Showing papers in "Revista Latino-americana De Enfermagem in 2010"

Psychosocial aspects of work and musculoskeletal disorders in nursing workers

Abstract: This study aimed to evaluate the association between psychological demands and control on work and the occurrence of musculoskeletal disorders among nursing workers. This cross-sectional study involved 491 nursing workers from a University hospital in Rio Grande do Sul. Brazilian versions of the Nordic Musculoskeletal Questionnaire and the Job Content Questionnaire were used. Among the participants, 96.3% reported some pain in any given part of the body last year, 73.1% in the last seven days and 65.8% reported difficulty in their daily routine. The chances of shoulder pain (OR=1.97; CI95%=1.07-3.64), in the thoracic spine (OR=1.83; CI95%=1.02-3.35) and in the ankles (OR=2.05; CI95%=1.05-4.02) were higher in the high work demand quadrant when compared to the low demand quadrant, after adjustments for potentially confusing factors Intervention measures in the organizational structure are needed, redefining demand levels and control at work.

Knowledge on Pressure Ulcer Prevention Among Nursing Professionals

Abstract: This study aimed to describe and to analyze knowledge on pressure ulcer prevention among nursing team members working in direct care to adult and elderly patients at a university hospital. A descriptive and exploratory research was carried out between January and March 2009, after approval by the Research Ethics Committee at the study institution. Data were collected through a validated questionnaire. Participants were 386 professionals, of whom 64.8% were nursing auxiliaries/technicians and 35.2% baccalaureate nurses (BSN). The mean percentage of correct answers on the knowledge test was 79.4% (SD=8.3%) for nurses and 73.6% (SD=9.8%) for nursing auxiliaries/technicians. Both professional categories display knowledge deficits in some areas related to the theme. The identification of deficient areas can guide strategic planning with a view to the dissemination and adoption of prevention measures by the team.

Clinical reasoning and critical thinking

Abstract: O objetivo deste trabalho foi identificar e analisar estudos da literatura de enfermagem sobre raciocinio clinico e pensamento critico. Realizou-se busca bibliografica nas bases de dados LILACS, SciELO, PubMed e CINAHL, escolha de resumos, com posterior leitura dos textos na integra. Essa revisao permitiu verificar que o raciocinio clinico se desenvolve a partir dos conhecimentos cientificos e profissionais, permeado por decisoes eticas e valores dos enfermeiros e, ainda, que existem diversas estrategias pessoais e institucionais que podem aprimorar o pensamento critico e raciocinio clinico dos enfermeiros e que ha necessidade de realizar pesquisas e avaliacao de programas de formacao sobre raciocinio clinico que integrem as respostas psicossociais as fisiologicas das pessoas cuidadas pela enfermagem.

Relation Between Quality of Life of Mothers of Children With Cerebral Palsy and the Children's Motor Functioning, After Ten Months of Rehabilitation

Abstract: This study aims to analyze the quality of life of mothers of children with cerebral palsy, correlated with the evolution of their children's gross motor function after ten months of rehabilitation. An observational, longitudinal study was carried out in Goiânia, Goias, Brazil, involving 100 mothers and children with cerebral palsy. The children's motor function was evaluated using the Gross Motor Function Measure (GMFM) and the mothers' quality of life using the Medical Outcomes Study 36-item Short Form Health Survey (SF-36). After ten months of rehabilitation, the children's gross motor function had significantly improved (p<0.001), while the mothers only presented a significant improvement (p<0.001) in the bodily pain domain. The improvement in the motor function of children with cerebral palsy did not influence the changes in the mothers' quality of life.

Anthropology, health and illness: an introduction to the concept of culture applied to the health sciences

Abstract: This article presents a reflection as to how notions and behavior related to the processes of health and illness are an integral part of the culture of the social group in which they occur. It is argued that medical and health care systems are cultural systems consonant with the groups and social realities that produce them. Such a comprehension is fundamental for the health care professional training.

