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ISSN-e: 1518-8345 | ISSN Print 0104-1169

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Original Articles

Nursing diagnoses in trauma victims with fatal outcomes in the emergency scenario

Diagnósticos de enfermagem em vítimas fatais decorrentes de trauma no cenário da emergência

Ana Maria Calil Sallum; Jair Lício Ferreira dos Santos; Fernão Dias de Lima

The objective of this study was to identify and analyze the nursing diagnoses that constitute risk factors for death in trauma victims in the first 6 hours post-event. This is a cross-sectional, descriptive and exploratory study using quantitative analysis. A total of 406 patients were evaluated over six months of data collection in a tertiary hospital in the municipality of São Paulo, according to an instrument created for this purpose. Of the total, 44 (10.7%) suffered death. Multivariate analysis indicated the nursing diagnoses ineffective respiratory pattern, impaired spontaneous ventilation, risk of bleeding and risk of ineffective gastrointestinal tissue perfusion as risk factors for death and ineffective airway clearance, impaired comfort, and acute pain as protective factors, data that can direct health teams for different interventionist actions faced with the complexity of the trauma.

The Pain Disability Questionnaire: a reliability and validity study

The Pain Disability Questionnaire: um estudo de confiabilidade e validade

Patrícia Cantu Moreira Giordano; Neusa Maria Costa Alexandre; Roberta Cunha Matheus Rodrigues; Mari...

The goal of this study was to translate and adapt The Pain Disability Questionnaire (PDQ) to Brazilian Portuguese, as well as to assess its psychometric properties and practicability. The following methodological steps were followed: translation, synthesis, back-translation, expert committee assessment and pre-test. The psychometric properties were assessed through the application of a questionnaire to 119 patients with chronic musculoskeletal disorders. The results indicated the reliability of the instrument, with a Cronbach's alpha coefficient of 0.86, and high stability in the test-retest. A moderate correlation was found between the PDQ scores and the numerical pain scale. Negative correlations were found between the Spitzer Quality of Life Index and the functional condition, psychosocial component and total PDQ score. Construct validity demonstrated significant difference in PDQ scores between symptomatic and asymptomatic individuals. The PDQ revealed fast application and easy understanding. The results indicated a successful cultural adaptation and reliable psychometric properties.

Cross-cultural adaptation of the Work Disability Diagnosis Interview (WoDDI) for the Brazilian context

Adaptação transcultural do Work Disability Diagnosis Interview (WoDDI) para o contexto brasileiro

Vivian Aline Mininel; Vanda Elisa Andres Felli; Patrick Loisel; Maria Helena Palucci Marziale

The Work Disability Diagnosis Interview (WoDDI) is a structured interview guide developed by the University of Sherbrooke, Canada to help clinicians detect the most important work-related disability predictors and to identify one or more causes of prolonged absenteeism. This methodological study aims for the cross-cultural adaptation of the WoDDI for the Brazilian context. The method followed international guidelines for studies of this kind, including the following steps: initial translation, synthesis of translations, back translation, evaluation by an expert committee and testing of the penultimate version. These steps allowed obtaining conceptual, semantic, idiomatic, experiential and operational equivalences, in addition to content validity. The results showed that the translated WoDDI is adapted to the Brazilian context and can be used after training.

Relationship among social support, treatment adherence and metabolic control of diabetes mellitus patients

Relação entre apoio social, adesão aos tratamentos e controle metabólico de pessoas com diabetes mellitus

Lilian Cristiane Gomes-Villas Boas; Milton Cesar Foss; Maria Cristina Foss de Freitas; Ana Emília P...

This cross-sectional and quantitative study aimed to analyze the relationship among social support, adherence to non-pharmacological (diet and physical exercise) and pharmacological treatments (insulin and/or oral anti-diabetic medication) and clinical and metabolic control of 162 type 2 diabetes mellitus patients. Data were collected through instruments validated for Brazil. Social support was directly correlated with treatment adherence. Adherence to non-pharmacological treatment was inversely correlated with body mass index, and medication adherence was inversely correlated with diastolic blood pressure. There were no associations between social support and clinical and metabolic control variables. Findings indicate that social support can be useful to achieve treatment adherence. Studies with other designs should be developed to broaden the analysis of relations between social support and other variables.

