Does whole-body vibration improve risk of falls, balance, and heart rate variability in post-COVID-19 patients? A randomized clinical trial.

INTRODUCTION: Whole-Body Vibration (WBV) can be a therapeutic recovery strategy for patients hospitalized for COVID-19. OBJECTIVES: To evaluate the effects of a 36-session WBV protocol on the risk of falls, balance, mobility and heart rate variability (HRV). STUDY DESIGN: A randomized clinical trial. METHODS: 13 patients affected by COVID-19, trained with WBV, 3×/week on alternate days, totaling 36 sessions, were evaluated before and after the intervention. RESULTS: WBV training at 2 mm and 4 mm amplitude resulted in a reduction in the risk of falls when compared to Sham (p = 0.023), with effect size of 0.530. No changes were observed for mobility and balance outcomes (p = 0.127) or for any of the HRV variables (p = 0.386). CONCLUSION: WBV training reduced the risk of falls in post-COVID patients. No changes were observed regarding balance and mobility, nor for HRV.

Comparison of terbutaline and atosiban as tocolytic agents in intrauterine repair of myelomeningocele: a retrospective cohort study.

BACKGROUND: Myelomeningocele (MMC) is a neural tube defect disease. Antenatal repair of fetal MMC is an alternative to postnatal repair. Many agents can be used as tocolytics during the in utero fetal repair such as ß2-agonists and oxytocin receptor antagonists, with possible maternal and fetal repercussions. This study aims to compare maternal arterial blood gas analysis between terbutaline or atosiban, as tocolytic agents, during intrauterine MMC repair. METHODS: Retrospective cohort study. Patients were divided into two groups depending on the main tocolytic agent used during intrauterine MMC repair: atosiban (16) or terbutaline (9). Maternal arterial blood gas samples were analyzed on three moments: post induction (baseline, before the start of tocolysis), before extubation, and two hours after the end of the surgery. RESULTS: Twenty-five patients were included and assessed. Before extubation, the terbutaline group showed lower arterial pH (7.347 ± 0.05 vs. 7.396 ± 0.02 for atosiban, p = 0.006) and higher arterial lactate (28.33 ± 12.76 mg.dL-1 vs. 13.06 ± 6.35 mg.dL-1, for atosiban, p = 0.001) levels. CONCLUSIONS: Patients who received terbutaline had more acidosis and higher levels of lactate, compared to those who received atosiban, during intrauterine fetal MMC repair.

Prevalence of pelvic floor disorders and the associated quality of life among institutionalized and noninstitutionalized elderly women: A cross-sectional study.

Background: An increase in life expectancy has led to an increased elderly population. In turn, this aging population is more likely to develop health conditions, such as pelvic floor disorders (PFDs). This study aimed to assess the prevalence of these disorders and the associated quality of life in institutionalized and noninstitutionalized elderly women. Materials and methods: A cross-sectional study was conducted with 80 female participants older than 60 years, divided into 2 groups: institutionalized and noninstitutionalized participants. The Pelvic Floor Distress Inventory Short-Form and a sociodemographic questionnaire were used. A chi-squared test was used to assess the differences in prevalence between groups. Results: There was no statistically significant difference between the groups in the prevalence of PFDs or quality of life. In this study, the prevalence of PFDs was higher than that reported previously. In institutionalized women, a higher prevalence of PFDs and impaired quality of life were expected, although not observed. Conclusions: There was a higher prevalence of pelvic disorders and impaired quality of life due to these disorders in elderly women.

Cuidados de enfermagem omissos na perceção da equipa: Uma análise das razões / The nursing team's perspective on missed nursing care: An analysis of the reasons / Cuidados de enfermería omitidos en la percepción del personal: Un análisis de las razones

Resumo Enquadramento: Diante de múltiplas solicitações e recursos insuficientes, os profissionais de enfermagem podem não executar alguns cuidados requeridos. Objetivos: Identificar os cuidados de enfermagem omissos, as razões atribuídas pelos profissionais de enfermagem e verificar se as razões diferem entre as categorias profissionais. Metodologia: Estudo descritivo, transversal, utilizando o instrumento MISSCARE-Brasil numa amostra por conveniência de 115 participantes, distribuídos entre 48 enfermeiros e 67 técnicos em enfermagem. Resultados: Os participantes apresentaram média de idade de 34,9 anos, predominando o sexo feminino, 88,6%. Os cuidados de enfermagem mais omitidos foram a deambulação três vezes por dia ou conforme prescrito, 58,3%; a participação em discussão da equipa interdisciplinar sobre a assistência ao paciente, 55,6%; e a oferta das refeições para os pacientes que se alimentam sozinhos, 53,1%. As principais razões para omissão foram relacionadas os domínios "Recursos Materiais" e "Laborais". Conclusão: Os recursos materiais e laborais influenciam na frequência de cuidados de enfermagem omissos, apesar das justificações diferenciadas para omissão do cuidado entre enfermeiros e técnicos em enfermagem.

