The Journal of Nursing of the Federal University of Piauí (REUFPI) The Journal of Nursing of the Federal University of Piauí (REUFPI) is an online journal, edited by the Graduate Program in Nursing - Nursing Department of the Federal University of Piauí (UFPI). Its first edition was published in 2012. It is among of the 50 most cited journals in Ibero-america according to the Ranking Citacion Cuiden and uses the Digital Object Identifier (DOI®). The journal's mission is disseminate scientific knowledge and professional practice in nursing and other areas of health, through the publication of empirical or theoretical manuscripts, focusing on international dialogue. From 2020, REUFPI began to adopt the rolling pass system and accepts manuscripts in Portuguese, English and Spanish. It is intended for the publication of original manuscripts of research, review, experience report, reflection paper, clinical trial and review protocols and letters to the editor, once they meet its publication standards. Notice that published manuscripts in preprints platforms will be accepted for submission. Electronic ISSN: 2238-7234
Autores mantém os direitos autorais e concedem à REUFPI o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attibution BY 4.0 que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
Nursing care provided to incarcerated women: an integrative review
Objective: to describe, based on the literature, how Nursing care is provided to women in the prison system. Methods: this is an integrative review of the literature. Searches were conducted in the Virtual Health Library (VHL), in the Latin American and Caribbean Health Sciences Literature (LILACS) database, and the Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed. Results: incarcerated women face significant challenges in accessing health services. The prison system has structural and organizational flaws that hinder adequate care, nurses encounter limitations in exercising their autonomy, resources are scarce, and there is a lack of emotional preparation to deal with demands related to the specific needs of female prisoners. There is a high prevalence of syphilis and other sexually transmitted infections, which could be reduced through preventive care and health education initiatives. Conclusion: it is necessary to implement public policies aimed at improving the health conditions of women in prison, including comprehensive health care programs focused on disease prevention, equitable access to basic care, and reproductive health services. It is also essential to train and support health professionals, especially nurses, who are the most accessible to incarcerated women.
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Cross-mapping to support clinical nursing practice in the prevention of falls in adults
Objective: To provide a basis for clinical nursing practice by cross-mapping the main risk factors for falls in adults with nursing interventions and activities. Methods: A methodological study carried out through an integrative literature review to identify the main risk factors and map them with the nursing interventions and activities of the Nursing Interventions Classification. Results: Were found 279 risk factors for falls which, after being grouped, resulted in 23 standard terms. These were mapped, resulting in 16 interventions and 125 nursing activities. Nursing interventions related to the Basic Physiological Domain were more prevalent, with the most prevalent activities corresponding to the classes “facilitating self-care” and “controlling elimination”. The Safety domain, with the “fall prevention” intervention, had the highest number of nursing activities when compared to the other interventions. All the risk factors found in the review were included in the nursing diagnosis “Risk of falls in adults”. Conclusion: The cross-mapping helped to identify the main nursing interventions and activities related to fall prevention in adults and could contribute to clinical nursing practice, as well [...].
Big data and machine learning in predicting suicidal ideation: an integrative review
Objective: To analyze, in literature, the application of Machine Learning and Big Data techniques to predict suicidal ideation in different populations. Methods: An integrative review, conducted according to the model proposed by Whittemore and Knafl in October 2024. Two independent reviewers performed the search in the MEDLINE/PubMed, Web of Science and PsycINFO databases. Primary studies that addressed the use of Big Data and Machine Learning in predicting suicidal ideation were included, with no restrictions regarding language or publication date. The presentation of results followed the PRISMA protocol guidelines. Results: Ten studies were selected to compose this review, which demonstrated the potential of Big Data and Machine Learning in identifying risk patterns for suicidal ideation in various groups, such as sexual and gender minorities, students, psychiatric patients, patients who have suffered a stroke, workers and the general population, with high predictive accuracy. Conducted in Asia and North America, the studies employed varied collection and analysis methods, with random forest standing out as a recurring and potentially effective technique. Conclusion: The use of Big Data and Machine Learning in mental health offers significant advances in predicting suicidal ideation.
Giovanna Vitória Aragão de Almeida Santos
The role of supervision in the stress management of nursing students in clinical internship: scoping review
Objective: to map the scientific evidence about the role of supervision in the stress management of nursing students in clinical internship. Methods: scoping review, according to the methodology of the Joanna Briggs Institute. The research was carried out in the Cumulative Index to Nursing and Allied Health Literature; Nursing & Allied Health Collection; Library, Information Science & Technology Abstracts and MedicLatina (via EBSCOhost), National Library of Medicine and National Institutes of Health and MEDLINE Complete® (via Pubmed). Included studies published between 2019-2025 in any language. Results: twenty studies were identified that highlighted the central role of supervision in managing stress among nursing students during clinical internships. Supervisory strategies such as peer mentoring, regular and individualized feedback, and emotional support programs proved effective in promoting the well-being and professional development of students, contributing to a significant reduction in perceived stress. Conclusion: effective supervision plays a critical role in stress management by providing structured guidance, ongoing emotional support, and constructive feedback. These supervisory practices contribute to the construction of a safe and favorable learning environment, reinforcing the need to invest in the qualification of supervisors in the context of the clinical internship.
Risk factors associated with violence against institutionalized elderly people: An integrative review
Objective: To identify in the literature the factors associated with violence against elderly people living in Long Stay Institutions for the Elderly (LSIE). Methods: Integrative review, carried out in the databases: Medical Literature Analysis and Retrieval System online, SCOPUS, Web of Science, Bibliographic Index of Health Sciences (Índice Bibliográfico de Ciências da Saúde), Nursing Database and Latin American and Caribbean Health Sciences Literature, between October and November 2023, systematized from the PRISMA flowchart, with the help of Rayyan software, including primary studies without time or language restrictions, analyzed and synthesized by the descriptive method. Results: The final sample included 20 studies, mostly published in English, carried out in countries such as the United States, Norway, and China and published between 2004 and 2021, with a predominance of cross-sectional exploratory studies. Risk factors related to the individual characteristics of the elderly residents, the team providing care in this setting, and the organization of the services and physical structure of the LSIEs were identified. Conclusion: Through the review, it was possible to corroborate the multifactoriality of violence against elderly people living in LSIEs, contributing to the development of violence prevention tools in this context.