The dialogic life-death in care delivery to adolescents with cancer

A dialógica vida/morte no cuidado do adolescente com câncer

Maria José Menossi; Juliana Cardeal da Costa Zorzo; Regina Aparecida Garcia de Lima

This study aims to understand the experience of adolescents with cancer, family and the health team regarding death in the healthcare context, in the light of Edgar Morin's proposed theoretical framework of complexity. Participants were 12 adolescents, 14 relatives and 25 health professionals. The interview was used for data collection. The discussion of data was guided by the dialogic life-death in the context of care to adolescents with cancer. It was observed that the singularity in the way the adolescent experiences time and faces death and the possibility that the family will lose a loved one may not be in accordance with the care the health team offers, considering structural, organizational and affective aspects. It is not enough for the team just to rationally make choices on the use of diagnostic-therapeutic devices, in line with predefined moments in the disease. Instead, a contextualized and sensitive understanding of each situation is needed.

Process of construction of an educational booklet for health promotion of pregnant women

O processo de construção de material educativo para a promoção da saúde da gestante

Luciana Magnoni Reberte; Luiza Akiko Komura Hoga; Ana Luisa Zaniboni Gomes

This study aimed to describe the production process of an educational booklet focusing on health promotion of pregnant women. The action research method was used in this process composed of the following steps: choice of the content based on the needs of pregnant women, creation of illustrations, content preparation based on scientific literature, validation of the material by experts and pregnant women. This work resulted in the final version of the booklet, which was entitled "Celebrating life: our commitment with the health promotion of pregnant women". Active participation of health professionals and pregnant women through dialogue and collective strategy permeated the process of development of the booklet. The opinions of pregnant women and experts who considered the booklet enriching and enlightening justify the use of it as an additional resource of educational activities carried out during the prenatal care.

Nursing in the hospital accreditation process: practice and implications in the work quotidian

A enfermagem no processo de acreditação hospitalar: atuação e implicações no cotidiano de trabalho

Bruna Figueiredo Manzo; Helen Cristiny Teodoro Couto Ribeiro; Maria José Menezes Brito; Marília Al...

The aim of this study was to investigate the role and influence of nursing in the hospital accreditation process. It is a qualitative study, conducted in a private hospital of Belo Horizonte. The study subjects were nine nurses and 15 nursing technicians. Data collection was through semi-structured interviews, which were subjected to content analysis. The results showed that the role of the nursing team in the accreditation involves care, administrative, educational and research issues. The study subjects presented different perceptions regarding the influence of the accreditation process in their work. The positive aspects of personal growth and valorization of the curriculum were highlighted as well as negative aspects such as stress and little professional valorization. Therefore, it is necessary that the professionals understand the logic of the process and act with a view to the interdisciplinarity and overcoming the fragmentation of care, thus achieving integral healthcare and the quality of care desired.

Minor psychiatric disorders among nurses university faculties

Distúrbios psíquicos menores em enfermeiros docentes de universidades

Juliana Petri Tavares; Carmem Lúcia Colomé Beck; Tânia Solange Bosi de Souza Magnago; Roselaine R...

This cross-sectional study addresses 130 nursing faculty members in federal universities from Rio Grande do Sul, Brazil. It investigated the psychological demands and decision latitude (the Demand-Control Model by Karasek) and their association with Minor Psychological Disorders (MPDs). The Brazilian versions of the Self-Report-Questionnaire-20 and the Job Stress Scale were used. MPDs were prevalent in 20% of the studied individuals. After adjusting for potential confounders, the chances of participants presenting mental disorders were higher in the quadrant 'active strain jobs' (OR=14.23, 95% CI 1.55 to 130.73), followed by the 'high strain jobs' quadrant (OR=10.05, 95% CI 1.23 to 82.44), compared to nursing professors classified in the 'low strain jobs' quadrant. We conclude that high psychological demands and low control over work can cause disorders in nursing professors, among them, MPDs.

Functional disability of adult individuals with spinal cord injury and its association with socio-demographic characteristics

Incapacidade funcional e associações com aspectos sociodemográficos em adultos com lesão medular

Alexsandro Silva Coura; Inacia Sátiro Xavier de França; Bertha Cruz Enders; Mayara Lima Barbosa; J...