Abstract Background: Faced with multiple requests and insufficient resources, the nursing professionals may not perform some required care. Objectives: Identify the missing nursing care, the reasons attributed by nursing professionals and check whether the reasons differ between professional categories. Methodology: A descriptive, cross-sectional study using the MISSCARE-Brazil instrument in a convenience sample of 115 participants, distributed between 48 nurses and 67 nursing technicians. Results: Participants had a mean age of 34.9 years, predominantly female, 88.6%. The most omitted nursing care were walking three times a day or as prescribed, 58.3%; the participation in the discussion of the interdisciplinary team about patient care, 55.6% and the offer of meals to patients who eat alone, 53.1%. The main reasons for the omission were related to the "Material Resources" and "Laboratory" domains. Conclusion: material and labor resources influence the frequency of missing nursing care, despite different justifications for omission of care among nurses and nursing technicians.

Resumen Marco contextual: Ante la multitud de solicitudes y la insuficiencia de recursos, los profesionales de enfermería pueden no realizar algunos de los cuidados necesarios. Objetivos: Identificar los cuidados de enfermería omitidos, las razones atribuidas por los profesionales de enfermería y verificar si las razones difieren entre las categorías profesionales. Metodología: Estudio descriptivo, transversal, utilizando el instrumento MISSCARE-Brasil en una muestra de conveniencia de 115 participantes, distribuidos entre 48 enfermeros y 67 técnicos de enfermería. Resultados: Los participantes tenían una edad media de 34,9 años, con predominio del sexo femenino, el 88,6%. Los cuidados de enfermería más omitidos fueron los paseos tres veces al día o según lo prescrito, el 58,3%; la participación en las discusiones con el equipo interdisciplinario sobre los cuidados del paciente, el 55,6%; y la provisión de comidas para los pacientes que se alimentan solos, el 53,1%. Los principales motivos para omitirlos estaban relacionados con los ámbitos "Recursos materiales" y "Mano de obra". Conclusión: Los recursos materiales y laborales influyen en la frecuencia de los cuidados de enfermería omitidos, a pesar de las diferentes justificaciones para omitirlos entre los enfermeros y los técnicos de enfermería.

Professional Nursing Communication Competence: Theoretical procedures for instrument development and pilot test.

AIMS: To describe the theoretical procedures for the development of the Professional Nursing Communication Competence instrument, determine the content validity and describe the pilot test application. BACKGROUND: Measuring instruments must be developed in accordance with the context and communication process by adopting theoretical procedures based on competence structures to support quality patient-centred care and nursing management. METHODS: A methodological study was employed. The instrument was developed by using content-validated theoretical construct in accordance with 33 communication theories followed by semantic analysis and content validity by experts. The instrument was tested over three phases: before the lecture on professional nursing communication competence, after the simulation scenario experience and after debriefing. RESULTS: The instrument showed an extremely high agreement (CVI = 0.99). Linear regression suggested three domains of the 46-item content-validated instrument comprising knowledge (18 items), skills (12 items) and attitudes (16 items). CONCLUSION: The instrument was found to measure professional communication competence with a high theoretical reliability of the contexts and processes through a simulation strategy. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing educators, managers and staff can adopt the Professional Nursing Communication Competence (IMC-CPE) instrument to improve the effectiveness level of knowledge, skills and attitudes to reduce misunderstanding among team members and health care errors.

A novel measurement instrument for pressure-injury risk assessment competence: Theoretical procedures, simulation, and psychometric quality.

