

PURPOSE: To validate the content nursing diagnosis "Readiness for enhanced healthy aging." METHODS: Descriptive, methodological study of diagnostic content validation, using the Fehring model. The sample consisted of 74 nurses experts in gerontology, with knowledge in NANDA-I nursing diagnoses. FINDINGS: The title, one definition, and the three defining characteristics proposed for the diagnosis were validated, as well as the suggestion of domain and location class in NANDA-I Taxonomy II. The Diagnostic Content Validity Index was 0.81. CONCLUSIONS: The validation of the diagnostic content by experts was fundamental for adequacy of the elements of the proposed diagnosis, which supported the elaboration of the diagnostic framework for submission to the NANDA-I taxonomy. IMPLICATION FOR NURSING PRACTICE: The diagnosis "Readiness for enhanced healthy aging" can help nurses understand the phenomenon of "Healthy Aging" and, consequently, will support the planning and implementation of interventions aimed at promoting the health of the elderly population and those in the aging process. In addition, this diagnosis will offer nurses the opportunity to rethink health promotion strategies in their care plan, making a commitment to the population regarding the promotion of healthy aging, as recommended by the Word Health Organization.

Theoretical, Conceptual, and Operational Aspects in Simulation Training With Rapid Cycle Deliberate Practice: An Integrative Review.

SUMMARY STATEMENT: An integrative review following Whittemore and Knafl's 5-stage approach (problem identification, literature search, data evaluation, data analysis, and presentation) was conducted to synthesize the evidence on the theoretical, conceptual, and operational aspects of simulation training with rapid cycle deliberate practice (RCDP). After the literature search, 2 reviewers independently read and critically evaluated primary studies using the eligibility criteria. A third more experienced reviewer solved disagreements between the reviewers.This review included 31 articles. Eight themes were identified and grouped into 2 pre-established categories: theoretical/conceptual and operational aspects. The first category had the following 3 themes: definition of RCDP, concepts related to the principles of RCDP, and theories underpinning RCDP. The second category had the following 5 themes: total training time, number of participants in the training, training system, first scenario without intervention, and progressive difficulty. This review showed that knowledge about RCDP is still under construction. As a new simulation strategy, there are some theoretical, conceptual, and operational differences in the studies applying RCDP interventions as simulation training.

Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study.

AIM: to compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses. BACKGROUND: The use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure. DESIGN: A randomized simulation experimental pre-post interventional study. METHODS: Sixty participants were allocated to intervention (n = 30) or control (n = 30) groups. Participants allocated to the intervention group were trained through the Rapid cycle deliberate practice simulation strategy, while participants in the control group were trained through the skill-training simulation strategy. A pre-test was applied before any intervention and a post-test after intervention. The primary outcome was the performance in the peripheral intravenous catheter insertion skill. The comparison of correct performance in the tests was analyzed intergroup and intragroup. The effect size of the interventions was also analyzed. The t-Student and Mann-Whitney tests compared the difference between the groups. The training effect was calculated by Cohen's dm and Glass's Δ measures. RESULTS: Performance between the pre-post-test increased from 59.4% to 96% (p < 0.001) in the intervention group and from 57.8% to 93.5% in the control group (p < 0001). There was no statistical difference between the groups after intervention (p = 0225). Cohen's dm measurement was 2.95 and 3.59 in the control and intervention groups, respectively. CONCLUSIONS: The rapid cycle deliberate practice simulation strategy resulted in Licensed Practical Nurses' performance improvements in peripheral intravenous catheter insertion, evidenced by the increase of correct performance actions in the post-test compared to the pre-test. However, with no statistical difference compared to the skill-training simulation strategy.

Can support surfaces characteristics influence high-quality chest compression? manikin experiment with a mechanical device.

BACKGROUND: Support surfaces variables, such as size, material, and density, can determine chest compression depth in cardiopulmonary resuscitation. OBJECTIVE: to analyze the force required to do a high-quality chest compression concerning different surfaces in CPR. METHOD: This experimental study was developed using a Little Anne manikin and a mechanical device to perform chest compressions. Nine sets of surfaces were tested and compared to a control. RESULTS: 230 experimental tests were done in sets of bed or stretcher + mattress and presence or absence of different backboards. In the control condition, the average force to reach 5 cm of depth was 42.14±0.97 (kgf). Set 9, compatible with a narrow stretcher with a thin mattress, had the best surfaces to reach recommended depth, with or without a backboard. All other sets required significantly more force for high-quality chest compression. Regression analysis confirms that backboard size is not significant for the force for high-quality chest compression. CONCLUSION: There is an association of dimensions and types of beds or stretchers and mattresses with a force increase. Type and dimensions of the backboard are not relevant for the force required, regardless of the characteristics of the set of the bed or stretcher and mattress.

Guide for Systematization of Care and Nursing Process: educational technology for professional practice.

OBJECTIVE: to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process. METHODS: applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout. RESULTS: the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges. FINAL CONSIDERATIONS: the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.

Compromised end-of-life syndrome: Concept development from the condition of adults and older adults in palliative care.

PURPOSE: This study aimed to develop the nursing diagnosis concept "compromised end-of-life syndrome" in palliative care. METHODS: The authors used the integrative strategy by Meleis to develop the concept in this study and identifying clinical indicators from a literature review. For data organization, we applied the Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA). FINDINGS: Some clusters of unpleasant signs and symptoms in palliative care patients at the end of life, such as pain, dyspnea, depression, constipation, and anxiety, were identified. Through conceptualization, the authors propose a new nursing diagnosis, "compromised end-of-life syndrome." The manuscript includes a model case of a patient with nursing diagnosis syndrome as a clinical example. CONCLUSIONS: Simultaneous patterns of signs and symptoms present in the literature reinforce the utility of the proposition of end-of-life syndrome as a nursing diagnostic construct. IMPLICATIONS FOR NURSING PRACTICE: The concept development related to patients' unpleasant signs and symptoms critically ill at palliative care supports the proposition of a new nursing diagnosis relevant to selecting adequate nursing interventions and nursing outcomes. Some clusters of unpleasant signs and symptoms in palliative care patients at the end of life, such as pain, dyspnea, depression, constipation, and anxiety were identified. Conceptualization was used to propose a new nursing diagnosis, "compromised end-of-life syndrome." A model case of a patient with nursing diagnosis syndrome is described as a clinical example. CONCLUSION: Simultaneous patterns of signs and symptoms present in the literature reinforce the utility of the proposition of end-of-life syndrome as nursing diagnostic construct. IMPLICATIONS FOR NURSING PRACTICE: The concept development related to patients' unpleasant signs and symptoms critically ill at palliative care supports the proposition of a new nursing diagnosis relevant to selecting adequate nursing interventions and nursing outcomes.