Revista Enfermería Actual en Costa Rica (REVENF) is one of the official journals of the University of Costa Rica (UCR), and is endorsed by the Office of the Vice-president for Research. REVENF is linked to the School of Nursing (EE, for its acronym in Spanish), where it is edited and published, and to the Center for Research in Nursing and Health Care (CICES, for its acronym in Spanish) through mutual collaboration strategies. REVENF aims to publish scientific production in the field of healthcare, particularly in Nursing, both nationally and internationally, allowing researchers to share their findings, and readers to gauge the broad work of the discipline, as well as its impact and relation to other disciplines. Founded in 2000, REVENF is pioneer in the dissemination of scientific knowledge in electronic format in the field of Nursing at a national level. Since then, it has produced uninterrupted publications every six months, where the first issue is published from January 1 to June 30 and the second issue from July 1 to December 31. In addition, there is a permanent call for articles, so people interested in publishing can send their manuscript at any time of the year. REVENF publishes original and unpublished articles that disclose the results of primary research, reviews and reflections. Authors interested in publishing in REVENF should review the submission guidelines, prior to submitting. REVENF do not publish notes, review protocols, narrative reviews and articles derived from clinical practice such as case reports. The target audience is broad. It includes the scientific community and university students, as well as anyone interested in acquiring or improving their knowledge on any of the subjects addressed in the publications. Currently, REVENF is in the first positions of the UCRindex and is indexed in: Scielo RedAlyC Cuiden DOAJ LATINDEX LILACS Dialnet MIAR Qualis Plataforma Sucupira ERIHPLUS SHERPA/Romeo JournalTOCs BDENF REDIB PERIÓDICA Biblat Ulrichs It should be noted that this scientific publication complies with open access policies. There are no fees for submitting an article for review or processing, and all content is free to download in full. Finally, the Tesario section has provided a space to showcase research projects carried out by undergraduate students since 2001. This tool could guide the lines of national research as well as the gaps in knowledge that can be addressed by further studies.
The authors of this journal will have the right to copy their documents without restriction, as well as maintain the rights of publication in their articles.
Nursing students' learning about therapeutic toys in the care of hospitalized children: a qualitative study
Introduction: Therapeutic toy is a recognized care technology for nursing professionals. However, there is low adoption of this technology in hospitals for several reasons, including the scarce approach to the subject during academic training. Objective: To analyze the experience of undergraduate nursing students regarding the learning and applications of the therapeutic toy care technology. Methods: Descriptive study with qualitative data analysis, following the steps of content analysis. Nineteen individual semi-structured interviews were conducted online with undergraduate nursing students from 5th to the 8th semester in a private institution in the city of São Paulo. The data were analyzed considering Ausubel's meaningful learning theory and represented by thematic categories. Results: The ages of the students ranged from 20 to 41 years. The data analyzed were grouped into two major thematic categories, each accompanied by a subcategory: “Therapeutic toy in pediatric care: students' impressions and feelings” and “Meaningful and integrative learning for differentiated care of children during hospitalization”. Conclusion: The participating students recognized the contributions and skills developed during the academic training process, emphasizing empathy, development of bonds and trust, humanization, and the facilitating potential of the therapeutic toy in communicating and understanding the individualities of children.
Education, Nursing; Pediatric Nursing; Play and Playthings.
Copyright (c) 2024 https://creativecommons.org/licenses/by-nc-sa/4.0
Mothers' perceptions of the development of premature newborns
Introduction: Despite advances in research on child development, there is a scarcity of studies addressing mothers’ perceptions of this process in premature newborns. This represents a significant knowledge gap, as child development is influenced by biological, social, and environmental factors, and prematurity may compromise this journey. Objective: To describe mothers’ perceptions of child development in premature newborns. Methods: A descriptive and exploratory study with a qualitative approach, conducted in a general hospital in Southwestern Bahia, Brazil, with the participation of 15 mothers of premature infants selected by convenience sampling. Data were collected through semi-structured interviews and analyzed using Bardin’s content analysis method and the IRAMUTEQ software. Results: Mothers associated child development with physical growth, developmental stages, and feeding. Their perceptions highlighted motor and cognitive progress, but they also recognized delays, especially in motor and language skills. Strategies such as playful and sound stimulation, and tummy time were identified as promoting development, although the lack of adequate guidance during the hospital stay was mentioned as an obstacle. Conclusion: Maternal perceptions reveal a partial understanding of child development and suggest the need for educational guidance and continuous support for mothers to optimize the development of premature infants in the home environment.
