Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants.

OBJECTIVE: To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. METHOD: Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). RESULTS: Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. CONCLUSION: Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

The Mastery of Competencies for the Care of LGBT+ People by Different Health Professionals.

This study aims to compare the mastery of competencies in assisting the LGBT+ population of Brazilian health professionals. Data collection occurred in a face-to-face and virtual manner, in the first semester of 2018. The health professionals answered a socio-demographic and functional questionnaire, in addition to the questionnaire Measurement of Training Needs for Health Care for the LGBT+ Public. The data was analyzed using Mann-Whitney and Chi-square tests. The project research was submitted to and approved by the IMED Research Ethics Committee (CAAE 69116917.6.0000.5319). The sample (n= 380) was made up mostly of psychologists (42.3%), female (81%), heterosexual (73.2%), aged between 26 and 35 years (36%), Catholic (41%), living in the south region (36.9%), and working in the profession for ten years or more (34.3%). Skills gaps on the LGBT+ theme was identified, especially in topics such as "approach to the patient's sexuality," "interference of religious beliefs in care," "care with the genitalia and breast of the trans individual," among others. Professionals trained in psychology and non-heterosexuals had a greater mastery of the theme than the others. The fragmentation of knowledge and skills hinders the full and equal access to the health system, and continued educational actions are recommended.

Breastfeeding at discharge and in the third stage of the Kangaroo Mother Care among hospitalized preterm infants / Lactancia materna al alta y en la tercera etapa del Método Madre Canguro en recién nacidos prematuros hospitalizados / Aleitamento materno na alta e na terceira etapa do Método Canguru entre recém-nascidos prematuros hospitalizados

ABSTRACT Objective: To identify the type of feeding and analyze the sociodemographic and clinical factors associated with exclusive breastfeeding at hospital discharge, in the first and in the last follow-up visit of the third stage of the Kangaroo Mother Care among infants admitted to the kangaroo unit. Method: Longitudinal and retrospective study. A total of 186 infants of gestational age <37 weeks admitted to the kangaroo unit in 2018 and 2019 was included. Data collected from medical records and subjected to inferential analysis and the Poisson regression model (P < 0.05). Results: Exclusive breastfeeding rate was 73.1% at discharge, with a drop at the last follow-up visit (68.1%). At discharge, there was a greater probability of exclusive breastfeeding in younger mothers, with higher education, infants born with higher birth weight and who received exclusive human milk during hospitalization; in the first follow-up visit, in a younger mother and infant who received only human milk during hospitalization; and in the last follow-up visit, a young mother, infant who received only human milk and suckled at the breast for the first time in the kangaroo unit. Conclusion: Most infants hospitalized in the second stage of the Kangaroo Mother Care were exclusively breastfed and presented maternal and clinical factors related to breastfeeding. This fact can help manage the challenges of the method and promote breastfeeding.

RESUMEN Objetivo: Identificar el tipo de alimentación y analizar los factores sociodemográficos y clínicos asociados a la lactancia materna exclusiva al alta hospitalaria, en el primero y en la última visita de seguimiento de la tercera etapa del Método Madre Canguro entre los recién nacidos ingresados en la unidad canguro. Método: Estudio longitudinal y retrospectivo. Se incluyeron 186 neonatos en edad gestacional <37 semanas ingresados en la unidad canguro en 2018 y 2019. Datos recopilados de historias clínicas sometidas a análisis inferencial y modelo de regresión de Poisson (p < 0,05). Resultados: La tasa de lactancia materna exclusiva fue del 73,1% al alta, con descenso en la última visita de seguimiento (68,1%). Al alta hubo mayor probabilidad de lactancia materna exclusiva en madres más jóvenes, con mayor escolaridad, recién nacidos con mayor peso al nacer y que recibieron leche materna exclusiva durante la internación; en la primera visita de seguimiento, en una madre más joven y un recién nacido que recibió únicamente leche materna durante la hospitalización; y en la última visita de seguimiento, una madre joven, recién nacido que recibió sólo leche humana y con la primera succión del pecho en la unidad canguro. Conclusión: La mayoría de los recién nacidos hospitalizados en la segunda etapa del Método Madre Canguro fueron amamantados exclusivamente y presentaron factores maternos y médicos relacionados con la lactancia materna, que pueden ayudar a gestionar los desafíos del método y promover la lactancia materna.

RESUMO Objetivo: Identificar o tipo de alimentação e analisar os fatores sociodemográficos e clínicos associados ao aleitamento exclusivo na alta hospitalar, no primeiro e no último retorno da terceira etapa do Método Canguru entre neonatos internados na unidade canguru. Método: Estudo longitudinal e retrospectivo. Incluídos 186 neonatos com idade gestacional <37 semanas admitidos na unidade canguru em 2018 e 2019. Dados coletados do prontuário submetidos à análise inferencial e ao modelo de regressão Poisson (p < 0,05). Resultados: Taxa de aleitamento exclusivo foi de 73,1% na alta, com queda no último retorno (68,1%). Na alta, houve maior probabilidade de aleitamento exclusivo em mãe mais jovem, com escolaridade superior, neonato nascido com maior peso e que recebeu leite humano exclusivo durante internação; no primeiro retorno, em mãe mais jovem e neonato que recebeu apenas leite humano na internação; e no último retorno, mãe jovem, neonato que recebeu apenas leite humano e com primeira sucção na mama na unidade canguru. Conclusão: A maioria dos neonatos internados na segunda etapa do Método Canguru estava em aleitamento exclusivo e apresentou fatores maternos e clínicos relacionados ao aleitamento, podendo auxiliar no manejo dos desafios do método e na promoção da amamentação.

