PPGE - Mestrado em Enfermagem

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Eficácia da suplementação de ferro em pacientes anêmicos no pré-operatório de cirurgia cardíaca: revisão sistemática e metanálise
(Universidade Federal do Rio Grande do Norte, 2025-12-16) Teixeira, Fernanda de Castro; Dantas, Rodrigo Assis Neves; https://orcid.org/0000-0002-9309-2092; http://lattes.cnpq.br/9161806467102041; http://lattes.cnpq.br/2072086060226520; Feijão, Alexsandra Rodrigues; https://orcid.org/0000-0002-8686-9502; http://lattes.cnpq.br/8649283681727209; Ribeiro, Katia Regina Barros; https://orcid.org/0000-0002-3513-7483; http://lattes.cnpq.br/4422189971983553; Leal, Nahadja Tahaynara Barros
Iron deficiency is one of the most frequent comorbidities in patients with heart failure and represents an important risk factor for complications during the perioperative period of cardiac surgeries. Considering the role of the perfusionist nurse in blood management and the prevention of transfusion events, it is relevant to evaluate therapeutic strategies that contribute to the correction of anemia in patients undergoing cardiac surgeries. Thus, this study aimed to evaluate the effectiveness of iron supplementation in anemic patients in the preoperative period of elective cardiac surgeries. This is a systematic review with meta-analysis of randomized clinical trials, conducted according to PRISMA recommendations and registered in PROSPERO under number CRD42024568295. The research question was based on the PICO strategy (P): adults older than 18 years with CVD, (I): Intravenous, oral or subcutaneous iron supplementation; (C): Usual institutional care; (O): To evaluate the effect of iron supplementation on reducing the need for blood transfusion and the use of blood products. (S): Randomized Clinical Trials. Searches were conducted between March 10, 2025, and April 25, 2025, in the Cochrane Library, PubMed/Medline, Scopus, Embase, Web of Science, and Clinical Trials databases, without restriction of language or publication period. The search and selection of studies was performed independently by two researchers, and disagreements were discussed and resolved by a third researcher. Studies that analyzed adult patients diagnosed with anemia and heart failure undergoing cardiac surgery who received oral, intravenous, and subcutaneous iron supplementation in the preoperative period were included. Quantitative analysis was conducted using R software, employing fixed and random effects models according to the level of heterogeneity (I²). The risk of bias was assessed using the ROB2 tool, and the certainty of evidence was assessed using GRADE. The final sample consisted of seven studies that met the eligibility criteria. The majority of the population was female, with ages ranging from 18 to 67 years. The primary outcome, "reduction in the use of blood products," was analyzed descriptively and comparatively, and secondary outcomes were analyzed through meta-analysis. This analysis revealed no statistically significant differences between the control and intervention groups regarding the occurrence of atrial fibrillation (OR = 0.75; 95% CI: 0.32–1.77; I² = 0%). Similarly, there was no significant difference in length of hospital stay (mean difference = -2.50 days; 95% CI: -7.27 to 2.27; I² = 72.7%) or length of stay in the ICU (mean difference = -0.25 days; 95% CI: -1.67 to 1.17; I² = 93.7%), and the mortality rate, the meta-analysis indicated OR = 0.47 (95% CI: 0.10–2.28; I² = 0%), suggesting... A trend toward reduced risk was observed in the group that received iron, although without statistical significance. It is concluded that intravenous iron supplementation in the preoperative period of cardiac surgery appears to be a promising strategy to reduce complications and improve the recovery of anemic patients, but further studies with large samples and standardized methodological designs are still required.
Validação de terminologia especializada de enfermagem para o cuidado de gestantes com sífilis à luz da teoria da adaptação de Callista Roy
(Universidade Federal do Rio Grande do Norte, 2025-12-18) Silva, Ana Beatriz Pereira da; Silva, Richardson Augusto Rosendo da; https://orcid.org/0000-0001-6290-9365; Dantas, Ana Márcia Nóbrega; Menezes, Harlon França de; Diniz, Kessya Dantas; Filho, Luiz Alves Morais; https://orcid.org/0000-0002-8122-4705
Syphilis is a systemic Sexually Transmitted Infection caused by Treponema pallidum, exclusively affecting humans. Transmitted sexually, it can also be vertical, resulting in congenital syphilis, associated with abortions, fetal deaths, and disabilities. This study constructed and validated specialized terminology specific for pregnant women with syphilis, structured by Callista Roy's Adaptation Model, to strengthen nursing practice in prenatal care. To develop and validate specialized terminology for pregnant women with syphilis, based on Roy's Adaptation Model. This is a methodological study conducted in four stages: identification of terms via scoping review; lexical analysis and cross-mapping; terminology construction and theoretical classification; and content validation by experts. The project was approved by the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN), under Opinion No. 7.518.523, as recommended by Resolution No. 466/2012. The study resulted in the extraction of 6,658 occurrences of high-frequency terms, with the highest concentration in the CIPE® axes: Focus (n = 148), Action (n = 79), and Means (n = 65). Semantic equivalence analysis revealed that 55.89% of the terms were non-constant in the taxonomy, indicating the specificity of the language for the studied population. The subsequent content validation stage demonstrated high agreement among the experts: out of 641 terms evaluated, 433 were validated with a CVI ≥ 0.80 (67.55% of the total). The overall CVI mean was 0.946 and the global Intraclass Correlation Coefficient (ICC) was 0.91, confirming the rigor of the subset. As limitations, the theoretical nature of content validation is noted, requiring future clinical validation to consolidate the practical applicability of the subset. The results indicate that clinical practice requires terminology complementary to the official one. This study offers contributions to education by providing theoretical foundations for evidence-based professional training; to management, by enabling the creation of quality indicators in prenatal care; and to research, by fostering the development of clinical decision support systems. It is concluded that the subset facilitates the nurse's clinical and critical reasoning by allowing the formulation of more precise and holistic nursing diagnoses and interventions, as recommended by Roy's Adaptation Theory, positively impacting maternal and child outcomes.