Copyright (c) 2025 Jamille Souza Silva, Ivanete Fernandes do Prado, Beatriz Bonfim Lima, Samara Pimentel Paes, Darlyane Antunes Macedo, Talitha Sonally Soares Fernandes (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Care Management in Platelet Donation by Apheresis: A Scoping Review
Introduction: Care management during the process of platelet donation by apheresis should include actions that promote constant evaluation of the processes, aiming to promote continuous improvements based on scientific practices. Objective: To map potential evidence in the literature for care management in platelet donation by apheresis. Method: A scoping review was carried out, following the recommendations of the Joana Briggs Institute using the Prisma ScR checklist. To answer the research question: What are the practices in care management during the process of platelet donation by apheresis?, it was used the acronym PCC, where the problem (P) of the research is care management; the concept (C) are the practices, and the context (C) is the process of donating platelets by apheresis. The stages of identification, selection, eligibility, and inclusion of the listed articles were carried out by two reviewers individually and are represented through the Prisma ScR flowchart. Results: Of the 419 studies found, 29 articles addressing the study topic were included. The following were highlighted from the extraction of evidence: hematocrit/hemoglobin assessment at each apheresis platelet donation. Conclusion: The compilation of this evidence can serve as a basis for care management in clinical practice and the quality of care for donors. It contributes to the strengthening of work processes of nurses specializing in hemotherapy.
Copyright (c) 2025 Ana Cláudia Pinheiro Machado, Paula Vanessa Peclat Flores , Ana Paula Amorim Moreira (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
The Use of the Health Booklet/Prenatal Record and Women's Satisfaction with the Prenatal Care in Nampula, Mozambique
Introduction: Prenatal care plays a crucial role in promoting maternal and fetal health, and women’s health records, in their proper use, are a tool for improving maternal and child health. Therefore, it is necessary to consider women’s satisfaction with prenatal care. Objectives: (1) To verify the use of the woman’s health booklet/prenatal record and (2) describe women’s satisfaction with prenatal care. Method: A quantitative, cross-sectional, descriptive study conducted in Nampula, Mozambique, with 339 women aged 18 to 49 years, interviewed using a structured instrument in Google Forms, which was pre-tested and applied with a tablet. The use of the booklet was evaluated based on the prenatal care information recorded on prenatal and the women’s satisfaction with prenatal care was assessed using the Patient Expectations and Satisfaction with Prenatal Care Scale. Results: 393 women were approached, but 54 of them (13.7%) were not carrying their health record booklet. Of the 339 women interviewed, 50.7% of them had records of four or more prenatal visits; 57.8% of them had records of syphilis testing; and 64.3% of blood pressure measurement. There was also a low percentage of records for urine tests, complete vaccination schedules, and blood counts. In terms of satisfaction, more than half of the women were dissatisfied with the waiting time to be seen by a health professional. Conclusion: The low number of entries in women's health records and the dissatisfaction with prenatal care highlight the need to train professionals and raise awareness among women.
Copyright (c) 2025 Belarmina Reis-Muleva , Luciane Simões Duarte , Natália de Castro Nascimento (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Factors Related to Healthcare-Associated Infection in individuals Treated for External Causes in the Intensive Care Unit
Introduction: Healthcare-associated infections in individuals hospitalized for external causes pose a challenge for the intensive care unit team. Therefore, determining the causes of these infections during hospitalization can support healthcare planning, with the aim of providing care that promotes the reduction of these infections. Objective: To identify factors related to healthcare-associated infections in individuals treated for external causes in an Intensive Care Unit (ICU). Methods: Cross-sectional epidemiological study, drawn from medical records of patients admitted to the Intensive Care Unit of a general hospital in the interior of Bahia. Data were analyzed using descriptive statistics and the Pearson's Chi-square test was used to verify associated factors. Results: There was an association between the infection and the variables: race/color (p value= 0.017), type of external cause (p=0.010), nature of the injury (p=0.002), affected body segment (p=0.001), length of stay in the ICU (p<0.001), surgery (p=0.030), vasoactive drugs (p<0.001), invasive mechanical ventilation (p<0.001), invasive mechanical ventilation time (p<0.001), acute renal failure ( p=0.001), indwelling urinary catheter (p<0.001), nasoenteral catheter (p<0.001), central venous catheter (p<0.001), invasive blood pressure (p<0.001), pressure injury (p<0.001), and culture (p<0.001). Conclusion: Identifying factors related to healthcare-associated infections in individuals treated for external causes may contribute to the development of control protocols and techniques aimed at reducing infections in the Intensive Care Unit and ensuring patient safety.