Conhecimento, Atitude e Prática de Gestantes Sobre Incontinência Urinária: Estudo Observacional / Knowledge, Attitude, and Practice of Pregnant Women About Urinary Incontinence: Observational Study / Conocimiento, Actitud y Práctica De Gestantes Sobre la Incontinencia Urinaria: Estudio Observacional

Objetivo:avaliar o conhecimento, a atitude e a prática (CAP) de gestantes sobre incontinência urinária (IU), identificar a prevalência de IU durante a gestação, avaliar seu impacto na qualidade de vida (QV) e identificar os fatores associados ao CAP inadequados em relação à IU. Metodologia: Estudo observacional realizado de maio a novembro de 2019 na cidade de Fortaleza, Ceará. Utilizaram-se dois instrumentos para coleta de dados: um para avaliação sociodemográfica, obstétrica e de perdas urinárias e outro para avaliação do CAP sobre IU. Resultados: Participaram 237 gestantes. A prevalência de IU foi de 49,3% e observou-se baixo impacto na QV. A maioria apresentou conhecimento (89,6%) e prática inadequados tanto para prevenir (89,2%) quanto para tratar (78,8%) a IU. Identificaram-se baixos percentuais de acerto relacionados ao conhecimento sobre fatores de risco (46,8%), prevenção (43,8%) e tratamento da IU (42,8%). Apesar disso, a atitude foi considerada adequada para a maioria das mulheres (98,5%). Ausência de orientação sobre o preparo do períneo para o parto durante o pré-natal (p = 0,019), baixa escolaridade (p < 0,001), casos mais leves de IU (p = 0,027) e gestação de alto risco (p = 0,004) associaram-se a prática inadequada. Conclusão: o conhecimento sobre causas, prevenção e tratamento da IU é insuficiente e interfere no manejo dessa condição.perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objectives:To assess the knowledge, attitude and practice (KAP) of pregnant women about urinary incontinence (UI), identify the prevalence of UI, assess its impact on quality of life (QoL) and identify factors associated with inadequate KAP in relation to UI. Methodology: Observational study carried out from May to November 2019 in the city of Fortaleza, Ceará, Brazil. Two instruments were used for data collection: one for sociodemographic, obstetric and urinary loss assessment and another for KAP assessment on UI. Results: 237 pregnant women participated. The prevalence of UI was 49.3% and a low impact on QoL was observed. Most had knowledge (89.6%) and inadequate practice both to prevent (89.2%) and to treat (78.8%). Low percentages of correct answers were identified related to knowledge about risk factors (46.8%), prevention (43.8%) and treatment of UI (42.8%). Despite this, the attitude was considered adequate for most women (98.5%). Absence of guidance on preparation of the perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objetivos:evaluar el conocimiento, la actitud y la práctica (CAP) de las gestantes sobre la incontinencia urinaria (IU), identificar la prevalencia de la IU, evaluar su impacto en la calidad de vida (CV) e identificar los factores asociados a una PAC inadecuada en relación con la IU. Metodología: estudio observacional realizado de mayo a noviembre de 2019 en la ciudad de Fortaleza/CE. Se utilizaron dos instrumentos para la recolección de datos: uno para la evaluación sociodemográfica, obstétrica y de pérdidas urinarias y otro para la evaluación del CAP en la IU. Resultados: Participaron 237 gestantes. La prevalencia de IU fue del 49,3% y se observó un bajo impacto en la CV. La mayoría tenía conocimiento (89,6%) y práctica inadecuada tanto para prevenir (89,2%) como para tratar (78,8%). Se identificaron bajos porcentajes de aciertos relacionados con el conocimiento sobre factores de riesgo (46,8%), prevención (43,8%) y tratamiento de la IU (42,8%). A pesar de ello, la actitud fue considerada adecuada por la mayoría de las mujeres (98,5%). La ausencia de orientación sobre la preparación del perineo para el parto durante el control prenatal (p = 0,019), la baja escolaridad (p < 0,001), los casos más leves de IU (p = 0,027) y el embarazo de alto riesgo (p = 0,004) se asociaron con una atención inadecuada. práctica. Conclusión: el conocimiento sobre las causas, la prevención y el tratamiento de la IU es insuficiente e interfiere con el manejo de esta condición.

Brazilian Portuguese translation, cross-cultural adaptation, and content validation of the pediatric lower urinary tract symptom score.

BACKGROUND: Early screening instruments for professionals are important to reduce the cost and time of diagnosing pediatric lower urinary tract dysfunction. This study aimed to translate, cross-culturally adapt, and validate pediatric lower urinary tract symptom scores. METHODS: This methodological study was conducted in 2019 in two phases: translation and cross-cultural adaptation, and content validation. In the first phase, we used translators, specialists, and 30 parents of children with voiding dysfunction. In the second phase, validation was performed by 11 pediatric urology specialists. FINDINGS: The instrument was translated and adapted to Brazilian Portuguese and presented an excellent level of verbal comprehension. Further, the instrument presented a good content validity index >0.8 for all items, except for the nomenclature and clarity of two items, as indicated by the Cronbach's alpha value of 0.75 for internal consistency. DISCUSSION: The final version showed semantic, idiomatic, experiential, and conceptual equivalence with the original instrument, indicating that it is adequate for other assessments of psychometric qualities. PRACTICE IMPLICATIONS: The translation and adaptation of an important instrument for diagnosing lower urinary tract dysfunction in children to other countries helps nurses identify the disease early and monitor the treatment.

Validation of Visual Prostate Symptom Score (VPSS) in Brazilian Sample Population.

PURPOSE: The aim of the study was to evaluate the reliability and validity of the Visual Prostate Symptom Score (VPSS), its correlation with the International Prostate Symptom Score (IPSS), and the time required and need for help when completing the instrument. We also aimed to identify variables associated with difficulty completing these instruments. DESIGN: Longitudinal, prospective correlational study. SUBJECTS AND SETTING: The target population was Brazilian men from different cities within the state of São Paulo with lower urinary tract symptoms followed in urological consultation at a university hospital during October 2017. The sample comprised 59 patients with a mean age of 66.53 years. METHODS: Reliability of the VPSS was evaluated using a test-retest approach and its convergent validity with the IPSS. Cronbach α coefficient was also calculated. Both questionnaires were self-administered and, in case of difficulty of comprehension, assistance was provided. RESULTS: Mean completion time of the IPSS was 6.56 minutes and for VPSS was 5.02 minutes. The variables skin color and educational level were associated with the difficulty in completing the IPSS and for comprehending meaning of the VPSS pictograms. Internal consistency evaluated using Cronbach α coefficient was 0.74 for IPSS and 0.15 for VPSS, respectively. Test-retest reliability testing revealed that both instruments had a high intraclass correlation index (>0.75). There was a significant correlation between the health-related quality of life (QoL) scores of the 2 instruments (0.71, P = .0001) and between the total score of each instrument with its corresponding QoL score. CONCLUSION: Although time for response of the VPSS was shorter and it demonstrated good test-retest reliability, it more frequently required help to answer. The VPSS showed low internal consistency and low correlation with the IPSS (except for the QoL item).

