Conhecimento dos acadêmicos de enfermagem sobre suporte básico de vida / Knowledge of nursing academics on basic life support

Objetivo: avaliar o conhecimento sobre suporte básico de vida com ênfase em parada cardiorrespiratória de graduandos de Enfermagem, antes e após a disciplina Saúde do Adulto em Enfermagem. Método: trata-se de um estudo quantitativo, descritivo e exploratório, realizado com acadêmicos de Enfermagem. Utilizou-se um instrumento para a coleta de dados, tendo como referência as diretrizes da AHA. Empregou-se, para a análise dos resultados das questões objetivas e da pesquisa sociodemográfica, a análise descritiva das variáveis, e, apresentaram-se os resultados em forma de tabelas. Resultados: revela-se que, dos 77 acadêmicos avaliados, 66% eram do gênero feminino e a média de idades foi de 18,37 anos; em relação ao período, o maior número foi do sexto, com 24,7%, e o menor do oitavo, com 2,6%, sendo que apenas 32,46% dos acadêmicos atingiram uma nota igual ou superior a 70% do questionário. Conclusão: identificou-se que os estudantes que já haviam passado pela disciplina Saúde do Adulto, momento em que a temática é abordada, obtiveram nota média maior do que os estudantes que não haviam cursado a referida disciplina, contudo, de maneira global, os estudantes apresentam conhecimentos insuficientes para atuar, de forma resolutiva, em um atendimento de vítima em parada cardiorrespiratória.(AU)

Objective: to evaluate the knowledge about basic life support with emphasis on cardiorespiratory arrest of Nursing undergraduates before and after the Adult Health in Nursing discipline. Method: This is a quantitative, descriptive and exploratory study carried out with nursing students. An instrument for data collection was used, with reference to the AHA guidelines. The descriptive analysis of variables was used to analyze the results of objective questions and sociodemographic research, and the results were presented in the form of tables. Results: it is revealed that, of the 77 academics evaluated, 66% were female and the mean age was 18.37 years; in relation to the period, the highest number was of the sixth, with 24.7%, and the lowest of the eighth, with 2.6%, and only 32.46% of the students reached a grade equal to or greater than 70% of the questionnaire. Conclusion: it was identified that students who had passed through the discipline Adult Health, when the subject is approached, obtained a higher average grade than the students who did not attend said discipline, however, in a global way, the students present insufficient knowledge to act, in a resolutive way, in a victim care in cardiorespiratory arrest.(AU)

Objetivo: evaluar el conocimiento sobre soporte básico de vida con énfasis en parada cardiorrespiratoria de graduandos de Enfermería, antes y después de la asignatura Salud del Adulto en Enfermería. Método: se trata de un estudio cuantitativo, descriptivo y exploratorio, realizado con académicos de Enfermería. Se utilizó un instrumento para la recolección de datos, teniendo como referencia las directrices de la AHA. Se utilizó, para el análisis de los resultados de las cuestiones objetivas y de la investigación sociodemográfica, el análisis descriptivo de las variables, y, se presentaron los resultados en forma de tablas. Resultados: se revela que, de los 77 académicos evaluados, el 66% eran del género femenino y el promedio de edades fue de 18,37 años; en relación al período, el mayor número fue del sexto, con el 24,7%, y el menor del octavo, con el 2,6%, siendo que sólo el 32,46% de los académicos alcanzaron una calificación igual o superior al 70% del cuestionario. Conclusión: se identificó que los estudiantes que ya habían pasado por la asignatura Salud del Adulto, momento en que la temática es abordada, obtuvieron una nota promedio mayor que los estudiantes que no habían cursado la referida asignatura, sin embargo, de manera global, los estudiantes se presentan conocimientos insuficientes para actuar, de forma resolutiva, en una atención de víctima en parada cardiorrespiratoria.(AU)

Primary care physicians' attitudes regarding race-based therapies.

BACKGROUND: There is little to no information on whether race should be considered in the exam room by those who care for and treat patients. How primary care physicians understand the relationship between genes, race and drugs has the potential to influence both individual care and racial and ethnic health disparities. OBJECTIVE: To describe physicians' use of race-based therapies, with specific attention to the case of BiDil (isosorbide dinitrate/hydralazine), the first drug approved by the FDA for a race-specific indication, and angiotensin-converting enzyme (ace) inhibitors in their black and white patients. DESIGN: Qualitative study involving 10 focus groups with 90 general internists. PARTICIPANTS: Black and white general internists recruited from community and academic internal medicine practices participated in the focus groups.Of the participants 64% were less than 45 years of age, and 73% were male. APPROACH: The focus groups were transcribed verbatim, and the data were analyzed using template analysis. RESULTS: There was a range of opinions relating to the practice of race-based therapies. Physicians who were supportive of race-based therapies cited several potential benefits including motivating patients to comply with medical therapy and promoting changes in health behaviors by creating the perception that the medication and therapies were tailored specifically for them. Physicians acknowledged that in clinical practice some medications vary in their effectiveness across different racial groups, with some physicians citing the example of ace inhibitors. However, physicians voiced concern that black patients who could benefit from ace inhibitors may not be receiving them. They were also wary that the category of race reflected meaningful differences on a genetic level. In the case of BiDil, physicians were vocal in their concern that commercial interests were the primary impetus behind its creation. CONCLUSIONS: Primary care physicians' opinions regarding race-based therapy reveal a nuanced understanding of race-based therapies and a wariness of their use by physicians.