Copyright (c) 2025 Marta Almeida de Jesus , Pietra Brito Rocha, Valéria Pereira Ribeiro, Roberta Laíse Gomes Leite Morais, Vanda Palmarella Rodrigues, Maria Eduarda Lima Barreto, Juliana da Silva Oliveira (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Prevalence of Smoking and Associated Sociodemographic Factors in Older Adults in Primary Health Care.
Introduction: The increase in the older adult population, while positive, poses challenges related to chronic diseases, including smoking, which remains understudied. Objective: To estimate the prevalence of smoking among older adults and assess its association with sociodemographic factors. Methods: A cross-sectional study was conducted with 1,322 older adults receiving primary healthcare services across the state of Roraima, Brazil. Tobacco use was assessed by healthcare professionals. The available sociodemographic variables included sex, age, skin color, education level, and place of residence. Logistic regression was used to calculate Odds Ratios (OR) for possible associations. Results: The prevalence of smoking was 11.6% and showed significant differences across sociodemographic groups (p < 0.05), except for the education level (p = 0.06). Smoking among older adults was directly associated with the male sex (OR = 1.77), the 60–69 age group (OR = 4.70), and the indigenous (OR = 2.97) and yellow (OR = 2.54) skin colors, while it was inversely associated with higher education (OR = 0.44). The place of residence was not significant after adjustment. Conclusion: With one in ten older adults smoking, this study highlights the need for public policies aimed at smoking prevention, particularly among men, younger older adults, indigenous individuals, and those with lower education levels. Smoking cessation programs targeting specific groups can help reduce chronic diseases, improve the quality of life of older adults, and alleviate the burden on healthcare systems.
Copyright (c) 2025 Ana Clara Silva de Jesus, Luis Gustavo Raposo dos Santos, Guilherme José Silva Ribeiro, André de Araújo Pinto (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Operationalization of teledebriefing in health education: scoping review
Introduction: Telesimulation is characterized as an innovative educational technology capable of reaching remote, hard-to-access locations. However, despite its importance, one of its stages, teledebriefing, still lacks sufficient scientific exploration. Objective: To map scientific literature on the operationalization of teledebriefing aimed at teaching students and health professionals. Materials and methods: This is a scoping review based on the recommendations of the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews: Checklist and Explanation, conducted in April 2025 in 13 databases. Results: Twenty-nine studies were identified as the final sample. Two categories were identified: practice and elements for the implementation of teledebriefing in teaching and learning in health, and benefits versus challenges of teledebriefing. Conclusion: In short, the operationalization of teledebriefing mainly involved the need for teletransmission resources, the presence of a trained facilitator/teledebriefer, the determination of a teledebriefing method and duration. The main benefit of teledebriefing is its contribution to improving the learner’s self-confidence, motivation, decision-making, and critical thinking. A key challenge, however, is the teledebriefer’s limited ability to observe the reactions of remote participants during the discussion.
Copyright (c) 2025 Fabiana Cristina Pires Bernardinelli, Gustavo Correa de Amorim, Marisa Ferreira de Freitas, Juliana da Silva Garcia Nascimento, Suzel Regina Ribeiro Chavaglia (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
Jean Watson’s Theory of Human Caring and its Applicability in Nursing Care and Education: An Integrative Review
Introduction: It is important to identify the current scenario of transpersonal nursing care and how the training scenarios of the Theory of Human Care are constructed according to the precepts of Jean Watson. Objective: To integrate and analyze the application of Jean Watson’s Theory of Human Caring in nursing studies, particularly in terms of care provision and educational practices within the nursing field. Method: Integrative Review based on Whittemore and Knafl. The search strategy encompassed the following databases: Web of Science, PubMed/Medline, Embase, Scielo, Lilacs, Scopus, and Cinahl, with no time restrictions. A thematic analysis was performed to synthesize the findings of the review and relevant information from the selected articles was extracted. The PRISMA checklist and quality appraisal were used to ensure the robustness of the identified publications. Results: Thirty-two articles met the eligibility criteria and were included in this review. Three themes emerged: 1. Unveiling the dimensions of care in the light of Jean Watson’s ideas; 2. Beyond the concept of care; 3. Care management and organizational culture. The significance of adopting transpersonal care approaches in caring for individuals with illness is highlighted, facilitating moments of spiritual and safe care. Nurses are required to possess both knowledge and skills to enable the provision of more meaningful care, alongside integrating material, educational, and human resources to enhance this caregiving process. Conclusion: The findings emphasize the importance of cultivating specialized skills within nursing practice, highlighting the necessity of specialized training and education focused on transpersonal care principles.
