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

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Number V23N6

From 1 to 12 of 27 item(s).

Editorial

Clinical Economics and Nursing

Economia Clínica e Enfermagem

Franz Porzsolt

Original Articles

Pain, health perception and sleep: impact on the quality of life of firefighters/rescue professionals

Dor, percepção de saúde e sono: impacto na qualidade de vida de bombeiros/profissionais do resgate

Rafael Silva Marconato, Maria Ines Monteiro

Objective: to evaluate the quality of life of firefighters and rescue professionals, and characterize their socio-demographic, health, work and lifestyle profile. Methods: cross-sectional study that used a socio-demographic, lifestyle, health, work data questionnaire and the WHOQOL-BREF quality of life aspects, in Fire Department bases, Civil Air Patrol Group of the Military Police and Rescue Group of Emergency Services. Results: ninety professionals participated in this study - 71 firefighters, 9 nurses, 7 doctors and 3 flight crew members. The average age of the group was 36.4 ± 7.8 years; they worked about 63.7 hours per week; 20.2% reported pain in the last week and 72.7% had body mass index above 25 kg/m2. The average of the WHOQOL-BREF domains was: physical (74.6), psychological (75.2), social (76.5) and environmental (58.7). Significant association was found (Mann-Whitney test and Spearman correlation) between the WHOQOL-BREF domains and pain in the past six months, in the last week, health perception, job satisfaction, hours of sleep, domestic tasks and study. Conclusion: the main factors related to quality of life were presence of pain, health perception, sleep and domestic activity.

Analgesic efficacy of lidocaine and multimodal analgesia for chest tube removal: A randomized trial study

Eficácia analgésica da lidocaína e analgesia multimodal na remoção do dreno torácico: Um estudo randomizado controlado

Valdecy Ferreira de Oliveira Pinheiro, José Madson Vidal da Costa, Marcelo Matos Cascudo, Ênio de ...

Objective: to assess the analgesic efficacy of subcutaneous lidocaine and multimodal analgesia for chest tube removal following heart surgery. Methods: sixty volunteers were randomly allocated in two groups; 30 participants in the experimental group were given 1% subcutaneous lidocaine, and 30 controls were given a multimodal analgesia regime comprising systemic anti-inflammatory agents and opioids. The intensity and quality of pain and trait and state anxiety were assessed. The association between independent variables and final outcome was assessed by means of the Chi-squared test with Yates’ correction and Fisher’s exact test. Results: the groups did not exhibit significant difference with respect to the intensity of pain upon chest tube removal (p= 0.47). The most frequent descriptors of pain reported by the participants were pressing, sharp, pricking, burning and unbearable. Conclusion: the present study suggests that the analgesic effect of the subcutaneous administration of 1% lidocaine combined with multimodal analgesia is most efficacious.

Validation to Portuguese of the Scale of Student Satisfaction and Self-Confidence in Learning

Validação para a língua portuguesa da escala Student Satisfactionand Self-Confidence in Learning

Rodrigo Guimarães dos Santos Almeida, Alessandra Mazzo, José Carlos Amado Martins, Rui Carlos Negr...

Objective: translate and validate to Portuguese the Scale of Student Satisfaction and Self-Confidence in Learning. Material and Methods: methodological translation and validation study of a research tool. After following all steps of the translation process, for the validation process, the event III Workshop Brazil – Portugal: Care Delivery to Critical Patients was created, promoted by one Brazilian and another Portuguese teaching institution. Results: 103 nurses participated. As to the validity and reliability of the scale, the correlation pattern between the variables, the sampling adequacy test (Kaiser-Meyer-Olkin) and the sphericity test (Bartlett) showed good results. In the exploratory factorial analysis (Varimax), item 9 behaved better in factor 1 (Satisfaction) than in factor 2 (Self-confidence in learning). The internal consistency (Cronbach’s alpha) showed coefficients of 0.86 in factor 1 with six items and 0.77 for factor 2 with 07 items. Conclusion: in Portuguese this tool was called: Escala de Satisfação de Estudantes e Autoconfiança na Aprendizagem. The results found good psychometric properties and a good potential use. The sampling size and specificity are limitations of this study, but future studies will contribute to consolidate the validity of the scale and strengthen its potential use.