Educational Technologies aimed at promoting parental care of premature newborns at home: an integrative review
Objective: To identify scientific evidence about Educational Technologies aimed at promoting parental care of premature newborns at home. Methods: Integrative review based on primary studies published in full, in all languages, with no defined time frame, in the following databases: National Library of Medicine; Scopus, Web of Science, Embase and Biblioteca Virtual em Saúde Brasil. The articles were screened using the Rayyan application. The included studies were duly read and entered into the Red Internacional de Enfermería en Salud Ocupacional form, from which the following data were extracted: author, year of publication, country, language, specifications of the target group, study design, level of evidence, objective, type of technology and outcome. The analysis of the results was based on Merhy's classification of technologies. Results: Of the twenty-two studies included in the review, there was a predominance of educational technologies categorized as Smartphone apps, in addition to thematic educational approaches based on relationships. Twenty-one technologies met the needs of the study participants satisfactorily, and only one revealed insecurity among the target audience. Conclusion: Educational Technologies were vital to support the transition of premature babies from hospital to home and served as an instrument aimed at promoting care [...].
Effects of the use of complementary therapies by nurses on labor pain: an integrative review
Objective: To identify in the literature the effects of the use of complementary therapies by nurses on labor pain. Methods: Integrative literature review, carried out in the following databases: MEDLINE (via PubMed), CINAHL, Web of Science, and SciElo Virtual Library. The search took place in a paired manner in January 2023, with articles available in full that addressed Integrative and Complementary Practices and the inclusion of Nursing in this context. Results: 11 articles were included which showed that complementary therapies reduced pain during labor, helped to relieve symptoms of stress-medium tension and anxiety, as well as increased emotional well-being and relaxation. Nursing professionals appeared to be responsible for offering and supporting the use of methods to humanize care and encourage women's autonomy during the process. Conclusion: Complementary therapies have been shown to be effective in minimizing pain during childbirth and nursing care was the crucial element in providing opportunities for the use of these methods and their effects.
Characterization of Covid-19 vaccines and outcomes in the older adults population: a scoping review
Objective: To map, in the scientific literature, the relationship between the number of doses and manufacturers of Covid-19 vaccines administered and outcomes in the older adults population. Methods: Scoping review based on the six-step methodology outlined by the Joanna Briggs Institute (JBI). Nineteen primary studies published in English, Spanish, and Portuguese were included, retrieved from the PubMed, Web of Science, Scopus, and BVS databases. Results: Vaccination significantly reduced hospitalization and mortality rates among vaccinated older adults compared to those unvaccinated. Booster doses were assessed for their effectiveness, demonstrating increased protection and a sustained antibody response. Conclusion: Immunization played a crucial role in reducing hospitalizations and mortality among vaccinated older adults. Factors such as immunosenescence and comorbidities affect vaccine effectiveness, making long-term immunization with adherence to booster doses essential to ensure continued protection for this population.
Errors in the preparation and application of insulin: an integrative review
Objective: To analyze the scientific literature on errors in the preparation and application of insulin by people with diabetes mellitus and/or their guardians. Methods: This is an integrative literature review, carried out between January and April 2023, in the MEDLINE via PubMed, CINAHL via Ebsco, LILACS, Embase and Scopus databases. Studies published as original articles, in Portuguese, English, and Spanish and published in the last 10 years were included, resulting in a sample of 12 articles. Results: The most prevalent errors in the practice of preparing and applying insulin were: incorrect preparation of doses, above or below those prescribed; incorrect application; failure to rotate application sites; inadequate storage and preservation of insulin vials. Conclusion: Given the errors revealed, diabetes education for patients and those responsible for this practice is a fundamental strategy for avoiding errors in insulin therapy. Nursing can contribute to planning educational actions aimed at this public, making decisions to qualify the care provided.
Building m-health technology to promote breastfeeding
Objective: to develop an m-health technology to promote breastfeeding in nursing mothers. Methods: methodological study, carried out from February 2020 to July 2021. Technological development application, following Pressman's prototyping model. The content was based on the precepts of Meaningful Learning, elaborated through a situational diagnosis and an integrative review, which guided the compilation of information and guidelines. It has a Computer Program Registration Certificate from the National Institute of Industrial Property (Process No. BR512021002438-9). Results: the application is entitled "Amamente" (Breastfeeding), and consists of the visual identity of the nursing mother, the welcome screen, and the "We want to meet you" screen. This is followed by eleven interactive interfaces for ouaccessing guidance and information such as breastfeeding; milk production; my breasts; signs of correct positioning; signs of correct latch-on; milk extraction; breast problems; signs of effective breastfeeding; when not to breastfeed; mom's space and references. Conclusion: the technology was built successfully and its final version brought together national and international scientific recommendations. "Amamente" can be used as a resource with potential reach and favorable to the process of health education and future interventions for mothers during breastfeeding.
Knowledge of women undergoing mastectomy regarding lymphedema
Objective: Assess knowledge held by women who have undergone mastectomy concerning lymphedema. Methods: Descriptive qualitative study conducted with women in the intermediate postoperative period following mastectomy at an oncology hospital in Northern Brazil. Data were collected through semi-structured interviews. Analysis followed Bardin’s content analysis principles combined with IRaMuTeQ software. Results: A total of twenty women participated, aged between 36 and 75 years, with mean education level, predominantly mixed race, most having undergone chemotherapy and presenting Systemic Arterial Hypertension. IRaMuTeQ generated a dendrogram encompassing five classes. Semantic content from classes 1, 2, and 5 was subdivided into the class “Communication: nursing professionals’ care guidelines regarding lymphedema,” while semantic content from classes 3 and 4 originated the order of classes 2 and 3 described subsequently as: “Understanding among women who underwent mastectomy regarding lymphedema” and “Surgical experience of women who underwent mastectomy: reflections and consequences.” Conclusion: Knowledge held by women who underwent mastectomy regarding lymphedema and the guidance received during postoperative care varies according to understanding. Guidance received mainly focused on general postoperative care following mastectomy. Improvement opportunities are suggested for communication that promotes self-care aimed at prevention.