Neural network-based method to stratify people at risk for developing diabetic foot: A support system for health professionals.

BACKGROUND AND OBJECTIVE: Diabetes Mellitus (DM) is a chronic disease with a high worldwide prevalence. Diabetic foot is one of the DM complications and compromises health and quality of life, due to the risk of lower limb amputation. This work aimed to build a risk classification system for the evolution of diabetic foot, using Artificial Neural Networks (ANN). METHODS: This methodological study used two databases, one for system design (training and validation) containing 250 participants with DM and another for testing, containing 141 participants. Each subject answered a questionnaire with 54 questions about foot care and sociodemographic information. Participants from both databases were classified by specialists as high or low risk for diabetic foot. Supervised ANN (multi-layer Perceptron-MLP) models were exploited and a smartphone app was built. The app returns a personalized report indicating self-care for each user. The System Usability Scale (SUS) was used for the usability evaluation. RESULTS: MLP models were built and, based on the principle of parsimony, the simplest model was chosen to be implemented in the application. The model achieved accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 76%, 91%, 89%, and 79%, respectively, for the test data. The app presented good usability (93.33 points on a scale from 0 to 100). CONCLUSIONS: The study showed that the proposed model has satisfactory performance and is simple, considering that it requires only 10 variables. This simplicity facilitates its use by health professionals and patients with diabetes.

Barreiras e facilitadores da implementação do pré-natal em grupo: um protocolo de scoping review / Barriers and facilitators to the implementation of group prenatal care: a scoping review protocol

OBJETIVO: Mapear modelos de Pré-Natal em Grupo (PNG) para identificar barreiras, facilitadores, desafios de implementação e manutenção do PNG. MÉTODO: Este protocolo descreve uma Scoping Review desenvolvida de acordo com a metodologia do Joanna Briggs Institute (JBI). A questão de pesquisa que norteia esta revisão é: "Quais são os modelos de PNG existentes, as barreiras, facilitadores e desafios na implementação e manutenção desses modelos?". A busca será conduzida em oito bases de dados e incluirá a pesquisa em literatura cinzenta. O software Rayyan será utilizado para gerenciar a seleção dos artigos. Dois revisores realizarão a avaliação do título e resumo dos artigos de forma independente. Aqueles que atenderem aos critérios de inclusão serão selecionados para a leitura completa. Em caso de divergências, um terceiro revisor será consultado para resolver as discordâncias. A síntese dos dados será realizada de forma descritiva, com um resumo narrativo dos resultados apresentado em tabelas, descrevendo como esses resultados se relacionam com o objetivo e a questão de pesquisa.

OBJECTIVE: To map group prenatal care (GPC) models to identify barriers, facilitators, implementation challenges, and maintenance of GPC. MÉTODO: This protocol describes a scoping review conducted using the methodology outlined by the Joanna Briggs Institute (JBI). The research question guiding this review is: "What are the existing GPC models, barriers, facilitators, and challenges in implementing and sustaining these models?". The search will be conducted in eight databases and include gray literature searches. Rayyan software will be used to manage the article selection process. Two reviewers will independently assess the title and abstract of the articles. Those that meet the inclusion criteria will be selected for full-text reading. A third reviewer will be consulted to resolve disagreements in case of discrepancies. Data synthesis will be performed descriptively, with a narrative summary of the results presented in tables, describing how these results relate to the objective and research question.

Planejamento e Dimensionamento da Força de Trabalho em Saúde no Brasil: avanços e desafios / Planning and Sizing of the Health Workforce in Brazil: advances and challenges

RESUMO Este estudo visa a analisar a produção de conhecimento acerca do Planejamento e Dimensionamento da Força de Trabalho em Saúde (PDFTS) desenvolvida no Brasil identificando modelos e metodologias que consideram as diretrizes do Sistema Único de Saúde (SUS) para a constituição de redes de atenção regionalizadas. Trata-se de uma revisão integrativa, incluindo estudos brasileiros e com texto completo, em português, disponível nas bases de dados Capes, BVS e Google Acadêmico. As buscas retornaram 48.083 documentos e, após seleção com a ferramenta Prisma, foram incluídos 62 estudos publicados entre 2011 e 2020. A maioria das produções analisadas aborda o PDFTS com análises comparativas entre as necessidades estimadas e a disponibilidade atual, sendo mais frequentes os estudos de apenas uma categoria profissional, com destaque para a enfermagem. Os achados contribuem à promoção do debate sobre a essencialidade da força de trabalho em saúde para a conformação das redes, ao demonstrar que os métodos de cálculo privilegiam o uso de indicadores e parâmetros relacionados à oferta de serviços em estabelecimentos de saúde específicos, especialmente hospitais, não operacionalizando aspectos de regionalização e integração sistêmica da Rede de Atenção à Saúde.

