Acquisition of mastery by the caregiver for the continuity of care after hospital discharge.

Caregivers who provide transitional care to people with functional dependence require the mastery of skills that ensure successful continuity of care. This domain of care requires nursing interventions to support the caregiver. This study aims to understand aspects of the development of caregiver mastery for continuity of care after hospital discharge. METHOD: Exploratory, qualitative research carried out in a university hospital in Salvador, Bahia, Brazil, from July to December 2022, with fourteen qualified caregivers participating. Data was organized using the software Web Qualitative Data Analysis, analyzed by thematic content analysis, and discussed in light of the Theory of Transitions proposed by Dr. Afaf Meleis. RESULTS: The caregivers were women who cared for functionally dependent individuals and received training for care during hospitalization and telephone follow-up after discharge. Twelve achieved mastery; those with less experience needed more calls to acquire mastery. CONCLUSIONS: Discharge planning and caregiver education are essential to support them in safe and effective hospital-home transitions.

Health-related consequences of caring for dependent relatives in older adult caregivers.

OBJECTIVE: To know the health-related consequences of caring for dependent relatives in older adult caregivers. METHOD: Qualitative research carried out with older adult women who cared for family members enrolled in a federal public home care program. The identification of the older adult caregivers was done by consulting the patient's charts, and the interview took place from March to June 2017. The data were systematized based on Content Analysis. RESULTS: Six older adult caregivers of people with impaired functional capacity participated in the study. Three categories emerged: care-related musculoskeletal pain; health problems related to the somatization of the lived feeling; and self-care deficit by virtue of caring for another. CONCLUSION: The study revealed the consequences of caring for dependent family members on the health of older adult caregivers. Careful management is essential to prevent and/or reduce health problems, especially regarding the musculoskeletal system.

Older Brazilian caregivers and their lived experiences of caring-A hermeneutic phenomenological study.

AIMS AND OBJECTIVES: To understand the lived experiences of older Brazilian carers. BACKGROUND: For many caregivers, the practice of caregiving becomes their daily lives, embedding in their care and the experiences, beliefs, learning and techniques that contribute to the meanings these caregivers attach to their world. Studies have reported on the experiences of caregivers in general; however, few studies have addressed the unique characteristics of older caregivers. METHOD: Phenomenological research was conducted in the homes of these persons who were registered in a public programme of home care. This study utilised recorded interviews with a guiding question and roadmap for characterisation. The transcribed interviews were analysed based on philosophical hermeneutics and on the understanding of the hermeneutic circle. The units of meaning were discussed from the perspective of Heidegger's phenomenology. RESULTS: Six older primary caregivers participated, aged between 62-84 years. The following units of meaning were developed: the daily life of being in the world as an older person caring for another older person, the historicity and their disclosedness to the world of care. CONCLUSIONS: The worldliness of these people is influenced by a taxing routine and being overloaded and lonely, which renders these caregivers vulnerable because of this routine and because of the inherent weaknesses induced by the ageing process. RELEVANCE TO CLINICAL PRACTICE: This research can help health professionals better understand the worldliness of older caregivers. Such understanding will enhance the assistance available to caregivers, which must extend beyond the care of the sick person: interventions can reduce their overburden and risk of illness, improving their experiences as caregivers and their quality of life.

[The formation of nurses in residency programs in public and private intensive care units]. / A formação de enfermeiros residentes em UTI em instituição pública e privada.

This qualitative study aimed to acknowledge the importance of practice in public and private institutions in the training of nurses in residency programs. Data were collected at two hospitals between February and March 2013, through interviews. From their analysis the following categories emerged: experience of graduate nurses in residency programs in ICUs of public and private institutions and potential for learning in public and private institutions regarding the training of nurses. Differences were detected in the work process and in the profile of patients between the public and private fields, and dissociation between caring and management functions carried out by residents was demonstrated. It was concluded that the development of practices in public and private institutions provides different and complementary experiences which prepare residents for management and care activities, improve management and technical assistance skills, encourages the exercise of in-service education and, by means of surveys, the search for solutions to problems that emerge from daily work.

Home caregiver strategies for feeding older adults with dysphagia after dehospitalization.

