Fatores intervenientes na gerência do cuidado de enfermagem à criança hospitalizada com cardiopatia reumática / Intervening factors in the management of nursing care for children hospitalized with rheumatic heart disease / Factores que intervienen en la gestión del cuidado de enfermería al niño hospitalizado con cardiopatía reumática

Objetivo: analisar os fatores intervenientes na gerência do cuidado de enfermagem à criança hospitalizada com cardiopatia reumática. Método: estudo descritivo-exploratório com abordagem qualitativa, que utilizou a Teoria Fundamentada em Dados e o Interacionismo Simbólico, respectivamente, como referencial metodológico e teórico. A coleta de dados foi realizada em uma instituição especializada em atendimento cardiológico, no munícipio do Rio de Janeiro. Foram entrevistados 19 profissionais de enfermagem através de um roteiro semiestruturado. Resultado: emergiram os seguintes fatores intervenientes na prática da gerência do cuidado: condição socioeconômica da família, comportamento da criança, condições de trabalho, comunicação ineficaz, educação permanente, trabalho em equipe e experiência profissional. Conclusão: os resultados apontam para a necessidade de proposição de estratégias de ação e interação que facilitem a prática gerencial de cuidado à criança com cardiopatia reumática e sua família face aos fatores intervenientes identificados.

Objective: to analyze the factors involved in the management of nursing care for children hospitalized with rheumatic heart disease. Method: this is a descriptive-exploratory study with a qualitative approach, which used Data-Based Theory and Symbolic Interactionism, respectively, as methodological, and theoretical references. Data was collected in an institution specializing in cardiac care in the city of Rio de Janeiro. Nineteen nursing professionals were interviewed using a semi-structured script. Result: the following intervening factors in the practice of care management emerged: the family's socioeconomic status, the child's behavior, working conditions, ineffective communication, continuing education, teamwork, and professional experience. Conclusion: the results point to the need to propose strategies for action and interaction that facilitate management practice in caring for children with rheumatic heart disease and their families, given the intervening factors identified.

Objetivo: analizar los factores que intervienen en la gestión del cuidado de enfermería al niño hospitalizado con cardiopatía reumática. Método: estudio descriptivo-exploratorio con enfoque cualitativo, cuyos marcos metodológico y teórico fueron la Teoría Fundamentada y el Interaccionismo Simbólico, respectivamente. La recolección de datos se realizó en una institución especializada en atención cardiológica, en la ciudad de Río de Janeiro. Fueron entrevistados 19 profesionales de enfermería mediante un cuestionario semiestructurado. Resultado: surgieron los siguientes factores intervinientes en la práctica de la gestión del cuidado: condición socioeconómica de la familia, comportamiento del niño, condiciones de trabajo, comunicación ineficaz, educación continua, trabajo en equipo y experiencia profesional. Conclusión: los resultados indican que es necesario proponer estrategias de acción e interacción que faciliten la práctica de la gestión del cuidado al niño con cardiopatía reumática y a sus familiares, con respecto a los factores intervinientes identificados.

Discussing the midwifery scope of practice within the NANDA-I taxonomy.

PURPOSE: To discuss the midwifery scope of practice within the NANDA-I taxonomy. METHODS: Review of the NANDA-I taxonomy followed by critical analysis of the nursing diagnoses (NDs) within the scope of midwifery practice. Search terms were defined. Two authors independently analyzed all diagnoses, and another author validated the results. FINDINGS: Of the 267 NDs in the NANDA-I taxonomy, 39 (14.6%) perceived a relationship with midwifery's scope of practice, and among these, 15 (5.6%) guaranteed greater specificity and accuracy for clinical reasoning. CONCLUSIONS: The suitability of NDs for the broad spectrum of the midwifery scope of practice may need to be completed. Women's responses to life events and health conditions are simultaneously complex and specific, and many NDs in the NANDA-I terminology may be far from fully identified and developed to represent these responses. IMPLICATIONS FOR NURSING PRACTICE: Improvements in NANDA-I diagnosis would contribute to advanced terminology and increased specificity and accuracy of the diagnostic process. This is important in achieving appropriate outcomes and safe and effective interventions for which the nurses and nurse-midwives are accountable. Many NDs would not necessarily be used in any other context since they are specific to midwifery; however, it would help to develop a NANDA-I taxonomy that is more inclusive and comprehensive internationally.

OBJETIVO: Discutir o âmbito da prática de atenção materna dentro da taxonomia da NANDA­I. MÉTODOS: Revisão da taxonomia da NANDA­I com análise crítica dos diagnósticos de enfermagem, no âmbito da prática de atenção materna. Os termos de pesquisa foram definidos. Dois autores analisaram, independentemente, todos os diagnósticos e um outro autor validou os resultados. RESULTADOS: Dos 267 diagnósticos de enfermagem da taxonomia NANDA­I, em 39 (14,6%) percebe­se relação com o âmbito da prática de atenção materna. Além disso, destes 38 diagnósticos incluídos, 15 (5,6%) garantem maior especificidade e acurácia para o raciocínio clínico. CONCLUSÕES: A adequação dos diagnósticos de enfermagem ao amplo espectro da prática de atenção materna pode precisar ser completada. As respostas das mulheres aos acontecimentos de vida e às condições de saúde são, simultaneamente, complexas e específicas e muitos diagnósticos de enfermagem na terminologia da NANDA­I podem não estar totalmente identificados e desenvolvidos para representar essas respostas. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Melhorias nos diagnósticos da NANDA­I contribuiriam para uma terminologia avançada e para o aumento da especificidade e precisão do processo de diagnóstico. Isto é importante para a obtenção de resultados apropriados e intervenções seguras e eficazes, pelas quais os enfermeiros de atenção à saúde materna são responsáveis. Muitos diagnósticos de enfermagem não seriam necessariamente usados em qualquer outro contexto, uma vez que são específicos da atenção materna; no entanto, ajudaria a desenvolver uma taxonomia NANDA­I mais inclusiva e abrangente, a nível internacional.