Evolução e projeção salarial da força de trabalho da enfermagem no Brasil: tendências, desigualdades e implicações para a valorização do trabalho
(Universidade Federal do Rio Grande do Norte, 2025-11-27) Pereira, Wanesca Caroline; Oliveira, Jonas Sâmi Albuquerque de; Diniz, Kessya Dantas; http://lattes.cnpq.br/6905727224383587; https://orcid.org/0000-0003-0303-409X; http://lattes.cnpq.br/4740097927047538; https://orcid.org/0000-0003-2129-4004; http://lattes.cnpq.br/1061707488862509; David, Helena Maria Scherlowski Leal; https://orcid.org/0000-0001-8002-6830; http://lattes.cnpq.br/9481043825318572; Carmo, Hercules de Oliveira; https://orcid.org/0000-0002-6996-4233; http://lattes.cnpq.br/1215968745520641; Fernandes, Sandra Michelle Bessa de Andrade; http://lattes.cnpq.br/0883238003524970
Salary remuneration encompasses multiple dimensions of an individual’s life, influencing well-being, professional recognition, and financial security. However, persistent wage disparities are observed among workers, especially within the field of nursing, which may contribute to professional migration, illness, and demotivation regarding the profession. In this context, conducting research on this subject becomes essential to promote wage equity, better working conditions, and the development of public policies aimed at enhancing the value of nursing professionals. The objective of this study was to analyze the evolution and salary trends of the nursing workforce in Brazil (2003–2023), including future projections and the impact of the national minimum wage for the profession. This was an analytical-descriptive study with a quantitative approach and an ecological time-trend design, conducted across the five regions of the country. Data were obtained from the Annual Report on Social Information (RAIS), a public-access database, encompassing nurses, nursing technicians, and nursing assistants. The dependent variable was the average remuneration, and the independent variable was the study period. Data extraction, processing, and analysis were performed using R® software and complemented in Microsoft Excel®, employing descriptive statistics, moving average technique, first-order differencing, and the Mann-Kendall-Sen test to identify temporal trends. The study followed the ethical principles of Resolution No. 466/2012 of the National Health Council and was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte (Opinion No. 6.289.051 / CAAE 26519519.5.0000.5537). Between 2003 and 2023, the salary ranges assigned to nursing professionals showed relative stability, with little variation in the number of workers per range over the years, highlighting the persistence of a historical remuneration pattern. The time-trend analysis demonstrated real growth in earnings, although uneven across regions and professional categories, reflecting persistent structural disparities. The establishment of the national nursing wage floor in 2022 impacted the composition of salary ranges, especially among nursing technicians and assistants, leading to a moderate increase in minimum wage levels. However, the wage floor does not account for regional differences in cost of living and economic structure, which limits its effectiveness in promoting homogeneous valorization across the category. The projection based on the historical series revealed an upward trend in salary ranges close to the established wage floor and a downward trend in higher salary ranges for both professional groups. Overall, the evolution and salary trends of the nursing workforce in Brazil between 2003 and 2023 indicate gradual progress and positive effects following the implementation of the national wage floor, but also reveal the persistence of inequalities and the need for broader policies to ensure fair valuation and equity within the profession.
Efeitos do contato pele a pele imediato entre mãe e recém-nascido: uma revisão sistemática
(Universidade Federal do Rio Grande do Norte, 2025-02-07) Bezerra, Cinthia Daniele da Silva; Souza, Nilba Lima de; http://lattes.cnpq.br/9885047732117091; Sousa, Carolina Pereira da Cunha; Pinto, Erika Simone Galvão; Medeiros, Kleyton Santos de
Introduction: Skin-to-skin contact in the first hour of life is essential for the baby's adaptation to the transition from intrauterine to extrauterine life. However, it is observed that there is controversy about adherence, correct execution and benefits of this contact for mothers and newborns. Given these conflicts, this systematic review aims to evaluate the effects of immediate skin-to-skin contact between mother and newborn in the first hour of life and is based on the following review question: What are the effects of immediate skin-to-skin contact between mother and newborns in the first hour of life? Method: This is a systematic review, whose inclusion criteria were randomized or quasirandomized clinical trials on the topic. The search, collection and analysis of data were carried out by two reviewers and a third reviewer mediated the disagreements. The search was carried out in the following information sources: PubMed/Medline, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CI-NAHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus, Scientific Electronic Library (SciELO), Embase and The Cochrane Library. For the purposes of this study, the searches carried out in PubMed/Medline, Embase and the Virtual Health Library will be presented. A data extraction form was developed to extract the data from the selected studies, which were synthesized in a table and presented descriptively. Results: A total of 2,359 studies were identified. After removing duplicates, the selection process was based on the title and abstract of 1,995 studies. Then, a full-text screening was performed on 26 studies. Seventeen of them were not included because they were not available in full. Finally, nine studies met the eligibility criteria. More than 65% (n=6) of the studies evaluated skin-to-skin contact in infants born vaginally. Breastfeeding was the outcome in 100% of the articles and neonatal thermoregulation in two studies. The articles evaluated early initiation of breastfeeding and exclusive breastfeeding among other variables influenced by skin-to-skin contact. Final Considerations: The effects of skin-to-skin contact on breastfeeding were identified: early initiation of breastfeeding, longer duration of the first feeding, better breastfeeding and sucking capacity, higher rates of exclusive breastfeeding, better self-efficacy and greater success in breastfeeding. Regarding neonatal thermoregulation, there were no risks of hypothermia for the newborn in the CPP. Protocol registration: PROSPERO - CRD42024561462.
Diagnóstico de enfermagem letramento em saúde inadequado: revisão sistemática de etiologia e risco e de acurácia diagnóstica
(Universidade Federal do Rio Grande do Norte, 2025-02-24) Lima, João Pedro Machado de; Vitor, Allyne Fortes; https://orcid.org/0000-0002-8582-4281; http://lattes.cnpq.br/1002205973338852; Silva, Fernando de Souza; Fernandes, Maria Isabel da Conceição Dias
This study aimed to review the nursing diagnosis Inadequate Health Literacy in people with chronic conditions. To this end, two systematic reviews were prepared. The first is a systematic review of etiology and risk, with data collection taking place in October 2024, while the second is a systematic review of diagnostic accuracy, with data collection carried out in November 2024. Both followed the criteria proposed by the Joanna Briggs Institute and adopted the mnemonic strategy PEO - Patient, Exposure, and Outcome to formulate the research questions. The first review sought to answer the question: “What are the etiological factors related to the nursing diagnosis Inadequate Health Literacy in people with chronic conditions?”, while the second investigation: “What are the clinical indicators identified based on expert opinion, evaluation panels, or analysis of latent variables that characterize the nursing diagnosis Inadequate Health Literacy in people with chronic conditions?”. The etiology and risk review protocol was registered and approved on the International Prospective Register of Ongoing Systematic Reviews platform, under number CRD42024609074, and the diagnostic accuracy review protocol was approved under number CRD42024619306. The etiology and risk review included 15 studies, most of which were published between 2015 and 2022, with a crosssectional design and predominantly involving patients with diabetes mellitus and cardiovascular diseases. The results indicated that the nursing diagnosis Inadequate Health Literacy is related to predisposing, disabling, precipitating and reinforcing factors that affect the ability of individuals to access, understand and apply health information. Etiological factors of an educational, social, technological, psychological, systemic and population nature were identified, with emphasis on low education, difficulty in understanding medical or nursing guidelines and lack of access to accessible and daily health information. The review of diagnostic accuracy included eight studies, published between 1988 and 2024, with a crosssectional design and a predominance of participants with an unspecified type of chronic noncommunicable disease and multiple diseases. Eighteen defining characteristics of the diagnosis Inadequate Health Literacy were identified, the most prevalent being: difficulty in interpreting medication labels and medical instructions; inability to understand information about disease prevention and management; frequent need for third-party mediation; low knowledge about signs and symptoms of common health conditions; anxiety or frustration with complex information; lack of adherence to self-care recommendations; difficulty accessing health systems; limited understanding of educational materials; failure to monitor health signs; low use of technological tools; reduced frequency of consultations and check-ups; and reports of poor communication with health professionals. This study presents an important contribution to the health and nursing fields, since, through two systematic reviews, it presents relevant scientific reviews on the nursing diagnosis Inadequate Health Literacy. The review allowed not only to confirm factors already present in the current taxonomy, but also to map new components that broaden the understanding of the diagnosis. This combination reinforces the validity of existing elements and highlights the evolution of the concept, contributing to the updating and strengthening of evidence-based clinical practice.