Care received in Primary Health Care: perspective of patients in palliative oncological care and their families
Objective: to understand how health care is provided in Primary Health Care from the perspective of oncological patients in palliative care and their families. Methods: descriptive-exploratory study, with a qualitative approach, carried out with patients diagnosed with cancer in palliative care and their families. Data collection took place between September and November 2023, using open-ended interviews, guided by a semi-structured instrument. The audio recorded was transcribed in full and later analyzed using Content Analysis. Results: two thematic categories were identified: “Health care provided by Primary Health Care” and “Satisfaction with care despite obstacles perceived”. Health care involved referrals to specialists, support in the initial diagnosis and treatment of the physical consequences of the disease. Despite the obstacles experienced, such as delays and lack of professional training, the participants perceived the care as satisfactory. Conclusion: : palliative care is not present in the daily routine of Primary Health Care, which to some extent may reflect the need for professional training.
Social vulnerability and mortality from gastric cancer in the state of Pará: an ecological study
Objective: To analyze the spatial pattern of gastric cancer mortality associated with the Social Vulnerability Index in the period 2016-2020. Methods: An ecological study, whose sample consisted of deaths from gastric cancer that occurred in the state of Pará, reported to the Mortality Information System. Population data and Social Vulnerability Index data, respectively, provided by the Brazilian Institute of Geography and Statistics and the Institute of Applied Economic Research, were also used. Descriptive statistical analysis and spatial analysis were performed using univariate and bivariate Local and Global Moran’s Index, with the aid of GeoDa and ArcGis softwares, considering p≤0.05. Results: A total of 2,964 deaths were studied, with higher proportions in the age groups of 60-69 (n=777/26.21%) and 70-79 years (n=766/25.84%), males (n=2,007/67.71%), brown race/color (n=2,298/77.53%), married marital status (n=1,321/44.57%) and with one to three years of education (n=865/29.18%). Higher mortality rates occurred in the Lower Amazon, Marajó and Northeast Pará mesoregions, with statistically significant clusters being identified (I=0.791/p<0.001). Conclusion: The association between gastric cancer and Social Vulnerability Index highlights the need for measures to encourage risk-avoiding behaviors and enable early screening. In this context, specific care pathways and a responsive care network are necessary.
Use of and access to health services by the elderly: visibility of nurses' work
Objective: to associate the visibility of nurses, from the perspective of the elderly, with the use of and access to health services by this age group. Methods: This was a cross-sectional, analytical study conducted at home between March 2017 and June 2018 with 1,635 elderly people living in Uberaba, Minas Gerais. The data was collected at home using a structured questionnaire prepared by the researchers and based on publications on the subject, as well as questions from the National Household Sample Survey. A chi-square test was used (p<0.05), and the project was approved by the Human Research Ethics Committee (no. 2.053.520). Results: Most elderly people went to the same place, with the prevalence of health centers. Also, a higher percentage recognized the nurse and were assisted by him/her when seeking care in these places. [...]. However, a higher proportion of elderly people who sought the same place of healthcare were identified among those who knew the nurse compared to those who did not (p=0.011). Conclusion: Elderly people who knew the nurse sought care in the same place, indicating that recognizing the professional can lead to continuity of care. [...].
Nurses' perceptions regarding Quality of Life in the COVID-19 pandemic context
Objective: To identify the perceptions concerning quality of life among nurses who provided healthcare assistance during the COVID-19 pandemic. Methods: A mixed-methods study conducted in Paraíba, Brazil. Data collection took place online between 2022 and 2024, involving a total of 552 nurses and supported by a questionnaire and semi-structured interviews. The quantitative data underwent descriptive and inferential statistical analysis, while the qualitative analysis was conducted using the NVivo software. Results: Quality of life was associated with the provision of adequate Personal Protective Equipment by the employing institution (p=0.002), changes in friendship relations (p<0.001), sexual satisfaction (p<0.001) and changes in some life aspects (p<0.001). The narratives revealed that excessive workload exerted negative impacts on quality of life, that providing healthcare during the pandemic affected nurses' physical and psychological health, and that faith was crucial in overcoming uncertainties. Some participants reported a decline in quality of life after the pandemic, while others indicated improvements. Conclusion: Enhancing access to decent working conditions and valuing the professional practice are essential measures to ensure that these professionals preserve their quality of life.
Perception of children and guardians on the use of virtual reality in peripheral intravenous catheter
Objective: To find out the perception of children and their guardians regarding the use of virtual reality goggles in the insertion of peripheral intravenous catheter in Pediatric Emergencies. Methods: A descriptive, exploratory and qualitative study was carried out between April and September 2022 in the Emergency Department of a Public Children's Hospital in Southern Brazil. Twelve children between the ages of 4 and 12 and their respective guardians made up the sample. Data collection took place in three phases: 1) Invitation to collaborate in the research and interview; 2) Instructional therapeutic toy session with virtual reality goggles; 3) Peripheral intravenous catheter procedure. Data was analyzed using deductive analysis and the DIVA, OSDB and FPS-R scales. Results: Participants were predominantly male children aged seven, accompanied by their mothers. All the children had a good chance of success on their first attempt at the procedure according to the DIVA Scale; virtual reality corroborated collaborative behavior according to the OSDB Scale; and only one child felt the worst pain according to the FPS-R Scale. The qualitative data was categorized into: pre, during and post-procedure. Conclusion: Virtual reality is positive in reducing negative feelings and attenuates physical [...].