Children and Adolescents with Cancer: experiences with Chemotherapy

Abstract: This study aimed to comprehend chemotherapy from the perspective of children and adolescents with cancer. Ten children and adolescents between eight and 18 years of age, in different phases of chemotherapy, participated in this exploratory, qualitative study. Data collection was carried out through semi-structured interviews and analysis of the patients’ medical records. Analysis of the empirical material followed the content analysis technique. The study allowed the comprehension that, for the children and adolescents, chemotherapy is mainly remembered for its collateral effects and suffering. After the initial impact, mainly due to physical changes, preoccupations are related to disease recovery, i.e. a cure. Over time, they also mentioned that the disease was seen as something to be overcome and, due to the chemotherapy, likely to be the outcome.

Factors associated to breastfeeding cessation before 6 months

Abstract: This research aimed to identify the determinants of full breastfeeding (FBF) and any breastfeeding (ABF) cessation before 6 months, through a six-month follow-up of 248 mothers going a postpartum visit Data were collected by personal interview during the first month and telephone interviews at four and six months postpartum Coxs proportional hazards model was used Not having previous ABF experience, previous ABF duration

Crianças e adolescentes com câncer: experiências com a quimioterapia

Abstract: Objetivando compreender como a terapeutica quimioterapica e vista pelas criancas e adolescentes com câncer, participaram deste estudo exploratorio de abordagem qualitativa 10 criancas e adolescentes, entre oito e 18 anos, em diferentes momentos da quimioterapia. Para a coleta dos dados, utilizou-se como instrumentos a entrevista semiestruturada e os prontuarios. A analise do material empirico seguiu a tecnica de analise de conteudo. O estudo permitiu compreender que, para as criancas e adolescentes, a quimioterapia e lembrada, principalmente, por seus efeitos colaterais, acompanhado de sofrimento. Passado esse primeiro impacto, sobretudo das alteracoes fisicas, as preocupacoes dirigem-se a recuperacao da doenca, ou seja, a cura. Com o tempo, relatam que a doenca foi vista como algo a ser vencido e, gracas a quimioterapia, passivel de tal desfecho.

Factors Related to Musculoskeletal Disorders in Nursing Workers

Abstract: This cross-sectional study identified factors associated to musculoskeletal disorders in nursing auxiliaries and technicians in Salvador - Bahia. Three hundred and eight randomly selected female workers answered a questionnaire administered by an interviewer, with questions related to physical and psychosocial demands at work, individual characteristics and activities outside work. Multivariate analysis revealed that musculoskeletal disorders in neck, shoulder or upper back and musculoskeletal disorders in low back are associated to physical demand (material handling, poor back posture and work repetitiveness), psychosocial demand and precarious physical fitness. Musculoskeletal disorders in distal upper extremities are associated to physical demands (repetitiveness and force) and years of work (> 19). The results appoint the need for intervention strategies, incorporating both the organizational aspects of work and adaptations in the physical environment and in the characteristics of tasks.

Conhecimento dos profissionais de enfermagem sobre prevenção da úlcera por pressão

Abstract: O objetivo deste estudo foi descrever e analisar o conhecimento dos membros da equipe de enfermagem que atuam diretamente na assistencia a pacientes adultos e idosos, em um hospital universitario, sobre a prevencao da ulcera por pressao. Trata-se de estudo descritivo-exploratorio, realizado entre janeiro e marco de 2009, aprovado pelo Comite de Etica em Pesquisa da instituicao. Os dados foram coletados por meio de um questionario validado. Participaram deste estudo 386 individuos, 64,8% eram auxiliares/tecnicos de enfermagem e 35,2%, enfermeiros. Ve-se, pelos resultados, que a porcentagem media de acertos no teste de conhecimento foi de 79,4% (dp=8,3%) para os enfermeiros e 73,6% (dp=9,8%) para os auxiliares/tecnicos de enfermagem. Conclui-se que ambas as categorias de profissionais apresentam deficits de conhecimento em algumas areas referentes ao tema. A identificacao das areas deficientes pode nortear o planejamento de estrategias para disseminacao e para adocao de medidas preventivas pela equipe.

