Benchmarking mobile applications for the health of people with Diabetes Mellitus.

OBJECTIVE: to map the content and features of mobile applications on the management of Diabetes Mellitus and their usability on the main operating systems. METHOD: benchmarking research. The mapping of apps, content, and resources on the Play Store and App Store platforms was based on an adaptation of the Joanna Briggs Institute's scoping review framework. For the usability analysis, the apps were tested for two weeks and the System Usability Scale instrument was used, with scores between 50-67 points being considered borderline, between 68-84, products with acceptable usability and above 85, excellent user acceptance and, for the analysis, descriptive statistics. RESULTS: the most prevalent contents were capillary blood glucose management, diet, oral drug therapy, and insulin therapy. As for resources, diaries and graphs were the most common. With regard to usability, two apps were considered to have excellent usability; 34, products with acceptable usability; 29, the resource may have some flaws but still has acceptable usability standards and 6, with flaws and no usability conditions. CONCLUSION: the content and resources of mobile applications address the fundamental points for managing Diabetes Mellitus with user-friendly resources, with usability acceptable to users and have the potential to assist in the management of Diabetes Mellitus in patients' daily lives.

Concept analysis of "Insufficient health literacy" in older adults and refinement of a diagnosis proposal.

PURPOSE: This study aims to conduct a thorough analysis of the concept of insufficient health literacy (IHL) in older adults and to refine a nursing diagnosis proposal while considering the specific characteristics of this demographic. METHODS: A comprehensive concept analysis was undertaken using Walker & Avant's method as a framework. FINDINGS: A systematic search across seventeen databases yielded 29 relevant studies for inclusion. Through analysis, we identified 15 antecedents, 3 attributes, and 7 consequents associated with IHL in older adults. CONCLUSIONS: The concept analysis brought clarity to the understanding of IHL within older adults, facilitating the refinement of a diagnosis proposal. This process was instrumental in establishing a diagnostic structure that accounts for the unique needs and challenges faced by older adults. IMPLICATIONS FOR NURSING PRACTICE: The structured diagnosis derived from the concept analysis provides a solid theoretical foundation for nurses specializing in Gerontology. By tailoring care interventions to address the specific requirements of older adults, this framework enhances the quality of nursing practice and contributes to improved patient outcomes in geriatric care settings.

OBJETIVO: Este estudo tem como objetivo realizar uma análise detalhada do conceito de Letramento em saúde insuficiente na população idosa e refinar uma proposta de diagnóstico de enfermagem, levando em consideração as características específicas desse público. MÉTODOS: Foi realizada uma análise conceitual abrangente utilizando o método de Walker & Avant. RESULTADOS: Uma busca sistemática em dezessete bases de dados resultou em 29 estudos relevantes para inclusão. Através da análise, identificamos quinze antecedentes, três atributos e sete consequentes associados ao Letramento em saúde insuficiente na população idosa. CONCLUSÕES: A análise conceitual trouxe clareza à compreensão do Letramento em saúde insuficiente na população idosa, facilitando o refinamento de uma proposta de diagnóstico. Esse processo foi fundamental para estabelecer uma estrutura diagnóstica que considera as necessidades e desafios únicos enfrentados pelos idosos. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: O diagnóstico estruturado derivado da análise conceitual fornece uma base teórica sólida para enfermeiros especializados em Gerontologia. Ao adaptar intervenções de cuidados para atender aos requisitos específicos dos idosos, esse framework melhora a qualidade da prática de enfermagem e contribui para resultados de pacientes aprimorados em ambientes de cuidados geriátricos.

Contributions of representing the elements of nursing practice in the ISO 18.104:2023 standard: a theoretical study.