Impacts of COVID-19 on patients who underwent percutaneous transluminal coronary angioplasty
Objective: To assess the impact of COVID-19 on patients diagnosed with acute coronary syndromes who underwent percutaneous transluminal coronary angioplasty. Methods: This is a cross-sectional study conducted in accordance with the STROBE guidelines in the city of Recife, Pernambuco, Brazil. Data were collected on sociodemographic characteristics, personal history, symptoms, complications, length of hospital stay and chest pain duration, anatomical and physiological aspects, pharmacological therapy, and occurrence of death, involving two groups of patients who underwent percutaneous transluminal coronary angioplasty. Group 1 consisted of 75 patients treated between March and June 2020, while Group 2 included 51 patients treated between May and August 2023. Variables were compared between groups using statistical tests with a 95% confidence level and a p-value < 0.05. Results: The study population showed a predominance of elderly male patients (54.6%), with hypertension (70.6%), and diabetes (41.3%). Statistically significant differences were found in smoking status (p=0.00), presence of dyspnea (p=0.00), nausea (p=0.00), perioperative complications (p=0.03), length of hospital stay (p=0.00), and the presence of single vessel versus multivessel coronary artery disease (p=0.001). Conclusion: The study revealed that, during the pandemic period, patients with acute coronary syndromes who underwent percutaneous transluminal coronary angioplasty were predominantly smokers, exhibited more [...]
Vaccination status of nursing and medical students against measles and associated factors
Objective: To analyze the vaccination situation of nursing and medical students against measles and associated factors. Methods: This is a cross-sectional and quantitative study, carried out with nursing and medical students in a municipality in the semi-arid region of Piauí, through an electronic questionnaire and verification of the vaccination card. For association between variables, Pearson's Chi-Square was used and, for frequencies less than five, the likelihood test, with a significance level of 5% (p<0.05) and 95% Confidence Interval. Results: 223 students participated, with a prevalence of the nursing course (87.0%), female (74.4%), brown (53.8%), single (91.9%), Catholic (55.6%) and with a median age of 22 years. 54.7% had a vaccination card, which showed vaccination coverage of 41.7%, access to the vaccine of 49.3% and abandonment rate of the vaccination schedule of 15.6%. There was a significant association between being vaccinated, being in the nursing course (p=0.000; OR=25.255) and being single (p=0.025; OR=3.913). Conclusion: The students had vaccination coverage much lower than recommended, low access to the vaccine and a high rate of abandonment of the vaccination schedule, implying the need for educational institutions to carry out an evaluation of the students' vaccination card and subsequent immunization interventions [...].
Portugues Construction of a playful nurse uniform from the child's perspective: a methodological study
Objective: To construct a playful uniform based on children's imagery, aiming to reduce childhood anxiety in clinical settings. Method: A methodological study with a technological innovation approach, focused on the creation of an evidence-based care product. An integrative literature review was conducted in LILACS, BDENF, MEDLINE, and Google Scholar databases, using the descriptors "uniform," "nurse," and "child," identifying 11 studies. The sketch design stage was guided by the Child Drawing: Hospital Manual (CD:H) technique, with drawings produced by children with very low, low, and medium levels of anxiety. Results: 36 drawings were selected, seven of which presented recurring elements, such as human figures, nature, hospital equipment, and predominant colors: blue, green, yellow, and orange. From this, a uniform prototype was developed consisting of a white shirt with prints of the drawings. The analysis of the drawings revealed the importance of integrating visual elements significant to children in the clinical environment. The color blue, frequently associated with tranquility, showed potential for reducing anxiety, reinforcing its choice in the uniform design. Conclusion: Uniforms based on children's imagery can constitute an innovative strategy for promoting humanized care, reducing anxiety, and valuing care practices focused on the child.
Continuing Health Education from the perspective of nurses at a university hospital
Objective: to analyze nurses' perceptions of the effectiveness of the educational process of the Continuing Health Education (CHE) service of a university hospital. Methods: exploratory and descriptive study with a qualitative approach, conducted in a university hospital. The study population consisted of clinical nurses linked to the institution under study. Data collection was performed through interviews consisting of a questionnaire and a semi-structured script with open-ended questions. Results: Twelve clinical nurses from the institution participated in the study, consisting of 10 (83.3%) women and 2 (16.7%) men. Through Bardin's analysis, three categories were constructed: Recognition of the positive impacts of CHE for the nursing team, Difficulties faced in participating in educational activities, and Perception regarding the role of management in the implementation of educational activities. Conclusions: The need for adequate management of CHE, effective sizing of the nursing team, participation of nurses in the training planning process and flexibility of the National Policy for Continuing Education (NPCE) are evident, in order to provide interaction, better adherence and significant results of the program.
Presenteeism and productivity of public university employees in Bahia and Ceará: a cross-sectional study
Objective: To identify factors associated with presenteeism and its impact on the productivity of civil servants at a public university. Methods: This study involved 253 civil servants. Data was collected from April to August 2021 using an online questionnaire. Descriptive statistics were applied with the Chi-Square Test of Adherence and analytical statistics based on Pearson's Chi-Square Test of Independence and Fisher's Exact Test. Results: The factors associated with presenteeism were female gender, low physical activity, medication use, absenteeism, excessive commitment, job dissatisfaction, illness during emergency remote work, and work during the pandemic. Around 61.38% of the civil servants who were not absent from work due to illness (n=116; p=0.042) and 71.25% of those who were present at work even when sick (n=114; p=0.000), had medium/high presenteeism, with a moderate ability to concentrate and complete work activities, resulting in average productivity. Conclusion: Presenteeism was associated with negative aspects of health and working relationships, especially among women. It is necessary to know the characteristics of presenteeism in work environments to support actions to promote health and improve workplaces.