Posttraumatic growth in women after a childbirth experience: The influence of individual characteristics and intrusive and deliberate rumination.

OBJECTIVE: This study targets women who had a self-defined traumatic childbirth experience to (a) explore the differences between sociodemographic-, obstetric-, and trauma-related variables in relation to the rumination style; (b) determine differences between intrusive and deliberate rumination in relation to posttraumatic growth (PTG) dimensions, and (c) test whether intrusive rumination is associated with deliberate rumination, which in turn is associated with PTG dimensions. METHOD: A cross-sectional study design was employed using a web-based survey method for data collection. In total, 202 women who identified their childbirth experience as traumatic participated in this study. RESULTS: Intrusive rumination and deliberate rumination were positively associated with all dimensions of PTG in women following the traumatic childbirth event. Deliberate rumination fully explained the relationship between intrusive rumination and PTG aspects of relating to others, new opportunities, and personal strength, and partially explained the relationship between intrusive rumination and PTG aspects of spiritual changes and appreciation of life. CONCLUSIONS: The results suggest that deliberate rumination can contribute to explain the occurrence of PTG. These findings could help develop psychosocial interventions to maximize opportunities for deliberate rumination for women with traumatic childbirth experiences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Factors that interfere in maternal perception of security at postpartum / Fatores que interferem na percepção de segurança materna no pós-parto

Abstract Objectives: to identify the factors and variables that interfere with the maternal perception of security at postpartum. Methods: a cross-sectional study, carried out in three Portuguese hospital units, with a non-probabilistic sample of 352 puerperal women, recruited from the postpartum units on the day of hospital discharge after delivery. Maternal sociodemographic and obstetric characteristics, as well as data on monitored pregnancy, childbirth and infant feeding, were collected through the application of a questionnaire developed by the researchers. For the analysis of maternal perception of security, the instrument "Parents' postnatal sense of security" (PPSS) was used. Descriptive and inferential statistics were used for data analysis. Results: women who lived with their partner (t (349) = - 2.34, p=0.020), were multiparous (t (349) = - 2.26, p=0.025), had pregnancy monitored (t (349) = -3.25, p=0.001), had a positive childbirth experience (F (1, 351) = 7.07, p=0.008) and those who exclusively breastfed during hospitalization (F (2, 351) = 11,43, p<0.001), presented greater perception of security at postpartum. Conclusions: the factors that affect the maternal perception of security at postpartum are cohabitation with a partner, parity, monitored pregnancy, childbirth experience and infant feeding. Defining which factors interfere with maternal security at postpartum may contribute to the construction of intervention programs that promote the maternal perception of security at the time of hospital discharge after delivery.

Resumo Objetivos: identificar os fatores que interferem na percepção de segurança materna no pós-parto. Métodos: estudo transversal, realizado em três unidades hospitalares portuguesas, com uma amostra não probabilística de 352 puérperas recrutadas nos serviços de internamento, no dia da alta hospitalar após o parto. As caraterísticas sociodemográficas e obstétricas maternas, assim como os dados relativos aos cuidados pré-natais, ao parto e ao tipo de aleitamento, foram recolhidos através da aplicação de um questionário desenvolvido pelas investigadoras. Para a análise da percepção de segurança materna foi usado o instrumento "Parents' Postnatal Sense of Security" (PPSS). Foi utilizada estatística descritiva e inferencial para a análise de dados. Resultados: as mulheres que viviam com o companheiro [t (349) = - 2,34, p=0,020], as multíparas (t (349) = - 2,26, p=0,025), as que vigiaram a gravidez [t (349) = -3,25, p=0,001], as que tiveram uma experiência de parto positiva [F (1, 351) = 7,07, p=0,008] e as que amamentaram em exclusivo durante o internamento [F (2, 351) = 11,43, p<0,001], apresentaram maior percepção de segurança no pós-parto. Conclusões: os fatores que interferem na percepção de segurança materna no pós-parto são a coabitação com o companheiro, a paridade, a vigilância da gravidez, a experiência de parto e o tipo de aleitamento. Determinar os fatores que interferem com a segurança materna no pós-parto pode contribuir para a construção de programas de intervenção promotores da percepção de segurança materna no momento da alta hospitalar após o parto.

Women's fear of childbirth during pregnancy: A concept analysis.