This study developed a measuring instrument of pressure-injury risk assessment competence for nursing education adopting theoretical procedures based on competence structuration to support the psychometric quality. The objective of this study is testing the psychometric properties of the instrument using simulation strategy and to determine the instrument's standardisation and normalisation. A methodological study was designed. The instrument was developed by a content-validated theoretical construct administered to 155 undergraduate nursing students from universities in the northeast and south of Brazil using simulation. The instrument was applied over three phases: before the lecture on pressure-injury risk assessment competence, after scenario of simulation experience, and after debriefing experience. The instrument comprised 32 items. The factorial analysis found that three domains explained 64.6% and 62.18% of the total variance in post-scenario and debriefing cases. The perfect and very high discrimination index of the instrument indicated minimal differences in measured latent trait levels. It also found that reliability was excellent (0.973 and 0.967). Moreover, an equation applicable to instruments using study's theoretical procedure was proposed. The instrument was found to be a valid, accurate, and reliable educational tool for pressure-injury risk assessment competence.

Relationship between the implementation of primary nursing model and the reduction of missed nursing care.

AIMS: To evaluate and predict the relationship between the implementation of the primary nursing model and the reduction of missed nursing care. BACKGROUND: Primary nursing can provide hospital leaders and nursing staff with guidance in implementing safe, patient-centred care, with responsibility and accountability during the nursing process. The implementation can be measured in terms of missed nursing care. METHODS: A predictive correlational study was used. The study was conducted in four inpatient units at the University Hospital, Northeast, Brazil. Data were collected from 96 nursing professionals, using the MISSCARE instrument at four and seven months after the implementation of the primary nursing model. RESULTS: Missed nursing care was reduced by 78.5%. Job title and staff satisfaction showed significant associations with decreased missed care (p < .05). CONCLUSION: The predictive effect between efficacy in reducing missed nursing care and reasons and efficiency in the management of nursing care, using the primary nursing model, was verified. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing staff and managers should consider adopting a Primary Nursing Model of care to reduce missed nursing care.

Informações epidemiológicas sobre a Covid-19: influência da cibercultura no engajamento popular às medidas de controle / Informaciones epidemiológicas sobre Covid-19: influencia de la cíbercultura en el acatamiento de la población a las medidas de control / Epidemiological information on Covid-19: influence of cyberculture on popular engagement to control measures

OBJETIVO: analisar a comunicação de informações epidemiológicas para a adesão da população às medidas de controle, na perspectiva de Pierre Levy e Littlejohn. DESENVOLVIMENTO: a reflexão contextualiza a influência das informações online, mídias sociais e televisão na construção da cibercultura brasileira. Foi analisada a importância de informações epidemiológicas detalhadas, incluindo deficiências no rastreamento de contatos e na expansão da cobertura dos testes, para o efetivo engajamento comunitário. CONCLUSÃO: a comunicação em massa contribui efetivamente para nova inteligência coletiva em ciberespaços que caracterizam a cibercultura brasileira. Quanto mais transparentes forem as informações oficiais, maior adesão e apoio das populações no controle da pandemia.

OBJETIVO: analizar la comunicación de las informaciones epidemiológicas para el acatamiento de la población a las medidas de control, desde la perspectiva de Pierre Levy y Littlejohn. DESARROLLO: la reflexión contextualiza la influencia que ejercen las informaciones en línea, en los medios sociales, y en la televisión en la construcción de la cíbercultura brasileña. Se analizó la importancia de informaciones epidemiológicas detalladas, incluidas deficiencias en el rastreo de contactos y en la expansión de la cobertura de las pruebas, a fin de lograr un efectivo acatamiento comunitario. CONCLUSIÓN: la comunicación masiva contribuye de manera eficaz a desarrollar una nueva inteligencia colectiva en los ciberespacios que caracterizan a la cibercultura brasileña. Cuanto más transparente sea la información oficial, mayor será el acatamiento y el apoyo de las poblaciones en cuanto al control de la pandemia.

OBJECTIVE: To analyze the communication of epidemiological information for the population's adherence to control measures, from the perspective of Pierre Levy and Littlejohn. DEVELOPMENT: Reflection contextualizes the influence of online information, social media, and television in the construction of the Brazilian cyberculture. The importance of detailed epidemiological information was analyzed for effective community engagement, including deficiencies in tracking contacts and expanding test coverage. CONCLUSION: Mass communication contributes effectively to new collective intelligence in cyberspaces that characterize the Brazilian cyberculture. The more transparent the official information, the greater the adherence and support of the populations in controlling the pandemic.