OBJECTIVE: To understand caregivers' strategies for offering food to older adults with oropharyngeal dysphagia after dehospitalization. METHOD: Qualitative research carried out with caregivers of older adults with oropharyngeal dysphagia, who were discharged after hospitalization at a university hospital in Bahia. Data collection was carried out between January and February 2023 through a semi-structured interview, whose data were organized based on content analysis and analyzed with the help of IRaMuTeQ software. RESULTS: Three categories emerged: Caregivers' strategies for safely offering food to older adults with dysphagia; Caregiver strategies for oral hygiene for older adults; Recognition of continuity of speech therapy after dehospitalization. CONCLUSION: Caregivers' strategies for offering food to older adults with oropharyngeal dysphagia were supported by tacit knowledge and effective care in the hospital-home transition.

Nursing Interventions for Client and Family Training in the Proper Use of Noninvasive Ventilation in the Transition from Hospital to Community: A Scoping Review.

Noninvasive ventilation is an increasingly disseminated therapeutic option, which is explained by increases in the prevalence of chronic respiratory diseases, life expectancy, and the effectiveness of this type of respiratory support. This literature review observes that upon returning home after hospital discharge, there are difficulties in adhering to and maintaining this therapy. The aim of this study is to identify nursing interventions for client and family training in the proper use of noninvasive ventilation in the transition from hospital to community. A scoping review was carried out by searching MEDLINE, CINAHL, Scopus, and Web of Science. The articles were selected by two independent reviewers by applying the predefined eligibility criteria. Regarding transitional care, the authors opted to include studies about interventions to train clients and families during hospital stay, hospital discharge, transition from hospital to home, and the first 30 days after returning home. The eight included publications allowed for identification of interventions related to masks or interfaces, prevention of complications associated with noninvasive ventilation, leakage control, maintenance and cleaning of ventilators and accessories, respiratory training, ventilator monitoring, communication, and behavioral strategies as transitional care priority interventions to guarantee proper training in the transition from hospital to community.

Atypical Presentation of COVID-19 in Older Adults: A Scoping Review.

Background: COVID-19 has currently well-described signs and symptoms. However, older adults often present with an atypical condition, which can confuse and delay diagnosis and treatment. Summary: A scoping review was performed according to Joanna Briggs Institute methodology and prepared using the PRISMA-ScR. It included 61 studies. The objectives were to identify the atypical symptoms of COVID-19 in older adults and summarize and synthesize the evidence regarding the clinical outcomes of older adults with atypical presentations of COVID-19. Fifty-eight atypical symptoms were identified. Geriatric syndromes were the most prevalent atypical presentations of COVID-19. The prevalence of older adults with atypical presentation was 29 ± 18.45%. The mortality rate of older adults with atypical presentation was 28.3 ± 10.26 (17-37%). Key Messages: This scoping review showed that geriatric syndromes represent a frequent atypical presentation of COVID-19 in older adults. It is necessary to give visibility to those presentations in older populations with COVID-19 to advance the required interventions.

Contexto: A COVID-19 apresenta atualmente sinais e sintomas bem descritos. No entanto, as pessoas idosas (PI) geralmente têm apresentações atípicas, que podem confundir e atrasar o diagnóstico e o tratamento. Resumo: Uma scoping review foi realizada de acordo com a metodologia do Instituto Joanna Briggs e preparada usando o PRISMA-ScR. Incluiu 61 estudos. Os objetivos foram identificar os sintomas atípicos de COVID-19 em PI e resumir e sintetizar as evidências sobre os eventos clínicos adversos das PI com apresentações atípicas de COVID-19. Cinquenta e oito sintomas atípicos foram identificados. As síndromes geriátricas foram as apresentações atípicas mais prevalentes da COVID-19. A prevalência de PI com apresentação atípica foi de 29 ± 18,45%. A taxa de mortalidade das PI com apresentação atípica foi de 28,3 ± 10,26 (17­37%). Mensagens-Chave: Esta scoping review evidenciou que as síndromes geriátricas representam as apresentações atípicas mais frequentes de COVID-19 em PI. É necessário dar visibilidade a essas apresentações na população idosa com COVID-19 para avançar nas intervenções necessárias.