PURPOSE: To map and analyze the concept of women's fear of childbirth (FOC) during pregnancy and to develop a new nursing diagnosis (ND). METHODS: Concept analysis based on Walker and Avant's methodology. An integrative literature search was conducted in Scopus, Web of Science, and CINAHL Complete databases, including peer-reviewed articles published in English from January 1981 to October 2022. FINDINGS: Thirty-one studies were included in the review. Women's FOC during pregnancy comprises three central categories: attributes, antecedents, and consequences. Nine main characteristics (attributes) are related to one or more of eight prior conditions (antecedents) that have the potential to exert negative or favorable impacts (consequences), depending on whether coping strategies have been a part of a fearful woman's pregnancy. These elements and relationships among them should be viewed as dynamic. CONCLUSIONS: Women's FOC during pregnancy is a subjective, multidimensional, and dynamic concept that benefits prenatal care responses. A conceptual matrix on prenatal care will consider the factors underlying women's FOC and their potential mechanisms, how fearful pregnant women respond, the aspects that shape FOC, and how it influences outcomes when supporting pregnant women with FOC. Therefore, the study findings can be used to inform ways of identifying fearful women or as a basis for interventions to manage fears and enhance the confidence of pregnant women for childbirth. IMPLICATIONS FOR NURSING PRACTICE: The results of this study help nurses, OB nursing practitioners, nurse-midwives, and midwives to identify the condition of women's FOC during pregnancy and guide nursing therapeutic interventions to decrease the negative effects on women's health and well-being. Therefore, there are valuable reasons to propose using "fear of childbirth" as a ND in the class "coping responses" within domain coping/stress tolerance, contributing to refining the NANDA-I taxonomy.

OBJETIVO: Mapear e analisar o conceito de medo do parto em mulheres durante a gravidez e desenvolver um novo diagnóstico de enfermagem. MÉTODOS: Análise de conceito com base na metodologia de Walker e Avant. Foi realizada uma pesquisa integrativa da literatura nas bases de dados Scopus, Web of Science e CINAHL Complete e incluiu artigos revistos por pares, publicados em inglês, de janeiro de 1981 a outubro de 2022. RESULTADOS: Trinta e um estudos foram incluídos na revisão. O medo do parto em mulheres durante a gravidez é composto por três categorias centrais: atributos, antecedentes e consequências. Nove características principais (atributos) estão relacionadas com uma ou mais das oito condições anteriores (antecedentes) que têm o potencial de exercer um impacto negativo ou favorável (consequências), dependendo se estratégias de coping fizeram parte da gravidez de uma mulher com medo. Estes elementos e as relações entre eles devem ser vistos como dinâmicos. CONCLUSÕES: O medo do parto em mulheres durante a gravidez é um conceito subjetivo, multidimensional e dinâmico que beneficia de respostas pelos cuidados pré-natais. Uma matriz conceptual sobre cuidados pré-natais considerará os fatores subjacentes ao medo do parto nas mulheres e os seus potenciais mecanismos, como as mulheres grávidas com medo respondem, os aspetos que moldam o medo do parto, e como influenciam os resultados quando as mulheres grávidas com medo do parto são apoiadas. Portanto, os resultados do estudo podem ser usados para identificar mulheres com medo ou desenvolver intervenções que permitam gerir os medos e aumentar a confiança das mulheres grávidas para o parto. IMPLICAÇÕES PARA A PRÁTICA DE ENFERMAGEM: Os resultados deste estudo ajudarão os enfermeiros de atenção à saúde materna a identificar a condição do medo do parto nas mulheres durante a gravidez e orientar intervenções terapêuticas de enfermagem, no sentido de diminuir os efeitos negativos do medo na saúde e no bem-estar das mulheres. Portanto, há razões relevantes para propor a utilização do "medo do parto" como um diagnóstico de enfermagem na classe "coping responses" do domínio "coping/stress tolerance", contribuindo para o refinamento da taxonomia NANDA-I.

Qualidade de vida das pessoas com cancro da próstata: Um modelo de cuidados de enfermagem / Quality of life of prostate cancer patients: A nursing care model / Calidad de vida de los pacientes con patología oncológica prostática: Un modelo de cuidados de enfermería

Resumo Enquadramento: O cancro representa uma experiência dramática na vida de qualquer pessoa, perturbando a sua homeostasia. Dado o envelhecimento da população e a sobrevivência mais prolongada destes doentes, é essencial melhorar a sua qualidade de vida. Objetivo: Desenvolver e implementar um modelo de acompanhamento em enfermagem centrado nas vulnerabilidades dos doentes com cancro da próstata, a fim de melhorar a sua qualidade de vida. Metodologia: Estudo piloto realizado através da aplicação das escalas QLQ-INFO25 e HADS e de uma entrevista, na consulta de ambulatório de um hospital privado, a seis doentes com cancro da próstata. Resultados: Alterações nas dimensões da qualidade de vida relacionada com a saúde. A implementação do modelo de acompanhamento permitiu concluir que "educação em saúde, autoconfiança e atitude" são aspetos essenciais no trabalho dos enfermeiros com estes doentes. O trabalho direcionado às vulnerabilidades dos doentes melhorou a sua qualidade de vida. Conclusão: O modelo contribui para a promoção da saúde e do bem-estar, prevenção de complicações e aumento da satisfação. O trabalho individualizado da equipa melhora a qualidade de vida destes doentes.

Abstract Background: Cancer constitutes a dramatic life experience, disrupting homeostasis. With population aging and prolonged survival in cancer patients, it is essential to increase their quality of life. Objective: To develop and implement a nursing follow-up model focused on the vulnerabilities of patients with prostate cancer in order to improve their quality of life. Methodology: A pilot study was conducted on six patients with prostate cancer. Data were collected through the application of the QLQ-INFO25 and HADS and interviews in the outpatient consultation of a private hospital. Results: Changes in the dimensions of health-related quality of life. Implementing the follow-up model revealed that "health education, self-confidence, and attitude" are essential aspects of the nurses' work with these patients. Working on patients' vulnerabilities improved their quality of life. Conclusion: The model benefits health promotion, well-being, complication prevention, and increased satisfaction. The team's individualized work improves these patients' quality of life.