Planejamento estratégico situacional em uma instituição psiquiátrica: contribuições e desafios / Situational strategic planning in a psychiatric institution: contributions and challenges / Planificación estratégica situacional en una institución psiquiátrica: contribuciones y desafios

OBJETIVO: aplicar o Planejamento Estratégico Situacional no serviço de enfermagem de uma instituição psiquiátrica. MÉTODO: pesquisa-ação em um hospital psiquiátrico do Nordeste Brasileiro, no período de dezembro/2015 a junho/2016, com a participação de 34 profissionais de enfermagem. Realizadas entrevistas e reuniões, as quais foram gravadas, transcritas e procedida análise de conteúdo. RESULTADOS: os problemas prioritários foram dimensionamento inadequado de pessoal, insegurança, falhas no gerenciamento de recursos materiais e déficit no cuidado integral prestado. Além disso, houve dificuldades para implementação - baixa governabilidade, comunicação deficiente e desmotivação profissional. CONCLUSÃO: o planejamento estratégico situacional é útil para o delineamento das ações em saúde mental e sua eficácia depende do comprometimento dos atores envolvidos.

OBJECTIVE: to aplly the situational strategic planning in the nursing service of a psychiatric institution. METHOD: action research in a psychiatric hospital of Northeast Brazil, during the period of December/2015 to June/2016, when 34 nursing staff participated. Enterviews and meetings were conducted, which were recorded/transcripted and content analysis performed. RESULTS: the priority problems were inadequate staffing, insecurity, failures in the material management and deficit in the comprehensive care provided. Besides that, the difficulties to implementation were- low governability, poor communication and staff desmotivation. CONCLUSION: situational strategic planning is useful to delineaction of actions in mental health and its efficacy depends on the envolved actors commitment.

OBJETIVO: aplicar la planificación estratégica situacional en un servicio de enfermería de una institución psiquiátrica. MÉTODO: investigación/acción en hospital psiquiátrico del nordeste brasileño, período entre diciembre de 2015 y junio de 2016, participación de 34 profesionales de enfermería. Realizadas las encuestas y las reuniones, que fueron registradas y transcritas, y se hizo análisis de contenido. RESULTADOS: los problemas primeros fueron la dimensión insuficiente de personal, inseguridad, faltas en la gestión de los recursos materiales y el déficit en la atención integral proporcionada. Incluso, las dificultades para la aplicación- baja de gestión, mala comunicación y baja motivación profesional. CONCLUSIÓN: planificación estratégica situacional es útil para la delineación de acciones en salud mental y su efectividad depende del compromiso de los actores ivolucrados.

Padrões de cuidados em prevenção e tratamento de extravasamento de antineoplásicos baseado em evidências clínicas / Patterns of care in prevention and treatment of clinical evidence-based antineoplastic extravasation

Objetivo: descrever padrões de cuidados em prevenção e tratamento de extravasamento de antineoplásicos baseado em evidências clínicas. Métodos: revisão integrativa da literatura realizada nas bases de dados Medline/PuBMed, CINAHL, LILACS e Science Direct. Resultados: foram localizados 30 estudos em inglês e espanhol, entre 2005 a 2015. Os temas predominantes quanto ao extravasamento são fatores de risco, medidas de prevenção e tratamento, como o uso de compressas e antídotos, estes foram organizados em quadros e classificados quanto ao nível de evidência e grau de recomendação. Conclusão: a prevenção é a principal estratégia. Ressalta-se a importância de implementação de protocolo assistencial

Objective: to describe patterns of care in the prevention and treatment of clinical evidence based antineoplastic extravasation. Methods: integrative literature review carried out in Medline/PuBMed, CINAHL, LILACS and Science Direct databases. Results: 30 studies were conducted in english and spanish between 2005 and 2015. The predominant themes regarding extravasation are risk factors, prevention and treatment measures, such as the use of compresses and antidotes, these were organized in tables and classified as level of evidence and degree of recommendation. Conclusion: prevention is the main strategy. It is important to emphasize the importance of implementing a care protocol

Whole body vibration to attenuate reduction of explosive force in chronic kidney disease patients: a randomized controlled trial.

To investigate whether whole body vibration (WBV) training increases the explosive force of the knee extensors in chronic kidney disease (CKD) patients. Fourteen CKD patients undergoing hemodialysis were randomly allocated in WBV training or Sham group. Explosive force parameters (contractile impulse [CImp] and relative rate of force development [RFDr]) obtained in early (30 and 50 msec) and late phases (100 and 200 msec) of the knee extensors force/time curve. CImp and RFDr obtained at the early phase of force/time curve reduced after the intervention period, with a smaller decline for WBV (CImp at 50 msec [~-15% and -51%, P=0.038], RFDr at 30 msec [~-22% and -52%, P=0.044] and RFDr at 50 msec [~-11% and -54%; P=0.008]). In the late phase there was a lower decline for WBV group compared to Sham group, respectively: CImp: 100 msec (~-8% and -55%, P=0.025), 200 msec (~-3% and -46%, P= 0.025); RFDr 100 msec (~0.01% and -56%, P=0.033), 200 msec (~-5% and -36%, P=0.004). Three months of WBV training may attenuate the explosive force reduction in CKD patients.