Antropologia, saúde e doença: uma introdução ao conceito de cultura aplicado às ciências da saúde

Abstract: O objetivo deste artigo foi apresentar uma reflexao de como as nocoes e comportamentos ligados aos processos de saude e de doenca integram a cultura de grupos sociais onde os mesmos ocorrem Argumenta-se que os sistemas medicos de atencao a saude, assim como as respostas dadas as doencas, sao sistemas culturais, consonantes com os grupos e realidades sociais que os produzem A compreensao dessa relacao se mostra fundamental para a formacao do profissional da saude

Nosocomial Infection in an Intensive Care Unit in a Brazilian University Hospital

Abstract: Este estudio prospectivo tuvo como objetivo determinar la incidencia de infeccion hospitalaria (IH) en una Unidad de Terapia Intensiva (UTI), su asociacion con caracteristicas clinicas del paciente y sitios de ocurrencia. Fueron incluidos 1886 pacientes de la UTI de un hospital universitario, entre agosto de 2005 y enero de 2008. Se utilizo el test exacto de Fisher y Riesgo Relativo. Fueron identificadas 383 (20,3%) IH: 144 (37,6%) del tracto urinario, 98 (25,6%) neumonia, 58 (15,1%) sepsis, 54 (14.1%) sitio quirurgico y 29 (7,7%) otras infecciones. La permanencia promedio fue 19,3 dias para pacientes con IH y 20,2 dias para colonizados con microorganismos resistentes. Se registro 39.5% obitos entre pacientes con IH (RR: 4,4; 3,4-5,6). La IH estuvo asociada a pacientes provenientes de otra unidad de la institucion/unidad de emergencia, internacion mayor que 4 dias, con infeccion comunitaria, colonizados por microorganismos resistentes, uso de procedimientos invasivos y obitos resultantes de IH.

Burnout and Stress Among Nurses in a University Tertiary Hospital

Abstract: Estudo transversal, analitico e correlacional que objetivou investigar a existencia de Burnout em amostra de 149 enfermeiros de um hospital universitario de alta complexidade, no periodo de outubro a dezembro de 2008, correlacionando-o com estressores do ambiente de trabalho hospitalar. Foram aplicados o inventario de Burnout de Maslach, o inventario de estresse em enfermeiros e uma ficha de caracterizacao dos sujeitos. Os resultados indicaram a presenca das tres dimensoes sugestivas de Burnout em 7,3% dos enfermeiros (quartil) e 10,22% (tercil), bem como a correlacao entre dominios dos inventarios. A vulnerabilidade para esse tipo de adoecimento em enfermeiros foi potencializada pela vivencia de estresse no ambiente de trabalho.

Stressors in breast cancer post-treatment: a qualitative approach.

Abstract: With the increasing effectiveness of breast cancer treatment, the scientific interest in investigating the quality of life of survivors has increased. However, research addressing the post-treatment period is still scarce. The aim of this study was to identify the stressors present in the lives of women in the one to five years post-diagnosis period. The sample was composed of 16 women assisted at a specialized mastectomy rehabilitation service. Data were collected through semi-structured interviews and analyzed using content analysis. The results indicate conflicts with self-image and alteration in the feeling of autonomy, fear in relation to the evolution of the condition, feelings of guilt about the disorder generated in the family, experience of disturbing social situations and a desire to return to their professional occupation. These results reveal the existence of stressors in this phase and the importance of support offered by psychosocial rehabilitation services for this population.

Adverse events related to the use of central venous catheters in hospitalized newborns

Abstract: This study identifies the adverse events related to the use of central venous catheters (CVC) in newborns admitted to a neonatal care unit. This is a quantitative, descriptive and retrospective study. The population consisted of 167 newborns admitted in the neonatal unit of the Hospital de Clinicas at Porto Alegre, RS, Brazil which used CVCs inserted through percutaneous puncture (PICC) and surgical insertion, totaling 241 catheters. There was a higher prevalence of mechanical adverse events in the PICC line insertions, with a preponderance of catheter occlusions (19.44%) and ruptures (8.8%). The surgically inserted CVCs had a higher prevalence of catheter-related infectious adverse events with the most common being clinical sepsis (16%). This study suggests that the correct insertion technique should be used and a specialized team should monitor the CVCs to ensure safety and prevent adverse events.