OBJECTIVE: To reflect on the contributions of representing nursing practice elements in the ISO 18.104:2023 standard. METHOD: This is a theoretical study with standard analysis. Categorical structures were described to represent nursing practice in terminological systems and contributions identified in the parts of the version were analyzed. RESULTS: There is innovation in the inclusion of nurse sensitive outcomes, nursing action, nursing diagnosis explanation as an indicator of nursing service demand and complexity of care, representation of concepts through mental maps and suggestion of use of restriction models for nursing actions. It describes that the Nursing Process is constituted by nursing diagnosis, nursing action and nurse sensitive outcomes. FINAL CONSIDERATIONS: Indicating a nursing diagnosis as an indicator will bring benefits for knowledge production and decision-making. Although care outcomes are not exclusive responses to nursing action, the modifiable attributes of a nursing diagnosis generate knowledge about clinical practice, nursing action effectiveness and subjects of care' health state. There is coherence in understanding the Nursing Process concept evolution.

Geropalliative Caring Model analysis and assessment according to Fawcett's criteria.

OBJECTIVES: To analyze and assess Lee Geropaliative Caring Model according to Fawcett's criteria. METHOD: A theoretical-reflective study about the Geropaliative Caring Model. The analysis resulted in a detailed review of the scope, context and content of a situation-specific theory, in order to determine aspects related to nursing practice and research, and assessment addressed the concrete concepts developed in theory, their significance, internal consistency, parsimony, testability and empirical and pragmatic adequacy in nursing as a discipline. RESULTS: Based on the analysis, a situation-specific theory was used based on the science of care and aimed at caring for older adults undergoing palliation and their families, structured into four fields, namely: (1) aligning care; (2) keeping safe; (3) comforting body/mind/spirit; and (4) facilitating transitions. FINAL CONSIDERATIONS: The analyzed and assessed theory leads to a structure that includes well-defined, delimited and interrelated concepts, based on the science of care as a grand theory that allowed Geropaliative Care Model derivation.

Contributions of representing the elements of nursing practice in the ISO 18.104:2023 standard: a theoretical study / Contribuições da representação dos elementos da prática de enfermagem na norma ISO 18.104:2023: estudo teórico / Aportes de la representación de los elementos de la práctica de enfermería en la norma ISO 18.104:2023: estudio teórico

ABSTRACT Objective: To reflect on the contributions of representing nursing practice elements in the ISO 18.104:2023 standard. Method: This is a theoretical study with standard analysis. Categorical structures were described to represent nursing practice in terminological systems and contributions identified in the parts of the version were analyzed. Results: There is innovation in the inclusion of nurse sensitive outcomes, nursing action, nursing diagnosis explanation as an indicator of nursing service demand and complexity of care, representation of concepts through mental maps and suggestion of use of restriction models for nursing actions. It describes that the Nursing Process is constituted by nursing diagnosis, nursing action and nurse sensitive outcomes. Final considerations: Indicating a nursing diagnosis as an indicator will bring benefits for knowledge production and decision-making. Although care outcomes are not exclusive responses to nursing action, the modifiable attributes of a nursing diagnosis generate knowledge about clinical practice, nursing action effectiveness and subjects of care' health state. There is coherence in understanding the Nursing Process concept evolution.

RESUMO Objetivo: Refletir sobre as contribuições da representação dos elementos da prática de enfermagem na norma ISO 18.104:2023. Método: Estudo teórico com análise da norma. Foram descritas estruturas categoriais para representação da prática da enfermagem nos sistemas terminológicos e analisadas as contribuições identificadas nas partes da versão. Resultados: Há inovação na inclusão do resultado sensível à ação da enfermeira, explicitação do diagnóstico de enfermagem como indicador da demanda de serviços e complexidade de assistência, representação dos conceitos por mapas mentais e sugestão do uso de modelos de restrição para ações de enfermagem. Descreve que o Processo de Enfermagem é constituído pelo diagnóstico, ação e resultado sensível à ação da enfermeira. Considerações finais: A indicação do diagnóstico de enfermagem como um indicador trará benefícios para produção de conhecimento e tomada de decisão. Embora os resultados do cuidado não sejam respostas exclusivas a uma ação da enfermeira, os atributos modificáveis de um diagnóstico de enfermagem geram conhecimentos sobre a prática clínica, a eficácia das ações de enfermagem e o estado de saúde dos sujeitos de cuidado. Há coerência na compreensão da evolução do conceito de Processo de Enfermagem.