Occurrence of Pressure Injuries before and during the Covid-19 Pandemic: a comparative study
Objective: To compare the occurrence of Pressure Injuries (PI) in patients hospitalized before and during the Covid-19 pandemic. Method: This is a cross-sectional, retrospective and comparative study, with a quantitative approach, in which medical records of patients who developed PI twelve months before and in the first twelve months of the Covid-19 Pandemic, in a hospital in southern Brazil, were analyzed. Results: PI affected 544 patients in the twelve months prior to the pandemic and in the first twelve months of the event. In both periods, there was a higher occurrence of stage 2 PI, with 30% and 42.1%, respectively, and the sacral region was the most affected in both periods, with 42.9% in the first period and 30.2% in the second. Also noteworthy was the increase in pressure injuries in the anterior face region, from 5.9% to 14.3% from one period to the next, with the majority of cases occurring in Intensive Care Units (ICU), reaching 60% and 77%. Conclusion: When compared to the previous year, there was an increase in the number of PI cases in the first year of the Covid-19 pandemic, especially in ICUs and in the type of PI, with a higher incidence [...].
Laryngeal cancer: family caregivers’ knowledge and practices regarding tracheostomy care
Objective: To analyze family caregivers’ knowledge and practices regarding tracheostomy care. Methods: This is a qualitative descriptive study carried out in a referral hospital for oncology. Seven family caregivers of patients with tracheostomy participated in the study. Data collection was carried out through a semi-structured interview. Bardin’s content analysis was adopted in association with the IRAMUTEQ program. Results: Three categories were formed: Family caregivers’ knowledge about tracheostomy care; Use of materials for tracheostomy care; Family caregivers’ knowledge about laryngeal cancer. Furthermore, from the interviews, gaps in knowledge regarding the diversion were identified. A lack of training of family members was also observed, with insecurity and fear of handling the respiratory diversion being portrayed in all statements. Conclusion: The study made it possible to understand the perception of family caregivers regarding tracheostomy care, identifying their difficulties and experiences during the process. With the data obtained, it was noted that knowledge gaps are caused by the lack of training and preparation of skills during the hospitalization of a sick family member.
Adverse events related to foreign body retention
Objective: to analyze events related to foreign body retention recorded in a healthcare institution and to describe the process of reformulating the prevention protocol. Methodology: observational, descriptive, and retrospective study based on all adverse event notifications between 2021 and 2022. The outcomes of the change in the institutional protocol on the incidence of foreign body retention in a large, private, philanthropic hospital were analyzed. Data were extracted and analyzed with a focus on notified adverse events, observing possible changes in the number of occurrences after the implementation of the new protocol. Results: in the year 2021, 14,370 surgical procedures were performed, with four cases of retention notified, a rate of 0.02%. In the year 2022, 17,920 surgical procedures were performed, with five cases of retention, maintaining the same rate of 0.02%. The cases involved needles, gauzes, and instruments, without evidence of reduction after the implementation of the new protocol. Conclusion: despite the low incidence observed, retention is an adverse event with serious consequences for patients and significant losses for institutions. It is essential to carefully analyze the causes of failure to adhere to the protocol and invest in continuous training to strengthen safety culture.
Caregivers’ perceptions about preventing childhood hospitalizations for primary care-sensitive conditions
Objective: To understand the perceptions of caregivers regarding child care for the prevention of hospitalizations due to Primary Care-Sensitive Conditions, such as the diagnosis of gastroenteritis, pneumonia and/or asthma, in Teresina. Methods: This is a descriptive study with a qualitative approach, conducted through a semi-structured interview with ten caregivers of children under the age of five years. The analysis of the collected data was based on Bardin's content analysis. Results: It was observed that the culture of immediate care is still very present, which makes the hospital-centric model clear. In addition, impairment in care related to factors such as caregiver co-responsibility, the need to understand the role of Primary Health Care, investments in public policies for basic sanitation in the city and socioeconomic conditions were identified. Conclusion: Financial aspects, both on the part of the user and the health service itself, cultural aspects, poor basic sanitation and lack of knowledge about the role of PHC, make it difficult to prevent PCSC. Therefore, PHC care needs to be reviewed in several aspects, considering financing, qualified human resources and promotion of health education actions.
Socorro Adriana de Sousa Meneses Brandão
Sociodemographic, occupational and health aspects of nurses at a hospital specialized in Cardiology
Objectives: To identify sociodemographic, occupational and health aspects in nurses at a public hospital specialized in Cardiology from São Paulo. Methods: This is a descriptive and quantitative study involving 87 nurses working at the institution. Data collection took place from May to October 2023, using a questionnaire. Subsequently, the variables were grouped and analyzed. Results: Most of the professionals were female, married and white-skinned. Their mean age was 43.3 years old, with an mean income from 5,000 to 10,000 BRL; 85% were specialists, with cardiovascular care as the most common area of expertise. The most frequent health issues reported were high cholesterol and musculoskeletal disorders. The participants that reported higher happiness levels showed lower incidence of high cholesterol, cancer-related conditions and emotional disorders. Higher satisfaction levels were associated with private-sector employment contracts. The individuals who believed their health problems were not work-related reported greater happiness, higher satisfaction and lower stress levels. Conclusion: The analysis allowed characterizing the nurses in the context under study, revealing predominance of women, advanced-degree holders and professionals engaged in direct patient care. Most of the participants reported good health. An association was observed between happiness, satisfaction and self-reported stress levels.
Prenatal care in rural areas: from nurses’ perspective
Objective: To understand prenatal care based on nurses’ experiences in the context of rural areas. Methods: An exploratory-descriptive study, with a qualitative approach, carried out with 12 nurses from ten Basic Health Units in the rural area of a capital in the North region of the country. Data were collected through semi-structured interviews from July 2022 to August 2023. For data analysis, Bardin’s categorical content analysis was performed, with the aid of Atlas.ti® software. Results: Based on the analyses, three categories emerged: a) Implications of socioeconomic and demographic factors on access to services; b) Implications of culture on pregnancy monitoring; c) The importance of the multidisciplinary team’s work in rural areas. Conclusion: Professionals are faced with users in a situation of socioeconomic vulnerability, in addition to an unfavorable geographic situation and care isolation, which makes it difficult to provide quality care.