Functional capacity of elder elderly: comparative study in three regions of Rio Grande do Sul

Abstract: Study conducted with secondary data from cross-sectional population-based studies developed in three regions of the state of Rio Grande do Sul (RS), which aimed to compare the level of dependency for activities of daily living (ADL) of 155 older persons aged 80 years and over. Demographic data and the ADL scale from the 3 studies were used and a multinomial multivariate logistic regression analysis was carried out. The older persons from the urban region of Porto Alegre/RS and from the Northern region of this state presented significantly higher severe dependency than people from the countryside. The results illustrate the heterogeneity of the aging process. Health policies and actions should be planned for the elder elderly in this state.

Food Consumption and Iron Intake of Pregnant and Reproductive Aged Women

Abstract: This study compares the eating habits and consumption of natural and fortified iron sources in pregnant and reproductive aged women. This cross-sectional study was developed in a health center located in Sao Paulo, SP, Brazil. We studied 61 women, of which 30 were pregnant. A food frequency questionnaire and a 24-hour recall instrument were used. The main natural sources of iron were beans and greens, although fortified foods were also an important source. There was little statistically significant difference between the food consumption of pregnant and non-pregnant women. Inadequate intake of iron, folate and calcium was observed in both groups. Non-pregnant women meet the iron recommendation, considering the iron added in fortified foods, though pregnant women do not. These results suggest the need for mixed strategies: food fortification, iron supplements for pregnant women and nutritional instruction for women in general.

Incidence of bloodstream infection among patients on hemodialysis by central venous catheter

Abstract: This study evaluated the incidence and risk factors of bloodstream infection (BSI) among patients with a double-lumen central venous catheter (CVC) for hemodialysis (HD) and identified the microorganisms isolated from the bloodstream. A follow-up included all patients (n=156) who underwent hemodialysis by double-lumen CVC at the Federal University of Sao Paulo - UNIFESP, Brazil, over a one-year period. From the group of patients, 94 presented BSI, of whom 39 had positive cultures at the central venous catheter insertion location. Of the 128 microorganisms isolated from the bloodstream, 53 were S. aureus, 30 were methicillin-sensitive and 23 were methicillin-resistant. Complications related to BSI included 35 cases of septicemia and 27 cases of endocarditis, of which 15 cases progressed to death. The incidence of BSI among these patients was shown to be very high, and this BSI progressed rapidly to the condition of severe infection with a high mortality rate.

Eficácia da esterilização de canetas de bisturi elétrico de uso único reprocessadas

Abstract: No Brasil, a caneta de bisturi eletrico de uso unico (CBEUU) e um dos artigos mais comumente reutilizados. O presente estudo avaliou a eficacia da esterilizacao de CBEUUs reprocessadas, utilizando dois metodos de limpeza (manual ou automatizado), seguidos de um dos seguintes metodos de esterilizacao: plasma de peroxido de hidrogenio (PPH), oxido de etileno (OE) ou vapor de baixa temperatura de formaldeido (VBTF). Foram analisadas 360 CBEUUs apos sua primeira utilizacao. A probabilidade de falha de esterilizacao foi estimada considerando o numero de resultados positivos de cultura dos dispositivos estudados. A probabilidade geral de falha de esterilizacao das CBEUUs foi de 0,26. A menor probabilidade de falha foi obtida com o VBTF (0,01), seguida do OE (0,21) e do PPH (0,56). A limpeza automatizada obteve melhores resultados quando comparada a limpeza manual. O presente estudo demonstrou que a probabilidade de esterilizacao das CBEUUs reprocessadas e altamente dependente dos metodos de limpeza ou esterilizacao aplicados.

Antropología, salud y enfermedad: una introducción al concepto de cultura aplicado a las ciencias de la salud

Abstract: Este articulo presenta una reflexion acerca de como las nociones y comportamientos asociados a los procesos de salud y enfermedad estan integrados a la cultura de los grupos sociales en los que estos procesos ocurren. Se argumenta que los sistemas medicos de atencion a la salud, asi como las respuestas dadas a la enfermedad son sistemas culturales que estan en consonancia con los grupos y las realidades sociales que los producen. Comprender esta relacion es crucial para la formacion de profesionales en el area de la salud.