Oral hygiene self-care: Concept analysis for the development of a new nursing diagnosis.

OBJECTIVE: This study aims to analyze the concept of oral hygiene self-care and develop a new problem-focused nursing diagnosis (ND) based on the NANDA-I terminology. METHOD: A concept analysis was performed based on the Walker and Avant framework, including a scoping review phase according to the Joanna Briggs Institute guidelines. Searches were performed in PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Virtual Health Library, and specific gray literature databases. The development of the diagnostic structure followed the NANDA-I guidelines with a focus on Orem's self-care theory. RESULTS: Including 51 studies, the analysis facilitated the formulation of attributes, antecedents, and consequences of oral hygiene self-care. The ND "Oral hygiene self-care deficit" was created and included 17 defining characteristics, 9 related factors, 5 associated conditions, and 5 high-risk populations. Two cases were constructed to illustrate the use of key terms. CONCLUSIONS: The conceptual analysis provided insight into the concept of oral hygiene self-care and supported the structure of a new ND. IMPLICATIONS FOR NURSING PRACTICE: This study contributes to the implementation of the nursing process by focusing on the identification of individuals with oral hygiene self-care deficit. It will facilitate the promotion of oral health, thereby impacting the individual's quality of life. In addition, it will aid in the development of public policy for the prevention of oral diseases.

Validation of the hospital resources assessment scale for the preservation of urinary continence in the elderly.

OBJECTIVES: to validate the internal structure of the Hospital Resources Assessment Scale for the Preservation of Urinary Continence in the Elderly. METHODS: validation study of the internal structure of a scale constructed based on the Donabedian conceptual model and an integrative review, with prior content validation. The scale was applied to the target population, and 124 nurses responded to the questionnaire. Exploratory Factor Analysis was performed using the FACTOR software, employing multiple techniques. RESULTS: a factorial model with 11 items organized into two dimensions (support for human resources and material resources) was obtained. The "physical structure" dimension was removed from the initial model and adopted as a complementary checklist to the instrument, as it was not possible to obtain a factorable model with this dimension. CONCLUSIONS: we provide a valid scale that can measure indicators, identifying weaknesses and/or strengths related to hospital resources for the preservation of urinary continence in the elderly.

Predictors of frailty in older people users of Primary Health Care.

OBJECTIVE: to identify the prevalence and predictors of frailty in older people in Primary Health Care. METHOD: this is a descriptive and correlational study, carried out in a convenience sample of 136 older people in the community. Data were collected through a sociodemographic and clinical questionnaire and frailty phenotype. Student's t test or U-Mann-Whitney test, chi-square and binary logistic regression were used for data analysis. RESULTS: the prevalence of frailty was 26.5% (n=36). Frail individuals had older age (p=0.011), worse self-rated health (p=0.001) and lower physical capacity (p<0.001). In the multivariable regression, it was observed that frail individuals had older age (Odds Ratio=1.111; 95% confidence interval=1.026-1.203) and worse physical capacity (Odds Ratio=0.673; 95% confidence interval=0.508-0.893). CONCLUSIONS: the prevalence of frailty in older people in Primary Health Care was considerable. Advanced age and worse physical capacity were the most relevant predictors of frailty in the elderly.

Freirean pedagogy implications for the teaching of phenomenology in nursing: an experience report.

OBJECTIVE: To report the learning experience of students in the discipline "Phenomenology, Formation and Research", and to analyze the pedagogic planning of its problematization in the process of construction of knowledge, in a strict sensu program in Nursing and Health. METHOD: Descriptive-analytic report of the learning plan offered and of the theoretical framework of the data, from a Freirean perspective. RESULTS: The discipline was offered in the form of distance-education classes to six students and organized in three units: the first included five synchronous meetings and one asynchronous meeting; the second, three synchronous meetings; and the third, seven synchronous meetings and one asynchronous meeting. The methodologies applied included: presentations from guest lecturers, inverted classroom, and conceptual map. Husserl's and Heidegger's lines of thought were discussed. CONCLUSION: The construction of knowledge in phenomenology by postgraduates took place according with Freire's pedagogical structure, highlighting the concept of problematization.