RESUMEN Objetivo: Reflexionar sobre los aportes de representar los elementos de la práctica de enfermería en la norma ISO 18.104:2023. Método: Estudio teórico con análisis de la norma. Se describieron estructuras categóricas para representar la práctica de enfermería en sistemas terminológicos y se analizaron las contribuciones identificadas en las partes de la versión. Resultados: Hay innovación en la inclusión del resultado sensible a la acción del enfermero, explicación del diagnóstico de enfermería como indicador de demanda de servicios y complejidad del cuidado, representación de conceptos a través de mapas mentales y sugerencia del uso de modelos de restricción para las acciones de enfermería. Describe que el Proceso de Enfermería está constituido por el diagnóstico, la acción y el resultado sensible a la acción del enfermero. Consideraciones finales: La indicación del diagnóstico de enfermería como indicador traerá beneficios para la producción de conocimiento y la toma de decisiones. Aunque los resultados del cuidado no son respuestas exclusivas a la acción del enfermero, los atributos modificables de un diagnóstico de enfermería generan conocimiento sobre la práctica clínica, la efectividad de las acciones de enfermería y el estado de salud de los sujetos del cuidado. Hay coherencia en la comprensión de la evolución del concepto de Proceso de Enfermería.

Benchmarking mobile applications for the health of people with Diabetes Mellitus / Benchmarking de aplicativos móviles dirigidos a la salud de personas con Diabetes Mellitus / Benchmarking de aplicativos móveis voltados à saúde de pessoas com Diabetes Mellitus

Objective: to map the content and features of mobile applications on the management of Diabetes Mellitus and their usability on the main operating systems. Method: benchmarking research. The mapping of apps, content, and resources on the Play Store and App Store platforms was based on an adaptation of the Joanna Briggs Institute's scoping review framework. For the usability analysis, the apps were tested for two weeks and the System Usability Scale instrument was used, with scores between 50-67 points being considered borderline, between 68-84, products with acceptable usability and above 85, excellent user acceptance and, for the analysis, descriptive statistics. Results: the most prevalent contents were capillary blood glucose management, diet, oral drug therapy, and insulin therapy. As for resources, diaries and graphs were the most common. With regard to usability, two apps were considered to have excellent usability; 34, products with acceptable usability; 29, the resource may have some flaws but still has acceptable usability standards and 6, with flaws and no usability conditions. Conclusion: the content and resources of mobile applications address the fundamental points for managing Diabetes Mellitus with user-friendly resources, with usability acceptable to users and have the potential to assist in the management of Diabetes Mellitus in patients' daily lives.

Objetivo: mapear los contenidos y los recursos de los aplicativos móviles sobre el manejo de la Diabetes Mellitus y su usabilidad en los principales sistemas operacionales. Método: investigaciones de benchmarking . El mapeo de los apps , de los contenidos y recursos en las plataformas Play Store y App Store fue realizado a partir de una adaptación en la estructura de revisiones del objetivo del Joanna Briggs Institute. Para el análisis de la usabilidad, los aplicativos fueron comprobados por dos semanas; para esto, se utilizó el instrumento System Usability Scale , siendo que puntajes entre 50-67 puntos, son considerados limítrofes; entre 68-84, tienen usabilidad aceptable; y, arriba de 85, tienen excelente aceptación por el usuario y para realizar análisis estadística descriptiva. Resultados: los contenidos más prevalentes fueron el manejo de la glucemia capilar, alimentación, terapia medicamentosa oral e insulinoterapia. En cuanto a los recursos se obtuvo mayor frecuencia de diarios y gráficos. En relación a la usabilidad, 2 apps fueron considerados de excelente aceptación; 34, productos con usabilidad aceptable; 29, los apps pueden presentar algunas fallas, sin embargo tiene estándares de usabilidad todavía aceptables; y, 6 presentaron fallas sin condiciones de usabilidad. Conclusión: los contenidos y los recursos de aplicativos móviles abordan los puntos fundamentales para el manejo de la diabetes mellitus, con recursos de fácil utilización, usabilidad aceptable por los usuarios y con potencial para auxiliar en el manejo de la diabetes mellitus, en el día a día de los pacientes.