Resumen Marco contextual: La enfermedad oncológica representa una experiencia dramática en la vida de cualquier persona, ya que altera la homeostasis. Dado el envejecimiento de la población y la supervivencia más prolongada de estos pacientes, es esencial aumentar su calidad de vida. Objetivo: Desarrollar e implantar un modelo de seguimiento de enfermería centrado en las vulnerabilidades de los pacientes con enfermedad oncológica prostática para mejorar su calidad de vida. Metodología: Se llevó a cabo un estudio piloto en el que se aplicaron las escalas QLQ-INFO25 y HADS, y una entrevista en la consulta externa de un hospital privado a seis pacientes con cáncer de próstata. Resultados: Cambios en las dimensiones de la calidad de vida relacionada con la salud. La implementación del modelo de seguimiento nos permitió concluir que "la educación sanitaria, la autoconfianza y la actitud" son aspectos esenciales del trabajo de los enfermeros con estos pacientes. Trabajar sobre las vulnerabilidades de los pacientes mejoró su calidad de vida. Conclusión: El modelo beneficia la promoción de la salud, el bienestar, la prevención de complicaciones y el aumento de la satisfacción. El trabajo individualizado del equipo mejora la calidad de vida de estos pacientes.

Patterns of use of wild food plants by Brazilian local communities: systematic review and meta-analysis.

BACKGROUND: This systematic review and meta-analysis sought to investigate the patterns of use of native wild food plants of Brazil (native and non-cultivated). METHODS: We searched ethnobiological works with food plants in Web of Science, Scielo, Scopus and PubMed using different sets of keywords. Initially, the studies were evaluated based on inclusion criteria (systematic data collection instruments, such as interviews; specification of methods for data collection; and the presence of a species list). The methodological quality of each study was evaluated to define the risk of bias. A total of 20 articles met all criteria and were included in the review. RESULTS: The results showed that there was a predominance of consumption of fruits, followed by leaves and seeds, which together represented 85.8% of the total parts. As for the meta-analysis, there was a predominance of use of plant parts classified as reproductive, non-persistent, non-destructive and parts of woody plants. There was no interference from the type of ecosystem (seasonally dry x moist). The results did not support the seasonality hypothesis. CONCLUSIONS: The concentration of studies in the Northeast, Southeast and South regions of Brazil and in the Atlantic Forest and Caatinga biomes points to the need for a greater effort in terms of quantitative ethnobotanical research in other regions and biomes. The predominance of fruits and plant parts classified as reproductive, non-persistent and non-destructive points to the high potential for implementation of sustainable management strategies aimed at these plants in the country.

Wild food plants of Brazil: a theoretical approach to non-random selection.

Ethnobiological investigations have focused on identifying factors that interfere with the criteria adopted for selection of plants, especially medicinal plants, by different populations, confirming the theory that plant selection is not random. However, regarding wild food plants, little effort has been made to confirm the theory in this context, especially in Brazil. Therefore, this systematic review aimed to contribute to the establishment of theoretical bases of the non-random selection of wild food plants by local populations in Brazil. For this, searches were made in 4 databases, namely, Web of Science, Scielo, Scopus and PubMed, using 8 sets of keywords in English and Portuguese in order to identify wild food plants occurring in Brazil. The steps were: application of inclusion and exclusion criteria, screening of articles, selection of studies based on risk of bias, data treatment and, finally, data analysis. Eighty articles met the inclusion criteria of this review. However, 45 of them were considered to present high risk of bias and thus 35 articles were kept for the identification of overused and underused families. The results were inferred through two different approaches (IDM and Bayesian). Annonaceae, Arecaceae, Basellaceae, Cactaceae, Capparaceae, Caryocaraceae, Myrtaceae, Passifloraceae, Rhamnaceae, Rosaceae, Sapotaceae, Talinaceae, and Typhaceae were considered overused. Eriocaulaceae, Orchidaceae, and Poaceae were considered underused. Therefore, considering that some families are more (or less) used than others, we confirm that the wild food plants occurring in Brazil, known and used by different populations, are not chosen at random.

Effectiveness of perioperative family-centered educational interventions in the anxiety, pain and behaviors of children/adolescents and their parents: Systematic Review Protocol / Eficacia de las intervenciones educativas perioperatorias familiares centradas en la ansiedad, el dolor y las conductas de las personas menores y adolescentes y de sus progenitores: protocolo de revisión sistemática

Introduction: Every year, millions of children and adolescents undergo surgery, 50%-75% of them experience fear and anxiety. Children are particularly susceptible to stress and anxiety surrounding surgery as a result of their cognitive development, previous experiences, and knowledge about healthcare; this leads to additional interventions to prevent and reduce these symptoms. Objective: To evaluate the effectiveness of family-centered educational interventions in the children's and adolescents' anxiety, pain, and behaviors and their parents' anxiety during the perioperative period. Methods: This review will follow the Joanna Briggs Institute guidelines for systematic reviews of effectiveness and will consider those studies (experimental and quasi-experimental) in which perioperative educational interventions have been applied to children and adolescents and their parents; these studies measured children and adolescents' pain, anxiety, and behaviors, as well as their parent's anxiety. An initial search of MEDLINE and CINAHL will be followed by a second search for published and unpublished studies from January 2007 on, available in English, Spanish and Portuguese. After all full texts are retrieved, the methodological quality assessment and data extraction will be independently and critically evaluated by two reviewers, and the data will then be presented in a tabular format. An explanatory synthesis will accompany the results. Whenever possible, a meta-analysis will be performed, and a Grading of Recommendations, Assessment, Development, and Evaluation Summary of Findings will be presented. Expected Results: This review will provide guidance on how family-centred educational interventions can be used as a resource to manage anxiety, pain, and behavior in children, adolescents and their relatives during the perioperative processes.