Tatiana do Socorro dos Santos Calandrini
Critical phase of the COVID-19 pandemic and health and working conditions in nursing
Objective: to identify changes in the health and work conditions of nursing professionals working in Primary and Tertiary Care during the critical phase of the COVID-19 pandemic. Methods: this was a descriptive, cross-sectional study with retrospective data collection conducted between December 2022 and June 2023. Ninety-six of the 230 eligible professionals who worked for at least three months during the critical phase of the pandemic participated. Data were collected through a self-administered questionnaire and analyzed using frequencies and Fisher's exact test, with a significance level of 5%. This study was approved by the Ethics Committee. Results: there was a significant association between Tertiary Care and the provision of training on the use of Personal Protective Equipment (p < 0.01), while Primary Care professionals were associated with a greater feeling of devaluation and lack of recognition by the user population (p = 0.01). Conclusion: inequalities were identified regarding working and health conditions during the critical phase of the COVID-19 pandemic, highlighting the need for specific strategies to support nursing professionals at different levels of care during health emergencies.
Epidemiological overview of gestational and congenital syphilis in a health region in the Brazilian Amazon
Objective: To determine the clinical, epidemiological, and spatial profile of gestational and congenital syphilis in a health region in the state of Pará. Methods: This is an analytical and ecological study conducted using data available in the Tabnet/DATASUS public database, from 15 municipalities belonging to the 12th Regional Health Center, Pará. Absolute and relative frequencies were used to characterize the cases. The absolute average annual variation was estimated by linear regression weighted by the municipal population. The correlation between municipal structural indicators and healthcare indicators, and the number of cases, was evaluated, with analyses conducted using Stata 18 software. Results: For the study period, 1,059 cases of gestational syphilis were detected, with the highest frequency in São Félix do Xingu with 21.6% of cases, in addition to VAMA with an average increase of 5.85 cases of gestational syphilis (95% CI = 2.14; 9.57; p = 0.006) per year. Conclusion: When evaluating the distribution of syphilis cases in the Araguaia health region, it was possible to suggest some associated gaps due to access to prenatal services and distribution of notifications [...].
Ellen Nathalia dos Santos Silva de Araújo
The influence of spirituality on the emotional crisis experienced by oncology patients
Objective: To understand spirituality as a factor influencing the emotional crisis experienced by cancer patients. Methods: A mixed-methods study, guided by Grounded Theory, which provides explanations for individuals’ concerns. The study was conducted in an oncology Hospital. Data were collected from July to September 2018 using two instruments: a semi-structured interview guide and the Spiritual Well-Being Scale for Assessment in Healthcare Contexts. The qualitative analysis identified the phases of the crisis, while the quantitative analysis linked these phases to the patients’ spirituality and helped identify their sociodemographic profile. Results: 30 patients participated, predominantly women, with breast cancer, aged over 50, with incomplete elementary education, married, with children, and Catholic. Two categories were developed regarding the experience of emotional crisis and its relationship with spirituality: emotional crisis in the oncological context and the influence of spirituality on the emotional crisis experienced by cancer patients. Conclusion: Spirituality was found to be a protective factor during the emotional crisis resulting from the cancer diagnosis. The participants scored positively on the applied scale for strong spirituality and showed effective resolution of the emotional crisis.
Mapping surgical positioning competencies: content validation through the Delphi technique
Aim: To validate surgical positioning competencies with expert judges in perioperative nursing using the Delphi technique. Methods: Validation study of a competence-related instrument via Delphi. Five expert judges in perioperative issues, selected through the Lattes Platform, received an invitation and the instrument for assessment in terms of relevance, pertinence, clarity, and applicability. The data were analyzed using the Content Validity Index (CVI). Results: In the first round, there was agreement in 97.03% (n=98) of the items, with CVI greater than 0.90 in 89 of the 101 items, and only two items with CVI < 0.80. The total CVI was 0.95. In the second round, agreement was 88.12% (n=89) of the items, with a total CVI of 0.93. Conclusion: The judges showed high agreement on the content. Two items with low agreement were kept by the researcher, as they were considered important for assessing the risk of injury due to positioning and the need for repositioning during long procedures or with patient movement.
"Recognition" of nurses' practices in specialized outpatient prenatal care: subsidies for protocol development
Objective: To recognize the practices of nurses in specialized outpatient prenatal care to support the construction of a protocol. Methods: Qualitative research, carried out in a specialized outpatient clinic, linked to a reference maternity hospital for the state of Piauí. Six nurses who make up the multidisciplinary care team for high-risk pregnant women participated in the study. Data were collected from May to June 2023 through participant observation and thematic workshop, conducted from the first stage of the Four Rs Process. For the organization and interpretation of the data, the Bardin content analysis technique was performed. Results: It is understood that the practice of nurses consists of carrying out educational activities, registration of diseases of compulsory notification, supervision of the service and cardiotocography. Potentialities in the service were identified, such as the provision of training courses at the institution and the presence of specialists, as well as weaknesses such as the absence of nursing consultation. Conclusion: The contributions of this study are that they can have an impact on the process of training nurses, on strengthening multidisciplinary actions based on public policies, on valuing obstetric nurses in high-risk prenatal care and improving work processes.
Adaptation and evidence of validity of the High Blood Pressure-Focused Health Literacy Scale into Portuguese
Objective: To adapt and estimate the validity evidence based on the content and internal structure of the High Blood Pressure-Focused Health Literacy Scale into Brazilian Portuguese. Method: methodological study with translation and back-translation. The content-based evidence was obtained by a committee of nine experts and 30 people with hypertension. For evidence based on internal structure, the adapted version was applied to 1,318 people with hypertension. Results: The adapted version showed a content validity index of 0.92. Parallel analysis indicated a two-factor structure. Exploratory Factor Analysis with the 43 items showed a negative correlation matrix with large covariance destruction (between 29.8% and 82.6%). The matrix was corrected after 12 items were removed. The final model showed correspondence with the theory and adequacy of the fit indices. Factor 1, Functional Health Literacy, explains 7.63% of the variance. Factor 2, Print Literacy, explains 44.33% of the variance. The reliability indicators were within the standards of adequacy. Conclusion: The adapted instrument showed evidence of validity related to content and internal structure for its application to people with hypertension in Brazil.