ABSTRACT This study aims to analyze the production of knowledge about Planning and Sizing of the Health Workforce (PDFTS) developed in Brazil, identifying models and methodologies that consider the Guidelines of the Unified Health System (SUS) for the constitution of regionalized care networks. This is an integrative review, including Brazilian studies and full text, in Portuguese, and available in the CAPES, BVS and Google Scholar databases. The searches returned 48,083 documents and, after selection with the PRISMA strategy, 62 studies published between 2011 and 2020 were included. Most of the analyzed productions approach the PDFTS with comparative analyzes between the estimated needs and the current availability, being more frequent the studies of only one professional category, with emphasis on nursing. The findings contribute to the debate on the essentiality of the health workforce for the conformation of networks, by demonstrating that the calculation methods favor the use of indicators and parameters related to the provision of services in specific health facilities, especially hospitals, not operationalizing aspects of regionalization and systemic integration of the Health Care Network.

Perfil de gestantes atendidas em maternidade de Natal/rn entre 2016 a 2018 / Profile of pregnant women attended in maternity of Natal/RNbetween 2016 to 2018 / Perfil de mujeres embarazadasasistidas enmaternidad deNatal/RNentre2016 a 2018

Introdução:A atenção à mulher nociclo gravídico-puerperal resulta na redução dos níveis de morbimortalidade materna e infantil e traduz a qualidade de vida de uma sociedade, devendo ser prioridade das políticas de saúde.Objetivo:Descrever o perfil sociodemográfico e obstétrico de gestantes admitidas para o parto em maternidade de alto risco, para identificar fatores de risco associados.Metodologia:Pesquisa descritiva, quantitativa, transversal, com dados secundários de 2016 a 2018. Análise descritiva ajustada pelo teste qui-quadrado,considerando p < 0,05.Resultados:Foram analisadas 11.704 mulheres. O perfil majoritário das pacientes foi: idades extremas (22,6%); baixa escolaridade (41,1%); 74,3% casadas/em união estável; provenientes do interior (53,4%); maioria do lar; primíparas.Percebeu-se: gestações prematuras (31,1%); 42,1% realizaram no máximo 6 consultas de pré-natal; e 62% de parto cesariano. Idade menor de 18 anos predominou em mulheres oriundas do interior. Houve associação entre baixa escolaridade com maior número de consultas de pré-natal, multiparidade e parto vaginal.Conclusões:Trata-se de um estudo pioneiro acerca do perfil epidemiológico deste serviço, contribuindo para o cuidado materno-infantil (AU).

Introduction:care for women in the gravidic-puerperal cycle results in the reduction of maternal and infant morbimortality levels and translates into quality of life in a society, and should be a priority in health policies.Objective:to describe the sociodemographic and obstetric profile of pregnant women admitted for childbirth in a high-risk maternity hospital, in order to identify associated risk factors.Methodology:descriptive, quantitative, cross-sectional research, with secondary data from 2016 to 2018. Descriptive analysis adjusted by the chi-square test, considering p < 0,05.Results:11.704 women were analyzed. The majority profile of patients was: extreme ages (22,6%); low education (41,1%); 74,3%married/living in cohabitation; from the countryside (53,4%); majority of them are housewife; primiparae. It was noticed: premature pregnancies (31,1%); 42,1% had a maximun of 6 prenatal consultations; and 62% of cesarean delivery. Age under 18 years was predominant in women from the countryside. There was an association between low education and a higher number of prenatal consultations, multiparity and vaginal delivery.Conclusions:this is a pioneer study on the epidemiological profile of this servisse,contributing to maternal and child care (AU).

Introducción: la atención a la mujer en el ciclo gravídico-puerperal resulta en la reducción de las tasas de morbimortalidad materna e infantil y traduce la calidad de vida de una sociedad, debiendo ser la prioridad de las políticas de salud.Objetivo: describir el perfil sociodemográfico y obstétrico de gestantes ingresadas por parto en una maternidad de alto riesgo, con el fin de identificar los factores de riesgo associados.Metodología: investigación descriptiva, cuantitativa, transversal, con datos secundários de 2016 a 2018. Análisis descriptivo ajustado por la prueba de chi-cuadrado, considerando p < 0,05.Resultados: se analizaron 11,704 mujeres. El perfil mayoritario de los pacientes fue: edades extremas (22,6%); baja escolaridade (41,1%); 74,3% casados/pareja de hecho; del interior (53,4%); la mayoría son amas de casa; primíparas. Se notó: embarazos prematuros (31,1%); 42,1% tuvo um máximo de 6 consultas prenatales; y el 62% de los partos por cesárea. La edad menor de 18 ãnos fue predominante em las mujeres del interior. Hubo associación entre baja escolaridade y maior número de consultas prenatales, multiparidad y parto vaginal.Conclusiones: se trata de un estudio pionero sobre el perfil epidemiológico de este servicio, contribuyendo a la atención materno-infantil (AU).

Form for planning and elaborating high fidelity simulation scenarios: A validation study.

Every human being has the right to safe, dignified and harm-free care in health institutions. High fidelity simulation has been used in teaching for the training and continuing education of health professionals to promote quality, safe and humanized patient care. Elaborating scenarios is an important phase to provide a simulation-based experience, and is relevant in the teaching-learning process. The objective of this study was to validate the content and applicability of the High Fidelity Simulation Scenario Planning and Development Form and its Operational Manual. The form could be used to development of scenarios to medicine, nursing, physiotherapy and as well as other specialties in the healthcare. This was a methodological validation study of the form and its manual content by experts in simulation and its feasibility, conducted in two phases: Phase 1: eight experts were selected using the "snowball" sampling technique to validate the content measured by the content validity index; Phase 2 (test): the form and its operational manual validated by the experts were made available to 28 participants in order to elaborate scenarios for the feasibility assessment and participation in the focus group. All items in the form and in the operational manual reached a content validity index above 0.80. The total content validity index was 0.98. The evaluation of the usability of the instruments carried out by the participants reached a percentage above 96.43% in all alternatives except for the item "It was easy to use the form to build your scenario" (75%). Eight participants were present in the focus group. Focus group discussions were categorized into completeness, practicality and usefulness according to comments and suggestions. The form and its operational manual proved to be valid instruments.

Nursing Process in the Brazilian context: reflection on its concept and legislation.