A content validity study of signs, symptoms and diseases/health problems expressed in LIBRAS

Um estudo da validade de conteúdo de sinais, sintomas e doenças/agravos em saúde expressos em LIBRAS

Jamilly da Silva Aragão, Inacia Sátiro Xavier de França, Alexsandro Silva Coura, Francisco Stéli...

Objectives: to validate the content of signs, symptoms and diseases/health problems expressed in LIBRAS for people with deafness Method: methodological development study, which involved 36 people with deafness and three LIBRAS specialists. The study was conducted in three stages: investigation of the signs, symptoms and diseases/health problems, referred to by people with deafness, reported in a questionnaire; video recordings of how people with deafness express, through LIBRA, the signs, symptoms and diseases/health problems; and validation of the contents of the recordings of the expressions by LIBRAS specialists. Data were processed in a spreadsheet and analyzed using univariate tables, with absolute frequencies and percentages. The validation results were analyzed using the Content Validity Index (CVI). Results: 33 expressions in LIBRAS, of signs, symptoms and diseases/health problems were evaluated, and 28 expressions obtained a satisfactory CVI (1.00). Conclusions: the signs, symptoms and diseases/health problems expressed in LIBRAS presented validity, in the study region, for health professionals, especially nurses, for use in the clinical anamnesis of the nursing consultation for people with deafness.

Governance of professional nursing practice in a hospital setting: a mixed methods study

Governança da prática profissional do enfermeiro no ambiente hospitalar: pesquisa de métodos mistos

José Luís Guedes dos Santos, Alacoque Lorenzini Erdmann

Objective: to elaborate an interpretative model for the governance of professional nursing practice in a hospital setting. Method: a mixed methods study with concurrent triangulation strategy, using data from a cross-sectional study with 106 nurses and a Grounded Theory study with 63 participants. The quantitative data were collected through the Brazilian Nursing Work Index – Revised and underwent descriptive statistical analysis. Qualitative data were obtained from interviews and analyzed through initial, selective and focused coding. Results: based on the results obtained with the Brazilian Nursing Work Index – Revised, it is possible to state that nurses perceived that they had autonomy, control over the environment, good relationships with physicians and organizational support for nursing governance. The governance of the professional nursing practice is based on the management of nursing care and services carried out by the nurses. To perform these tasks, nurses aim to get around the constraints of the organizational support and develop management knowledge and skills. Conclusion: it is important to reorganize the structures and processes of nursing governance, especially the support provided by the organization for the management practices of nurses.

Levels of career commitment and career entrenchment of nurses from public and private hospitals

Níveis de comprometimento e entrincheiramento com a carreira, de enfermeiros de hospitais públicos e privados

Mauren Pimentel Lima, Vânia Medianeira Flores Costa, Luis Felipe Dias Lopes, Laércio André Gassen...

Objective: to determine the prevalence of the types of relations to career – commitment and entrenchment – of nurses from public and private hospitals. Methods: field survey with a quantitative approach. A total of 237 nurses participated in the survey through a questionnaire with 43 questions about sociodemographic data, occupation, and relation to career. Descriptive statistics, frequency analysis, and Mann-Whitney U test were used for data analysis. Results: nurses from public and private hospitals have a high level of career commitment and a median level of career entrenchment. Conclusions: nurses have a stronger relation of affection and identification to career than a relation of stagnation, maintained primarily due to investments, followed by emotional costs and lack of alternatives. This fact is associated with individuals continuing in nursing and having a strong commitment to activities.

Safety culture in the operating room of a public hospital in the perception of healthcare professionals

Cultura de segurança no centro cirúrgico de um hospital público, na percepção dos profissionais de saúde

Paloma Aparecida Carvalho, Leila Bernarda Donato Göttems, Maria Raquel Gomes Maia Pires, Maria Liz ...

Objective: to evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ). Method: descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis. Results: participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD±9.2) years. And Cronbach’s α of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); unit’s management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages. Conclusions: the results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization.