Objetivo: mapear os conteúdos e os recursos dos aplicativos móveis sobre o manejo da Diabetes Mellitus e sua usabilidade nos principais sistemas operacionais. Método: pesquisa de benchmarking . O mapeamento dos apps , dos conteúdos e dos recursos nas plataformas Play Store e App Store foi realizado a partir de uma adaptação na estrutura de revisões de escopo da Joanna Briggs Institute. Para a análise da usabilidade, os aplicativos foram testados por duas semanas e utilizou-se o instrumento System Usability Scale , sendo que escores entre 50-67 pontos, é considerado limítrofe, entre 68-84, produtos com usabilidade aceitável e acima de 85, excelente aceitação pelo usuário e, para a análise, estatística descritiva. Resultados: os conteúdos mais prevalentes foram o manejo da glicemia capilar, alimentação, terapia medicamentosa oral e insulinoterapia. Quanto aos recursos, obteve-se a maior frequência de diários e gráficos. Em relação à usabilidade, dois apps foram considerados de excelente aceitação; 34, produtos com usabilidade aceitável; 29, o recurso pode apresentar algumas falhas, mas tem padrões de usabilidade ainda aceitáveis e 6, com falhas sem condições de usabilidade. Conclusão: os conteúdos e os recursos de aplicativos móveis abordam os pontos fundamentais para o manejo da Diabetes Mellitus com recursos de fácil utilização, com usabilidade aceitável pelos usuários e tem potencial para auxiliar no manejo da Diabetes Mellitus no dia a dia dos pacientes.

Nursing microtheory in the prevention of delirium in older adult in the intensive care unit. / Microteoría de enfermería en la prevención del delirium en personas mayores en la unidad de cuidados intensivos.

OBJECTIVE: to describe a microtheory for nursing care in the prevention of delirium in older adult in the intensive care unit. METHOD: prescriptive theoretical research, based on substruction. Roy's Adaptation Model constructs were deduced and data from the phenomenon of nursing care in the prevention of delirium in older adult in intensive care were induced, based on an integrative literature review. RESULTS: the microtheory has a theoretical and operational system and a model of care. In the theoretical system, Roy's focal and contextual stimulus constructs were used. From them, the concepts of focal and contextual care and the variable adaptive response to prevention were elaborated. From the relational statements, four axioms, two postulates, eight propositions and an epistemic assumption were elaborated. TWO EMPIRICAL INDICATORS WERE ESTABLISHED IN THE OPERATING SYSTEM: the Confusion Assessment Method for Intensive Care Units and the demographic/clinical history of the older adult. Subsequently, two transformational statements, four hypotheses and the model of care represented in figure were produced. CONCLUSION: the microtheory produced prescribes care in the prevention of delirium in older adult in intensive care, through a construct of interest to nursing, and allows interceptions for the development of instruments that guide nursing activities.

