RLAE | Number V32

Nursing participation in health technology assessment: a pending issue?

Participação da enfermagem na avaliação de tecnologias em saúde: um assunto pendente?

Juan Ramón Lacalle-Remigio, Soledad Benot-López.

International Nursing doctoral education: quality matters

Educação internacional de doutorado em Enfermagem: a qualidade importa

Shaké Ketefian, Silvina Malvarez.

Investing in the future of Nursing: the urgent need for sustainable and innovative work environment

Investindo no futuro da Enfermagem: a necessidade urgente de ambientes de trabalho sustentáveis e inovadores

Renata Cristina Gasparino, Olga Maria Pimenta Lopes Ribeiro, José Luís Guedes dos Santos, Andrea B...

Digital health: contributions from Nursing

Saúde digital: contribuições da Enfermagem

Ana Estela Haddad, Swedenberger Barbosa, Paulo Eduardo Guedes Sellera, Marcelo D’Agostino.

Quality of home visits by community health workers in primary care and associated factors

Qualidade da visita domiciliar do agente comunitário de saúde na atenção básica e fatores associados

Marciane Kessler, Elaine Thumé, Luiz Augusto Facchini, Luiza Carolina Moro, Elaine Tomasi.

Objective: to evaluate community health workers’ and quality of home visits associated factors. Method: a cross-sectional study of 38,865 teams and 140,444 Primary Care Access and Quality Improvement Program users. We established the “quality of home visits” and its association with the characteristics of the municipalities, teams and individuals, estimated by the prevalence ratio and 95% confidence intervals. Results: 139,362 (99.2%) users said the health team had community workers. The prevalence of quality was 51.9%. After adjustments, the prevalence was higher in the Northeast (Prevalence Ratio: 1.19 [1.18-1.21]), smaller municipalities (PR: 1.06 [1.03-1.09]), among teams with area definition (PR: 1.15 [1.06-1.25]), evaluation of indicators (PR: 1.14 [1.12-1.17]) and user satisfaction (PR: 1.11 [1.08-1.13]), that considered risk and vulnerability criteria for defining the number of people under responsibility (PR: 1.05 [1.04-1.07]) and without an uncovered population of workers (PR: 1.03 [1.01-1.04]); among users with chronic diseases (PR: 1.02 [1.01-1.05]) and with someone at home with walking difficulties (PR: 1.05 [1.02-1.07]). Conclusion: the importance of organizing the teams’ work process for the quality of the worker’s home visits and their role in health equity is highlighted.

Multicenter study on satisfaction, stress and working conditions in nursing in Latin American countries

Estudo multicêntrico sobre satisfação, estresse e condições de trabalho na Enfermagem em países latino-americanos

Diana Carolina Tiga-Loza, Anyela Mancilla-Lucumi, Maria Andrea Castro-Bernal, Oscar Javier Vergara-E...

Objective: to assess the job satisfaction level, stressors and working conditions of nursing professionals in some Latin American countries during the COVID-19 pandemic. Method: this is a cross-sectional study of nursing professionals working in hospital, primary care, educational, governmental, research, commercial and independent institutions. An online survey was carried out to assess satisfaction with the Font-Roja instrument, sociodemographic characteristics, stress factors and working conditions. Results: a total of 1,215 workers from Argentina, Colombia, Mexico, Ecuador and Panama participated. The overall satisfaction score was 81.5 (SD:11.6). There was less satisfaction in the dimensions of tension, pressure, extrinsic characteristics and monotony. Increased stress at work (84.3%), workload (81.3%), fear of SARS-CoV-2 (67.7%), uncertainty at work (51.2%) and salary reduction (20.4%) were reported. The work factors related to satisfaction were, as follows: job recommendation, mixed working hours, care work, increased stress, increased workload, salary reduction and purchase of protective equipment. Conclusion: the aspects of job satisfaction most affected during the pandemic were pressure, tension, lack of independence and monotony at work; this satisfaction was reduced due to increased stress and workload, the acquisition of personal protective equipment and a reduction in salary.

Smartphone and tablet use pattern in children up to 5 years old in Spain: a cross-sectional study

Padrão de uso de smartphones e tablets em crianças de até cinco anos de idade na Espanha: um estudo transversal

Sonia de Paz-Cantos, Adrián González-Marrón, Cristina Lidón-Moyano, Maria Cerrato-Lara, Ana Díe...