Self-care deficit among older men in the COVID-19 pandemic: implications for nursing.

OBJECTIVES: to analyze self-care deficit among older men in the COVID-19 pandemic in Brazil and to discuss the implications for nursing practice. METHODS: web survey, multicentric, qualitative. A total of 120 older men participated, applying a form from April to June 2020 and April to August 2021. Reflective Thematic Analysis, interpreted by Orem's Self-Care Deficit Theory, was used. RESULTS: temporally, the self-care of older men was manifested in the self-care requirements - affective bonds, self-care for development - meditation and self-care with health deviations - remote consultations. Fully, partially compensatory, educational/support systems mobilized self-care. FINAL CONSIDERATIONS: as care managers, nurses can strengthen the support network for older men by activating professionals from the multidisciplinary team, family members, caregivers and the community to promote self-care and correct health deviations in times of crisis.

Meanings and perspectives of men on what they lived during the Covid-19 pandemic. / Sentidos e significados atribuídos por homens ao vivido na pandemia da Covid-19.

OBJECTIVE: To understand the meanings and perspectives attributed by men to the period lived in the Covid-19 pandemic. METHOD: Qualitative study structured on the concepts of phenomenology, based on Heidegger's ontic interpretation, carried out with 400 men residing in Brazil. Data was produced through a form made available online. The responses were processed in the NVIVO12 software and analyzed according to the Discourse of the Collective Subject. RESULTS: Two units of analytical meanings revealed in discourse-synthesis emerged. These units were supported by central ideas and ordered in five subunits that represent the collectivity of the investigated phenomenon. The units are: Being and being-in-the-world in the context of the pandemic - experiencing its possibilities and The vigor of the past and the present are presented as possibilities for a new future in the face of the pandemic. CONCLUSION: The meanings and perspectives revealed a being-there in the context of the pandemic based on themselves, with changes in the routine and feelings and willingness to new possibilities and transformations, which generated psychosocial impact and coping and care strategies in the period of the pandemic. As implications, it is necessary to have a new understanding of the man-being, as they demonstrate the need for care, and for a care that goes beyond physical health.

Interprofessional communication in an emergency care unit: a case study. / Comunicação interprofissional em unidade de emergência: estudo de caso.

OBJECTIVE: To map internal and external factors in an emergency care unit that interfere with interprofessional communicative practice. METHOD: This is a single case study carried out in the emergency care unit of a general hospital. Data were collected through participant observation, document analysis, and semi-structured interviews, and were triangulated and subjected to thematic analysis, out of categories defined a priori, based on the SWOT matrix. RESULTS: Twenty-two health care professionals participated in the study. As for the strengths and opportunities, it was found that professionals understand the importance of communication as a safety measure, and they use the shift change and written communication to share information. However, overcrowding, work overload, the lack of behaviors standardization, the inexperience of professionals, and the deficit in the interprofessional relationship are factors that hinder effective communication. CONCLUSION: The fragile interprofessional communicative process hampers interaction and information sharing for shared decisions that allow the safe continuity of care.

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory.

OBJECTIVE: To analyze the planning and implementation of the care offered by nurses to elders with coronary disease during the hospital-house transition. METHODS: Qualitative research that used the Transitions Theory as a theoretical reference. The participants were 12 nurses who work in a hospital that specializes in cardiology, in the city of Salvador-BA. A semistructured interview was carried out from January to February 2018, and the data was analyzed using the Content Analysis technique. RESULTS: Transition care takes place on the day of discharge. The presence of the family was found to be a facilitator; low adherence, poor financial situations, the low educational levels inhibited its implementation. The rehospitalization is an indicator of the results of the transition of care. FINAL CONSIDERATIONS: The planning and implementation of transition care is not effective. It must provide safety in the management of self-care in the home of elders with coronary disease and their families.

Musculoskeletal disorders of older adults: an integrative literature review.