OBJECTIVES: to reflect on the global understanding of the Nursing Process concept, with emphasis on the Brazilian context. METHODS: a reflection article, aligned with the vision and expertise of researchers who are members of the Nursing Process Research Network. RESULTS: the reflection is presented in two main topics: The evolution of Systematization of Nursing Care X Nursing Process concepts and its consonance with national and international practices, and Brazilian legislation; The Nursing Process concept realignment in Brazilian legislation in line with current care, teaching and research practices. Final Considerations: the reflections were oriented to the Nursing Process' conceptual, normative and legal issues, including elements of its historical evolution, and, with that, pointed to the need to modify the Brazilian regulation on the Nursing Process.

Translation and Cross-Cultural Adaptation of the System Usability Scale to Brazilian Portuguese / Tradução e adaptação transcultural da System Usability Scale para o português do Brasil / Traducción y adaptación transcultural de la System Usability Scale al portugués de Brasil

Objective: To adapt culturally the System Usability Scale to Brazilian Portuguese and assess its internal consistency and structural construct validity. Materials and methods: This methodological study of a measurement instrument's cultural adaptation included the initial translation, the translations' synthesis, the back-translation, the evaluation by a committee of eight experts, testinh with a sample of 100 students, who evaluated the usability of the WhatsApp application, and the evaluation of structural construct validity by exploratory factor analysis. Results: The judges validated the Brazilian version of the System Usability Scale in the second round. It was revealed that, following the structural construct validation, the version had a unidimensional structure and an acceptable level of reliability (Cronbach's alpha of 0.76). Besides, in the usability test, no suggestions for change were made. Conclusions: It is worth noting that the Brazilian version of this scale was semantically, idiomatically, conceptually, and culturally equivalent to the original English version and showed adequate reliability and structural construct validity.

Objetivo: realizar a adaptação cultural da System Usability Scale para a língua portuguesa do Brasil e avaliar a sua consistência interna e a validade estrutural de constructo. Materiais e método: trata-se de um estudo metodológico, de adaptação cultural de instrumento de medida, que contemplou a tradução inicial, a síntese das traduções, a retrotradução, a avaliação por comitê de oito especialistas, o teste com uma amostra de 100 estudantes, que avaliaram a usabilidade do aplicativo WhatsApp, e a avaliação da validade de constructo estrutural por análise fatorial exploratória. Resultados: validou-se a versão brasileira da System Usability Scale pelos juízes na segunda rodada. Revela-se que, após a validação de constructo estrutural, a versão apresentou estrutura unidimensional e nível aceitável de confiabilidade (alfa de Cronbach de 0,76). Acrescenta-se que, no teste de usabilidade, não houve sugestão de mudança. Conclusões: informa-se que a versão brasileira dessa escala apresentou equivalência semântica, idiomática, conceitual e cultural com a versão original em inglês, bem como adequada confiabilidade e validade de constructo estrutural.

Objetivo: realizar la adaptación cultural de la System Usability Scale al idioma portugués, variante brasileña, y evaluar su consistencia interna y su validez de constructo estructural. Materiales y métodos: se trata de un estudio metodológico de adaptación cultural de un instrumento de medición, que contempló traducción inicial, síntesis de traducciones, retrotraducción, evaluación por ocho expertos, prueba con una muestra de 100 estudiantes, quienes evaluaron la usabilidad de la aplicación WhatsApp, y evaluación de la validez de constructo estructural mediante análisis factorial exploratorio. Resultados: los expertos en la segunda ronda validaron la versión brasileña de la System Usability Scale. Se reveló que, luego de la validación de constructo, la versión presentó una estructura unidimensional y un nivel aceptable de confiabilidad (alfa de Cronbach de 0,76). Además, en la prueba de usabilidad, no hubo sugerencia de cambio. Conclusiones: se informa que la versión brasileña de la escala presentó equivalencia semántica, idiomática, conceptual y cultural con la versión original en inglés, así como una confiabilidad y validez de constructo estructural adecuadas.

Scale of pregnant women's assessment of knowledge, attitude and practice related to urinary incontinence.

INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is prevalent during pregnancy and negatively affects quality of life. Despite this, few women seek professional assistance during prenatal care. Assessing the knowledge, attitude and practice (KAP) of pregnant women related to UI can contribute to the development and improvement of the quality of interventions performed during this period. For this, it is essential to apply targeted and valid instruments for this population. Thus, the present study aimed to construct and validate the content of a scale to evaluate the KAP of pregnant women related to UI. METHODS: Extensive literature review guided the operationalization of the instrument's initial items. Ten experts were selected for the theoretical analysis of the items, which was carried out using the Delphi technique, and the analysis of semantic adequacy proceeded from the application of the scale to 30 pregnant women. The data were analyzed using the content validity coefficient and kappa coefficient. RESULTS: The proposed Scale of Pregnant Women's Assessment of Knowledge, Attitude and Practice related to UI was approved by consensus by the experts, with a mean Cohen's kappa of 0.84 (p < 0.01), comprising 23 items. CONCLUSIONS: The results of the study confirm that the presented scale can be used as a valid tool to assess the KAP of pregnant women related to UI.

Gender and Empowerment by Nursing Students: Representations, Discourses and Perspectives.

Nursing history is marked by stigmas of gender, race and class. Nowadays, this scenario is evidenced by the social disqualification of the profession and biomedical and male supremacy. Nevertheless, the profession has the potential to change this paradigm with an intersectional approach. The current study aims to understand how the relationships of gender, feminism and empowerment are experienced by nursing students at a Brazilian public university. This is a qualitative study, exploratory-explanatory, with the application of interviews with nursing students in their five years of training. The chosen method of analysis was the Discourse of the Collective Subject based on the central ideas categorized after the interviews: (a) Profession-female and stigmatized due to its historical construction influenced by religiosity and moral; (b) Formation-far from gender relations by the perpetuation of stereotypes; and (c) Perspectives-empowerment of the profession if close to the feminist movement. The students' discourse alert to the historical reflexes of oppressive ideological mechanisms of women and nursing in their ongoing professional training, claiming transversal learning spaces for the critical expansion of gender awareness and consequent empowerment of nursing in a feminist and intersectional perspective.