Copyright (c) 2025 Shirley da Rocha Afonso, Maria Itayra Padilha , Noé Ramírez-Elizondo , Stéfany Petry Dal Vesco, Jaime Alonso Caravaca-Morera, Vanessa Ribeiro Neves (Autor/a) https://creativecommons.org/licenses/by-nc-sa/4.0
First contact with the pediatric intensive care unit: the role of the nurse in family involvement in care
Introduction: The admission of children to intensive care units is unexpected for both the family and the child. Feelings of fear and uncertainty dominate the first moments of contact with this unexpected reality. In this context, nurses act as a link between the family and the environment. Objective: To identify the practices used by nurses in preparing and welcoming the family members for the intensive care environment. Method: An exploratory descriptive study of a qualitative nature, with the participation of 26 nurses working in a Pediatric Intensive Care Unit at a Hospital Center, organized into focus groups that took place between May 9 and June 8, 2019. Result: After organizing the results into thematic categories, the research identified that, during the first contact with the Intensive Care Unit, the phase of integration involved the nurse’s introduction, the type of information transmitted, the presentation of the unit's structure, the presentation of the patient's overall condition, and the demystification of the context. Regarding the welcome, the participants in the study considered this to be an important moment, conditioned by the nurse's competences, an initial assessment of the family members, and the fulfillment of specific requirements. Conclusion: The first contact in the welcome process is a role of the nurse that cannot be delegated to another professional, and the preparation of the family is a continuous process from the first contact with the service.
Copyright (c) 2025 Tânia Filipa Cardoso Melo (Autor) https://creativecommons.org/licenses/by-nc-sa/4.0
Associated Religious/Spiritual Coping Factors Among Children with Chronic Health Conditions
Introduction: Children who experience chronic illnesses use their spirituality to cope with and adapt to the situation and health condition, therefore care focused on the spiritual dimension and its associated factors promotes a comprehensive approach in this context. Objective: To identify the factors associated with religious/spiritual coping among children with chronic health conditions. Methods: Cross-sectional, analytical, and correlational study involving children with chronic health conditions monitored in the outpatient service of a university hospital. Data was collected from August 2021 to January 2023 through interviews using the Characterization Instrument and Religious Coping Scale for Children. Data analysis used descriptive statistics and association research using non-parametric measures: Spearman correlation coefficient, Kruskal Wallis Test, and Mann Whitney Test. Results: Thirty-four children participated, with a median age of 10 years, the majority were male, white, had siblings, lived with their parents, and believed in God. Positive religious coping strategies predominated, with strategies focused on the belief in God's support. Individual, religious, and clinical characteristics shown to influence children's religious/spiritual coping were skin color, education, siblings, beliefs in God, religion, and the affected system by the health condition. Conclusion: Children with chronic health conditions engage in positive religious coping strategies, which are influenced by their individual, religious, and clinical characteristics, and, therefore, this is an aspect that should receive attention from health professionals.
Psychological adaptation; Chronic illness; Pediatric nursing; Spirituality; Religion and medicine.
HIV/AIDS as an agenda for family dialogues between adolescentes and parents
Introduction: In the last decade, the increase in HIV/AIDS cases among adolescents and young people highlights the challenges faced by public health management. The taboo imposed by society on the subject hinders their access to health services and professionals, in addition to hindering communication between parents and children about HIV/ AIDS. Objective: To understand how parents and children approach HIV/AIDS during adolescence and youth. Methodology: Descriptive and exploratory study, with a qualitative approach, with family members linked to the primary care network of a small municipality in southern Brazil. Data collection was conducted between November and December 2021, with audio-recorded interviews and subsequent transcription using the NVivo Release version 1.1.6® software. The content analysis followed the Bardin method, comprising the stages of pre-analysis, material exploration, and data categorization. Results: The participants were eleven family members, mothers of adolescents, aged between 30 and 50 years. The following discussion categories emerged from the interviews: "Current knowledge about HIV/aids", "The approach to HIV/aids within the family", and "Who is responsible for the sexual education of our children?". Conclusion: Families face difficulties in the approach and dialogue due to the lack of reliable information and the presence of deep-rooted beliefs and fears. It is essential to promote openness and encourage dialogue, highlighting the importance and need for health services in guiding the population.