Microteoría de enfermería en la prevención del delirium en personas mayores en la unidad de cuidados intensivos / Nursing microtheory in the prevention of delirium in older adult in the intensive care unit / Microteoria de enfermagem na prevenção do delirium em pessoas idosas na unidade de terapia intensiva

Objetivo: describir una microteoría para cuidados de enfermería en la prevención del delirio en personas mayores en la unidad de cuidados intensivos. Método: investigación teórica prescriptiva, basada en la subconstrucción. Se dedujeron constructos del Modelo de Adaptación de Roy y se indujeron datos del fenómeno de cuidados de enfermería en la prevención del delirium en personas mayores en cuidados intensivos, a partir de una revisión integrativa de la literatura. Resultados: la microteoría posee sistema teórico, operativo y modelo de cuidado. En el sistema teórico se utilizaron los constructos estímulo focal y contextual de Roy. A partir de ellos, se elaboraron los conceptos de cuidado focal y contextual y la variable respuesta adaptativa a la prevención. De las declaraciones relacionales se elaboraron cuatro axiomas, dos postulados, ocho proposiciones y una presuposición epistémica. En el sistema operativo se establecieron dos indicadores empíricos: el Confusion Assessment Method for Intensive Care Units y el historial demográfico/clínico de las personas mayores. Posteriormente, se produjeron dos declaraciones transformacionales, cuatro hipótesis y el modelo de cuidado representado en figura. Conclusión: la microteoría producida prescribe cuidados en la prevención del delirium en personas mayores en cuidados intensivos, por un constructo de interés para la enfermería, y permite intervenciones en el desarrollo de instrumentos que guían la actuación de la enfermería.

Objective: to describe a microtheory for nursing care in the prevention of delirium in older adult in the intensive care unit. Method: prescriptive theoretical research, based on substruction. Roy's Adaptation Model constructs were deduced and data from the phenomenon of nursing care in the prevention of delirium in older adult in intensive care were induced, based on an integrative literature review. Results: the microtheory has a theoretical and operational system and a model of care. In the theoretical system, Roy's focal and contextual stimulus constructs were used. From them, the concepts of focal and contextual care and the variable adaptive response to prevention were elaborated. From the relational statements, four axioms, two postulates, eight propositions and an epistemic assumption were elaborated. Two empirical indicators were established in the operating system: the Confusion Assessment Method for Intensive Care Units and the demographic/clinical history of the older adult. Subsequently, two transformational statements, four hypotheses and the model of care represented in figure were produced. Conclusion: the microtheory produced prescribes care in the prevention of delirium in older adult in intensive care, through a construct of interest to nursing, and allows interceptions for the development of instruments that guide nursing activities.

Objetivo: descrever uma microteoria para cuidados de enfermagem na prevenção do delirium em pessoas idosas na unidade de terapia intensiva. Método: pesquisa teórica prescritiva, baseada na substrução. Foram deduzidos construtos do Modelo de Adaptação de Roy e induzidos dados do fenômeno dos cuidados de enfermagem na prevenção do delirium em pessoas idosas na terapia intensiva, a partir de revisão integrativa da literatura. Resultados: a microteoria possui sistema teórico, operacional e modelo de cuidado. No sistema teórico utilizaram-se os construtos estímulo focal e contextual de Roy. A partir deles elaboraram-se os conceitos de cuidado focal, contextual e a variável resposta adaptativa à prevenção. Das declarações relacionais elaboraram-se quatro axiomas, dois postulados, oito proposições e um pressuposto epistêmico. No sistema operacional, estabeleceram-se dois indicadores empíricos: o Confusion Assessment Method for Intensive Care Units e o histórico demográfico/clínico das pessoas idosas. Posteriormente, produziram-se duas declarações transformacionais, quatro hipóteses e o modelo de cuidado representado em figura. Conclusão: a microteoria produzida prescreve cuidados na prevenção do delirium em pessoas idosas na terapia intensiva, por um construto de interesse para a enfermagem, além de permitir interceptações ao desenvolvimento de instrumentos que norteiam a atuação da enfermagem

Three-Dimensionally Printed Vaginal Rings: Perceptions of Women and Gynecologists in a Cross-Sectional Survey.