OBJECTIVE: to analyze in available scientific literature what problems are caused to the musculoskeletal system of caregivers of older adults in the home environment. METHODS: an integrative literature review indexed in the PubMed, CINAHL, Web of Science, SCOPUS, BDENF, LILACS and SciELO databases. RESULTS: the sample totaled 17 studies that showed three thematic categories: Care overload for caregivers' health; Caregivers' physical illness; Caregiver self-neglect. CONCLUSION: the evidence identified health problems for caregivers of older adults, regarding the musculoskeletal system, demonstrating the importance of considering intervention strategies that provide guidelines for self-care guidelines, in order to prevent musculoskeletal complications resulting from older adults' care activities at home.

Coping strategy for covid-19 in primary health care: experience report in Salvador-BA.

OBJECTIVE: To report the experience of actions to confront the Coronavirus developed by primary health care in the municipality of Salvador, Bahia, Brazil. METHODS: It is an account of the experience carried out by a nurse from the health management of the city of Salvador, in the fight against the Coronavirus, without a period from February 26 to April 26, 2020. RESULTS: A flow of action was elaborated to confront the Coronavirus in the primary health care network, aiming to implement conducts in the face of the pandemic. The professionals were trained to identify suspected cases of contamination and to guide or refer these people to the health service. CONCLUSION: It was concluded that the construction of a flow to attend suspected cases of contamination by Coronavirus was relevant to mitigate the impacts, protecting the community and professionals involved.

Factors inherent to the onset of urinary incontinence in the hospitalized elderly patients analyzed in the light of the Donabedian's triad. / Fatores inerentes ao surgimento da incontinência urinária no idoso hospitalizado analisados à luz da tríade donabediana.

OBJECTIVE: To apprehend the factors related to the onset and/or worsening of urinary incontinence in the hospitalized elderly patient, considering the Donabedian's triad. METHOD: This is a qualitative, descriptive study, conducted with nurses and nursing technicians from a public university hospital. Data were collected using the focus group technique; content analysis was used for treatment and analysis, with subsequent coding of the registration units in the software WebQDA, relating the corpus obtained with the Donabedian's pillars. RESULTS: The most reported factors related to the onset and/or worsening of urinary incontinence in hospitalized elderly patients were linked to the pillar structure, with emphasis on the attribute human resources, followed by the attributes material resources and physical structure; the second Donabedian's pillar with the greatest association with the reports was process and, finally, the pillar outcome. CONCLUSION: The identification of factors related to the outcome investigated in the hospital environment provided the participants with reflection and awareness about the problem, therefore allowing the proposition of measures and interventions to minimize it and ensure safe and quality care to the hospitalized elderly patient.

(Lack of) oral hygiene care for hospitalized elderly patients.

OBJECTIVE: to analyze the oral hygiene care for hospitalized elderly patients provided by the nursing staff. METHOD: this is a qualitative, exploratory-descriptive study carried out in a university hospital, with the participation of 35 professionals from the nursing staff. Data collection was carried out through semi-structured interviews, explored through thematic content analysis. RESULTS: two categories emerged: The oral hygiene of hospitalized elderly patients as an extension of body care and Barriers in (lack of) care with the oral hygiene of hospitalized elderly patients, with two subcategories: The oral hygiene and dental prosthesis technique performed divergently; Care hampered by deficit of materials and human resources. FINAL CONSIDERATIONS: this study showed weaknesses in the oral hygiene care of hospitalized elderly patients, promoting reflections on the practice informed in data and management actions, allowing recommendations of care standards for the nursing staff.

[Home care to the elderly who had stroke]. / Cuidados domiciliares ao idoso que sofreu Acidente Vascular Cerebral.

The purpose was to Identify the knowledge production about the stroke in elderly under home care. Bibliographic research whose data were collected though the abstracts from 1997 to 2007, contained in LILACS and SciELO databases. The following key words were used: home assistance, aged people and cerebrovascular accident. Fifty-two references were found in the LILACS database, nine in the SciELO Brazil, and three in the SciELO Cuba. Most of the researches were carried out in 2000. Regarding the method, qualitative method predominance were observed, and central theme is related to the care giver, as well as to the clinical and epidemiologic aspects of the disease. It was observed that this knowledge is still established in Brazil, and the themes related to the person submitted to home care and violence to the aged are still little explored.