Recomendações clínicas para prevenir e tratar a retenção urinária pós-parto / Clinical recommendations to prevent and treat postpartum urinary retention

A retenção urinária pós-parto (RUPP) é considerada um distúrbio urinário e embora não esteja associada à mortalidade, sua morbidade é significativa. Acredita-se que diretrizes pré-estabelecidas, somadas aos achados do exame físico puerperal, possam dar suporte à prática clínica do profissional e, consequentemente, preservam a autonomia estrutural e funcional do sistema urinário da mulher. Assim, o objetivo deste estudo é estabelecer consenso entre especialistas acerca de uma proposta de recomendações clínicas baseadas em evidências para prevenir e tratar a RUPP. Trata-se de estudo descritivo-exploratório, de natureza quantitativa, desenvolvido por meio da técnica Delphi. Foi elaborada uma proposta inicial com 48 recomendações clínicas baseadas em evidências, distribuídas em três domínios. A primeira rodada do Painel Delphi foi composta por 19 especialistas, a segunda por 16 especialistas e a terceira por 13 especialistas. Ao final do Painel Delphi, 27 (56,3%) recomendações obtiveram consenso superior a 90%. Dessas, nove (33,3%) visavam a prevenção da RUPP evidente e oculta, e pertenciam ao Domínio ­ 1, nove (33,3%) visavam o tratamento da RUPP evidente e oculta, e pertenciam ao Domínio ­ 2 e nove (33,3%) visavam a reeducação da bexiga na RUPP persistente e pertenciam ao Domínio ­ 3. Considera-se que as recomendações aprovadas por meio deste consenso apoiam a tomada de decisão dos profissionais diante dos riscos inerentes de RUPP, que pode causar, em função hiperdistensão da bexiga, danos irreversíveis ao músculo detrusor, assim como infecções recorrentes do trato urinário e dificuldade de eliminação urinária permanente.

Postpartum urinary retention (PPUR) is considered a urinary disorder and although it is not associated with mortality, its morbidity is significant. It is believed that pre-established guidelines, added to the findings of the puerperal physical examination, can support a professional's clinical practice and, consequently, preserve the structural and functional autonomy of the woman's urinary system. Thus, the aim of this study is to establish a consensus among experts on a proposal for evidence-based clinical recommendations to prevent and treat PPUR. This is a descriptive-exploratory study, of a quantitative nature, developed using the Delphi technique. An initial proposal was elaborated with 48 evidence-based clinical recommendations, distributed into three domains. The first round of the Delphi Panel consisted of 19 experts, the second of 16 experts, and the third of 13 experts. At the end of the Delphi Panel, 27 (56.3%) recommendations obtained a consensus greater than 90%. Of these, nine (33.3%) aimed at preventing overt and hidden PPUR, and belonged to Domain ­ 1, nine (33.3%) aimed at treating overt and hidden PPUR and belonged to Domain ­ 2, and nine (33.3%) aimed at bladder reeducation in persistent PPUR and belonged to Domain - 3. It is considered that the recommendations approved through this consensus support the decision-making of professionals in the face of the inherent risks of PPUR, which can cause overdistension of bladder function, irreversible damage to the detrusor muscle, as well as recurrent urinary tract infections and difficulty in permanent urinary elimination.

Nursing Process in the Brazilian context: reflection on its concept and legislation / Proceso de Enfermería en el contexto brasileño: reflexión sobre su concepto y legislación / Processo de Enfermagem no contexto brasileiro: reflexão sobre seu conceito e legislação

ABSTRACT Objectives: to reflect on the global understanding of the Nursing Process concept, with emphasis on the Brazilian context. Methods: a reflection article, aligned with the vision and expertise of researchers who are members of the Nursing Process Research Network. Results: the reflection is presented in two main topics: The evolution of Systematization of Nursing Care X Nursing Process concepts and its consonance with national and international practices, and Brazilian legislation; The Nursing Process concept realignment in Brazilian legislation in line with current care, teaching and research practices. Final Considerations: the reflections were oriented to the Nursing Process' conceptual, normative and legal issues, including elements of its historical evolution, and, with that, pointed to the need to modify the Brazilian regulation on the Nursing Process.

RESUMEN Objetivos: reflexionar sobre la comprensión global del concepto de Proceso de Enfermería, con énfasis en el contexto brasileño. Métodos: ensayo reflexivo, alineado con la visión y experiencia de investigadores integrantes de la Red de Investigación del Proceso de Enfermería. Resultados: la reflexión se presenta en dos temas principales: La evolución de los conceptos de Sistematización de la Atención de Enfermería X Proceso de Enfermería y su consonancia con las prácticas nacionales e internacionales, y la legislación brasileña; La realineación del concepto de Proceso de Enfermería en la legislación brasileña de acuerdo con las prácticas actuales de atención, enseñanza e investigación. Consideraciones Finales: las reflexiones se orientaron a las cuestiones conceptuales, normativas y legales del Proceso de Enfermería, incluyendo elementos de su evolución histórica, y, con eso, apuntaron para la necesidad de cambiar la regulación brasileña sobre el Proceso de Enfermería.

RESUMO Objetivos: refletir sobre a compreensão global do conceito de Processo de Enfermagem, com ênfase no contexto brasileiro. Métodos: ensaio reflexivo, alinhado à visão e expertise de pesquisadores membros da Rede de Pesquisa em Processo de Enfermagem. Resultados: a reflexão se apresenta em dois tópicos principais: A evolução dos conceitos de Sistematização da Assistência de Enfermagem X Processo de Enfermagem e a sua consonância com as práticas nacional e internacional, e a legislação brasileira; Realinhamento do conceito Processo de Enfermagem na legislação brasileira em consonância com as práticas assistenciais, de ensino e pesquisa atuais. Considerações Finais: as reflexões se orientaram às questões conceituais, normativas e legais do Processo de Enfermagem, incluindo elementos de sua evolução histórica, e, com isso, apontaram para a necessidade da modificação da regulamentação brasileira sobre o Processo de Enfermagem.