Challenges and potential of interprofessional communication in collaborative practices in the Family Health Strategy
Objective: To analyze the perception of Family Health Strategy professionals about interprofessional communication. Methods: This was a descriptive study, with a qualitative approach, carried out in October 2021, with nine professionals from a Basic Health Unit in the municipality of Fortaleza, Ceará, Brazil. A sociodemographic questionnaire was used to collect data and a focus group was held. The subjects' speeches were recorded and later analyzed using IRAMuTeQ® software. Results: Work overload, staff turnover, mismatches in professional behavior, fragile communication with patients and the lack of formal communication spaces were identified as the main challenges compromising interprofessional communication in the health unit. On the other hand, interpersonal relationships and the use of messaging apps were highlighted as communication enhancers. Conclusion: Ineffective communication weakens collaborative practices in Primary Health Care. This highlights the need to reorient the work process in this area of care and expand spaces for interprofessional dialog and collaboration.
Adult intensive care nursing in the face of Advance Directives: qualitative research
Objective: To understand the knowledge and practices of the Adult Intensive Care nursing team about the Advance Directives. Methods: Qualitative research carried out with 14 nursing professionals from an Adult Intensive Care Unit in the Northeast region of the state of Rio Grande do Sul. Data were collected through semi-structured interviews, between May and June 2022 and submitted to Content Analysis. Results: Three thematic categories emerged: Knowledge of the nursing team about the Advance Directives (directives related to care; nursing technicians are unaware of the concept of directives); Practice of the nursing team related to the wishes and desires of the patient (there is a sensitivity of nursing to the care of the Advance Directives of the patient, by communication and discussion in a multidisciplinary round) and Decisions of medical professionals or family members: (dis)respect for the autonomy of the patient (physicians and family members do not respect the prior decision of the patient and the invisibility of the nursing team by physicians, regarding compliance with the directives, was evidenced). Conclusion: There was little knowledge about Advance Directives by nursing technicians in Adult Intensive Care. The patient's wishes are met by affective care. [...]
The role of interpersonal support in the management of type 2 diabetes mellitus through self-care
Objective: To assess whether people with type 2 diabetes mellitus who participated in an educational intervention related to supported self-care can increase their knowledge and change their behaviors for the control of glycemic levels. Methods: A quasi-experimental study, typified as before-and-after, with a quantitative approach. the intentional sample consisted of 30 patients with type 2 diabetes mellitus. An educational intervention based on the “5 As” was applied over two months. Knowledge about diabetes (DKN-A Scale), capillary glycemia levels, and glycated hemoglobin levels were assessed before and after the intervention. Results: There was a significant improvement in knowledge about diabetes (p<0.05) and a reduction in the mean capillary glycemia (p=0.027). The reduction in glycated hemoglobin was not statistically significant (p=0.069). Conclusion: The intervention with self-care support was effective in improving disease knowledge and its treatment, as well as promoting glycemic control.
Quality and lifestyle of people with hypertension associated or not with diabetes
Objective: To describe the sociodemographic and clinical profile and aspects of quality of life (QoL) of people with Systemic Arterial Hypertension (SAH) and/or Diabetes Mellitus (DM), as well as assessing the association between lifestyle and QoL in users of a Family Health Strategy (FHS) in Picos-PI. Methods: This is an observational, quantitative, analytical cross-sectional study. The sample consisted of 45 patients divided into two groups (SAH, and SAH+MD). The instrument used was the Medical Outcomes Short-Form Health Survey (SF-36). Results: The profile of the patients consisted of adult, female, brown, retired, and with a low level of education. There was a reduction in QoL in the domains of pain (SAH), and pain, vitality, and functional capacity (SAH+DM). When life habits were associated with QoL, there was a reduction in the mental health domain with smoking and a sedentary lifestyle (p<0.05) (SAH) and an increase in QoL in the following domains: social, emotional, physical, vitality and functional capacity with physical exercise (p<0.05) (SAH + DM). Conclusion: It is essential to understand the profile of hypertensive and diabetic patients in the FHS and to see how their lifestyle interferes with the treatment protocol and quality of life.
Impact of Fake News about Vaccination on Mortality from COVID-19: An Epidemiological Analysis in Brazil
Objective: To correlate the temporal pattern of rates on mortality, vaccination coverage, and dissemination of fake news about COVID-19 in Brazil. Methods: Epidemiological study of aggregated data on COVID-19 from the Brazilian Ministry of Health and the Lupa and Aos Fatos fact-checking agencies from January 2021 to December 2022. We performed simple and multiple linear regressions to assess temporal trends and implemented Spearman’s correlation for associations between variables. We established significance at p<0.05, with a 95% confidence interval (95% CI). Results: Fake news about vaccines correlated positively with mortality from COVID-19 (ρ=0.473; p=0.020; 95% CI: 0.102; 0.707). Fatality significantly decreased (R²=0.5733; p<0.001; 95% CI: -2.396; -1.255). Vaccination coverage did not significantly correlate with mortality (ρ=0.075; p=0.729; 95% CI: -0.173; 0.308). We observed that the dissemination of fake news decreased over time (R²=0.0038; p=0.004; 95% CI: -0.125; -0.034). Conclusion: The findings suggest that disseminating misinformation may have influenced mortality from COVID-19 in Brazil, reinforcing the need for effective strategies to combat the infodemic and promote vaccine confidence.
Use of ultrasound by intensive care nurses to assess urinary volume and invasive bladder devices
Objective: To describe the experience of the use and applicability of ultrasound by intensive care nurses in the assessment of urinary volume and invasive bladder devices. Method: Experience report on the use of ultrasound by nurses in the adult Intensive Care Unit of a public hospital between July and December 2021, after the participation of about 20 nurses in a theoretical-practical course focused on ultrasound-guided urinary volume assessment. Results: The course covered handling the ultrasound device, assessing and quantifying urinary volume, as well as discussing clinical reasoning and decision-making. In care practice, ultrasound is a tool that has come to be used by nurses to analyze permanent bladder catheter obstruction, urinary retention, cystostomy clearance, and in decision-making regarding tube replacement. Conclusion: It can be concluded that the use of ultrasound by nurses in the Intensive Care Unit is extremely important, as it is a useful, practical, non-invasive, and easy-to-use tool. This tool and approach were only possible after the course [...].