Physicians' attitudes toward race, genetics, and clinical medicine.

PURPOSE: This qualitative study explored black and white general internists' attitudes about the relevance of race in clinical care; views of the relationships among race, genetics, and disease; and expectations about the future of genetics and health. METHODS: We conducted 10 racially concordant focus groups of primary care physicians in five metropolitan areas in the United States. Ninety board certified or eligible general internists (50 self-identified whites and 40 self-identified blacks) participated in the study. Analysis included a two-stage independent review and adjudication process. RESULTS: Both black and white physicians concluded that the race of the patient is medically relevant but did not agree upon why race is important in clinical decisions. They were reticent to make connections among race, genetics, and disease and asserted that genetics has a limited role in explaining racial differences in health. However, they were enthusiastic about the future of genomic medicine, believing that the main benefit will be the potential to improve the efficacy of commonly used drugs. CONCLUSIONS: Understanding the similarities and differences between black and white physicians' attitudes and beliefs about race, health and genetics is important for the translation of genomics to clinical care.

Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups.

BACKGROUND: The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) is a brief validated screen for risky drinking and alcohol abuse and dependence (alcohol misuse). However, the AUDIT-C was validated in predominantly White populations, and its performance in different racial/ethnic groups is unclear. OBJECTIVE: To evaluate the validity of the AUDIT-C among primary care patients from the predominant racial/ethnic subgroups within the United States: White, African American, and Hispanic. DESIGN: Cross-sectional interview validation study. PARTICIPANTS: 1,292 outpatients from an academic family practice clinic in Texas (90% of randomly sampled eligible). MEASUREMENTS AND MAIN RESULTS: Race/ethnicity was self-reported. Areas under the receiver operating curve (AuROCs) evaluated overall AUDIT-C performance in the 3 racial/ethnic groups compared to diagnostic interviews for alcohol misuse. AUDIT-C sensitivities and specificities at recommended screening thresholds were compared across racial/ethnic groups. AuROCs were greater than 0.85 in all 3 groups, with no significant differences across racial/ethnic groups in men (P = .43) or women (P = .12). At previously recommended cut points, there were statistically significant differences by race in AUDIT-C sensitivities but not specificities. In women, the sensitivity was higher in Hispanic (85%) than in African-American (67%; P = .03) or White (70%; P = .04) women. In men, the sensitivity was higher in White (95%) than in African-American men (76%; P = .01), with no significant difference from Hispanic men (85%; P = .11). CONCLUSIONS: The overall performance of the AUDIT-C was excellent in all 3 racial/ethnic groups as reflected by high AuROCs. At recommended cut points, there were significant differences in the AUDIT-C's sensitivity but not in specificity across the 3 racial/ethnic groups.

AUDIT-C as a brief screen for alcohol misuse in primary care.

BACKGROUND: The Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questions have been previously validated as a 3-item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT-C's validity and optimal screening threshold(s) in other clinical populations are unknown. METHODS: This cross-sectional validation study compared screening questionnaires with standardized interviews in 392 male and 927 female adult outpatients at an academic family practice clinic from 1993 to 1994. The AUDIT-C, full AUDIT, self-reported risky drinking, AUDIT question #3, and an augmented CAGE questionnaire were compared with an interview primary reference standard of alcohol misuse, defined as a Diagnostic and Statistical Manual, 4th ed. alcohol use disorder and/or drinking above recommended limits in the past year. RESULTS: Based on interviews with 92% of eligible patients, 128 (33%) men and 177 (19%) women met the criteria for alcohol misuse. Areas under the receiver operating characteristic curves (AUROCs) for the AUDIT-C were 0.94 (0.91, 0.96) and 0.90 (0.87, 0.93) in men and women, respectively (p=0.04). Based on AUROC curves, the AUDIT-C performed as well as the full AUDIT and significantly better than self-reported risky drinking, AUDIT question #3, or the augmented CAGE questionnaire (p-values <0.001). The AUDIT-C screening thresholds that simultaneously maximized sensitivity and specificity were > or =4 in men (sensitivity 0.86, specificity 0.89) and > or =3 in women (sensitivity 0.73, specificity 0.91). CONCLUSIONS: The AUDIT-C was an effective screening test for alcohol misuse in this primary care sample. Optimal screening thresholds for alcohol misuse among men (> or =4) and women (> or =3) were the same as in previously published VA studies.