Knowledge, attitude and practice about hypertensive gestational syndrome among pregnant women: a randomized clinical trial / Conocimiento, actitud y práctica sobre el síndrome hipertensivo gestacional entre mujeres embarazadas: ensayo clínico aleatorizado / Conhecimento, atitude e prática sobre síndrome hipertensiva gestacional entre gestantes: ensaio clínico randomizado

ABSTRACT Objective: to evaluate knowledge, attitude and practice about Gestational Hypertensive Syndrome among pregnant women, after an educational intervention. Method: a controlled, randomized and longitudinal clinical trial, related to the Knowledge, Attitude and Practice survey on Gestational Hypertensive Syndrome complications, carried out with 120 pregnant women at a public maternity hospital in Fortaleza-CE, Brazil. Data collection was performed at three moments and the pregnant women were separated into two groups with 60 participants each. For quantitative comparisons, the Student's t test or the Mann-Whitney's test were applied. To study qualitative associations, the Chi-square or Fisher's exact tests were employed. Results: adequate assessment of knowledge, attitude and practice was identified in the intervention group, on the seventh and thirtieth days after the intervention (p<0.05), with an increased chance of adequate knowledge on the seventh (Odds Ratio=6.63 - Confidence Interval: 3.5-12.55) and on the thirtieth (Odds Ratio=6.25 - Confidence Interval: 3.13-12.50) days. In this group, the attitude was adequate on the seventh (Odds Ratio=6.11 - Confidence Interval: 3.28-11.39) and on the thirtieth (Odds Ratio=6.44 - Confidence Interval: 3.49-11.89) days. The practice was also adequate on the seventh (Odds Ratio=3.73 - Confidence Interval: 2.21-6.28) and on the thirtieth (Odds Ratio=4.91 - Confidence Interval: 2.90-8.32) days. Conclusion: the pregnant women who participated in the educational intervention presented more adequacy in relation to knowledge, attitude and practice, when compared to those in the control group. Brazilian Registry of Clinical Trials (Registro Brasileiro de Ensaios Clínicos, REBEC) RBR-8wyp8j

RESUMEN Objetivo: evaluar el conocimiento, la actitud y la práctica sobre el Síndrome Hipertensivo Gestacional entre mujeres embarazadas, después de una intervención educativa. Método: ensayo clínico controlado, aleatorizado y longitudinal, relacionado con la encuesta de Conocimiento, Actitud y Práctica sobre complicaciones del Síndrome Hipertensivo Gestacional, realizado con 120 mujeres embarazadas en una maternidad pública de Fortaleza-CE, Brasil. La recolección de datos tuvo lugar en tres momentos y se separó a las mujeres embarazadas en dos grupos de 60 participantes cada uno. Para las comparaciones cuantitativas, se aplicó la prueba t de Student o la de Mann-Whitney. Para estudiar las asociaciones cualitativas, se empleó la prueba de Chi-cuadrado o la prueba exacta de Fisher. Resultados: se identificó una evaluación adecuada del conocimiento, la actitud y la práctica en el grupo intervención, a los siete y treinta días posteriores a las intervenciones (p<0,05), con un incremento en la probabilidad de conocimiento adecuado al día siete (Odds Ratio=6,63 - Intervalo de Confianza: 3,5-12,55) y al día treinta (Odds Ratio=6,25 - Intervalo de Confianza: 3,13 - 12,50). En este grupo, la actitud fue adecuada al día siete (Odds Ratio=6,11 - Intervalo de Confianza: 3,28 -11,39) y al día treinta (Odds Ratio=6,44 - Intervalo de Confianza: 3,49-11,89). La práctica también resultó adecuada al día siete (Odds Ratio=3,73 - Intervalo de Confianza: 2,21-6,28) y al día treinta (Odds Ratio=4,91 - Intervalo de Confianza: 2,90-8,32). Conclusión: las mujeres embarazadas que participaron en la intervención educativa presentaron más adecuación en relación con el conocimiento, la actitud y la práctica, en comparación las participantes del grupo control. Registro Brasileño de Ensayos Clínicos (REBEC) RBR-8wyp8j

RESUMO Objetivo: avaliar conhecimento, atitude e prática sobre Síndrome Hipertensiva Gestacional entre gestantes, após intervenção educativa. Método: ensaio clínico controlado, randomizado e longitudinal, relacionado ao inquérito Conhecimento, Atitude e Prática sobre complicações da Síndrome Hipertensiva Gestacional, realizado em maternidade pública de Fortaleza-CE, Brasil, com 120 gestantes. A coleta de dados foi realizada em três momentos e as gestantes separadas em dois grupos com 60 participantes cada. Para comparações quantitativas, aplicou-se o teste t de Student ou Mann-Whitney. Para estudar associações qualitativas, empregou-se o teste Qui-quadrado ou exato de Fisher. Resultados: identificou-se avaliação adequada do conhecimento, da atitude e prática no grupo intervenção, no sétimo e trigésimo dia pós-intervenção (p<0,05), com aumento de chance para o conhecimento adequado no sétimo (Odds Ratio=6,63 - Intervalo de Confiança: 3,5-12,55) e no trigésimo dia (Odds Ratio=6,25 - Intervalo de Confiança: 3,13 - 12,50). Neste grupo, a atitude foi adequada no sétimo (Odds Ratio= 6,11 - Intervalo de Confiança: 3,28-11,39) e no trigésimo dia (Odds Ratio=6,44 - Intervalo de Confiança: 3,49-11,89). Prática também adequada no sétimo (Odds Ratio=3,73 - Intervalo de Confiança: 2,21-6,28) e trigésimo dia (Odds Ratio=4,91 - Intervalo de Confiança: 2,90-8,32). Conclusão: as gestantes que participaram da intervenção educativa apresentaram mais adequabilidade em relação ao conhecimento, à atitude e prática, quando comparadas às participantes do grupo controle. Registro Brasileiro de Ensaios Clínicos (REBEC) RBR-8wyp8j

A Brazilian Portuguese translation, cultural adaptation and validation of the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) health-related quality of life (HRQOL) scale.

