Effects of using a mobile health application on the health conditions of patients with arterial hypertension: A pilot trial in the context of Brazil's Family Health Strategy.

Brazil's Family Health Strategy (FHS) leads public health policies and actions regarding community health, addressing arterial hypertension (AH) in primary care settings. In this scenario, the use of communication technologies becomes appropriate for the monitoring of patients with AH. To preliminary verify the intervention approach and the effects of using an m-Health application on the health conditions of patients with AH for a future study, we conducted a non-randomized, controlled, non-blind trial (N = 39), comparing the use of a mobile health app (m-Health) with conventional AH monitoring over 3 months. During the study, we promoted health information workshops to engage patients from both intervention and control groups. Pre and post-intervention, we compared measurements of systolic and diastolic blood pressure; food frequency questionnaire; Appraisal of Self-Care Agency Scale; blood tests of hemogram, creatinine, uric acid, sodium, potassium, lipid profile, and glycemia. Improvements were identified in both groups due to the workshops, including the reduction in total and non-HDL cholesterol, healthier consumption of salads and sugary drinks, and increased self-care scores. Exclusively in the intervention group, which used the m-Health app, there was a change in systolic and diastolic pressure towards more adequate levels. In addition, the intervention group had improved levels of glucose and HDL cholesterol and reduced consumption of ultra-processed foods. In conclusion, the use of an m-Health app had positive effects on the health conditions of patients with AH under treatment within FHS, especially when combined with health information. On the context of FHS, the use of technology is encouraging supporting better health conditions.

An Electronic Health Platform for Monitoring Health Conditions of Patients With Hypertension in the Brazilian Public Health System: Protocol for a Nonrandomized Controlled Trial.

BACKGROUND: Chronic noncommunicable diseases such as arterial hypertension have a high impact in the context of public health. Previous studies have shown improvements in blood pressure due to simple lifestyle changes, which were supported by electronic health (eHealth) solutions. OBJECTIVE: The aim of this study is to develop an eHealth platform and assess the effects of its use on the health conditions of patients with hypertension, with assistance from health professionals in the public health system of a Brazilian city. METHODS: The platform will include a server that centralizes all the data and business rules, a website dashboard for health professionals, and a mobile app for patients. We will analyze the effects of its use through a controlled, nonrandomized, nonblind, prospective, monocentric clinical trial. We will enroll 68 participants diagnosed with arterial hypertension and under medical follow-up and categorize them into two groups. The participants of the intervention group will use the platform as a monitoring method, whereas the participants of the control group will use conventional methods. In both groups, we will assess and compare the evolution of blood pressure and treatment adherence before, during, and after the intervention. RESULTS: The project was funded at the end of 2018. We have been developing the software since 2019 with plans to complete it in 2020, and we will enroll patients between 2020 and 2021. We expect to submit the first results for publication in 2020. CONCLUSIONS: For the primary outcome, we expect a reduction and stabilization of blood pressure. For the secondary outcomes, we hope to see improvements in treatment adherence, physical activities and dietary practices, and acceptance of the eHealth platform. In public health, the technology that favors disease control also helps reduce complications and, consequently, treatment costs. The platform might encourage the adaptation of medical assistance to incorporate this technology into patient monitoring. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/15299.

Mobile health applications for chronic diseases: A systematic review of features for lifestyle improvement.

AIMS: To identify mobile health applications with features for improving the lifestyle of patients with chronic diseases. METHODS: We performed a systematic literature review between November 2017 and May 2018 on the Virtual Health Library's interface. A total of 816 records were identified. In the selection process, 24 studies met inclusion criteria for analysis. Study characteristics were extracted and synthesized. RESULTS: We identified applications with similar functionalities, such as the use of reminders and medical monitoring. Most of them addressed the treatment of conditions related to an already diagnosed chronic disease, including Diabetes Mellitus, Hypertension, Cardiovascular Diseases, Asthma, Neoplasms, and chronic conditions in general. The main lifestyle changes were the reduction of body weight, promotion of healthy eating, and adherence to the regular practice of physical exercises. CONCLUSIONS: Technology can facilitate health care with simple messages and alerts that aid in adherence to treatment. Changes in lifestyle with the use of applications are remarkable. Benefits may be even greater if more applications address the importance of prevention and not just treatment.