Adolescent; Family; HIV; Acquired Immunodeficiency Syndrome.
Meanings of a 'good death' for people with cancer assisted by home care services
Introduction: A "good death" is an individual and variable concept that encompasses practices to promote dying and death in a comfortable, dignified manner with the least possible suffering. Objective: To understand the meanings and describe the aspects involved in a 'good death' for people with cancer assisted by home care services. Method: Qualitative research conducted between December 2022 and January 2023 through semi-structured interviews with seven cancer patients affiliated to a home care and palliative care unit of a hospital in southern Brazil. The data were analyzed according to Creswell's theoretical proposal. Results: Three subcategories were developed: "Dialogues and silences about end of life and death," "Meanings of a good death," and "Care for a good death." In these, it was identified what the interviewees think about their own death, what a good death means to them, and what care is involved in fostering it. Conclusion: The meanings of a good death are attributed to dying at home peacefully, asleep, without pain, and with the presence of family, while care for a good death is mainly linked to receiving love and attention at the end of life.
Palliative care; Right to die; Oncology; Qualitative research.
Safety Culture in Intensive Care Units from Multiprofessional Team Perspective: A Multicenter Study
Introduction: Patient safety culture is considered an important structural component of the services, which promotes the implementation of safe practices and the reduction of adverse events. Objective: To identify the factors associated with patient safety culture in adult intensive care units in large hospitals in Belo Horizonte. Method: Cross-sectional survey and multicenter study. A total of 168 health professionals from four units (A, B, C and D) of adult intensive care participated. The questionnaire “Hospital Survey on Patient Safety Culture” was used. The patient's level of safety culture was considered as a dependent variable, and sociodemographic and labor aspects were the independent variables. Descriptive statistics were used and a multiple logistic regression model was developed to analyze the associated factors. Results: An association was identified between the type of hospital and eleven dimensions of the safety culture. In terms of function, the doctors, nursing technicians, and nurse were related to three dimensions; gender with two dimensions, and time working in the sector with one dimension. Conclusion: It was evidenced that the type of hospital, function, time working in the sector, and gender were associated with the dimensions of patient safety culture.
Patient Safety; Organizational Culture; Intensive Care Units; Patient Care Team; Health Care Quality Indicators.
Copyright (c) 2023 https://creativecommons.org/licenses/by-nc-sa/4.0
Depressive symptoms in healthcare workers during the covid-19 pandemic: A cross-sectional study
Introduction: The frequency of depressive symptoms among healthcare professionals during the COVID-19 pandemic was high. However, little evidence includes support workers, those who do not directly provide healthcare. Objective: To identify the prevalence of depressive symptoms and their levels, as well as the associated factors, in Brazilian healthcare workers during the COVID-19 pandemic. Method: This is a cross-sectional, analytical, and quantitative study, conducted with 108 healthcare workers (from direct care and support workers) from January to May 2021, using non-probabilistic sampling. The Depression, Anxiety, and Stress Scale was applied to identify the symptoms of depression. Data were analyzed using absolute and relative frequencies for variables related to sociodemographic, healthcare service and occupation, self-perceived health, factors associated with the risk of COVID-19, clinical history, and depressive symptoms. Association tests were applied, and prevalence ratios were estimated with a confidence interval of 95%. Results: The prevalence of depressive symptoms was 51.9% (95% CI = 43.1%–63.7%), with the extremely severe level being more frequent (16.7%, 95% CI = 8.8%–22.5%), mainly among workers who do not work directly in care (35.7%), compared to those who assist patients (12.9%). The prevalence of depressive symptoms stands out among workers with fair/poor/very poor self-perceived health (88.0%), diagnosis of mental disorder (81.2%), continuous use of medication (63.0%), and use of psychotropic drugs (69.6%). Conclusion: Depressive symptoms were predominant among healthcare workers during the pandemic, with extremely severe levels occurring more frequently among support workers. There is a need to focus attention on the mental health of healthcare workers according to specificities, mainly occupational, to minimize the occurrence of depressive symptoms.
COVID-19; Depression; Pandemics;Health Workers.