INTRODUCTION: The health-related quality of life (HRQOL) of patients with tachyarrhythmia can be negatively influenced by the clinical manifestations. The evaluation of HRQOL with validated instruments can provide valuable information that will contribute to clinical decision-making and treatment. In Brazil, however, there is no available scale that evaluates HRQOL in different types of arrhythmia. The purpose of this study was to adapt the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia-HRQOL scale (ASTA-HRQOL scale) to the Brazilian culture, and to assess the psychometric properties of the adapted questionnaire. METHODS: The study used a methodological process of cultural adaptation based on international literature guidelines. The analyses were performed with 172 participants, 32 for cultural adaptation and 140 for psychometric validation. Calculation included analysis of reliability by Cronbach's α coefficient, construct validity with convergent validity using the WHOQOL-BREF questionnaire and by the Spearman correlation coefficient, Average Variance Extracted, and assessment of confirmatory factor analysis. RESULTS: The translation and adaptation processes showed a satisfactory degree of comprehension and applicability (93% reported them to be easy to understand). Confirmatory factor analysis indicated exclusion of one item from the mental scale, but after qualitative analysis the item was retained. The items presented adequate internal consistency (Cronbach's alpha coefficient = 0.88), and an inverse correlation of moderate magnitude with the physical domain (rho = -0.63) and with the mental domain (rho = -0.58) of the WHOQOL-BREF. CONCLUSIONS: The Brazilian Portuguese version of the ASTA-HRQOL scale, the ASTA-Br-HRQOL scale, can be a valuable tool for use in clinical practice and research.

Análise de questionários para a avaliação de pacientes com arritmias cardíacas / Analysis of questionnaires for the assessment of patients with cardiac arrhythmias / Análisis de cuestionario para la evaluación de pacientes con arritmia cardíaca

Objetivo: analisar questionários de avaliação de sintomas e de Qualidade de Vida Relacionada à Saúde em pacientes com taquiarritmias. Método: trata-se de um estudo bibliográfico, bibliográfico, tipo revisão integrativa de artigos originais, sem limite temporal, nas bases de dados MEDLINE, CINAHL, Scopus, Embase e Web of Science, e na Biblioteca Virtual em Saúde, utilizando os descritores "Arritmias Cardíacas"; "Taquicardia Supraventricular"; "Taquicardia Ventricular"; "Fibrilação Atrial"; "Qualidade de Vida"; "Sintomas" e "Questionário". Realizou-se a análise descritiva dos dados que se apresentam em forma de figuras. Resultados: encontraram-se 14 estudos referentes a 11 questionários, sendo que a maioria avalia somente um aspecto, sintomas ou QVRS e apenas em pacientes com Fibrilação Atrial e somente um tem maior abrangência e avalia sintomas e QVRS em diversas formas de taquiarritmias supraventriculares e ventriculares. Conclusão: identificou-se, por meio da revisão integrativa, que existem vários questionários disponíveis para a avaliação de pacientes com taquiarritmias, porém, somente um abrange tanto sintomas quanto QVRS em taquiarritmias supraventriculares e ventriculares. Acrescenta-se que a utilização desses instrumentos por enfermeiros e demais profissionais da saúde é importante para uma adequada avaliação dos pacientes com arritmias.(AU)

Objective: to analyze questionnaires for the assessment of symptoms and Health-related Quality of Life in patients with tachyarrhythmias. Method: It is a bibliographic, bibliographic, integrative review type study of original articles, without time limit, in the MEDLINE, CINAHL, Scopus, Embase and Web of Science databases, and in the Virtual Health Library, using the descriptors "Cardiac Arrhythmias"; "Supraventricular Tachycardia"; "Ventricular Tachycardia"; "Atrial Fibrillation"; "Quality of Life"; "Symptoms" and "Questionnaire". The descriptive analysis of the data presented in the form of figures was carried out. Results: 14 studies were found referring to 11 questionnaires, the majority evaluating only one aspect, symptoms or HRQL and only in patients with Atrial Fibrillation and only one has a greater scope and evaluates symptoms and HRQL in several forms of supraventricular and ventricular tachyarrhythmias. Conclusion: It was identified, through the integrative review, that there are several questionnaires available for the assessment of patients with tachyarrhythmias, but only one covers both symptoms and HRQL in supraventricular and ventricular tachyarrhythmias. It is added that the use of these instruments by nurses and other health professionals is important for a proper assessment of patients with arrhythmias.(AU)

Objetivo: analizar cuestionarios para evaluar síntomas y calidad de vida relacionada con la salud en pacientes con taquiarritmias. Método: se trata de un estudio bibliográfico, tipo revisión integradora de artículos originales, sin límite de tiempo, en las bases de datos MEDLINE, CINAHL, Scopus, Embase y Web of Science, y en la Biblioteca Virtual en Salud, utilizando las palabras clave " Arritmia cardíaca "; "Taquicardia supraventricular"; "Taquicardia ventricular"; "Fibrilación auricular"; "Calidad de vida"; "Síntomas" y "Cuestionario". Se realizó un análisis descriptivo de los datos presentados en forma de figuras. Resultados: se encontraron 14 estudios referidos a 11 cuestionarios, la mayoría de los cuales evalúan solo un aspecto, síntomas o CVRS y solo en pacientes con Fibrilación Auricular y solo uno es más completo y evalúa síntomas y CVRS en diversas formas de taquiarritmias supraventriculares y ventriculares. Conclusión: se identificó, a través de la revisión integradora, que existen varios cuestionarios disponibles para la evaluación de pacientes con taquiarritmias, sin embargo, solo uno cubre tanto la sintomatología como la CVRS en taquiarritmias supraventriculares y ventriculares. Se agrega que el uso de estos instrumentos por parte de enfermeros y otros profesionales de la salud es importante para una adecuada evaluación de los pacientes con arritmias.(AU)