Do diagnóstico a terminalidade: enfrentamento da equipe multiprofissional na oncologia pediátrica / From diagnosis to terminal illness: the multiprofessional team endeavior in pediatric oncology / Del diagnostico a terminabilidad: afrontamiento del equipo multiprofesional en oncología pediátrica

Objetivo: Identificar las percepciones y sentimientos que permean la asistencia del equipo multiprofesional en el cáncer infantil. Métodos: Se trata de una investigación cualitativa, prospectiva y descriptiva, realizada con 32 profesionales actuantes en la oncología pediátrica de un hospital referencia en el norte del estado de Rio Grande do Sul. Resultados: La investigación revela la actuación en la oncología pediátrica rodeada de vínculos entre profesionales, pacientes y familias, en la cual el equipo multiprofesional termina involucrado en la red de relaciones interpersonales, enfrentándose diariamente con expectativas, miedos y angustias frente a la incertidumbre de curación y la muerte en la vida El niño, afectando directamente la salud psíquica del trabajador. Conclusión: El estudio expresa la fragilidad de las instituciones formadoras y empleadoras en capacitar al profesional para actuar en esta área desafiante

Objetivo: Identificar as percepções e sentimentos que permeiam a assistência da equipe multiprofissional no câncer infantil. Métodos: Trata-se de uma pesquisa qualitativa, prospectiva e descritiva, realizada com 32 profissionais atuantes na oncologia pediátrica de um hospital referência no norte do estado do Rio Grande do Sul. Resultados: A pesquisa revela a atuação na oncologia pediátrica cercada de vínculos entre profissionais, pacientes e famílias, na qual a equipe multiprofissional acaba envolvida na rede de relações interpessoais, defrontando-se diariamente com expectativas, medos e angústias frente à incerteza de cura e a morte na criança, afetando diretamente a saúde psíquica do trabalhador. Conclusão: O estudo expressa a fragilidade das instituições formadoras e empregadoras em capacitar o profissional para atuar nesta área desafiadora

Objective: The study's purpose has been to identify the perceptions and feelings that permeate the multiprofessional team assistance in childhood cancer. Methods: This is a both prospective and descriptive study with a qualitative approach, which was carried out with 32 professionals working in pediatric oncology at a referral hospital in the North region of the Rio Grande do Sul State. Results: The research reveals the role of pediatric oncology showing the bonds between professionals, patients and families, in which the multiprofessional team end up being involved in the network of interpersonal relationships. The multiprofessional team deals with daily expectations, fears and anguish in the face of uncertainty of both healing and death with regards to the child, then directly affecting the worker's psychic health. Conclusion: The study conveys the fragility of the training institutions in enabling the professional to properly perform in this challenging field

The nurses' viewpoint regarding the use of the Braden scale with the elderly patient / A visão de enfermeiros quanto a aplicação da escala de Braden no paciente idoso / La visión enfermeras para la aplicación de escala en Braden paciente anciano

Objective: The study's goal has been to identify if nurses are knowledgeable and use correctly of the Braden Scale with the elderly in their daily care practice. The Braden Scale is a consolidated instrument in pressure injury prevention. Methods: It is a descriptive-exploratory research with a qualitative approach, which has been performed in a hospital localized in North of Rio Grande do Sul State. Data were collected through semistructured interviews with fourteen nurses, and analyzed through thematic analysis. Results: It was found that most nurses use the scale and are knowledgeable about it, but they also have some difficulties, such as lack of time for performing the needed care. Conclusion: The Braden Scale is a health indicator that assesses the risk of injury formation, where the nurse plays a key role by using this scale. Although the nurses consider the scale an important instrument, they often use it only to meet institutional protocols

Objetivo: Identificar se os enfermeiros têm conhecimento e fazem uso correto em seu cuidado diário da escala de Braden em idosos, instrumento consolidado na prevenção das Lesões por Pressão. Método: Trata-se de uma pesquisa qualitativa, exploratória, descritiva, realizada em um hospital ao Norte do RS. Os dados foram coletados por meio de entrevistas semiestruturadas com quatorze enfermeiros e analisados mediante análise temática. Resultados: A maioria dos enfermeiros realiza a escala, tem conhecimento da mesma, porém encontram dificuldades como falta de tempo para que sejam realmente efetivado os cuidados que aparecem no escore de risco. Conclusão: A Escala de Braden é um indicador de saúde que avalia o risco de formação de lesão, onde o enfermeiro tem papel primordial no seu desempenho, apesar de considerá-la importante, muitas vezes realiza-a apenas para preencher protocolos institucionais