Objective: to characterize the smartphones and tablets use pattern in a sample of children up to 5 years old and assess with which variables it is associated. Method: cross-sectional study of 410 parents of children up to 5 years of age. Data were obtained from an online questionnaire. Questions about the time and pattern of daily use of smartphones and tablets were collected. We calculated the overall percentage (and 95% confidence interval) and median (and interquartile range) of each device’s use time and according to the variables associated with the child, and the respondent’s characteristics. Results: an estimated 44.7% (95% CI: 37; 51) of children used both smartphones and/or tablets daily. The median use time for smartphones and tablets separately was 30 minutes per day for smartphones (8.6-38.6) and 30 (17.1- 60.0) for tablet. In children who have free access to the devices, 11.6% (95% CI: 6; 16) use these devices up to 30 minutes after waking up on weekdays, 15.4% (95% CI: 10; 21) during weekends and 14.0% (95% CI: 8; 19) use smartphone and/or tablet up to 1 hour before going to bed. Conclusion: more than 4 out of 10 children in our sample used smartphones and/or tablets daily. Community nursing may be a viable avenue for implementing educational programs focused on promoting healthy practices in children’s electronic device usage given the pattern of excessive screen use in the pediatric population.

The “ Nasci Bem ” app for health professionals and families of newborns: construction, validation and evaluation

Aplicativo “Nasci Bem” para profissionais de saúde e familiares de recém-nascidos: construção, validação e avaliação

Ingrid Lucchese, Fernanda Garcia Bezerra Góes, Maithê de Carvalho e Lemos Goulart, Maria da Anunci...

Objective: to construct, validate and evaluate an app for mobile devices on humanized care practices for newborns at habitual risk in maternity wards, aimed at health professionals and family members. Method: a methodological study in seven stages: Literature review; Content organization; App construction; Validation by experts; Suitability after validation; Evaluation by the target audience; and Suitability after evaluation. A total of 22 experts took part in the validation and 21 individuals from the target audience in the evaluation. The instruments addressed content, face and/or motivation, with the System Usability Scale for usability. The following was calculated: Concordance Index and Usability Score. Results: in the validation process, the app achieved a Concordance Index of 0.97; ranging from 0.82 to 1.0 across the items analyzed. In the evaluation, the index was 0.99, varying from 0.95 to 1.0. In usability of the first version, the Concordance Index was 0.92 and the Usability Score was 93. In the second version, the index was 0.93 and the score was 94, indicating better usability achieved since the first version. Conclusion: the “ Nasci Bem ” app proved to be comprehensible, relevant, pertinent, efficient, easy to use, with low inconsistency, and with excellent potential to use it as educational technology for professionals and family members.

Educational technology to support patient safety in the operating room: clinical simulation guides

Tecnologia educacional para apoiar a segurança do paciente no bloco cirúrgico: guias clínicas de simulação

Letícia Marie Sakai, Neide da Silva Knihs, Ana Graziela Alvarez, Patrícia Treviso, Aline Lima Pest...

Objective: to develop and validate two clinical simulation guides to support and disseminate a culture of safety in the surgical environment. Method: methodological study supported by the International Nursing Association for Clinical Simulation and Learning theoretical framework. The snowball technique was used to validate the clinical guidelines with experts on the subject. Two scales validated for Brazil were used for the pilot test. Results: 89 operating room professionals took part, including 41 doctors, 40 nursing technicians, four nurses, two radiology technicians, and two nursing trainees. Two guides were created, one on conflict management and teamwork in patient safety during the transfer of the patient from the operating room to the post-anesthetic recovery room, and the other dealing with the assistance of the healthcare team in the transfer of care in the post-anesthetic recovery room. The evaluation of Satisfaction with Simulated Clinical Experiences had an average score of 8.3 and Satisfaction and Self-confidence in learning 4.1. Conclusion: the guides have been validated and are suitable for replication in any surgical environment. We believe that this technology could contribute to improving the safety culture in the operating room by providing an opportunity for reflection and critical thinking.