Untreated Congenital Hypothyroidism Mimicking Hirschsprung Disease: A Puzzling Case in a One-Year-Old Child.

Congenital hypothyroidism is a clinical emergency due to its potential risk of mental retardation. Constipation might be present in hypothyroid children. However, Hirschsprung disease is rarely associated with congenital hypothyroidism. Herein, a case of congenital hypothyroidism in a one-year-old child mimicking Hirschsprung disease is described. Adequate treatment with levothyroxine sodium tablets controlled intestinal dysmotility that mimicked congenital intestinal aganglionosis due to the critical influence of thyroid hormones on bowel motility.

Does blood flow restriction training increase the diameter of forearm vessels in chronic kidney disease patients? A randomized clinical trial.

INTRODUCTION:: Blood flow restriction training can be used as an alternative to conventional exercise in chronic kidney disease patients with indication of arteriovenous fistula. OBJECTIVE:: Evaluating the efficacy of blood flow restriction training in the diameter and distensibility change of the cephalic vein and the diameter and flow of the radial artery, muscle strength and forearm circumference in chronic kidney disease patients with arteriovenous fistula pre-creation. METHODS:: A blind randomized clinical trial consisting of 26 chronic kidney disease patients allocated into a blood flow restriction training group (blood flow restriction; n = 12) and a group without blood flow restriction training (control group; n = 14). Blood flow restriction was performed at 50% of systolic blood pressure and using 40% of handgrip strength as load for the isometric exercises in both groups. RESULTS:: An increase in the diameter of the cephalic vein in the 2 cm (p = 0.008) and 10 cm segments (p = 0.001) was observed in the control group. The diameter of the radial artery increased in all segments in the blood flow restriction group (2, 10 and 20 cm; p = 0.005, p = 0.021 and p = 0.018, respectively) and in the 10 and 20 cm segments (p = 0.017 and p = 0.026) in the control group. Handgrip strength only increased in the control group (p = 0.003). CONCLUSION:: Physical training associated with blood flow restriction increased cephalic vein diameters in both groups and was effective in increasing the diameter of the radial artery; however, it did not demonstrate superiority over the exercise group protocol without blood flow restriction.

Cultura de segurança do paciente na perspectiva da equipe de enfermagem / Patient safety culture from the perspective of the nursing team

Objetivo: avaliar a cultura de segurança do paciente na perspectiva da equipe de enfermagem. Métodos: delineamento transversal, tipo survey, realizado com 221 profissionais de enfermagem do Hospital Universitário. Foi utilizado o instrumento Hospital Survey on Patient Safety Culture. Foram realizados o teste de KolmogorovSmirnov, a correlação de Spearman e o coeficiente alpha de Cronbach. Resultados: a cultura de segurança do paciente é moderadamente desenvolvida, o trabalho em equipe dentro das unidades foi área de força (75,5%) e a resposta não punitiva aos erros constituiu área de melhoria (47,0%). Verificou-se que quanto maior a impressão de inexistência de problemas e adequação dos sistemas implantados, melhor foi a nota atribuída para o hospital. Conclusão: a cultura de segurança do paciente está em processo de desenvolvimento, a dimensão com mais respostas positivas foi o trabalho em equipe dentro das unidades e, a com menos, a resposta não punitiva aos erros. (AU)

Qualidade de vida de pacientes com úlceras vasculogênicas em tratamento ambulatorial / Quality of life of patients with vasculogenic ulcers in outpatient treatment

Objetivo: avaliar a qualidade de vida de pacientes acometidos por úlceras vasculogênicas em tratamento ambulatorial. Métodos: estudo quantitativo, descritivo-comparativo, do tipo antes e depois, realizado em ambulatório especializado no tratamento de feridas complexas, com pacientes acometidos por úlceras vasculogênicas, totalizando 10 pacientes e 26 feridas. Resultados: o escore global de qualidade de vida aumentou 6,8 unidades na mediana. Na avaliação global, tecido epitelizado, presença de odor fétido, realização de desbridamento cirúrgico e uso de hidrogel foram influenciadores do aumento dos escores. Conclusão: observou-se aumento significativo dos escores de qualidade de vida em todos os domínios e no escore global. Os aspectos tipo de tecido e odor influenciaram significativamente o aumento dos escores de todos os domínios e do escore global.(AU)