Nursings role in tuberculosis control: a discussion from the perspective of equity

Abstract: This paper aims to analyze nurses role in tuberculosis control from the perspective of equity in the context of Latin American countries. Tuberculosis is frequently associated with poverty, but many other determinants play an important role in its prevalence. Latin American countries fight against the presence of this illness and nursing professionals play a protagonist role in TB control, proposing comprehensive interventions in different spheres--individuals, families and society. The focus of nursing intervention ranges from public policy proposals, based on epidemiological research, through the establishment of multi-sector programs, to direct care and client education at the operative level. Different professional nursing institutions can play a decisive role in this problem integral approach, both in national and international scopes. This requires the establishment of educative, social, technical and politically integrated support networks.

Social Model: A New Approach of the Disability Theme

Abstract: The experience of disability is part of the daily lives of people who have a disease, lesion or corporal limitation. Disability is still understood as personal bad luck; moreover, from the social and political points of view, the disabled are seen as a minority. The aim of this study is to contribute to the knowledge about the experience of disability. The research presents a new approach on the theme: the social model. This approach appeared as an alternative to the medical model of disability, which sees the lesion as the primary cause of social inequality and of the disadvantages experienced by the disabled, ignoring the role of social structures in their oppression and marginalization. The study permits reflecting on how the difficulties and barriers society imposed on people considered different make disability a reality and portray social injustice and the vulnerability situation lived by excluded groups.

Competency-based curriculum and active methodology: perceptions of nursing students

Abstract: This study identifies the perceptions of undergraduate students at the University of Sao Paulo at Ribeirao Preto, Brazil, College of Nursing (EERP-USP) concerning the teaching-learning process in two courses: Integrated Seminar: Health-Disease/Care Process in Health Services Policies and Organization, which was offered to first-year students in 2005 and 2006 and Integrality in Health Care I and II, which was offered to second-year students in 2006. The courses proposal was to adopt active methodology and competency-based curriculum. Data were collected from written tests submitted to 62 students at the end of the curse, focusing on the tests pertinence, development of performance, structure and pedagogical dynamics, organization and settings. Thematic analysis indicated that students enjoyed the courses, highlighted the role of the professor/facilitator at points of the pedagogical cycle and learning recorded in students portfolios. Students valued their experience in the Primary Health Care setting, which was based on, and has since the beginning of the program been based on, the theory-professional practice interlocution and closeness to the principles of the Unified Health System (SUS).

Health related quality of life of women with cervical cancer

Abstract: This cross-sectional study aimed to evaluate the health related quality of life (HRQoL) of women with cervical cancer and to identify predictors of quality of life. Between November 2008 and February 2009, 149 women were interviewed. The instrument Functional Assessment of Cancer Therapy-Cervix Cancer (FACT-Cx) was used to assess HRQoL and, in general, the scores obtained indicated positive evaluation. The items that showed negative evaluation were: I am interested in sex, I feel sexually attractive, I am afraid to have sex and My vagina feels too narrow or short. In multiple linear regression analysis, using the backward method, of the 18 independent variables, eight were predictive of HRQoL. Self-perceived health status was the most influential factor. Special attention should be given to the sexual dysfunctions of these women after radiotherapy.

Investment in nursing human assets: education and minds of the future.

Abstract: This paper analyzes issues related to education, crises and changes in light of the postmodern order, emphasizing efforts towards human capital as the impetus to promote changes. Focusing on universities and organizations, we discuss the main five types of minds valued by modern and future societies, proposing investment in human assets through the use of strategies and technologies to ensure continuing education throughout life.