Morbimortality profile of nursing professionals due to COVID-19 in Brazil between the years of 2020 and 2022
Introduction: The global repercussion of the COVID-19 pandemic raises the need to understand the impact of the disease among nursing professionals, as they were responsible for direct care of infected people. Objective: To describe the morbimortality profile of nursing professionals due to COVID-19 in Brazil between 2020 and 2022. Methodology: An epidemiological study conducted with data collected at the Nursing Observatory of the Federal Council of Nursing. The data were tabulated using version 21 of the SPSS software and analyzed by descriptive analysis, using frequencies. Results: During the period analyzed, 64 610 cases of COVID-19 were reported among Nursing professionals in Brazil. Of these, 36 425 (56.4 %) were confirmed and 833 died, representing a case fatality rate of 2.29 %. In terms of cases, COVID-19 was prevalent among women (84.24 %) aged between 31 and 40 (41.34 %) years, residing in the southeastern part of the country (29.77%) and infected in 2020 (66.79 %). As for deaths, the prevalence of cases occurred in 2020 (52.10 %) among women aged 41 to 50 years (68.07 %), residing in the northern region of Brazil (28.93 %). Nursing professionals had a 14 % higher mortality rate than the general population of Brazil, with a higher frequency among men. Conclusion: The study raises the need to build public policies aimed at protecting these workers. Such policies must seek to guarantee better working conditions, ongoing education, and to address gender inequalities.
Epidemiology; Coronavirus Infections; Indicators of Morbidity and Mortality; Nurses.
Interprofessional communication and patient safety in the neonatal intensive care unit
Introduction: Respectful communication includes social, verbal, and non-verbal interaction, including mutual understanding and respecting values, beliefs, and cultural preferences to promote equity in health care. Failures in the communication process are considered one of the main factors behind the occurrence of adverse events and, consequently, a decrease in the quality of care. Objective: To understand how the interprofessional communication process is developed to ensure patient safety in the Neonatal Intensive Care Unit. Method: Convergent care research carried out from July to August 2019 with 17 professionals from the health team of the Neonatal Intensive Care Unit of a University Hospital in southern Brazil. Results: Two categories were elaborated to present the information collected: Verbal and non-verbal communication; Facilitating and hindering factors in communication. From the theoretical-practical convergence, it was possible to develop a Standard Operating Procedure Protocol for Effective Communication for its practical implementation. Conclusion: Verbal communication during the shift change was perceived as the main tool, contributing to patient care and safety, being the connection between professionals an important factor to improve it. This connection, together with ongoing training, favors effective communication.
Communication; Neonatal Nursing; Qualitative Research; Patient Safety; Neonatology; Intensive Care Units, Neonatal.
Transitions theory as a paradigm for supporting self-management in people with chronic conditions
Introduction: The experience of living with a chronic disease is not a simple task, since it requires tools that allow increasing the degree of awareness to face the needs and overcome challenges about the state of health and disease. In recent years, support for self-management has been established, with the aim of enhancing the skills of people with this type of condition. It is important to consider how the nursing discipline can contribute to achieve this. The aim of this paper is to reflect on Meléis' theory of transitions as a paradigm to support self-management in people with chronic conditions. Development: Meléis' theory of transitions establishes that people are in constant change, as occurs in the health-illness transition process. Receiving the diagnosis of a chronic disease involves a series of complex processes for the person, due to the multiplicity of variables involved. Meléis' theory provides guidelines to orient the nursing professional on key and interrelated elements, such as the previous conception of the nature of the transition and its conditions, which will serve for the planning of intervention modalities congruent with the person's experiences and their evaluation in the course of the health and disease process. Conclusion: The paradigm offered by Meléis can be considered a key approach to undertake the nursing care process aimed at supporting people with chronic illness in achieving self-management.
Self-management; Transitional Care; Nursing; Chronic diseases.
Nursing competencies in the care of patients with stroke who are eligible for thrombolytic therapy
Introduction: Ischemic stroke is treated with thrombolytic therapy, applied even in the acute phase, promoting a significant improvement in the after-effects caused by this condition. Considering the complexity of thrombolytic therapy, it is necessary for nurses to understand the skills required to assist in care. Objective: To identify scientific evidence about the competencies of nurses in the care of patients with stroke who are eligible for thrombolytic therapy. Methodology: An integrative review consisting of six stages (elaboration of the question, literature review, data collection, analysis, discussion, and presentation), conducted in MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase, and CINAHL databases. The search was carried out between August and September 2022 using primary studies as the inclusion criteria: free of charge, fully available electronically, published in English, Portuguese, or Spanish. Initially, 2.830 studies were obtained, which underwent a selection process that included only those studies that met the previously established criteria. Results: Based on the twelve studies included in this review, competencies focused on three care activities were identified: care management such as teamwork; codes; flows and protocols; patient care before, during, and after the use of thrombolytic therapy; and education health education for staff, patients, and families. Conclusion: The findings of this review highlighted the nurses' competencies in the care of patients eligible for thrombolytic therapy, which encompass different areas of the nurse's work. For this study, assistance competencies prevailed, followed by management competencies.