Vídeo educativo para promoção da saúde do homem: estudo comparativo descritivo / Educational video for promoting men's health: a descriptive comparative study / Vídeo educativo para promover la salud del hombre: estudio comparativo descriptivo

OBJETIVO: Avaliar o conhecimento de homens adultos sobre a promoção do bem-estar, da alimentação saudável e da saúde mental no trabalho do homem, antes e após a aplicação de vídeo educativo. MÉTODO: Estudo comparativo descritivo, do tipo antes e depois, realizado em estabelecimento comercial na abrangência de uma unidade de saúde, em junho de 2015. A amostra incluiu 20 homens trabalhadores. RESULTADOS: A idade média foi 26,8 (±6,7) anos. Apenas 25% realizavam exames clínicos anualmente. Após a aplicação do vídeo, houve aumento nos escores totais (p<0,01). As sentenças com aumento de acertos significativos abordaram o alcoolismo (p<0,01; p=0,02) e a higiene (p=0,02; p=0,04). DISCUSSÃO: As informações do vídeo educativo evidenciaram a necessidade de esclarecimentos das temáticas e importância da realização de exames preventivos. CONCLUSÃO: O vídeo educativo constituiu intervenção acessível e promissora para efetiva promoção da saúde, diante da melhora significativa dos escores da avaliação do conhecimento.

AiIM To evaluate the knowledge of adult men about promoting well-being, healthy eating and mental health in the work of men, before and after the application of educational video. METHOD: Descriptive, before-and-after, comparative study performed in a commercial facility within the scope of a health unit in June 2015. The sample included 20 working men. RESULTS: The mean age was 26.8 (± 6.7) years. Only 25% performed clinical examinations annually. After video application, there was an increase in total scores (p<0.01). The sentences with increase of significant hits approached alcoholism (p<0.01, p=0.02) and hygiene (p=0.02, p=0.04). DISCUSSION: The information of the educational video evidenced the need for clarification of the themes and importance of conducting preventive exams. CONCLUSION: The educational video was an accessible and promising intervention for effective health promotion, in the face of a significant improvement in knowledge assessment scores.

OBJETIVO: Evaluar el conocimiento que los hombres adultos tienen sobre la promoción del bienestar, de la alimentación sana y de la salud mental en el trabajo, antes y después de la aplicación del vídeo educativo. MÉTODO: Estudio comparativo descriptivo, del tipo antes y después, realizado en un estabelecimiento comercial correspondiente a una unidad de salud, en junio de 2015. La muestra incluyó a 20 hombres trabajadores. RESULTADOS: La edad media fue 26,8 (±6,7) años. Solamente 25% realizaban exámenes clínicos anualmente. Tras aplicar el vídeo, hubo un aumento de los escores totales (p<0,01). Las sentencias con aumento de aciertos significativos abordaron el alcoholismo (p<0,01; p=0,02) y la higiene (p=0,02; p=0,04). DISCUSIÓN: Las informaciones del vídeo educativo evidenciaron la necesidad de esclarecer las temáticas y la importancia de realizar exámenes preventivos. CONCLUSIÓN: El vídeo educativo constituye una intervención accesible y promisora para promover efectivamente la salud, por mostrar el aumento de los escores de la evaluación del conocimiento.

Quality of life and duration of hemodialysis in patients with chronic kidney disease (CKD): a cross-sectional study / Qualidade de vida e tempo de hemodiálise em pacientes com doença renal crônica (DRC): um estudo transversal

Abstract Introduction: Quality of life (QoL) of hemodialysis patients is a major evaluative marker currently measured, while treatment time is a clinical determinant associated with impaired QOL. Objective: To evaluate QOL in individuals undergoing hemodialysis (HD) considering treatment time and the presence of comorbidities. Methods: A cross-sectional study conducted in the hemodialysis unit of the Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE). We studied patients with Chronic Kidney Disease (CKD) of both genders over the age of 18 years, at any level of education and undergoing HD for at least 6 months. We evaluated the demographic/socioeconomic and clinical data, followed by application of the quality of life questionnaire (KDQOL-SF). Results: Participants were 47 patients with a mean age of 50.94 ± 13.33 years, 55.3% were male and average treatment time of 57.35 ± 61.46 months. Hypertension (59.6%) was the most frequent underlying disease. According to the responses obtained through the KDQOL-SF, the situation at work and physical limitation scored worse. Sexual function (85.83) and encouragement by the team had the best performance. There were no differences in dimensions of questionnaire and treatment time. Conclusion: The presence of comorbidities and HD duration were not found to be possible factors for changing QoL in this study. However, we suggest that future studies evaluate other factors such as laboratory, emotional and functional data to check for changes in QoL in these patients related to HD duration.