The joint evolution of Nursing and Artificial Intelligence: Safety and optimization in the Nursing Process
The adoption of Artificial Intelligence (AI) in Nursing is no longer a mere possibility and already manifests itself in the routine of various health services. Its scope encompasses from automated analysis of medical records to algorithms capable of foreseeing complications at a large scale. Each of the Nursing Process phases (Assessment, Diagnosis, Planning, Implementation and Evaluation) finds in AI a number of resources to expand patient safety and improve efficiency in the teams. However, the objective is not to substitute nurses' expertise but, on the contrary, to optimize repetitive tasks through AI, freeing time for advanced clinical reasoning, people-centered care and rational resource management. As for the Assessment phase, studies such as the one by Rossetti et al.(1) show that a real-time analysis of Nursing records through “deep learning” issues precise alerts about imminent clinical deterioration. This anticipation of risks enables earlier interventions and avoiding problems, thus improving care safety in a tangible way. In the Diagnosis phase, Natural Language Processing (NLP) algorithms can identify patterns linked to falls, infections and other threats(2). [...]
Vision of hope: a nursing perspective on global health for populations with complex life circumstances
Motivation to use the concept of complex life circumstances in nursing research Complex life circumstances refer to social determinants of health that contribute to inequities among underserved populations, increasing their susceptibility to poor health outcomes. These circumstances include homelessness, substance use, being HIV positive or at risk, violence, trauma, and low socioeconomic status, among other indicators.(1,2) Populations living in such circumstances are more susceptible to harmful experiences associated with health, social, and climate disadvantages.(1) We describe our international Brazil-Canada nursing academic-knowledge exchange collaboration aimed at generating nursing care solutions for people living with complex life circumstances. This collaboration creates a Community of Practice that facilitates multidirectional mentoring, team flourishing, and co-empowerment. Globally, Communities of Practice yield favorable research and academic outcomes.(2–4) Silverstein et al. utilized a global health practice to maximize the competencies of healthcare professionals working with vulnerable populations.(3) These practices decreased professional isolation, improved peer collaboration, and advanced clinical knowledge and best practices through strong partnerships.(3) Fruchtman et al. described the creation of a digital community of practice as a strategy to decolonize global health partnerships, fostering multidirectional peer-to-peer learning and coproduction of knowledge.(4) Our vision of hope leverages our team’s strengths and nursing solutions to improve the health of perinatal women and older adults living in complex life situations in Brazil and Canada. Approach between countries to disseminate the concept of complex life circumstances in nursing research While contributing to global health and nursing knowledge, our team recognizes that visibility and collaboration can advance conversations on complex life circumstances among perinatal women and older adults at micro, macro-regional, national, and international levels, beyond scientific publications. We believe it is essential to unite academic and community study groups to disseminate innovation transversally. Through our collaborative Brazil-Canada project, we prioritize fostering mutual learning and international dialogues on living with complex life circumstances. [...]
Health promotion and tobacco control: a transatlantic perspective between Brazil and Portugal
Health promotion, a concept based on the Ottawa Charter, recognizes that health is influenced by economic, social and environmental factors, as well as individual practices. The fight against smoking is one of the most challenging fronts in this context, given its direct relationship with the global burden of chronic diseases and preventable deaths. The articulation of public policies that involve multiple sectors and civil society has proved fundamental in dealing with this problem. In both Brazil and Portugal, health promotion plays a crucial role in integrating tobacco prevention and control actions, reflecting the guidelines of Canada's Population Health Promotion Model. This Canadian model highlights the intersection between health, public policies and community action, emphasizing the need for healthy environments and structural interventions that shape behaviour. The influence of this paradigm is evident in global policies, including those adopted in Brazil and Portugal. It offers a theoretical framework that guides governments to create evidence-based strategies that are sensitive to cultural and social particularities. In Brazil, the National Health Promotion Policy (Política Nacional de Promoção da Saúde, PNPS) translates these principles into concrete actions, whereas in Portugal, the National Program for the Prevention and Control of Smoking reflects a progressive normative approach, especially in relation to tobacco consumption and electronic devices. Brazil and Portugal have different histories and cultural dynamics, but they share similar challenges in tackling smoking. In Brazil, robust policies have contributed to a significant reduction in the prevalence of adult smokers, from 34.8% in 1989 to 12.6% in 2019(1). These achievements are the result of educational campaigns, tax increases and the creation of smoke-free environments. In Portugal, legislative efforts, such as the Tobacco Law (Law No. 37/2007), have significantly limited smoking in public places and restricted advertising, but the country still faces worrying rates, with 17% of the population identified as smokers in 2019(2). [...]
Nurse’s work process in the face of adverse events: reflections on the second victim
Objective: To reflect on the nurse’s work process in light of support strategies for the second victims of adverse events. Methods: Theoretical-reflective study conducted between August and November 2024, based on the analysis of the scientific literature, discussions held in a subject during a post-graduate course, as well as the authors’ experiences. Aspects inherent to the contextualization of adverse events in nursing, the phenomenon of the second victim, and the implementation of institutional support strategies were explored. Results: In addition to affecting patients, adverse events impact the involved professionals, configuring the phenomenon of the second victim, which requires the implementation of institutional support strategies to minimize the suffering of the involved professionals and strengthen safety culture. Conclusion: In the context of the second victim of adverse events, the critical analysis of the literature and the reflection on the nurses’ practice highlight the complexity and importance of their role, who, by integrating the five dimensions of the work process, contribute to strengthening safety culture in health institutions, ensuring the quality of the provided care, while also offering protection and support to the team itself.