The aim was to investigate the Functional Disability degree in adults with spinal cord injury and its association with socio-demographic characteristics. The Barthel Index was used and 75 subjects answered a questionnaire with socio-demographic variables. The Chi-Square, Cronbach's Alpha and Fisher tests were used in the analysis. The mean age was 42.23 years. Cronbach's Alpha for the Barthel Index was 0.807. The activities that were more difficult to perform were Climbing and Descending Stairs (92%) and Walking (82.7%). The mean Barthel Index score was 64 points. The tests of association demonstrated values with p>0.05. Even though this population demonstrated a low degree of dependency and no association was identified between the socio-demographic variables and Functional Disability, the study contributes to nursing care for individuals with spinal cord injury, considering the limitations the condition imposes on their self-care.

Effectiveness of participatory-action-research to put in practice evidence at a nursing onco-hematology unit

Avaliação da efetividade da aplicação de evidências por meio de pesquisa-ação-participante em uma unidade de enfermagem hematológica

Eva Abad-Corpa; Julio Cabrero-García; Pilar Delgado-Hito; Andrés Carrillo-Alcaraz; Cristobal Meseg...

The aim was to evaluate the effectiveness of evidence implementation through participatory-action research (PAR). A prospective quasi-experimental design with two non-equivalent and non-concurrent groups (2006 and 2008) was adopted. The research was conducted at the bone marrow transplant unit of a tertiary-level Spanish hospital. To put the evidence in practice, PAR was adopted as an "intervention studied". The dependent variables were: professional performance and patient outcomes (psycho-emotional area and adverse effects). In total, 125 patients were recruited (1st period=56; 2nd period=69). The results in the second period show significant improvements in professional performance in terms of the quality of the registers of signs and symptoms. In the psycho-emotional area, the psycho-social adjustment improved significantly; without caregiver burden or satisfaction showing any clear tendencies. Among the adverse effects, catheter-related thrombosis and catheter-related infection improved significantly; there were no significant differences in the level of pain or mucositis. Through the PAR, evidence could be put in practice and the outcomes under analysis could be improved.

Hospitalization of children under five years of age due to avoidable causes

Hospitalizações de menores de cinco anos por causas evitáveis

Rosana Rosseto de Oliveira; Josane Rosenilda da Costa; Thais Aidar de Freitas Mathias

This study characterizes the profile of hospital morbidity according to the main diagnosis upon admission, in individuals younger than five years old, residents of three cities (Maringá, Sarandi and Paiçandu) in the Paraná state, Brazil. Information contained in hospital admission forms from 1998 to 2009 was used. The hospitalizations of 41,220 individuals younger than five years old were analyzed. The results indicate a decline of 16.1% in hospital admissions of patients younger than five years old in relation to the total number of admissions in all age groups. As for the main diagnoses, there were diseases of the respiratory system (55.6%), infectious and parasitic diseases (14.8%) and diseases originating in the perinatal period (12.9%). Such conditions can be avoided by implementing primary health care measures, which shows the need to intensify the actions recommended by the programs directed to child health.

A cross-sectional study of factors underlying the risk of female nurses' suffering abuse by their partners

Estudo transversal sobre fatores de risco de violência por parceiro íntimo entre enfermeiras

María-Aurora Rodríguez-Borrego; Manuel Vaquero-Abellán; Liana Bertagnolli da Rosa

This study aimed to identify factors underlying the risk of suffering abuse by a partner. A cross-sectional study of 622 female nurses was accomplished, randomly chosen at their place of work, at a hospital and health centers. We used a self-administered validated questionnaire that covered psychological, physical and sexual abuse, complemented by a set of sociodemographic questions. The nurses at most risk of being abused by their partners were those who supported their family by their own salary (Odds Ratio: 2.41 [0.63-9.15]), those who lived with dependents (Odds Ratio: 4.27 [1.43-2.78]) and had a partner from social class IIIa (Odds Ratio: 2.62 [1.37-5.00]). The data appear to indicate financial independence as a risk factor for this type of abuse.