Resumo Introdução: A qualidade de vida (QV) dos pacientes hemodialíticos é um dos principais marcadores avaliativos atualmente e o tempo de tratamento é um determinante clínico associado à QV prejudicada. Objetivo: Avaliar a QV em indivíduos submetidos à hemodiálise (HD) considerando o tempo de tratamento e a presença de comorbidades. Métodos: Estudo transversal desenvolvido no setor de hemodiálise do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), realizado em pacientes com Doença Renal Crônica (DRC) de ambos os sexos, maiores de 18 anos, em qualquer nível de escolaridade e em HD a pelo menos seis meses. Foram avaliados os dados demográfico/socioeconômico e clínico, seguidos da aplicação do questionário de QV (KDQOL-SF). Resultado: Participaram do estudo 47 pacientes, com média de idade de 50,94 ± 13,33 anos, sendo 55,3% do sexo masculino e média do tempo de tratamento de 57,35 ± 61,46 meses. A Hipertensão Arterial Sistêmica (HAS) (59,6%) foi a patologia de base mais frequente. De acordo com as respostas obtidas através do KDQOL-SF, a situação no trabalho e a limitação física apresentaram piores resultados. A função sexual (85,83) e o encorajamento da equipe apresentaram o melhor desempenho. Não se observou diferenças no comportamento das dimensões do questionário com o tempo de tratamento. Conclusão: A presença de comorbidades e o tempo de HD não se apresentaram como possíveis fatores para alteração da QV em nosso estudo. No entanto, sugerimos que estudos futuros possam avaliar outros fatores como dados laboratoriais, emocionais e funcionais para verificar a existência de alterações na QV nesses pacientes relacionadas ao tempo de HD.

Knowledge regarding the prevention of chronic kidney disease in hypertensive and diabetic patients: a cross-sectional study / Conhecimento sobre a prevenção da Doença Renal Crônica em hipertensos e diabéticos: estudo transversal

Abstract Introduction: Hypertension (HT) and diabetes mellitus (DM) lead to functional and structural changes in target organs such as the kidneys, characterizing the need for preventive actions to avoid Chronic Kidney Disease (CKD). Objective: To verify cardiologists' and endocrinologists' knowledge, indications and practices regarding prevention of CKD in patients with HT and DM. Methods: A cross-sectional study with 14 cardiologists and 5 endocrinologists applying a questionnaire about the conduct of these professionals regarding the prevention of CKD in hypertensive and diabetic patients. Results: One hundred percent of the cardiologists and endocrinologists did not request specific tests for CKD screening (albuminuria and glomerular filtration rate (GFR), although 92.9% of the cardiologists and 60.0% of the endocrinologists report referring hypertensive and diabetic patients with impaired renal function to nephrologists. One hundred percent of the interviewees recognize the importance of physical exercise for their patients; however, only 68.6% of cardiologists and 60% of endocrinologists indicated a physiotherapist and/or physical trainer to implement these exercises. Conclusion: The professionals evaluated in this study do not request microalbuminuria and GFR examinations for hypertensive and diabetic patients as a follow-up routine, despite having found cases of renal function impairment in these patients; in contrast to what is proposed in the guidelines for hypertension and diabetes mellitus. They recognize the importance of physical exercise and report indicating their patients to a physiotherapist and/or physical trainer. We suggest continuing the study in order to ascertain the reasons for their not complying with the respective guidelines.