Introducción: Cada año, millones de personas menores y adolescentes se someten a cirugía, de las cuales entre el 50-75 % experimenta miedo y ansiedad. Las niñas y los niños son particularmente susceptibles al estrés y la ansiedad que rodea a la cirugía, como resultado de su desarrollo cognitivo, experiencias previas y conocimiento de la salud, lo que requiere intervenciones para prevenir y reducir estos síntomas. Objetivo: Esta revisión tiene como objetivo evaluar la efectividad de las intervenciones educativas familiares centradas en la ansiedad, el dolor y los comportamientos de las personas menores y adolescentes y de sus progenitores en el período perioperatorio. Métodos: Esta revisión seguirá las pautas del Instituto Joanna Briggs para revisiones sistemáticas de efectividad y considerará estudios experimentales y cuasiexperimentales en los que las intervenciones educativas perioperatorias para medir el dolor, la ansiedad y los comportamientos en niñas, niños y adolescentes y la ansiedad de sus progenitores. Se ha realizado una búsqueda inicial limitada de MEDLINE y CINAHL. Además, una segunda búsqueda de estudios publicados y no publicados de enero de 2007 disponibles en inglés, español y portugués. Una vez recuperados los textos completos, dos revisores evaluarán críticamente, de forma independiente, la calidad metodológica y la extracción de datos y se presentarán en forma de tabla. Una síntesis narrativa acompañará a los resultados y, si es posible, se realizará un metanálisis y se presentará un Grading of Recommendations, Assessment, Development and Evaluation. Resultados esperados: Esta revisión brindará orientación sobre cómo las intervenciones educativas centradas en la familia pueden usarse como un recurso para controlar la ansiedad, el dolor y el comportamiento en niñas, niños, adolescentes y sus familias en el contexto perioperatorio.

Introdução: Todos os anos, milhões de crianças e adolescentes são submetidos a cirurgias e 50-75% apresentam medo e ansiedade. Crianças/adolescentes são particularmente suscetíveis ao stress e ansiedade em torno da cirurgia devido ao seu desenvolvimento cognitivo, experiências anteriores e conhecimento que possuem sobre os cuidados de saúde, necessitando de intervenções para a prevenção/redução destes sintomas. Objetivo: Avaliar a eficácia de intervenções educacionais centradas na família na ansiedade, dor e comportamentos de crianças/adolescentes e ansiedade dos pais no período perioperatório. Métodos: Esta revisão seguirá a metodologia do Instituto Joanna Briggs para revisões sistemáticas de eficácia e considerará estudos (experimentais e quase-experimentais) em que as intervenções educacionais perioperatórias tenham sido aplicadas a crianças/ adolescentes e seus pais e avaliadas a dor, ansiedade e comportamento em crianças/adolescentes e ansiedade dos pais como resultados. Uma pesquisa inicial limitada de MEDLINE e CINAHL foi realizada. Será seguida por uma segunda busca por estudos publicados e não publicados de janeiro de 2007 disponíveis em inglês, espanhol e português. Após a recuperação dos textos completos, a avaliação da qualidade metodológica e a extração de dados serão avaliadas de forma crítica e independente por dois revisores e apresentadas em forma de tabela. Uma síntese narrativa acompanhará os resultados e, se possível, uma meta-análise será realizada e um resumo das Grading of Recommendations, Assessment, Development and Evaluation apresentado. Resultados esperados: Esta revisão fornecerá orientações sobre como as intervenções educativas centradas na família podem ser utilizadas como um recurso para gestão da ansiedade, dor e comportamento em crianças, adolescentes e suas famílias no contexto perioperatório.

Midwives' interventions for reducing fear of childbirth in pregnant women: a scoping review.

