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

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Editorial

Approach to reflective practice: an epistemological redignification of the professional nurse

O enfoque da prática reflexiva: uma redignificação epistemológica da enfermeira profissional

José Luis Medina

The use of robots in nursing

A utilização de robôs na enfermagem

Maria Lúcia do Carmo Cruz Robazzi

Nursing as the profession of the future and the foundation of universal health systems

A enfermagem como profissão do futuro e base de sustentação dos sistemas universais

Ricardo Alexandre Arcêncio

The inclusion of mental health in the international public health agenda and the leading role of nursing in this process

A inclusão da saúde mental na agenda da saúde pública internacional e o protagonismo da enfermagem no processo

Sueli Frari Galera

Interprofessional Health Education in the Region of the Americas

A Educação Interprofissional em saúde na Região das Américas

Fernando Antonio Menezes da Silva, Silvia Helena De Bortoli Cassiani, José Rodrigues Freire Filho

Editorial management and the 25 years of the Latin American Journal of Nursing

Gestão editorial e os 25 anos da Revista Latino-Americana de Enfermagem

Maria Helena Palucci Marziale

Original Articles

Cross-cultural adaptation and validation of Pamela Reed’s Self-Transcendence Scale for the Spanish context

Adaptação cultural da Escala de Autotranscendência de Pamela Reed ao contexto espanhol

Alberto Pena-Gayo, Víctor Manuel González-Chordá, Águeda Cervera-Gasch, Desirée Mena-Tudela

Objectives: the current study aimed to adapt the Self-Transcendence Scale (STS) to the Spanish context and analyse its psychometric properties. Method: the STS was administered to a general Spanish population of adults (i.e., older than 20 years; n = 116) through an online platform. The Psychological Well-Being (PWB) and the Functional Assessment of Chronic Illness Therapy - Spiritual Well-being - modified version for healthy people (FACIT-Sp-Non-Illness) scales were also applied in two moments separated by an interval of 15 days. Results: the results of the validation included the following statistics: α t = 0.772 (test) and α rt = 0.833 (retest); ICC = 0.278 (p = 0.097, intraclass) and 0.932 (p < 0.001, interclass); a Bland-Altman confirmation of the test/re-test (TRT) concordance; global content validity coefficient (S-CVI) = 0.92; r 1 = 0.636 (PWB) and r 2 = 0.687 (FACIT-Non-Illness; both p < 0.001); and three factors explained 42.3% of the variance. The STS showed positive apparent validity and feasibility. Conclusions: the Spanish version of the STS is valid for use in the general population, with updates relative to the Colombian version that include more natural wordings, syntactic corrections, inclusive language, a better definition of the concepts, and an alternative factor model.

Tuberculosis control from the perspective of health professionals working in street clinics

O controle da tuberculose na ótica de profissionais do Consultório na Rua

Paula Hino, Aline Aparecida Monroe, Renata Ferreira Takahashi, Káren Mendes Jorge de Souza, Tania M...

Purpose: to present the opinion of professionals about street dwellers undergoing treatment of tuberculosis and identify strategies of control of tuberculosis in this population. Method: an exploratory and descriptive study involving 17 health professionals working in street clinics. A semi-structured study composed of closed questions and a guiding question. The statements were analyzed using the discourse analysis technique, resulting in the identification of two analytical categories: 1. Meanings attributed to street dwellers with tuberculosis, and 2. Control of tuberculosis in homeless people. Results: the analysis identified situations that limited adherence to tuberculosis treatment, including the reasons for staying in the streets, living conditions, and risk factors (dependence on alcohol and other drugs, short-sightedness, constant relocations, and lack of perspectives). Street dwellers were knowledgeable about the disease. Furthermore, there were difficulties in solving several problems of people living in the streets, including living conditions and lifestyle, social stigma, relocations, drug abuse, and lack of life project. Conclusion: coping with the complexity of situations related to living in the streets limits to the work of health professionals because these situations go beyond health care and require intersectoral actions.