Adesão ao tratamento farmacológico no pós-transplante de células-tronco hematopoéticas
(Universidade Federal do Rio Grande do Norte, 2025-01-23) Souza, Larissa Beatriz Francisca de; Azevedo, Isabelle Campos de; http://lattes.cnpq.br/0677259394113490; http://lattes.cnpq.br/6978054952540828; Vitor, Allyne Fortes; Ferreira Júnior, Marcos Antonio; Santos, Viviane Euzebia Pereira
Introduction: Post-hematopoietic stem cell transplantation is a period in which adherence to pharmacological treatment is crucial to prevent complications such as graft-versus-host disease and graft failure. Therefore, the following research questions were formulated: What is the degree of adherence to pharmacological treatment in post-HSCT? What are the determining factors of adherence to pharmacological treatment in post-HSCT patients? What are the strategies to support adherence to pharmacological treatment used by post-HSCT patients? Objective: To investigate adherence to pharmacological treatment in post-hematopoietic stem cell transplant patients. Method: This is a cross-sectional study carried out between January and October 2024 in a reference hospital for hematopoietic stem cell transplantation in the state of Rio Grande do Norte. The population consisted of patients undergoing oral pharmacotherapy after stem cell grafting, treated at the Day Hospital. A questionnaire covering sociodemographic and clinical data, the Treatment Adherence Measurement Instrument, and questions about facilitating factors, challenges, interventions, and technologies to support adherence were used. Pearson's chi-square test and Student's t-test were used. Variables with p≤0.20 in the univariate analysis were included in the multiple logistic regression model. The magnitude of the association was calculated by the Prevalence Ratio. The significance level was 5% and the Confidence Interval was 95%. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion 6,599,477 and CAAE: 76470723.9.0000.5537. Results: The sample consisted of 99 participants, with a predominance of females (56.6%) and a mean age of 44.7 years. The most common diagnosis was acute myeloid leukemia (35.4%). Autologous transplantation was the most frequent type (52.5%) and systemic arterial hypertension was the most prevalent comorbidity (13.1%). 72.7% of the participants showed high adherence, with 45.5% achieving maximum adherence. The pharmacotherapeutic complexity index ranged from 6.5 to 47.0. The main factors facilitating adherence were health education (71.7%) and family support (69.7%), while the most cited challenges were psychological issues (53.5%). Support strategies such as alarms (45.4%) and medication organizer containers (43.4%) were widely used. The strategies most cited as useful to support adherence were medication guides and mobile applications. Logistic regression revealed that adherence to treatment was associated with the absence of systemic arterial hypertension, use of support strategies and fewer days post-transplant. Conclusion: Adherence to pharmacological treatment was high in most of the sample and was shown to be favored by the absence of arterial hypertension, use of support strategies and shorter posttransplant time, in addition to being influenced by the type of transplant and degree of complexity of pharmacotherapy.
Tradução e adaptação transcultural de guia para paciente formador em estomia intestinal
(Universidade Federal do Rio Grande do Norte, 2025-02-25) Rodrigues, Maria Izabel Rezende; Costa, Isabelle Katherinne Fernandes; https://orcid.org/0000-0001-9834-6226; http://lattes.cnpq.br/9007718874205907; Araújo, Rhayssa de Oliveira e; Cerdà, Joan Carles March
Since 2006, Spain has implemented programs to train expert patients and trainers through workshops that provide specific educational resources, such as the guide “Living with a Stoma: Training for Trainers”, which provides group dynamics techniques, communication skills and care plans adapted to the condition of the person with a stoma, focusing on autonomy, self-management and self-efficacy. Despite a global paradigm shift regarding care centered on the autonomy of people with chronic conditions, especially people with a stoma, Brazil still does not have patient training schools and scientific and technological productions on this topic are scarce. Thus, it is possible to introduce this paradigm shift with models and technologies that have already been tested and considered stable in other contexts. Thus, the study aimed to translate and cross-culturally adapt a guide aimed at training trainers in intestinal stoma. This is, therefore, a methodological study for the translation, adaptation and validation of the content of the aforementioned guide, developed by the Andalusia Expert Patient School program in Spain. The translation and cultural adaptation for the Brazilian context followed Beaton's (2007) methodological framework, adapted for educational technology, and occurred in five operational phases: Authorization from the authors of the work; Initial translations; Synthesis of translations; Back-translation; and Composition of a committee of experts. The back-translation demonstrated the semantic, idiomatic, and cultural adequacy of the initial translations and the synthesis. The last stage verified the content validation with experts in the area of stomatherapy and technological development, which occurred in two Delphi rounds. In both rounds, the Content Validity Index (CVI) was higher than 0.75 in the three evaluation aspects of the Health Educational Content Validation Instrument (CVI): objective, structure, and relevance. This result indicated quality regarding the content after corrections and adaptations suggested by the experts in the first round. This resulted in a material whose content was considered validated and adapted for the Brazilian context. It is concluded that the process of translating and adapting this material can strengthen the development and adherence of care strategies centered on the active participation of patients with intestinal ostomies in Brazil, as well as stimulate the development of future educational technologies, programs and public policies based on self-management and self-efficacy.
Construção e validação de protocolo de navegação para assistência ao trabalhador de saúde com doença crônica não transmissível
(Universidade Federal do Rio Grande do Norte, 2025-02-28) Guedes, Maria Luiza de Araújo; Martins, Quênia Camille Soares; http://lattes.cnpq.br/5126798976942401; Valenca, Cecília Nogueira; Pai, Daiane Dal; Dantas, Dandara Nayara Azevedo
The incidence of chronic non-communicable diseases among healthcare workers has increased significantly in recent decades. Their illness has an impact on both their professional and personal lives. In this perspective, this study aims to develop a navigation protocol for assisting healthcare workers with chronic non-communicable diseases. This is a methodological study conducted using Pasquali's psychometric framework, organized into three procedures: theoretical procedures in which a Scoping Review was carried out to support the definition of the contents that were part of the protocol; empirical procedures for constructing the protocol using scientific evidence and validating the content and appearance via Google forms and Delphi stages with judges who are experts in the area of occupational health and chronic diseases; and analytical procedures with analysis of the data from the previous phase using the content validation coefficient, when items with a minimum agreement of 80% among the judges were considered valid. This study was approved by the Research Ethics Committee (CAAE: 83295624.2.0000.5537). The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under Ethical Appreciation Certificate No. 7,168,956. After the protocol was developed, supported by the results of the Scoping Review, it was submitted to the assessment of 10 judges who responded to all Delphi I rounds, and a general content and appearance validity coefficient of 0.96 was achieved, and they made suggestions for improvements and enhancements. Therefore, the protocol was considered valid in its content and appearance, and can contribute to guiding health workers diagnosed with chronic disease, helping them to ‘navigate’ the health system.