OBJECTIVE: The objective of this review was to map and analyze midwives' interventions for reducing fear of childbirth in pregnant women. INTRODUCTION: Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy. Over the past few decades, there has been growing research interest in interventions for reducing fear of childbirth in pregnant women. One of the challenges in midwifery care is to provide an appropriate model of care for pregnant women with fear of childbirth. Further research efforts are needed to identify midwives' interventions for reducing fear of childbirth in pregnant women and to examine their characteristics. INCLUSION CRITERIA: This scoping review considered studies that included midwives' interventions for reducing fear of childbirth in pregnant women. Specifically, interventions were led and/or implemented by midwives during the antenatal period, and integrating all possible midwifery practice settings. Quantitative, qualitative, and mixed methods studies were included. This review also considered systematic reviews, text and opinion papers, and conference abstracts. METHODS: The JBI methodology for conducting scoping reviews was used. Published and unpublished literature in English, Portuguese, and Spanish from January 1981 to October 2020 was included. MEDLINE (PubMed), CINAHL Complete, APA PsycINFO, Scopus, Embase, Web of Science, SciELO, MedicLatina, Academic Search Complete, ERIC, Psychology and Behavioral Sciences Collection, and the Cochrane Library databases were searched. Searches for gray literature were also undertaken on the Repositório Científico de Acesso Aberto de Portugal, ProQuest Dissertations and Theses, British Library EThOS, OvidSP Resource Center, Banco de Teses da CAPES, and OpenGrey. A three-step search strategy was followed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist was used. Two independent reviewers extracted the data using a data extraction tool developed specifically for this scoping review. RESULTS: A total of 3704 articles were identified and screened, of which 34 articles were included. The majority of studies had been published in the past 10 years (88%) in Scandinavian countries or Australia (79%). Several midwives' antenatal interventions were found, such as midwife-led team models of care. Midwives played a facilitator role that varied across the included studies. In 20 studies (59%), midwives led and implemented the interventions alone ( n   =  13; 38%) or with the participation of other health professionals ( n   =  7; 21%). In the remaining 14 studies (41%), midwives were part of a multidisciplinary team that included different health professionals (mainly obstetricians and psychologists) who had been involved in delivering interventions alongside midwives or with minor participation from midwives. Counseling ( n   =  12; 35%) and psychoeducation ( n   =  8; 24%) were the most common midwife interventions for reducing fear of childbirth in pregnant women. CONCLUSIONS: Midwives working across their full scope of practice play a pivotal role in reducing fear of childbirth, which may explain the variety of midwives' antenatal interventions. Reducing fear of childbirth in pregnant women and promoting normal childbirth as a positive experience are key features of midwives' interventions, which should include women's empowerment measures. Evidence-based midwife-led intervention programs for pregnant women with fear of childbirth should be designed and tested to improve clinical practice as well as women's reproductive outcomes and perinatal experiences.

Prevalence and predictive factors for fear of childbirth in pregnant Portuguese women: A cross-sectional study.

OBJECTIVE: To measure the prevalence of the fear of childbirth (FOC) and determine which factors predict severe FOC among pregnant Portuguese women. METHODS: An online cross-sectional study among pregnant Portuguese women aged ≥ 20 years who were recorded using a convenience sampling. Self-administered questionnaires were used for data collection: socio-demographic and obstetric questionnaire and European Portuguese version of Wijma Delivery Expectancy Questionnaire-version A (WDEQ-A). Data of 669 participants were collected successfully from June 9 to October 30, 2019. Predictive factors for severe FOC were investigated using a multivariate logistic regression analysis. Odds ratios (OR) and 95% confidence intervals were calculated. RESULTS: The prevalence of severe FOC (WDEQ-A ≥ 85) among pregnant Portuguese women was 10%. Severe FOC was significantly associated with lower educational level, single/divorced marital status, and negative previous childbirth experience. Multivariate logistic regression analysis indicated that being single or divorced and having a negative previous childbirth experience were predictive variables for severe FOC. CONCLUSION: Pregnant Portuguese women have FOC, although with varying severity. The data suggest that marital status and women's perceptions of previous childbirth experience may be useful variables to predict severe FOC. Further research for extending the predictive factors of FOC should be refined. The results are clinically relevant for midwifery care, as they should be used in the sense of early identification of fearful pregnant women to provide adequate support strategies to reduce FOC.

Phytochemical profile, evaluation of antimicrobial and antioxidant activity in vitro of the hydroalcoholic extract of two species of the genus Cyperus (Cyperaceae)

Abstract Several factors contribute to the resistance of some pathogenic microorganisms and this fact requires the search for new therapeutic alternatives. The genus Cyperus (family Cyperaceae) groups species that present chemical compounds of pharmacological interest, mainly with antimicrobial action. Thus, the present work was carried out to investigate the antimicrobial activities, antioxidants and the phytochemical profile of Cyperus articulatus L. and Cyperus iria L. Hydroalcoholic extracts (1:1, v:v) of the aerial and underground parts of these species were used to analyze the total phenol content and to evaluate the in vitro antioxidant activity against the DPPH (2,2-diphenyl-1-picrylhydrazyl). The ethyl acetate and chloroform phases resulting from liquid-liquid partitioning of C. articulatus and C. iria extracts were evaluated in antimicrobial assays and subject to high performance liquid chromatography (HPLC-DAD) analysis. The chromatograms obtained by HPLC-DAD allowed us to identify four compounds: chlorogenic acid, catechin, quercetin, and quercitrin. The hydroalcoholic extracts of C. articulatus and C. iria showed a weak antioxidant activity with IC50 of 395.57 and 321.33 µg/mL (aerial parts), and 1,114.01 and 436.82 µg/mL (underground parts), respectively. Regarding antimicrobial activity, the chloroform phase of C. iria showed the best result at the concentration of only 31.2 µg/mL against the pathogens Candida albicans and Staphylococcus aureus. The ethyl acetate phases of the aerial parts of C. articulatus and C. iria did not show antimicrobial activity

Independência no autocuidado nos doentes com acidente vascular cerebral: contribuição da enfermagem de reabilitação / Independence in self-care in stroke patients: contribution of rehabilitation nursing