Stroke; Tissue Plasminogen Activator; Nursing Care; Clinical Competence; Thrombolytic Therapy.
Clinical Demands and Nursing Interventions in Gerontological Consultations: An Integrative Review
Introduction: The creation of guidelines that unify the prevalent clinical demands from gerontological nursing consultations and their corresponding interventions are necessary due to the heterogeneity of emerging pathologies in the aging process that will require nursing care. Objective: To identify clinical demands in gerontological nursing consultations and the interventions implemented by nurses. Method: An integrative review of original research published from 2018 and 2022, in English, Spanish, and Portuguese, in Scopus, MEDLINE/PubMed, BIREME/lilacs/BDENF/IBECS/VHL, SciELO, and Google Scholar databases, using the DeCS/MESH descriptors: "Elderly", "Nursing in the Office", "Geriatric Nursing", and "Geriatrics". The Rating System for the Hierarchy of Evidence for Intervention was used to determine the level of evidence of the final sample. Editorials, review studies, and duplicate articles were excluded. The data were analyzed by analytical and interpretative reading, guided by a checklist. Results: Eight articles were selected that showed clinical demands such as deficits in self-care for bathing, self-negligence, fatigue, risk of damaged skin integrity, hopelessness, sadness, and depression. Interventions were related to encouraging self-care, medication optimization, encouragement of exercise, skin care, counseling, music therapy, and psychosocial rehabilitation. Conclusion: There are many different clinical demands in gerontological nursing consultations, especially associated with the domain of activity/rest. These include interventions to treat and prevent diseases, and actions aimed at health promotion, in most cases associated with the Behavioral domain.
Geriatric Nursing; Office Nursing; Geriatrics; Aged.
The Nurse-Tuberculosis Patient Relationship according to Imogene King's Theory of Goal Achievement
Introduction: One of the main aspects in the fight against tuberculosis are the actions developed in Primary Health Care (PHC). At this level of care, the nurse's continuous contact through the nursing consultation allows them to maintain a relationship with the sick population. Regarding the nurse-patient relationship for establishing a bond and the compliance with tuberculosis treatment, we understand the importance of Imogene King's theoretical framework for structuring the nurse-patient interaction and offering a dynamic for this process. Objective: To analyze the nurse-tuberculosis patient relationship based on Imogene King's Theory of Goal Achievement. Method: A descriptive study with a qualitative approach, with 14 PHC nurses, selected by convenience. Data were collected from August to November 2018 through semi-structured interviews based on Imogene King's Meta-Oriented Nursing Record. The data were analyzed qualitatively using the IRAMUTEQ software. The research was approved by the Ethics Committee. Results: After the analysis, four classes emerged: 1) relationship established on the basis of welcoming; 2) nurse-tuberculosis patient relationship and the support of other professionals and family members; 3) relationship established towards treatment compliance; and 4) relationship established to confront prejudice associated with tuberculosis. Conclusion: The welcoming, the family, and the bond between the professional, the patient and Primary Health Care team strengthen the coping with the disease and reinforce the compliance with the pharmacological treatment.
Nursing Care; Nurses; Patients; Tuberculosis.
Influence of Sleep Quality on the Quality of Life and Work of Military Police Officers
Background: Police training is considered high risk and demands physical and mental vigor from the worker before preforming the service. Therefore, sleep quality is important as it directly impacts the health of these workers in several aspects. Furthermore, the lack of sleep quality due to work can negatively influence the quality of life outside of work. Aim: To analyze the influence of sleep quality on the quality of life and work of military police officers. Methods: A quantitative, cross-sectional correlational study, conducted in the first half of 2019 with police officers from three municipalities in Bahia, Brazil. Three instruments were used: sociodemographic and work characteristics; quality of life at work; and sleep quality. The chi-square test was applied for sociodemographic and occupational variations. Subsequently, the Spearman correlation test was applied between sleep quality and the quality of life and work dimensions. Results: Among the 298 police officers the median age was 40 years and the length of service was ≤ 7 years. It was also observed that police officers with poorer sleep quality had an unsatisfactory quality of life at work in all its dimensions (biological/physiological; psychological/behavioral; sociological/relational; economic/political, environmental/organizational). Conclusion: Police officers suffer from poor sleep quality and this negatively influence their quality of life and work. Therefore, there is a need to develop actions in the workplace that may reduce the risks of health problems caused by poor sleep quality.