Diagnostic evaluation of risk for bleeding in cardiac surgery with extracorporeal circulation

Avaliação diagnóstica do risco de sangramento em cirurgia cardíaca com circulação extracorpórea

Damaris Vieira Braga, Marcos Antônio Gomes Brandão

Objective: to identify the risk factors associated with cases of excessive bleeding in patients submitted to cardiac surgery with extracorporeal circulation. Method: case-control study on the factors of risk for bleeding based on the analysis of data from the medical charts of 216 patients submitted to cardiac surgery with elective extracorporeal circulation during a three-year period. Results:variables that are commonly associated with excessive bleeding in studies in the field were analyzed, and the following were considered as risk factors for the nursing diagnosis “risk for bleeding” (00206) in cardiac surgery with extracorporeal circulation: Body mass index lower than 26.35kg/m² (Odds ratio = 3.64); Extracorporeal circulation longer than 90 minutes (Odds ratio = 3.57); Hypothermia lower than 32°C (Odds ratio = 2.86); Metabolic acidosis (Odds ratio = 3.50) and Activated partial thromboplastin time longer than 40 seconds (Odds ratio= 2.55). Conclusion: such variables may be clinical indicators of an operational nature for a better characterization of the risk factor “treatment regimen” and a refinement of knowledge related to coagulopathy induced by extracorporeal circulation, which is currently presumably incorporated into the “treatment regimen” category of the nursing diagnostic classification by NANDA International, Inc.

Clinical trial for the control of water intake of patients undergoing hemodialysis treatment

Ensaio clínico para o controle da ingestão hídrica de pacientes em tratamento hemodialítico

Graziella Allana Serra Alves de Oliveira Oller, Marília Pilotto de Oliveira, Cláudia Bernardi Cesa...

Objective: to analyze the impact of an educational and motivational intervention for patients with a chronic kidney disease, undergoing hemodialysis treatment, on the control of fluid intake during interdialytic periods. Method: a quasi-experimental, non-randomized clinical trial with patients from a Nephrological Unit of the State of São Paulo. Participants were included in two groups: Control Group with 106 patients and Intervention Group with 86 patients, totaling 192 participants. The used intervention was an educational and motivational video to control liquid intake, based on the Bandura’s Theory. The measure of control of water intake was the percentage of lost weight, also considered the variable outcome of the research. For the data analysis, descriptive analyses and regression analysis of the Inflated Beta Model were used. Results: patients who participated in the intervention had a decrease in the pattern of weight gain in interdialytic periods, with a 3.54 times more chance of reaching the goal of 100% of weight loss when compared to participants from the control group. Conclusion: the educational and motivational intervention was effective in reducing the percentage of weight loss in patients undergoing hemodialysis. Brazilian Clinical Trials Registry (ReBEC) under the opinion RBR-4XYTP6.

Patient, cured, victim or survivor of urological cancer? A qualitative study

Paciente, curado, vítima ou sobrevivente de câncer urológico? Um estudo qualitativo

Rafaela Azevedo Abrantes de Oliveira, Márcia Maria Fontão Zago

Purpose: to describe the meanings that patients attribute to the term cancer survivor and to analyze the identities assumed by them according to their experience with the disease. Methods: qualitative study with a narrative method, theoretical framework of the medical anthropology and identity concept. The study included 14 participants, men and women, diagnosed with urologic cancer. The semi-structured interviews were performed at the individual’s home, after confirming participation. Results: eight participants assumed to be survivors, but five also assumed at least one other identity, in addition to cancer survivor. In contrast, among the six who defined themselves as cured, only one indicated another identity. Four considered themselves as victims and only two as cancer patients. However, the latter - cancer patient and victim - assumed at least one other associated identity. Conclusions: allowing patients to reflect on themselves and their experience with the disease, as well as attributing themselves a new identity, will be directly related to the wellbeing and momentum the survivor is going through. Therefore, it can direct care in the cancer survivorship phase according to each survivor’s individual context.

Validation of vulnerability markers of dysfunctions in the socioemotional development of infants

Validação de marcadores de vulnerabilidade de lactentes para disfunções em seu desenvolvimento socioemocional

Daniel Ignacio da Silva, Débora Falleiros de Mello, Renata Ferreira Takahashi, Cody Stonewall Holli...

Objectives: to validate the vulnerability markers of dysfunctions in the socioemotional development of infants. Methods: study with a sequential exploratory mixed-method design. The vulnerability markers elaborated in the qualitative phase were analyzed by experts in the quantitative phase using the Delphi technique with a minimum consensus of 70%. Seventeen judges answered the questionnaire in the first round of analysis and 11 answered in the second round. Results: in the first round, two markers did not reach minimum consensus: the presence of instability in family relationships (66%) and delinquency and/or drug abuse by parents/caregivers (65%). In the second round, all markers were validated, with more than 90% agreement in most of the attributes, and reached the minimum consensus of 73%. Conclusion: the eight vulnerability markers reached the minimum consensus for validation, and a relevant instrument for infant care can be developed after assessing the reliability and clinically validating these markers.