Three-dimensional printing technologies can be implemented for the fabrication of personalized vaginal rings (VRs) as an alternative approach to traditional manufacturing. Although several studies have demonstrated the potential of additive manufacturing, there is a lack of knowledge concerning the opinions of patients and clinicians. This study aimed to investigate the perception of women and gynecologists regarding VRs with personalized shapes. The devices were printed with different designs (traditional, "Y", "M", and flat circle) by Fused Deposition Modeling for a cross-sectional survey with 155 participants. Their anticipated opinion was assessed through a questionnaire after a visual/tactile analysis of the VRs. The findings revealed that most women would feel comfortable using some of the 3D-printed VR designs and demonstrated good acceptability for the traditional and two innovative designs. However, women presented multiple preferences when the actual geometry was assessed, which directly related to their age, previous use of the vaginal route, and perception of comfort. In turn, gynecologists favored prescribing traditional and flat circle designs. Overall, although there was a difference in the perception between women and gynecologists, they had a positive opinion of the 3D-printed VRs. Finally, the personalized VRs could lead to an increase in therapeutic adherence, by meeting women's preferences.

Theoretical, Conceptual, and Operational Aspects in Simulation Training With Rapid Cycle Deliberate Practice: An Integrative Review.

SUMMARY STATEMENT: An integrative review following Whittemore and Knafl's 5-stage approach (problem identification, literature search, data evaluation, data analysis, and presentation) was conducted to synthesize the evidence on the theoretical, conceptual, and operational aspects of simulation training with rapid cycle deliberate practice (RCDP). After the literature search, 2 reviewers independently read and critically evaluated primary studies using the eligibility criteria. A third more experienced reviewer solved disagreements between the reviewers.This review included 31 articles. Eight themes were identified and grouped into 2 pre-established categories: theoretical/conceptual and operational aspects. The first category had the following 3 themes: definition of RCDP, concepts related to the principles of RCDP, and theories underpinning RCDP. The second category had the following 5 themes: total training time, number of participants in the training, training system, first scenario without intervention, and progressive difficulty. This review showed that knowledge about RCDP is still under construction. As a new simulation strategy, there are some theoretical, conceptual, and operational differences in the studies applying RCDP interventions as simulation training.

Architectural accessibility and perception of falls of elderly people in the peridomicile: mixed method.

OBJECTIVE: To describe contents, structure and origin of social representations about falls by elderly people, the peridomiciliary structural conditions that predispose to falls, and to relate the implications of these empirical evidence on the routine of the elderly in the architectural context. METHOD: Convergent mixed method by triangulation. Qualitative approaches(structural, n=195 and procedural, n=40of the Theory of Social Representations) and quantitative (descriptive sectional, n=183) were used. Elderly people enrolled in primary care were interviewed at home in 2018. Analysis techniques: categorical-thematic, prototypical, statistical, and deductive according to Leininger. RESULTS: Categories of analysis: 1) Peridomicile: fall scenario and 2) Aging and vulnerability: risk of falls in peridomicile. The following environmental characteristics were precursors to falls: uneven floors, holes, unevenness and objects in the pathway. Feelings and behaviors allocated in the possible central core are associated, justifying falls, and determining their causes. CONCLUSION: There was an association between the peridomiciliary architectural environment and the predictive characteristics of the risk of falls.

Effect of rapid cycle deliberate practice in peripheral intravenous catheters insertion training: A simulation experimental study.

