Impact of multicomponent intervention on hospitalized clinical patient outcomes: A pre-post study in a university hospital.

BACKGROUND AND OBJECTIVE: Hospitalization significantly interferes with the individual's well-being and it occurs both during and after the hospitalization period. Different approaches to minimize morbidity related to hospitalization and the post-discharge period have been proposed, especially to those aimed at reducing readmission rates. The aim of this study is to evaluate the effect of multicomponent intervention (MI) on operational indicators and continuity of care outcomes. MATERIALS AND METHODS: A quasi-experimental study conducted in a Brazilian university hospital in order to compare the impact of the intervention with usual care. The MI was the implementation of multidisciplinary rounds, the inclusion of the role of the navigator nurse, and care transition actions with half of the Internal Medicine teams in a clinical unit of a general hospital. Adult patients hospitalized were included in 2 periods and divided in 3 groups - Group A: before the intervention; Group B: after and with MI; Group C after and without MI. RESULTS: A total of 2333 hospitalizations were evaluated. There was a reduction in the rate of intensive care transfers to intensive care unit (ICU) and in the length of stay (LOS). LOS, discharge before noon, and transfers to ICU improved when comparing before and after the intervention, but were not different in post-intervention groups with and without MI. CONCLUSION: These results reflect the improvement of care provided by MI, an effect that could be due to cross contamination also to teams without the intervention.

Transcultural adaptation of the filial responsibility interview schedule for Brazil.

BACKGROUND: In developed countries, filial responsibility in relation to caring for elderly parents has been systematically studied. In Brazil and other developing countries, however, it is a relatively new topic and has not yet been included in the research agenda on ageing. OBJECTIVE: To describe the process of cross-cultural adaptation of the qualitative phase of the filial responsibility interview schedule into Brazilian Portuguese. METHODS: An expert committee of six team members participated in the study. In addition, individual interviews were held with 11 caregivers of older persons to evaluate the quality of the final Portuguese version of the schedule. The process included examining conceptual, item, semantic and operational equivalencies. Conceptual and item equivalencies were based on a literature review and on discussions with the expert committee. Semantic equivalence was attained through translation, back-translation, expert committee evaluation and pre-testing. The final version was pre-tested in caregivers of older persons enrolled in the home care programme of a primary health care service in Southern Brazil. RESULTS: Conceptual, item, semantic and operational equivalencies were attained. Through the interviews, responses to the open-ended questions concerning filial responsibility in the care for elderly parents pertained to the following categories: possibility of institutionalization of elderly parents, caregiver expectations, difficulties in being a child caregiver and responsibility as a natural process. CONCLUSION: The Portuguese version presented good semantic equivalence and the results showed that the concepts and items are applicable to the Brazilian context.

Factors associated with quality of life of Brazilian older adults.

OBJECTIVE: The objective of the study was to explore factors associated with quality of life (QoL) of Brazilian community-dwelling older adults. METHODS: This was a descriptive exploratory cross-sectional study. Data were collected through a household survey. A random sample of 288 older adults from Porto Alegre, Brazil participated in the study. A demographic and health data sheet, the OARS activities of daily living (ADL) scale and the WHOQOL-BREF were administered. RESULTS AND DISCUSSION: The mean age of participants was 71.2 years (SD = 7.5) and 67.4% were female. Using multiple linear regression analysis, with overall QoL as the dependent variable, perceived health status, education level, engagement in physical activity, medical conditions, age group and use of primary health care were significant associated factors. With physical QoL as the dependent variable, significant factors included: perceived health status, medical conditions, education, physical activities and dependence in ADL; with social QoL as the dependent variable, only age group and paid work were significant. In relation to environmental QoL, education and perceived health were significant factors. CONCLUSIONS: The results illustrate the complexity of factors influencing QoL. With a better understanding of these factors, it is possible to plan appropriate health interventions.

[Public health work and nursing: concepts of the managers of Porto Alegre health units]. / O trabalho em saúde coletiva e a enfermagem: concepções dos gerentes das unidades de saúde de Porto Alegre.

This is a descriptive study done in a qualitative perspective. It aims to describe the conceptions of health care units' managers about the work in public health. The subjects perceptions are that this work goes from interdisciplinary thought with a preventive focus to the curative practice of ambulatory care. On what concerns Nursing, nurses' management functions and auxiliaries assistance activities are pointed out. They believe that strategies to approximate to the SUS principles are necessary in the context of Public Health.

[Experiencing the integration between nursing teachers and nurses. A research project]. / Vivenciando a integração docente-assistencial através da pesquisa.

This article reports the integration experience between registered nurses and nurse educators in a teaching hospital. The study is a research with focus on the care significance to adult clients in a outpatient unit.