Burnout e estresse em enfermeiros de um hospital universitário de alta complexidade

Abstract: Se trata de un estudio transversal, analitico y de correlacion que tuvo por objetivo investigar la existencia de Burnout en una muestra de 149 enfermeros de un hospital universitario de alta complejidad, en el periodo de octubre a diciembre de 2008, correlacionandolo con factores de estres del ambiente de trabajo hospitalario. Fueron aplicados el Inventario de Burnout de Maslach, el Inventario de Estres en Enfermeros y una ficha de caracterizacion de los sujetos. Los resultados indicaron la presencia de las tres dimensiones indicativas de Burnout en 7,3% de los enfermeros (cuartil) y 10,22% (tercil), asi como la correlacion entre dominios de los inventarios. La vulnerabilidad para ese tipo de enfermedad, en enfermeros, fue potencializada por la existencia de factores de estres en el ambiente de trabajo.

Multidimensional pain evaluation scale

Abstract: This study developed a pain evaluation scale and validated it for the Portuguese language. Development of the inventory - 308 readily available pain descriptors - were searched in international literature and validated by six judges. One hundred descriptors of acute pain and 100 descriptors of chronic pain were found, which were used in the next stage. Statistical validation - 493 health professionals and 146 patients experiencing acute and chronic pain participated in the study. Instructions, pain descriptors and respective definitions, pen and measuring tape were provided to participants. Psychophysical methods were used to establish categories, magnitude and cross-modality matching using line-length. Results revealed the ranking of the most frequently used descriptors of acute and chronic pain, with power equal to 0.99, close to the predicted (one), using line-length estimations. The Multidimensional Pain Evaluation Scale is thus validated for the Portuguese language.

Uso de alcohol en accidentes de tránsito: estudio del nivel de alcoholemia

Abstract: Se trata de estudio epidemiologico exploratorio y descriptivo. El objetivo fue correlacionar los niveles de alcoholemia detectados en las victimas fatales por accidentes de transito, en la ciudad de Rio de Janeiro (datos de los registros del Instituto Medico Legal/IML) con el perfil de la victima y las caracteristicas de los accidentes. Los datos fueron recolectados del archivo del IML, a traves de los registros que constaban en las fichas de victimas fatales por accidentes de transito; fueron compilados y se elaboraron tablas con el Programa estadistico SPSS, en el periodo comprendido entre enero y mayo de 2005. Fueron levantados datos sobre 348 victimas fatales por accidentes de transito, de estos, apenas 94 realizaron el examen de alcoholemia, siendo que en 83 fueron detectados niveles de alcoholemia; el 60,2% presento niveles por encima de 0,6g de alcohol por litro de sangre. Se mostro evidente el envolvimiento del alcohol en accidentes de transito con victimas fatales, en niveles por encima y por debajo de 0,6g de alcohol por litro de sangre.

Evaluation of quality of life and depression in nursing technicians and nursing assistants.

Abstract: The aim of this study was to evaluate the quality of life (QoL) and depression, and relate them to the sociodemographic characteristics of nursing technicians and nursing assistants in a private hospital. This was an epidemiological and cross-sectional study. The number of technicians and assistants who participated in this study was 266. The instruments used were the WHOQOL-BREF and the Beck Depression Inventory. The evaluation of quality of life of nursing technicians and assistants showed similar values to those found in individuals with chronic diseases. The presence of health problems led to higher indices of depression and lower QoL scores in the general and psychological domains and correlated to labor activity. Night-shift workers had higher scores of depression. Understanding factors, related to professional activities, which trigger health problems and alter quality of life, can provide tools in the search for alternatives to remedy or mitigate their effects.

Clinical validation of impaired spirituality in patients with chronic renal disease

Abstract: This study aimed to identify and validate the defining characteristics of the nursing diagnosis Impaired spirituality. The methodological framework proposed by Fehring for the clinical validation of nursing diagnosis was used. The investigation was carried out in a dialysis clinic and had as participants 120 patients with chronic renal disease. Data were collected by two expert nurses, through interviews. The prevalence of the nursing diagnosis Impaired spirituality in the sample was 27.5%. It was found that the most frequent defining characteristics were Expresses behavioral changes: rage, Inability to express creativity, Questions suffering and Expresses alienation. The clinical validation of Impaired spirituality contributed to refine this diagnosis. Its identification in patients with chronic renal disease undergoing dialysis treatment can offer alternatives for a safer and more effective intervention, aiming at the satisfaction of the spiritual needs of these patients.