AIM: to compare the effect of rapid cycle deliberate practice simulation training with skill-training simulation on peripheral intravenous catheter insertion for Licensed Practical Nurses. BACKGROUND: The use of peripheral intravenous catheters is associated with high rates of complications, although it is widely used in clinical practice. Training strategies to ensure good performance can minimize the risks inherent to this procedure. DESIGN: A randomized simulation experimental pre-post interventional study. METHODS: Sixty participants were allocated to intervention (n = 30) or control (n = 30) groups. Participants allocated to the intervention group were trained through the Rapid cycle deliberate practice simulation strategy, while participants in the control group were trained through the skill-training simulation strategy. A pre-test was applied before any intervention and a post-test after intervention. The primary outcome was the performance in the peripheral intravenous catheter insertion skill. The comparison of correct performance in the tests was analyzed intergroup and intragroup. The effect size of the interventions was also analyzed. The t-Student and Mann-Whitney tests compared the difference between the groups. The training effect was calculated by Cohen's dm and Glass's Δ measures. RESULTS: Performance between the pre-post-test increased from 59.4% to 96% (p < 0.001) in the intervention group and from 57.8% to 93.5% in the control group (p < 0001). There was no statistical difference between the groups after intervention (p = 0225). Cohen's dm measurement was 2.95 and 3.59 in the control and intervention groups, respectively. CONCLUSIONS: The rapid cycle deliberate practice simulation strategy resulted in Licensed Practical Nurses' performance improvements in peripheral intravenous catheter insertion, evidenced by the increase of correct performance actions in the post-test compared to the pre-test. However, with no statistical difference compared to the skill-training simulation strategy.

Systematization of Nursing Care: how did the concept mature?

OBJECTIVES: to analyze the Systematization of Nursing Care conceptual maturation from the perspective of pragmatic utility. METHODS: a concept analysis study. The stages were: select the concept; elaborate analytical questions; comprehensively review the literature; and determine concept structural components. Sixty-one documents were analyzed after a search carried out until October 2019. RESULTS: four temporal periods of contextual changes have occurred since the emergence of ideas of a systematization in the 1960s. This first lasted until 1990. It was followed by those from 1990 to 2002, from 2002 to 2009 and from 2009 onwards. Partial conceptual maturity was identified, operationalization over the years, based on multiple definitions, and, currently, a concept of Systematization of Nursing Care with managerial and organizational attributes. CONCLUSIONS: the concept of Systematization of Nursing Care is partially mature, presents multiple definitions, being operationalized in uncertain connections with other concepts.

Body image of women during breastfeeding: analysis supported by nursing theory.

OBJECTIVE: To describe and interpret a woman's perception of her body image during the breastfeeding process. METHOD: Descriptive qualitative study conducted at a university hospital in the Southeast region, Brazil. Forty-three puerperal women who were breastfeeding were interviewed. The interviews were submitted to lexical analysis using the IRAMUTEQ software and interpreted based on the Interactive Theory of Breastfeeding. RESULTS: Women report dissatisfaction with changes in body image during breastfeeding. But they also value and want to keep breastfeeding because of the benefits for the child. Finally, several women express the desire to perform plastic surgery in the future because of these body changes. CONCLUSION: The woman's perception of her body image as satisfactory/unsatisfactory indicates that body changes cover the breastfeeding process with feelings of ambiguity.Body changes are perceived by women in a personal, subjective and complex way.

Guide for Systematization of Care and Nursing Process: educational technology for professional practice.

OBJECTIVE: to elaborate and validate the content of a digital guide educational technology on Systematization of Nursing Care and Nursing Process. METHODS: applied research of technological development, developed between 2020 and 2021, in three steps. First, a scoping review was carried out to elaborate the content. In the second step, the content was validated with 46 nurse judges selected for convenience. The minimum criterion of agreement among judges was 80%. The third step consisted of content organization and layout. RESULTS: the guide content was elaborated from the Federal Nursing Council legislation, scientific articles and textbooks. Content was considered appropriate, relevant and organized by judges. FINAL CONSIDERATIONS: the digital guide is an alternative that can contribute to the NP execution and implementation, supporting the planning and implementation of actions for quality of care.