Objetivos: Identificar o número de dias necessários à obtenção de ganhos em independência e quais estes ganhos, em indivíduos com acidente vascular cerebral internados num serviço de Medicina Física e Reabilitação, após intervenção do Enfermeiro de Reabilitação. Método: estudo quantitativo, descritivo e retrospetivo. Analisados os registros de enfermagem referentes aos doentes com acidente vascular cerebral, internados no período de janeiro de 2013 a dezembro de 2014. A colheita de dados realizou-se em instrumento construído para este estudo de análise documental. Resultados: Nos registros de 96 pacientes, constatou-se que na admissão mais de 90% apresentavam algum grau de dependência nos autocuidados de higiene, arranjo pessoal e vestir-se. Na alta mais de 50% adquiriram independência nesses autocuidados. Foram necessários 9 a 28 dias para a aquisição da independência. Conclusão: os resultados obtidos permitiram concluir que se verificou a aquisição de ganhos em independência nos três autocuidados estudados. Sugere-se outros estudos que permitam perceber qual o contributo do Enfermeiro Especialista em Enfermagem de Reabilitação para a obtenção destes ganhos. (AU)

Objective: To identify the gains in independence of the individual with stroke admitted to a Physical Medicine and Rehabilitation service. Identify the number of days necessary to obtain gains in independence of the individual with stroke admitted to a Physical Medicine and Rehabilitation service, after intervention of the Rehabilitation Nurse. Methods: Quantitative, descriptive and retrospective study. We analyzed the nursing records of stroke patients admitted from January 2013 to December 2014. Data collection was performed using a grid analysis document. Results: In the records of 96 patients, on admission, more than 90% had some degree of dependency on self-care: hygiene; personal care; dressing. At discharge, more than 50% had acquired independence in self-care. It took 9 to 28 days to acquire independence. Conclusion: The results obtained allowed us to conclude that there was an acquisition of gains in independence in the three studied self-care. More research is suggested to allow us to understand the contribution of the Specialist in Rehabilitation Nurse to obtain these gains. (AU)

Objetivo: Identificar las ganancias en independencia del individuo con accidente cerebrovascular internado en un servicio de Medicina Física y Rehabilitación. Identificar el número de días necesarios para obtener ganancias en independencia del individuo con accidente cerebrovascular internado en un servicio de Medicina Física y Rehabilitación, después de intervención del Enfermero de Rehabilitación. Métodos: Estudio cuantitativo, descriptivo y retrospectivo. Analizados los registros de enfermería referentes a los pacientes con accidente cerebrovascular, internados en el período de enero de 2013 a diciembre de 2014. La recogida de datos se llevó a cabo mediante un modelo de análisis documental. Resultados: Analizados 96 registros de pacientes, se verificó en la admisión más del 90% presentaban algún grado de dependencia en los autocuidados estudiados: higiene, arreglo personal e vestir-se. En el alta más del 50% adquirieron independencia en el autocuidado. Se necesitaron de 9 a 28 días para adquirir la independencia. Conclusión: Los resultados obtenidos nos han permitido concluir que en los tres autocuidados estudiados se han obtenido beneficios de independientes. Se sugiere más investigación que permita saber cuál es la contribución del Enfermero Especialista en Enfermería de Rehabilitación para la obtención de estas ganancias. (AU)

Psychometric properties of the European Portuguese version of the Wijma Delivery Expectancy/Experience Questionnaire in pregnant women.

The researchers' aim is to examine the psychometric properties of the European Portuguese version of the Wijma Delivery Expectancy/Experience Questionnaire version A (WDEQ-A). Data from 669 pregnant Portuguese women was collected between June and October of 2019. From the initial 33-item Portuguese version of the WDEQ-A, a 27-item instrument was developed. Five-factor solution explained 63.8% of the total variance. The factors defined by the researchers were: fear/lack of self-efficacy, loneliness, negative appraisal, lack of positive anticipation and concern for the child. Cronbach's alpha coefficient was 0.934. The European Portuguese version of the WDEQ-A is a reliable and valid tool to measure fear of childbirth on both nulliparous and multiparous women and can be a useful tool for cross-cultural research. Moreover, researchers support the use of this tool in clinical practice to recognize and address fearful women during prenatal period.

Fear of childbirth in time of the new coronavirus pandemic.

OBJECTIVE: Reflect on how the new coronavirus pandemic triggered or accentuated the fear of childbirth in pregnant women and affected childbirth care practices. METHODS: Reflective analysis of women's pregnancy and childbirth experiences during the current pandemic, supported by the latest scientific evidence and recommendations on the topic. RESULTS: Pregnancy and childbirth are life-changing events for women, but during the new coronavirus pandemic, fear and uncertainty have taken on an unprecedented dimension in the negative way that many pregnant women have anticipated and experienced childbirth. FINAL CONSIDERATIONS: The current period has accentuated a chronic problem: a paternalistic system of health institutions in the approach to childbirth, dense with additional levels of fear in pregnant women. In this context, addressing the fear of childbirth means not giving up the promotion of safe and positive birth experiences for women.

Conflict management strategies used by Portuguese nurse managers.

OBJECTIVES: to analyze the perception and conflict management strategies used by nurses in the management of people in Portuguese health services. METHODS: descriptive, correlational study, carried out in Portuguese health services, with an intentional non-probabilistic sample, totaling 95 nurse managers. A questionnaire and Conflict Management Scale were used, analyzing the variables of managerial activities and conflict management, with the aid of software. RESULTS: it was identified that 60% of the managers, report having to mediate conflicts daily, and the majority report adopting dialogue in conduct. However, through the Kruskal-Wallis test, it was shown that enforcement strategies in conflict management prevail (p = 0.008), with collaborative ones being more restricted to monthly intervals (p = 0.049). CONCLUSIONS: managers perceive the importance of collaboration in the mediation of conflicts, however, in their daily lives; they tend to maintain imposing behaviors, signaling for a little transformational leadership style.