Validity of the Kessler Psychological Distress scale in Brazilian higher education students

Validade da escala de Sofrimento Psicológico de Kessler em estudantes brasileiros do ensino superior

Jaqueline Galdino Albuquerque Perrelli, Gabriel Vinícius Souza de Vasconcelos, Jéssica Rodrigues C...

Objective: to evaluate of the validity of the Brazilian version of the Kessler Psychological Distress Scale, based on its internal structure, concurrent validity, and predictive validity, for the screening of psychological distress among higher education students. Method: methodological study with 1,034 participants, using the Kessler Psychological Distress Scale as well as the Self-Reporting Questionnaire. An analysis of the internal structure was conducted using a two-factor confirmatory factor analysis, which evaluated fit indices and hierarchical omega reliability coefficients. A Pearson’s correlation test was used to assess concurrent validity, while sensitivity, specificity, areas under the ROC curve and 95% confidence intervals were used to assess predictive validity. Results: the bifactor model demonstrated excellent fit indices (CFI=1.000; TLI=0.999; SRMR=0.019; RMSEA=0.028; 95%CI: 0.015 - 0.041) as well as high reliability (ωH=0.886). It was observed that there was a strong correlation between the K10 and the SRQ (r=0.813; 95%CI: 0.784 - 0.837). The ideal cut-off point for screening was identified as being higher than 21, with a sensitivity of 85.2% and a specificity of 82.9%. Conclusion: the structure composed of a general factor, psychological distress, demonstrated a high level of reliability. The scale demonstrated concurrent and predictive validity for the assessment of psychological distress among university students.

Using expert-modeling videos in telesimulations to teach pediatric and neonatal nursing

Utilização do expert-modeling videos em telessimulações no ensino de enfermagem pediátrica e neonatal

Mariane Caetano Sulino Gonçalves, Aline Natalia Domingues, Luciana Mara Monti Fonseca, Regina Apare...

Objective: to assess the perception of self-efficacy, self-confidence, and satisfaction of undergraduate nursing students during the use of expert-modeling videos as a learning strategy in the period of social distancing. Method: this was a descriptive study with undergraduates studying disciplines of caring for hospitalized newborns and children at a higher education nursing institution in the interior of the state of São Paulo, Brazil. Activities were organized in three moments, in real time: prebriefing, expert-modeling videos and debriefing. The expert-modeling videos replaced the clinical simulation scenario during the social distancing required by the COVID-19 pandemic, for the development of telesimulation. Specific validated scales were used to analyze students’ self-confidence, self-efficacy and satisfaction. Content analysis assessed the advantages and disadvantages of using expert-modeling videos. Results: thirty-nine undergraduates took part in the study. High levels of self-confidence, self-efficacy and satisfaction were found among the participants. The advantages of expert-modeling videos were organized into the following categories: Convenience, Security and continuity of studies and Efficient teaching method, and the disadvantages into Problems with technology, Distractions, Lack of personal contact and Mental fatigue. Conclusion: telesimulation activities were consolidated as strategies that enabled learning in times of emergency online teaching due to the realness of telesimulation, the development of skills in caring for children and newborns and the link between theory and practice.

Transsexual men’s experiences of childbirth and postpartum in the light of transcultural care

Experiências de homens transexuais no parto e pós-parto à luz do cuidado transcultural

Danilo Martins Roque Pereira, Ednaldo Cavalcante de Araújo, Sheyla Costa de Oliveira, Anderson Reis...

Objective: to unveil the experiences of transsexual men during childbirth and postpartum in the light of the Theory of Diversity and Universality of Cultural Care. Method: a qualitative and descriptive study using the multiple case study method. Data was collected using an intentional sample of five transsexual men, selected on the basis of convenience and availability. The interviews were transcribed in full and the results were organized and adapted to the Sunrise Model. Results: the majority of the participants were «primiparous» and had given birth by cesarean section. In adapting the Sunrise Model, we observed the encouragement of medicalization and mechanistic management of childbirth; fear of natural childbirth; violence perpetrated against transsexual men resulting from the difficulty of access to information by the pregnant man, and obstetric care not qualified to meet the needs of the public, resulting in fragile care, with dissatisfaction with the health service. Conclusion: the experiences of transsexual men during childbirth and the postpartum period are a mixture of experiences that generate damage, especially when linked to situations of transphobic violence and violation of rights.

Number V32

Editorial