Quality of life, Police, Occupational Health, Sleep
“No Elderly Person Deserves to Go Through This”: Understanding Violence Towards Elderly Women
Introduction: Violence against the elderly is a growing phenomenon, causing damage to health, with different outcomes and consequences to the victims. The possibility of elderly women suffering it in the family context surpasses that of men, with gender being a considerable risk factor. Objective: To analyze the understanding of violence against the elderly according to elderly women. Method: Descriptive research with a qualitative approach developed with 22 elderly women from a community in the state of Paraíba, Brazil, chosen for convenience. The data collection was based on semi-structured interviews, processed by the Iramuteq software, with subsequent Content Analysis. Results: Five classes of violence against the elderly were evidenced: cycle of violence; support network for the elderly victims of violence; experience of violent situations; financial violence; and symbolism of violence in society, which denote an understanding of violence involving the different types. They are based on the factors of family experience, culture, and others, placing the health professional as a fundamental element for care and support. Gender influenced the perspective on physical and psychological violence, as well as the relevance given to health teams for the identification of occurrences and the prevention of possible damage. Conclusion: The various types of violence against the elderly have been recognized, including individual, community, and social factors in the violent cycle. In addition, they associated aging with greater susceptibility to suffering violence, regardless of the typology. It highlights the potential of the health service in assisting the elderly victim of violence, elucidating cases, and acting early to interrupt the cycles perpetrated, requiring the constant need for professional updating to deal with detected situations.
Elder Abuse; Health Personnel; Gender-Based Violence.
Emília Carolina Félix Rosas de Vasconcelos
Women's Feelings Facing High-Risk Pregnancy
Introduction: Pregnancy is considered a unique and memorable event in a woman's life. High-risk pregnancy is a stressful experience due to the risks to which the mother and the baby are exposed, and due to the changes that negatively affect their emotional balance. Objective: To identify the feelings experienced by pregnant women facing high-risk pregnancy. Method: Descriptive and exploratory, employing a qualitative approach, the study featured a convenience sample of women with high-risk pregnancies, selected based on inpatient service availability, until interview saturation was achieved. Data collection was conducted over a two-month period through scripted interviews. Data analysis was performed utilizing Minayo's content analysis technique. Results: Thirty-seven women participated in the study. The results were categorized as follows: How the high-risk diagnosis was determined; Feelings upon discovering the pregnancy was high-risk; Feelings regarding family support regarding the high-risk pregnancy. The feelings reported by pregnant and postpartum women who experienced high-risk pregnancies clearly reveal the impacts this event has, not only on physical health, but especially on emotional well-being, leaving the pregnant women in a vulnerable state. Conclusion: The study allowed us to realize that the feelings experienced in this process can negatively interfere in the lives of these women. However, despite this situation, many of them express mixed feelings, because even with the gestational risk, they are grateful for the gift of motherhood.
High Risk Pregnancy; Pregnancy; Pregnancy Complications; Prenatal care; Women's Health.
Relationships Between Unstable Glycemia, Hospital Length Of Stay, And Mortality In Critically Ill Patients: A Cohort Study
Introduction: The control and evaluation of glycemic levels in critically ill patients is a challenge and a responsibility of the nursing team; therefore, determining the consequences of this during hospitalization is key to demonstrate the importance of timely management. Objective: To determine the relationship between unstable glycemia (hyperglycemia and hypoglycemia), hospital length of stay, and the hospitalization outcome of patients in an Intensive Care Unit (ICU). Methods: A prospective cohort study conducted with 62 critically ill patients by convenience sampling between March and July 2017. Daily blood samples were collected to measure glycemia. The correlation of unstable glycemia with the hospital length of stay and the hospitalization outcome was assessed using Pearson's chi-square. A p-value <0.05 was considered significant. Results: Among the 62 patients, 50% were male and 50% were female. The mean age was 63.3 years (±21.4 years). The incidence of unstable glycemia was 45.2% and was associated with a longer ICU stay (p<0.001) and a progression to death as a hospitalization outcome (p=0.03). Conclusion: Among critically ill patients, unstable glycemia was associated with an extended hospital length of stay and a progression to death, emphasizing the importance of nursing intervention to prevent its occurrence.
Nursing; Hyperglycemia; Hypoglycemia; Mortality; Hospitalization; Intensive Care Units.