Jogo sério sobre lesão por pressão para estudantes de enfermagem: um estudo metodológico
(Universidade Federal do Rio Grande do Norte, 2025-02-27) Fernandes, Mariana Freire; Araújo, Rhayssa de Oliveira e; https://orcid.org/0000-0002-5068-2906; http://lattes.cnpq.br/4859174752145121; https://orcid.org/0000-0002-9220-5091; http://lattes.cnpq.br/4078383537844019; Costa, Isabelle Katherinne Fernandes; https://orcid.org/0000-0002-1476-8702; http://lattes.cnpq.br/5903265312273525; Medeiros, Lays Pinheiro de; https://orcid.org/0000-0002-1753-5330; http://lattes.cnpq.br/0040523308979789
Conteúdos sobre HIV/Aids compartilhados por meio de redes e mídias sociais na literatura científica: revisão de escopo
(Universidade Federal do Rio Grande do Norte, 2025-02-27) Brito, Vanessa Carla do Nascimento Gomes; Feijão, Alexsandra Rodrigues; https://orcid.org/0000-0002-8686-9502; http://lattes.cnpq.br/8649283681727209; https://orcid.org/0000-0003-0569-9888; http://lattes.cnpq.br/2929608319762338; Araújo, Gabriela de Sousa Martins Melo de; Silva, Bárbara Coeli Oliveira da
Social media and social networkds an important role in the dissemination of information about HIV/AIDS. The objective of the study was to map the content on HIV/AIDS shared through social networks and media in scientific materials. This is a scoping review developed in accordance with the recommendations of the Joanna Briggs Institute (JBI) and SCR Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and produced in five stages: 1) identification of the research question; 2) identification of relevant studies; 3) selection of studies; 4) data extraction, separation, summarization and reporting of results; and 5) communication of results. The mnemonic Participant, Concept and Context was applied to construct the research question, in which Participant corresponds to HIV, Concept to dissemination of information and Context to “social networks” and “social media”. The guiding question was defined as: “What are the main types of content on HIV/AIDS shared through social networks and media in the scientific literature?”. The searches were conducted in the following data sources/libraries/databases/academic search engines: Scopus, U.S. National Library of Medicine, Web of Science, Scientific Electronic Library Online, Virtual Health Library (BVS), Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel (CAPES), Cinahl, Digital Library of Theses and Dissertations of the University of São Paulo (USP), Open Access Scientific Repositories of Portugal (RCAAP), DARTEurope, Trove of the National Library of Australia and Theses Canada. Original and review articles, theses and dissertations, available in full, without time limit, in any language were included. For analysis, a synthesis matrix was created that included the extracted information. A total of 3,485 publications were identified, of which 156 were read in full, 117 were excluded and 39 studies comprised the final sample. Among the media and social networks most mentioned in the studies, Twitter (currently X) and Facebook stood out as the most cited platforms with 33.33%. As for content about HIV on networks and social media, it was possible to identify a variety of topics. Pre-Exposure Prophylaxis (PrEP) was the most cited content among the studies, followed by HIV testing, diagnosis, social support, treatment, HIV risk factors, condom use and PEP. The importance of networks and social media in disseminating information about HIV/AIDS is undeniable, however, there are challenges, such as misinformation and stigmatization, which reinforces the need to share evidence-based content. In addition, ongoing training of health professionals is essential to guide the public in the search for reliable sources.
Influência do contexto no seguimento da sífilis gestacional a luz da teoria dos sistemas de Betty Neuman: uma revisão de escopo
(Universidade Federal do Rio Grande do Norte, 2024-12-20) Araújo, Vitória Keller Gregório de; Pinto, Erika Simone Galvão; https://orcid.org/0000-0003-0205-6633; http://lattes.cnpq.br/2135320432342059; https://orcid.org/0000-0002-9779-6521; http://lattes.cnpq.br/7868234550719197; Monteiro, Bruna Rodrigues; Souza, Nilba Lima de; Silva, Sandy Yasmine Bezerra e
Introduction: In Brazil, syphilis is a relevant public health problem, with increasing numbers over the years. During pregnancy, quality prenatal care is essential, and it is the responsibility of Primary Health Care to welcome and treat pregnant women affected by the disease. However, challenges in treatment reinforce the need for health assessments to identify improvements in services and ensure efficacy, efficiency, and effectiveness. Nursing theories support professional practice and assist nurses in decision-making. Objectives: To evaluate the influence of context on the work of PHC professionals in the follow-up of gestational syphilis in light of Betty Neuman's systems theory. Methodology: Scoping review prepared according to the PRISMA-ScR guidelines and the Joanna Briggs Institute (JBI) Evidence Synthesis Manual. The initial search, carried out from September to November 2024, did not limit time or language and used national and international databases: PubMed, Cinahl, Scopus, Web of Science, LILACS, CAPES thesis platform, ERIC, Trove, DART-Europe, EThOS and RCAAP. Two reviewers independently mapped the data with an instrument tested in Microsoft Excel. Results: Thirty-nine articles were included. According to systems theory, 17.95% addressed primary prevention and nursing interventions. Regarding languages, 48.72% were published in English, and 30.77% presented level 3 of scientific evidence. Conclusion: Follow-up of gestational syphilis in PHC is broad, with emphasis on educational actions, social and family stigma, and the need for long-term follow-up.