Use of Balanced Indicators as a Management Tool in Nursing

Utilização de Indicadores Balanceados como ferramenta de gestão na Enfermagem

Neidamar Pedrini Arias Fugaça, Marcia Regina Cubas, Deborah Ribeiro Carvalho

Objective: to develop a proposal for a nursing panel of indicators based on the guiding principles of Balanced Scorecard. Method: a single case study that ranked 200 medical records of patients, management reports and protocols, which are capable of generating indicators. Results: we identified 163 variables that resulted in 72 indicators; of these, 32 nursing-related: two financial indicators (patient’s average revenue per day and patient’s revenue per day by product used); two client indicators (overall satisfaction rate of patient with nursing care and adherence rate to the patient satisfaction survey); 23 process indicators, and five learning and growth indicators (average total hours of training, total of approved nursing professionals in the internal selection process, absenteeism rate, turnover rate and index of performance evaluation). Conclusion: although there is a limit related to the amount of data generated, the methodology of Balanced Scorecard has proved to be flexible and adaptable to incorporate nursing services. It was possible to identify indicators with adherence to more than one area. Internal processes was the area with the higher number of indicators.

Diagnostic accuracy of the defining characteristics of the excessive fluid volume diagnosis in hemodialysis patients

Acurácia diagnóstica das características definidoras do diagnóstico volume de líquidos excessivo de pacientes em hemodiálise

Maria Isabel da Conceição Dias Fernandes, Miclécia de Melo Bispo, Érida Maria Diniz Leite, Marco...

Objective: to evaluate the accuracy of the defining characteristics of the excess fluid volume nursing diagnosis of NANDA International, in patients undergoing hemodialysis. Method: this was a study of diagnostic accuracy, with a cross-sectional design, performed in two stages. The first, involving 100 patients from a dialysis clinic and a university hospital in northeastern Brazil, investigated the presence and absence of the defining characteristics of excess fluid volume. In the second step, these characteristics were evaluated by diagnostic nurses, who judged the presence or absence of the diagnosis. To analyze the measures of accuracy, sensitivity, specificity, and positive and negative predictive values were calculated. Approval was given by the Research Ethics Committee under authorization No. 148.428. Results: the most sensitive indicator was edema and most specific were pulmonary congestion, adventitious breath sounds and restlessness. Conclusion: the more accurate defining characteristics, considered valid for the diagnostic inference of excess fluid volume in patients undergoing hemodialysis were edema, pulmonary congestion, adventitious breath sounds and restlessness. Thus, in the presence of these, the nurse may safely assume the presence of the diagnosis studied.

Prescriptive Authority and Nursing: a comparative analysis of Brazil and Canada

Autoridade Prescritiva e Enfermagem: uma análise comparativa no Brasil e no Canadá

Maria Lígia dos Reis Bellaguarda, Sioban Nelson, Maria Itayra Padilha, Jaime Alonso Caravaca-Morera

Objective: to analyse the differences between medication prescriptions by nurses in Brazil and Ontario, Canada. Methods: a comparative study between two different scenarios; this comparison was not performed between the two countries because Canada does not standardize this practice, which is legally established and is considered as an advanced professional knowledge area in Brazil. Results: prescription is a professional position to be occupied by nurses. However, there is tension surrounding this practice because it is perceived as a threat to privileges or traditions of other health professionals. Prescibing medication by nurses in Brazil and Ontario follows current legislation and training proccess in each context. Conclusions: there are some challenges to be overcome in ensuring the visibility and consolidation of the practice by nurses in these realities: guarantee of professional competence, credibility, acceptability, and the respectability of clientele in your professional scope by other health professionals.

Human error in daily intensive nursing care

O erro humano no cotidiano da assistência de enfermagem em terapia intensiva

Sabrina da Costa Machado Duarte, Ana Beatriz Azevedo Queiroz, Andreas Büscher, Marluci Andrade Conc...

Objectives: to identify the errors in daily intensive nursing care and analyze them according to the theory of human error. Method: quantitative, descriptive and exploratory study, undertaken at the Intensive Care Center of a hospital in the Brazilian Sentinel Hospital Network. The participants were 36 professionals from the nursing team. The data were collected through semistructured interviews, observation and lexical analysis in the software ALCESTE®. Results: human error in nursing care can be related to the approach of the system, through active faults and latent conditions. The active faults are represented by the errors in medication administration and not raising the bedside rails. The latent conditions can be related to the communication difficulties in the multiprofessional team, lack of standards and institutional routines and absence of material resources. Conclusion: the errors identified interfere in nursing care and the clients’ recovery and can cause damage. Nevertheless, they are treated as common events inherent in daily practice. The need to acknowledge these events is emphasized, stimulating the safety culture at the institution.