25-Hydroxyvitamin D as a biomarker of vitamin D status in plaque psoriasis and other dermatological diseases: a cross-sectional study

ABSTRACT BACKGROUND: Hypovitaminosis D is a public health problem associated with several chronic inflammatory and immunological diseases, including psoriasis. OBJECTIVES: This study aimed to determine the prevalence of hypovitaminosis D in patients with plaque psoriasis. A comparison was made between vitamin D levels in patients with psoriasis and those with other non-inflammatory dermatoses without photosensitivity. In addition, it evaluated the effects of the patients' Fitzpatrick skin phototype and the season of the year on the serum levels of vitamin D. DESIGN AND SETTINGS: A retrospective cross-sectional study was conducted at an outpatient clinic in a university center in Juiz de Fora (MG), Brazil. METHODS: A review of dermatology patients' demographic data, including skin phototype and serum levels of 25-hydroxyvitamin D [25(OH)D], over 12 months in 2016. RESULTS: This study included 554 patients: 300 patients allocated to the plaque psoriasis group and 254 control patients with other dermatological diseases. Regarding the season of the year, 229, 132, 62, and 131 participants were evaluated in summer, autumn, winter, and spring, respectively. As for the skin phototype, 397, 139, and 18 patients had phototypes III, IV, and V, respectively. The serum levels of 25(OH)D were significantly lower in the psoriasis group (24.91 ± 7.16 ng/mL) than in the control group (30.37 ± 8.14 ng/mL). CONCLUSIONS: Hypovitaminosis D (< 30 ng/mL) was present in 76.66% of patients with psoriasis versus 53.94% of control patients. Vitamin D deficiency (< 20 ng/mL) was observed in 25% of the patients with psoriasis versus 8.66% in the control group (P < 0.001). The season and patient's skin phototype were independent predictors of serum vitamin D levels.

Toward a theorizing strategy with components of terminologies, classifications, and nursing theories.

PURPOSE: This article describes a theorizing strategy that integrates the components of classifications or terminologies with elements of grand or middle-range theories. METHODS: The source of metatheoretical data to support the strategy was the levels of theories by Dickoff et al. (1968). Terminological data sources were professional classifications and terminologies. FINDINGS: The authors synthesized data and philosophical, metatheoretical, theoretical, and terminological knowledge from primary sources on the subject to construct arguments and demonstrate suitable links. CONCLUSIONS: The proposal presented in this article of a strategy for building theories integrates theories and classifications or standardized nomenclatures. It applies levels of theorization: scrutiny of phenomena, description, conceptualization, naming, relationship, modeling, and operationalization to achieve higher levels of explanatory, predictive, and prescriptive properties on generated theory. IMPLICATIONS FOR NURSING PRACTICE: The implications for practice and research are connected to the theorizing strategy proposed in this article. We assume that using professional language at all levels of theorization can ensure that the concepts generated are closer to clinical practice.

"Readiness for enhanced healthy aging" nursing diagnosis: Content validation by experts.

PURPOSE: To validate the content nursing diagnosis "Readiness for enhanced healthy aging." METHODS: Descriptive, methodological study of diagnostic content validation, using the Fehring model. The sample consisted of 74 nurses experts in gerontology, with knowledge in NANDA-I nursing diagnoses. FINDINGS: The title, one definition, and the three defining characteristics proposed for the diagnosis were validated, as well as the suggestion of domain and location class in NANDA-I Taxonomy II. The Diagnostic Content Validity Index was 0.81. CONCLUSIONS: The validation of the diagnostic content by experts was fundamental for adequacy of the elements of the proposed diagnosis, which supported the elaboration of the diagnostic framework for submission to the NANDA-I taxonomy. IMPLICATION FOR NURSING PRACTICE: The diagnosis "Readiness for enhanced healthy aging" can help nurses understand the phenomenon of "Healthy Aging" and, consequently, will support the planning and implementation of interventions aimed at promoting the health of the elderly population and those in the aging process. In addition, this diagnosis will offer nurses the opportunity to rethink health promotion strategies in their care plan, making a commitment to the population regarding the promotion of healthy aging, as recommended by the Word Health Organization.