Desenvolvimento de um plano de curso de capacitação de apoio à educação permanente sobre cuidados de enfermagem na prevenção e manejo do extravasamento de quimioterápicos
(Universidade Federal do Rio Grande do Norte, 2024-12-20) Neves Júnior, Tarcísio Tércio das; Menezes, Rejane Maria Paiva de; https://orcid.org/0000-0001-9026-0567; http://lattes.cnpq.br/6015903110008239; Silva, Carlos Jordão de Assis; https://orcid.org/0000-0002-9575-9030; http://lattes.cnpq.br/6554418704863469; Salvador, Petala Tuani Cândido de Oliveira; Araújo, Rhayssa de Oliveira e
Cancer is a chronic disease, evidenced as a strong indicator of global morbidity and mortality. In Brazil, it represents the second leading cause of death, constituting a public health problem. Among the possible treatments, chemotherapy stands out because it increases patient survival, but due to its high toxicity, it can cause the extravasation of antineoplastic agents, constituting an adverse event. Because of this, the administration of chemotherapy requires care that guarantees quality, safe and comfortable health care, avoiding pain or other undesirable reactions. This study aims to develop a training course plan to support continuing education on nursing care in the prevention of chemotherapy extravasation in cancer patients. Methodological study, carried out in three stages proposed by Filatro: in the first, mapping of nursing care for the prevention and management of chemotherapy extravasation in cancer patients, through a scoping review; In this stage, a field study was also carried out on the learning style of nursing professionals in two oncology hospitals in the city of Natal, capital of Rio Grande do Norte; in the second stage, the course plan was structured into four modules with the description of the contents, learning objectives, teaching resources and methodology, based on David Kolb's learning framework, in addition to Betty Neuman's theoretical nursing framework; in the third stage, the validation of the course content was implemented, with five expert judges through the application of the average of the Content Validation Index together with the Kappa Coefficient and the Delphi technique to reach consensus among them. The research was approved by the Research Ethics Committee of the Potiguar University and the Research Ethics Committee of the League Against Cancer, complying with the ethical precepts of Resolution No. 466/12, of the National Health Council. The results of the scoping review mapped nursing care for prevention and management of extravasation, categorized according to the levels of prevention of Betty Neuman's Systems Theory. The findings of the field research identified that, regarding the professionals interviewed, the majority were female (85.71%), up to 35 years of age (53.38%), married (47.73%), mixed race (60.15%) and Catholic (59.40%); regarding the level of education and time of experience, the majority (73.68%) had technical or high school education, with time of experience of up to 05 years in the service (62.99%); regarding knowledge about oncology, the majority (84.96%) reported having partial knowledge about chemotherapy, and only (2.26%) stated that they had sufficient knowledge; Knowledge about the routes of administration of chemotherapy drugs is also below expectations (32.33%), even though 61.65% of them know about the severe damage caused by vesicant chemotherapy drugs in the case of extravasation; while 44.36% knew how to differentiate vesicants from irritants, another 64.66% distinguished extravasation from infiltration; regarding nursing care, the majority (84.96%) identified preventive measures for extravasation and (79.70%) stated they knew how to implement them; however, only some of them (39.10%) know the existing protocols; however, the vast majority (93.98%) evaluate the venous network before infusing chemotherapy drugs. Other results showed significant differences between the functions of professionals and knowledge about vesicant and irritant chemotherapy drugs, as well as between extravasation and infiltration. Nurses demonstrated greater general knowledge, except in relation to extravasation protocols, in which technicians stood out. Regarding the results of the validation stage of the course by the judges, overall indices of 0.97 were achieved for clarity, 0.99 for relevance, and 1.00 for pertinence, consistency, and objectivity, reflecting high reliability of the instrument through a single Delphi round. It is concluded that the course plan was validated with high reliability, evidenced by the adequacy and precision of the proposed criteria. It is expected that the proposed course plan will contribute to the training of nurses and nursing technicians, with an emphasis on the prevention and management of extravasation of antineoplastic agents, which may result in safer, more effective comprehensive care and consequent reduction of harm and adverse effects for patients undergoing cancer treatment.
Validação clínica do diagnóstico de enfermagem risco de função cardiovascular prejudicada: estudo de caso-controle
(Universidade Federal do Rio Grande do Norte, 2025-01-24) Cruz, Maria de Lourdes Alves da; Fernandes, Maria Isabel da Conceição Dias; https://orcid.org/0000-0003-0569-5027; http://lattes.cnpq.br/1485293688968753; https://orcid.org/0000-0003-1794-8810; http://lattes.cnpq.br/3094894279037764; Lira, Ana Luisa Brandão de Carvalho; https://orcid.org/0000-0002-7255-960X; http://lattes.cnpq.br/4545130167501174; Dantas, Dândara Nayara Azêvedo; https://orcid.org/0000-0002-4759-9458; http://lattes.cnpq.br/5337191302271178
The cardiovascular system plays a vital role in the functioning of the body. Its functions are interconnected and work together to ensure body homeostasis. However, this system can be compromised by cardiovascular conditions. Therefore, the present study aims to clinically validate the nursing diagnosis Risk for impaired cardiovascular function in primary health care users. This is a case-control study, carried out with 88 primary health care users in the city of Natal. Data collection was carried out between May and June 2024, using an instrument containing sociodemographic and clinical information, as well as risk factors, populations at risk and associated conditions of the NANDA International diagnosis Risk for Impaired Cardiovascular Function. For comparison between groups, the chi-square test, Fisher's exact test and the adjusted multiple logistic regression model were used, with effect measures expressed in Odds Ratio (OR). This study was approved by the responsible Research Ethics Committee. Most participants were female (67%), with a partner (56.8%), self-declared brown (65.9%), with low income (80.6%) and unemployed (50%). Regarding the level of education, 45.4% had a low level of education. The majority also identified themselves as practicing some religion (57.9%). Regarding clinical data, the majority had a high body mass index (69.3%), blood pressure (82.9%) and adequate blood glucose levels (92%). The risk factors that showed a statistical association with impaired cardiovascular function are: body mass index above normal parameters for age and sex (p = 0.001; OR = 5.78), elderly (p < 0.001; OR = 6.5), postmenopausal women (p < 0.001; OR = 7.28), diabetes (p < 0.001), dyslipidemia (p < 0.001), hypertension (p < 0.001) and insulin resistance (p < 0.001; OR = 7.8). When evaluated together, the risk factors that may increase the chances of developing impaired cardiovascular function are: elderly (p = 0.008; OR = 5.15), body mass index above normal parameters for age and sex (p = 0.020; OR = 4.11) and insulin resistance (p = 0.003; OR = 6.08). It is concluded that the diagnosis of risk of impaired cardiovascular function is verifiable in primary care users with seven risk factors of greater diagnostic prediction, including high body mass index, elderly, postmenopausal women, insulin resistance, diabetes, dyslipidemia and hypertension. These findings reinforce the need to continuously assess these risks in users treated in primary care to prevent future cardiovascular complications.