Resumo Introdução: A hipertensão arterial (HAS) e o diabetes mellitus (DM) ocasionam alterações funcionais e estruturais de órgãos alvo como os rins, caracterizando a necessidade de ações preventivas para evitar a Doença Renal Crônica (DRC). Objetivo: Verificar o conhecimento, indicação e prática de condutas dos cardiologistas e endocrinologistas quanto a prevenção de DRC em pacientes com HAS e DM. Métodos: Estudo transversal realizado com 14 cardiologistas e 5 endocrinologistas, através de questionário referente a conduta desses profissionais quanto a prevenção da DRC entre hipertensos e diabéticos. Resultados: Cem por cento dos cardiologistas e endocrinologistas não solicitam os exames específicos para o rastreamento da DRC (albuminúria e estimativa da taxa de filtração glomerular - TGF), embora 92,9% dos cardiologistas e 60,0% dos endocrinologistas relatem encaminhar pacientes hipertensos e diabéticos com comprometimento da função renal ao nefrologista. Cem por cento dos entrevistados reconhecem a importância do exercício físico para seus pacientes, no entanto, apenas 68,6% dos cardiologistas e 60% dos endocrinologistas indicam o fisioterapeuta e ou educador físico para a realização dos mesmos. Conclusão: Os profissionais avaliados neste estudo não solicitam exames microalbuminúria e de TFG para pacientes hipertensos e diabéticos como rotina de acompanhamento, embora tenham encontrado casos de comprometimento da função renal nesses pacientes, diferentemente do proposto nas diretrizes para hipertensão arterial e diabetes mellitus. Reconhecem a importância do exercício físico e referem indicar seus pacientes ao fisioterapeuta e ou educador físico. Sugerimos continuidade do estudo a fim de averiguar as razões para o não cumprimento das respectivas diretrizes.

Relacionamento interpessoal entre usuários e profissionais de saúde na atenção psicossocial / Interpersonal relationship between users and health professionals in psychosocial car / Relacionamiento interpersonal entre usuarios y profesionales en la atención psicosocial

O objetivo deste estudo foi identificar como se estabelece o relacionamento interpessoal entre usuários e profissionais de saúde, na perspectiva dos usuários de um Centro de Atenção Psicossocial tipo II em Maceió, Alagoas. Pesquisa qualitativa, exploratória, realizada no período de 2010 a 2012, coleta de dados com oito usuários. Utilizou a triangulação por meio de entrevistas semiestruturadas em profundidade, observação não participante e diário de campo. Dados tratados pela análise qualitativa de Minayo. Emergiram três categorias: 1. Olhar sensível; 2. A formação do vínculo; 3. Habilidades do profissional que atua no serviço de saúde mental. Identificou-se: relacionamento como imprescindível para atenção psicossocial; importância do olhar humano do profissional ao usuário; vínculo como amenizador do sofrimento; habilidades decisivas de escuta e atenção para estabelecer confiança. Observa-se a necessidade de trabalhar a temática do relacionamento interpessoal junto aos profissionais do serviço, a fim instrumentalizá-los sobre a criação e fortalecimento do vínculo no cuidado integral em saúde mental (AU).

The objective in this study was to identify how the interpersonal relationship is established between users and health professionals from the perspective of the users of a Psychosocial Care Center type II in Maceió, Alagoas. Qualitative and exploratory research, undertaken between 2010 and 2012. Data were collected from eight users. Triangulation was used through in-depth semi-structured interviews, non-participant observation and a field diary. Minayo's qualitative analysis was applied to the data. Three categories emerged: 1. Sensitive looking; 2. Establishing the bond; 3. Skills of professionals working at the mental health service. The following results were identified: relationship is fundamental for psychosocial care; it is important for the professional to adopt a humane look towards the user; the bond mitigates suffering; listening and attention skills are decisive to establish trust. The need is observed to discuss the theme interpersonal relationship with the professionals from the service, with a view to enabling them to create and strengthen the bond in comprehensive mental health care (AU).

La finalidad de este estudio fue identificar como se establece el relacionamiento interpersonal entre usuarios y profesionales de salud en la perspectiva de los usuarios de un Centro de Atención Psicosocial tipo II en Maceió, Alagoas. Investigación cualitativa, exploratoria, desarrollada en el período de 2010 a 2012, recolecta de datos con ocho usuarios. Fue utilizada la triangulación mediante entrevistas semiestructuradas a hondo, observación no participante y diario de campo. Datos tratados con el análisis cualitativo de Minayo. Emergieron tres categorías: 1. Mirada sensible; 2. La formación del vínculo; 3. Habilidades del profesional que actúa en el servicio de salud mental. Fueron identificados: relacionamiento como imprescindible para atención psicosocial; importancia de la mirada humana del profesional al usuario; vínculo como suavizador del sufrimiento; habilidades decisivas de escucha y atención para establecer confianza. Se observa la necesidad de trabajar el tema del relacionamiento interpersonal con los profesionales del servicio para equiparles sobre la creación y el fortalecimiento del vínculo en el cuidado integral en salud mental (AU).