Objetivo: Identificar si las enfermeras tienen conocimiento y hacer un uso adecuado en su cuidado diario de la escala de Braden en la herramienta de edad avanzada, consolidada en la prevención de lesiones por presión. Método: Se trata de un salto cualitativo, exploratorio, descriptivo, realizado en un hospital al norte de la RS. Los datos fueron recolectados a través de entrevistas semiestructuradas con catorce enfermeras y analizados mediante el análisis temático. Resultados: La mayoría de las enfermeras se dan cuenta de la escala, es consciente de ello, pero se encuentran con dificultades como la falta de tiempo para ser realmente efectuado el cuidado que aparece en la puntuación de riesgo. Conclusión: La escala de Braden es un indicador de salud que evalúa el riesgo de formación de lesiones, donde la enfermera tiene un papel clave en su rendimiento, a pesar de que es importante tener en cuenta, a menudo llevado a cabo sólo para llenar los protocolos institucionales

Terapia intravenosa em idosos hospitalizados: avaliação de cuidados / Intravenous therapy in hospitalized older adults: care evaluation / Terapia intravenosa en ancianos que están en hospital: evaluación de cuidados

Objetivou-se avaliar os cuidados de enfermagem na terapia intravenosa periférica em idosos internados ou em observação em um hospital-escola do sul do Brasil, nos meses de agosto e setembro de 2016. Pesquisa de natureza quantitativa prospectiva, avaliando as medidas de prevenção de infecção na terapia intravenosa, por meio de instrumento baseado nas recomendações da Agência Nacional de Vigilância Sanitária. Participaram do estudo 80 pacientes com idade média de 70,7 anos, sendo 51 (63,7%) do sexo masculino. A identificação estava adequada em 15 (18,8%) dos acessos venosos e o preenchimento correto dos rótulos não foi identificado em nenhuma solução avaliada. O curativo de fixação do cateter apresentava sujidade em 29 (36,3%) casos e a incidência de flebite ocorreu em seis (7,5%) pacientes. Concluiu-se que há inconformidades, que interferem na segurança do paciente hospitalizado, requerendo monitoramento da qualidade de assistência e educação permanente dos profissionais (AU).

The aim of this study was to evaluate the nursing care related to peripheral intravenous therapy in older adults hospitalized or under observation in a teaching hospital in southern Brazil, between August and September 2016. This prospective quantitative study evaluated intravenous therapy infection prevention measures, by means of an instrument based on the recommendations of the Brazilian Health Regulatory Agency. The study included 80 patients with a mean age of 70.7 years, 51 (63.7%) of whom were male. The identification was adequate in 15 (18.8%) of the venous accesses and the correct completion of the labels was not identified for any solution evaluated. The dressing for catheter fastening was unclean in 29 (36.3%) cases and the incidence of phlebitis occurred in six (7.5%) patients. It was concluded that there are nonconformities, which impact on the safety of the hospitalized patient, requiring monitoring of the quality of care and ongoing education of the professionals (AU).

Estudio cuyo objetivo fue evaluar los cuidados de enfermería en terapia intravenosa periférica de ancianos internados o en observación en un hospital-escuela de sur de Brasil, en los meses de agosto y septiembre de 2016. Investigación cuantitativa prospectiva que analizó las medidas de prevención de infección en la terapia intravenosa, por medio de instrumento que considera las recomendaciones de la Agencia Nacional de Vigilancia Sanitaria. Participaron del estudio 80 pacientes con edad media de 70,7 años, siendo 51 (63,7%) del sexo masculino. La identificación estaba adecuada en 15 (18,8%) de los accesos venosos y no se completó correctamente ninguno de los rótulos de la solución evaluada. El apósito de fijación del cateter presentaba suciedad en 29 (36,3%) casos y hubo incidencia de flebitis en seis (7,5%) pacientes. Se concluye que hay disconformidades que inlfluyen en la seguridad del paciente hospitalizado, lo que hace necesario monitorar la cualidad de asistencia y educación permanente de los profesionales (AU).