Desenvolvimento do Game Design Document de um Serious game para apoiar a educação em saúde de pacientes no transplante de células-tronco hematopoéticas
(Universidade Federal do Rio Grande do Norte, 2025-01-22) Sátiro, Luana Silva Pereira; Azevedo, Isabelle Campos de; https://orcid.org/0000-0001-5322-7987; http://lattes.cnpq.br/0677259394113490; https://orcid.org/0000-0001-7128-7393; http://lattes.cnpq.br/9453960033656777; Ferreira Júnior, Marcos Antonio; https://orcid.org/0000-0002-9123-232X; http://lattes.cnpq.br/0912795990605736; Salvador, Pétala Tuani Cândido de Oliveira; https://orcid.org/0000-0002-3208-6270; http://lattes.cnpq.br/5628089389342234; Santos, Viviane Euzébia Pereira; https://orcid.org/0000-0001-8140-8320; http://lattes.cnpq.br/5808110442588994
Serious games are educational technologies with broad applicability in the health field. The relevance of this game is even more evident when considering hematopoietic stem cell transplantation, a therapy with high potential for morbidity and mortality due to its potential complications. An essential preliminary step for Serious games is the development of the Game Design Document, a descriptive material composed of content and dialogues. Thus, the research question was defined: How should the Game Design Document of a Serious game be structured to support health education for patients undergoing hematopoietic stem cell transplantation? In view of this, the objective was to develop the Game Design Document of a Serious game to support health education for patients undergoing hematopoietic stem cell transplantation. This is a methodological study with a quantitative approach, based on the psychometric framework of Pasquali et al (2010), which encompasses a set of three procedures: theoretical, empirical and analytical. For the theoretical procedures, a scoping review was carried out to map the contents for self-care of transplant patients; which took place between March and July 2024; and the Game Design Document was constructed with the selected contents between July and September 2024. The empirical procedures involved two phases for the evaluation of the psychometric properties, carried out between September and November 2024. In the first phase, the selection of expert judges was carried out, who were recruited through searches on the Lattes platform and who met the adapted Fehring criteria. In the second phase, the content of the Game Design Document was validated using the Delphi technique. This validation was carried out through a questionnaire via Google forms, in which the judges evaluated the criteria proposed by Pasquali et al. Finally, the analytical procedures were carried out by calculating the content validation coefficient and the level of agreement between the judges, carried out between November and December 2024. This study was previously approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte and received a favorable opinion on May 8, 2024, under CAAE: 77538424.5.0000.5537. The ethical precepts of the research were followed and the anonymity of the participants was preserved. As the main results, guidelines were mapped that addressed the necessary care for the patient both in the hospital environment and at home. Thus, the initial and secondary interface and four scripts were constructed, namely: glossary, pre-, intra- and post-transplant period. After constructing the scripts that composed the Game Design Document, the material was submitted to the Delphi I and II stages for content validation. Thus, after Delphi II, the initial and secondary interfaces and scripts presented a content validation coefficient above 0.8 and an agreement level equal to or greater than 80%. Therefore, the Game Design Document was validated to compose a Serious game to support health education for patients undergoing hematopoietic stem cell transplantation. The study presents as a contribution the validated Game Design Document that will compose a Serious game to support health education for patients, in order to promote learning in an interactive and meaningful way, given the complexity to which these patients are exposed. It is emphasized that it is necessary to continue research to develop the Serious game, validate appearance, usability and effectiveness in order to prove the efficacy of the technology.
Diagnóstico de enfermagem risco de doença ocupacional em profissionais de enfermagem: revisão sistemática e análise de conceito
(Universidade Federal do Rio Grande do Norte, 2025-01-24) Silva, Cyntia Leenara Bezerra da; Vitor, Allyne Fortes; https://orcid.org/0000-0002-4672-2303; http://lattes.cnpq.br/1927801553508976; https://orcid.org/0000-0001-5254-1536; http://lattes.cnpq.br/4621749375756321; Ayllón, Francisca Sánchez; https://orcid.org/0000-0003-2097-4147; http://lattes.cnpq.br/0595087656684320; Fernandes, Maria Isabel da Conceição Dias; https://orcid.org/0000-0003-0569-5027
Objective: To review the Nursing Diagnosis Risk for Occupational Illness in Nursing Professionals. Method: This is a methodological study, operationalized according to the model proposed by Lopes, Silva and Araújo (2022). To achieve the objective proposed in this study, the first stage for diagnostic validation was carried out, a concept analysis operationalized by a systematic review. The analysis was developed according to the approach proposed by Walker and Avant (2019) and addressed eight stages, namely: 1. Concept selection; 2. Determination of the objectives of the conceptual analysis; 3. Identification of the possible uses of the concept; 4. Determination of the essential critical attributes; 5. Construction of a model case; 6. Construction of additional cases; 7. Identification of antecedents and consequences of the concept; 8. Definition of empirical references. To cover stages 3, 4, 7 and 8 of the concept analysis, a systematic review of etiology and risk was carried out, in addition to elucidating the concept and defining the following elements: Attributes, associated conditions, risk factors and population at risk. Results: Twenty articles were selected and three attributes, 36 antecedents, one associated condition and 11 situations at risk were identified. Among the 36 risk factors highlighted in this study, 21 are not included in NANDA-I, namely: physical and/or emotional exhaustion; difficulty in relationships with management; ineffective sleep patterns; ethical crisis between values and professional issues; unhealthy lifestyle habits; poor quality of professional life; low emotional intelligence; competitiveness; exposure to noise; ambient temperature; scarcity of material and/or human resources; rigid time control; offensive behaviors; lack of investment in training; authoritarian supervision; demand for high productivity; long working hours; poor environmental hygiene; social disrepute; insecurity and versatility of activities. The only condition associated with chronic disease, with no other similar or divergent condition in the taxonomy. Finally, with regard to the population at risk, four are not mentioned in the classification: night workers; female gender; individuals who perform domestic work; and age over 60 years. Based on these findings, conceptual and operational definitions were made for each etiological factor. Conclusion: It is concluded that this study enabled the first stage of diagnostic validation, enabling the review of the Nursing Diagnosis Risk for Occupational Disease and granting it the level of evidence 2.1.1 based on the concept analysis. The review of this diagnosis improves the taxonomy by updating information that enables its accuracy and corroborates evidence-based nursing and the improvement of the quality of health care.