Antenatal care policies for low-risk pregnant women in high-income countries with a universal health system: a scoping review protocol.

OBJECTIVE: The aim of this scoping review is to map the available evidence on the nature, extent, and range of antenatal care policies for low-risk pregnant women in high-income countries with a health system founded on the Beveridge Model. INTRODUCTION: Low-risk women in high-income countries have good evolutionary perinatal outcomes but high intervention rates in pregnancy and childbirth, which ultimately leads to high morbidity. This has implications at all levels including families, the health care system, and society. This review aims to inform future policy and identify the viability of the adoption of alternative models to the Portuguese context that can reduce unnecessary interventions. INCLUSION CRITERIA: Studies, protocols, guidelines, and policies that provide guidance on antenatal care for low-risk pregnant women in high-income countries with a health system founded on the Beveridge Model (universal health care) will be considered. Documents from 2005 to present will be included, and no language restrictions will be imposed. METHODS: An initial search will be conducted in databases including MEDLINE (via PubMed) and CINAHL (via EBSCOhost), followed by a manual search of the reference lists from the documents accepted for inclusion, and a hand search of gray literature. For the countries whose policies are not available through the earlier steps, key persons from health ministries and academia will be contacted. Search results will be exported and data extracted using charting forms. Data will be synthesized using narrative description.

Midwifery interventions to reduce fear of childbirth in pregnant women: a scoping review protocol.

OBJECTIVE: The objective of the review is to map and analyze midwifery interventions to reduce fear of childbirth in pregnant women. INTRODUCTION: Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy, as well as after childbirth. During the previous few decades, there has been a growing interest in research into interventions to reduce the fear of childbirth in childbearing women. Currently, providing an appropriate model of care for pregnant women with fear of childbirth is a challenge in midwifery care. Therefore, further efforts are needed to identify and examine the characteristics of different midwifery interventions to reduce fear of childbirth in pregnant women. INCLUSION CRITERIA: This scoping review will consider studies that include interventions to reduce fear of childbirth in pregnant women, led and implemented by midwives, during the antenatal period, in all possible birth scenarios. Quantitative, qualitative, and mixed methods studies will be included. METHODS: The JBI methodology for conducting scoping reviews will be employed. Published and unpublished literature in English, Portuguese, and Spanish, from 1981 to the present, will be included. MEDLINE, CINAHL Complete, Scopus, Web of Science, Embase, and Cochrane Library databases will be searched. Searches for gray literature will be performed. Data will be extracted using a tool developed specifically for the scoping review objectives.

FOODS, NUTRACEUTICALS AND MEDICINAL PLANTS USED AS COMPLEMENTARY PRACTICE IN FACING UP THE CORONAVIRUS (COVID-19) SYMPTOMS: A REVIEW / ALIMENTOS, NUTRACÊUTICOS E PLANTAS MEDICINAIS UTILIZADOS COMO PRÁTICA COMPLEMENTAR NO ENFRENTAMENTO DOS SINTOMAS DO CORONAVÍRUS (COVID-19): UMA REVISÃO

The present prospective work of scientific articles related to foods and natural products with anti-Covid activity in databases in order to present a scientific community, to governments and society as main foods, nutraceuticals and medicinal plants as strategies used by countries during the COVID-19 pandemic. A review of articles on food, medicinal plants and biotechnology was carried out in databases of scientific articles such as: CAPES journals, PubMed, Elsevier's Science Direct, Willey on library library, Taylor & Francis Springer-Nature database, BMC, Hindawi, Scielo, ACS - American Chemical Society, Google Scholar, in addition to the Patent Database "The LENS" and "Questel-Orbit". Foods used in daily life such as garlic, ginger, turmeric, sour orange, vegetables, lactobacilli demonstrate proven anti-virus action. Medicinal plants used by Traditional Chinese, Korean and Indian Medicine also demonstrate anti-Covid activity and used during the coronavirus outbreak. Some medicinal plants, green propolis extract, red propolis extract, royal gelly, polen, honey have also been cited as anti-covid, natural anti-inflammatory and immunomodulatory products.

O presente trabalho prospectou artigos científicos relacionadas à alimentos e produtos naturais com atividade anti-Covid com o intuito de apresentar, à comunidade científica, aos governos e à sociedade, dados sobre as principais estratégias nutracêuticas, biotecnológicas e plantas medicinais utilizadas em alguns países durante o enfrentamento da pandemia COVID-19. A revisão de artigos sobre alimentos, plantas medicinais e produtos biotecnológicos foi realizada nas bases de dados periódicos da CAPES, PubMed, Science Direct, Willey on line library, Springer-Nature, Taylor & Francis, BMC, Hindawi, Scielo, ACS ­ American Chemical Society, Google acadêmico, "The LENS" e Questel-Orbit. Alimentos de uso frequente como alho, gengibre, cúrcuma, laranja azeda, vegetais e lactobacilos demonstraram ação anti-coronavirus comprovada. Foram descritos usos de plantas medicinais da Medicina tradicional Chinesa, Coreana, Indiana bastante utilizadas durante a pandemia. Algumas plantas medicinais e nutracêuticos como: extrato de própolis verde e extrato de própolis vermelha brasileiras, geleia real, pólen e mel também foram citados como produtos anti-covid, antiinflamatórios naturais e imunomodulatórios.