Efeito do módulo on-line sobre liderança na aquisição do conhecimento de discentes de enfermagem: estudo piloto de ensaio clínico randomizado
(Universidade Federal do Rio Grande do Norte, 2024-11-18) Fonseca, Jucielly Ferreira da; Dantas, Daniele Vieira; https://orcid.org/0000-0003-0307-2424; http://lattes.cnpq.br/0404704679319143; https://orcid.org/0000-0001-8904-8809; http://lattes.cnpq.br/6947516413159623; Duarte, Fernando Hiago da Silva; Araújo, Gabriela de Sousa Martins Melo de; Silva, José Adailton da
This study evaluated the effect of an online educational module on leadership on knowledge acquisition by nursing students. The research was conducted in two phases: methodological and experimental. In the methodological phase, experts validated the content and appearance of the module; and the content of the problem situation was also validated. In the experimental phase, a randomized clinical trial was conducted with 14 sixth-semester nursing students at the Federal University of Rio Grande do Norte, divided into an experimental group (seven students), who accessed the online module, and a control group (seven students), who participated in face-to-face lectures at the Nursing Department itself. The educational module, previously developed and authorized for use through a Term of Assignment of Rights, included four multimodal classes addressing topics such as professional competencies, emerging skills according to the World Economic Forum, positive psychology, communication, and conflict management. The control group participated in a conventional lecture class in a face-to-face environment. The sample was predominantly composed of young women, aged between 20 and 25 years, enrolled in the sixth period of the Nursing course, in the first semester of 2024. Data collection included a problem situation and an adapted questionnaire to assess self-perception of the exercise of leadership in Nursing. The research was approved by the Ethics Committee (CAAE 75851023.0.0000.5537, Opinion 6,599,419) and registered in the Brazilian Registry of Clinical Trials (REBEC) under number RBR-2dfqmr2. The results showed significant advances in leadership skills, especially in the experimental group. This group showed a significant increase in the appreciation of interpersonal skills, from 57.14% in the pre-test to 85.71% in the post-test. In the mediation of ethical conflicts, 85.71% of the control group and 100% of the experimental group in the post-test opted for open debate, demonstrating a participatory approach. There was also an increase in self-identification as a leader in the experimental group, from 42.86% to 57.14%, evidencing the positive impact of the training on self-perception of leadership. The definition of leadership as a process of influence was widely recognized, with 100% of the students in the experimental group in the post-test understanding leadership as the exercise of influence to achieve goals. It is concluded that the online educational module on leadership related to the acquisition of knowledge by nursing students had a positive effect on the development of leadership skills of nursing students. The study reinforces the importance of interpersonal skills, self-perception of leadership and collaborative practices for the safety and professional performance of future nurses.
Eficácia de um método ativo de ensino para a aprendizagem da escrita da prescrição enfermagem no contexto da Atenção Primária à Saúde: estudo piloto
(Universidade Federal do Rio Grande do Norte, 2025-01-24) Silva, Fillipi André dos Santos; Medeiros, Soraya Maria de; https://orcid.org/0000-0003-2833-9762; http://lattes.cnpq.br/2068281775213576; https://orcid.org/0000-0002-0935-5014; http://lattes.cnpq.br/7986188553475510; Oliveira, Jonas Sâmi Albuquerque de; https://orcid.org/0000-0003-0303-409X; http://lattes.cnpq.br/4740097927047538; Araújo, Marília Souto de; https://orcid.org/0000-0002-6975-8683; http://lattes.cnpq.br/9165569425489092; Costa, Raphael Raniere de Oliveira; https://orcid.org/0000-0002-4199-9696; http://lattes.cnpq.br/4311190570015694
INTRODUCTION: In nursing consultations, in light of the Nursing Professional Practice Law and the Ministry of Health's references and protocols, prescribing medications is a possible reality in certain situations conditioned by the protocols of programs linked to health policies. Although there is legal support for prescribing medications for nurses, this advanced practice is still little explored in Primary Health Care. OBJECTIVE: To evaluate the effectiveness of an active teaching method for learning how to write nursing prescriptions in the context of Primary Health Care. METHOD: This is a quasi-experimental single-group study conducted with undergraduate nursing students at the Federal University of Rio Grande do Norte. The intervention was carried out following the instructions of the “Teaching Good Practices for Writing Medication Prescriptions” method, in which students produced medication prescriptions and their quality was assessed using the QualiPresc instrument before and after the intervention (pre-test, immediate post-test, 15 and 45 days later). Regarding the measurement of motivation, the Situational Motivation Scale was used before and after the intervention (pre-test and immediate post-test). The data were processed using the JAMOVI statistical software. In addition to descriptive statistics, the Friedman and Cochran's Q tests were applied to assess the quality of the prescriptions. The paired and Wilcoxon tests and Pearson's correlation were used to assess the situational application of the participants. Spearman's correlation was used to assess the interactions between the dimensions of the Situational Motivation Scale. This study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under substantiated opinion no. 7,080,533 on September 16, 2024, CAAE: 81497124.4.0000.5537. RESULTS: An intervention produced significant improvements in the quality of medication prescriptions issued, with significant effects immediately after training and sustained over time. Despite a reduction in the level of the indicator between the immediate post-test and 15 and 45 days, the results obtained after the 15th day undermine the durability of the effects of the intervention. Regarding the results for situational motivation, the intervention had an effect on global motivation with greater consistency in the perception of situational motivation among participants, however the global effect of the intervention varied among participants, evidencing a positive, although not uniform, impact on global situational motivation. The intervention strengthened intrinsic motivation, prevented dependence on external regulation, and highlighted the complementarity of motivational dimensions in the change process. CONCLUSION: The application of the aforementioned teaching method based on peer learning favors the development of specific and practical skills, expanding the performance of nurses. In addition, the study provides support for the improvement of academic curricula, encouraging the use of active teaching methods that can be applied in different contexts, aligning with international guidelines and strengthening public health with safe and evidence-based practices.
Assédio moral com trabalhadores de enfermagem na contemporaneidade: uma questão de gênero
(Universidade Federal do Rio Grande do Norte, 2024-08-22) Silva, Vera Lúcia Morais da; Medeiros, Soraya Maria de; https://orcid.org/0000-0003-2833-9762; http://lattes.cnpq.br/2068281775213576; http://lattes.cnpq.br/5324680399785287; Martins, Quenia Camille Soares; Araújo, Anne Karoline Candido
The history of nursing contributes to the understanding of its roots, permeating the trajectory of care, and thus, facilitating the understanding of the contemporary characteristics of work. Therefore, this look at history refers to the sociocultural role of this category, which is mostly made up of female workers, maintaining cultural heritages that structure the profession. In this way, we have a category that reproduces actions and values equally inherent to the feminine and, consequently, experiences the oppressions imposed on the class by an antiquated and prejudiced culture, originating from the beginning of its formation. As a result, aspects of the work environment that permeate violence, such as moral harassment, are observed. Thus, the objective was to analyze moral harassment towards nursing workers in contemporary times and the issue of gender. This is a study of a hypothetical deductive method, as a methodological, quantitative and statistical procedure, making it possible to cross-reference responses and verify hypotheses. Data collection will take place in the city of Natal, in the state of Rio Grande do Norte, through electronic interviews, via Forms, with nursing workers who are linked to health institutions. To analyze the data, Software R was used. Next, an analysis will be carried out to verify the associations between the variables. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, respecting all ethical premises for studies with human beings. In the results, a total of 44 health professionals participated in the study, 22 females and 22 males. This equal sample was due to the need to try to answer the research's guiding question. In this research, the sample was intentionally carried out with the aim of ensuring that the number of responses was equal between men and women, to try to understand moral harassment between genders. The associations between age, length of service, who the harassers are in contemporary times, perception of moral harassment and the gender that suffers most from this violence were analyzed. During the discussion, it was observed that young workers, with little experience and recently hired, are those who suffer the most from moral harassment. Another perception was about harassers, which in contemporary times is still the most common downward harassment. Another point, there is a hypothetical possibility that, based on the research associations, moral harassment in nursing may be linked to gender. It is concluded that they have weaknesses in understanding and identifying the characteristics of what is or is not moral harassment, often going unnoticed in the day-to-day activities of services, thus making the reliability of the research difficult. It is still confirmed that the culture in which nursing is down on hierarchy and submission. This reality and other findings in the research contribute to the hypothesis that bullying in nursing is associated with gender.
Fatores de risco associados às infecções relacionadas à assistência à saúde em Unidades de Terapia Intensiva Adulto: revisão de escopo
(Universidade Federal do Rio Grande do Norte, 2024-02-29) Nascimento, Rafaela Cavalcanti de Albuquerque; Feijão, Alexsandra Rodrigues; https://orcid.org/0000-0002-8686-9502; http://lattes.cnpq.br/8649283681727209; http://lattes.cnpq.br/4988438485298037; Dantas, Rodrigo Assis Neves; https://orcid.org/0000-0002-9309-2092; http://lattes.cnpq.br/9161806467102041; Silva, Bárbara Coeli Oliveira da
Nosocomial Infection (NI) are recognized by the World Health Organization as a problem of broad global magnitude. HAIs are a serious public health problem, they can be caused by several risk factors, which vary according to the hospital context, patient profile and health care practices adopted, and can thus assess that carrying out a systematic review to identify risk factors for HAIs will become a useful tool for infection control. Identify and map the risk factors associated with healthcare-associated infections in people hospitalized in adult intensive care units. This is a scoping review developed within the recommendations of the Joanna Briggs Institute and PRISMA-SCR (DOI 10.17605/OSF.IO/MYEJ5), developed in five stages: 1) identification of the research question; 2) identification of relevant studies; 3) selection of studies; 4) data extraction, separation, summarization and reporting of results and 5) communication of results. According to JBI, the Participant, Concept and Context mnemonic was applied to construct the research question, in which Participant corresponds to “People in hospital”, Concept “Risk factors for healthcare-related infections” and the Context “Adult ICU”, and the guiding question was: “What are the risk factors in the development of HAIs in people admitted to intensive care units?”. The search was carried out in eleven databases. 6989 studies were found, including 109 of them. Fifty-nine variables were obtained that can be evaluated as predictive factors for NI, namely: age (40.3%), sex (44%), smoking (4.5%) and alcohol consumption (2.7%). Cancer (6.4%), Diabetes Mellitus (DM) (12.84%), Chronic obstructive disease (COPD) (8.25%), Kidney diseases (9.17%), Ischemic heart disease (2.75 %), Systemic Arterial Hypertension (SAH) (4.58%), Human Immunodeficiency Virus – Acquired Immunodeficiency Syndrome (HIV-AIDS) (1.83%), Previous infections (4.58%), Liver Failure (1 .83%), and obesity (4.58%). Antibiotics (14.6%), Corticosteroids (2.75%) and Immunosuppressive therapy (4.5%). Respiratory syndromes (4.58%), trauma (13.76%). Coma (11%), sedation (6.42%). APACHE (2%), SAPS (4.58%). Nutrition: enteral (6.42%), parenteral (8.25%), malnutrition (1.3%). Intubation (12.84%), reintubation (4.58%), tracheostomy (16.51%), performing some procedure (1.83%). Antacids (4.58%), antibiotic therapy (4.5%), vasoactive drugs (1.83%), hemotherapy (3.66%). Night admission (0.91%), team sizing (2.75%); length of stay in the ICU (33%), type of hospitalization (in ICU) (3.66%), aseptic techniques (2.75%) and out-of-hospital transport (0.91%). Central Venous Catheter (11%) and time of use (7.3%), Peripheral Venous Catheter (1.8%), urinary catheter (15.59%) and time of use (4.58%), drain (1.83%), endotracheal tube (11%), mechanical ventilator (33%) and time of use (13.7%). CD4 (1.83%), hypoalbuminemia (0.91%), leukocytosis (0.91%), neutropenia (2.75%). Bronchoscopy (1.83%) and cystoscopy (0.91%). The development of this study culminated in mapping the patient's sociodemographic risk situation for the development of HAIs, in addition to the medical conditions upon admission, and care during hospitalization that may influence the increased risk of developing these infections.
Aplicação do brinquedo terapêutico instrucional sobre o cateterismo vesical em crianças hospitalizadas
(Universidade Federal do Rio Grande do Norte, 2024-02-29) Medeiros, Katarine Florêncio de; Medeiros, Soraya Maria de; https://orcid.org/0000-0003-2833-9762; http://lattes.cnpq.br/2068281775213576; http://lattes.cnpq.br/7556473431100732; Maia, Edmara Bazoni Soares; Oliveira, Jonas Sami Albuquerque de
Among the playful interventions proposed for children undergoing hospitalization, Therapeutic Toys which can be classified in three types: dramatic, physiological and instructional function. The instruction toy aims to clarify and train the child-family about hospitalization and the therapy involved. This is a descriptive and exploratory study with a qualitative approach through multiple case studies, supported by Winnicott contributions, with the aim of understanding the meaning attributed by hospitalized children to participating in preparation for bladder catheterization. Ten children hospitalized in the University Hospital in a northeastern capital from October to November 2023 participated. Data collection occurred in three phases: 1) collection of data from medical record; 2) intervention with instruction toy; 3) semi-structured interview with the child. The second and third phases were recorded in video and audio using electronic media and transcribed at all. The field diary was used to record observations related to non-verbal communication during the use of the therapeutic toy and the interview. The criteria used to interrupt collection was theoretical saturation od the data. The data was analyzed based on inductive thematic analyses with the support of Winnicott theorical framework, resulting in the identification of three themes: control over reality, perceptions related to instruction toy, bladder catheterization from the perspective of hospitalized children. The study follows ethical prerogatives required by resolution number 466-2012, from Nation Health Council and its complements, being approved by sight number 6.417.881 and CAAE 71444523.0.0000.5537, issued by the Ethics and Research Committee of the Federal University of Rio Grande do Norte. For children, Therapeutic toys allow them to have control over reality, decide what to do and want to be. By reliving previous experiences, they had the opportunity to dramatize their experiences related to past and current hospitalizations, with the aim of, through creativity deal with the situation better. It was identified that the children perceive therapeutic toys as a pleasurable activity, as it allows them to enter their imagination and play, but it also awakens paradox or negative feelings by reviving memories of past experiences. For some children, bladder catheterization meant healing and care and, as it was an invasive procedure, it was associated with pain. For others children, when contacting their internal reality, the therapeutic toy caused internal disorders and disturbed feeling, which caused an escape from reality. Although the session was intended to instruct children about bladder catheterization, it became a dramatic therapeutic toy recounting their experience and expressing emotions and perceptions related not only to the catheterization, but also to other procedures experience during hospitalization.

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