Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto
RLAE’s authorship concept is based on the substantial contribution by each of the individuals listed as authors, mainly in terms of conceiving and planning the research project, collecting or analyzing and interpreting data, writing and critical review. Indication of authors’ names under the article title is limited to six. If more, authors are listed on the online submission form under Acknowledgements. The possibility of including more than six authors will only be examined on multicenter studies, considering the explanations presented by the authors. Including names of authors whose contribution does not fit into the above criteria cannot be justified. Those names can be included in the Acknowledgements section. Authors are fully responsible for the concepts disseminated in their manuscripts, which do not necessarily reflect the editors’ and editorial board’s opinion.
Non-viral Sexually Transmitted Infections in pregnant women in Primary Care: prevalence and associated factors
Objective: to analyze the factors associated with the occurrence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis in pregnant women followed up in Primary Health Care. Method: a cross-sectional study of 302 pregnant women aged between 15 and 49 years. Vaginal secretion samples were collected for molecular biology detection of chlamydia, gonorrhea, mycoplasma and trichomoniasis; a structured questionnaire was applied with sociodemographic, behavioral, obstetric and clinical data, and results of rapid tests (Human Immunodeficiency Virus, Syphilis, Hepatitis B and C). Analysis was carried out using STATA 15.0 software. Results: the prevalence rates found were: Chlamydia trachomatis (11.6%), Mycoplasma genitalium (9.6%), Neisseria gonorrhoeae (1.7%) and Trichomonas vaginalis (3.6%). Age under 25 (adjusted odds ratio=2.06), presence of symptoms (adjusted odds ratio=1.99), absence of a steady partner or up to one year of relationship (adjusted odds ratio=2.64) increased the chance of having at least one infection. Conclusion: this study describes the high global prevalence of curable sexually transmitted infections in pregnant women in Primary Health Care. Knowing the prevalence of these infections in pregnant women and the main determinants are essential for reorganizing prenatal care and reducing pregnancy, puerperal and fetal complications.
Pregnant People; Sexually Transmitted Diseases; Prenatal Care; Primary Health Care; Screening; Prevalence
Copyright (c) 2026 Revista Latino-Americana de Enfermagem https://creativecommons.org/licenses/by/4.0
Design and assessment of an intervention for parents of premature newborns: a mixed-methods study
Objective: to design and assess an intervention targeted at reinforcing parents’ competency in caring for premature newborns. Method: a mixed-methods, exploratory and sequential intervention study. A grounded theory was applied in the first phase. The participants were 12 mothers and 4 fathers. A randomized pilot study was implemented in the second phase, with 14 mothers in each group. The main response variable was “care competency”. The CUIDAR Ma-Pre scale was applied in the baseline and follow-up measurements. Results: four categories emerged: Facing premature births, Experiencing the prematurity routine in Neonatal Units, Self-empowerment to care for premature newborns, and Caring for premature newborns at home. Self-empowerment to care for premature newborns was the central category. These results were integrated into the intervention design. Differences in favor of the intervention were found in the assessment. Although these differences were not statistically significant between the groups, it were in fact so intra-group (Control n=13 baseline 82.15; at discharge 117.08 p=0.000 vs Intervention n=14 baseline 80.71; at discharge 121.14 p=0.000). Conclusion: empowerment was essential in the experience; an intervention with this approach is relevant, and its preliminary assessment suggests that it can improve care competency. It is pertinent to conduct a study at a larger scale. ClinicalTrials.gov. Identifier: NCT05005988.
Neonatal Nursing; Premature Infant; Parents; Neonatal Intensive Care Units; Empowerment; Nursing Research
Family health coverage and care reorganization during the COVID-19 pandemic
Objective: to evaluate the reorganization of Primary Health Care services for individuals with suspected and/or confirmed COVID-19 during the critical phase of the pandemic, considering family health team coverage. Method: analytical cross-sectional study conducted with 1,474 managers of Primary Health Care services. Data were collected using Google Forms and analyzed by prevalence ratios, employing a Poisson regression model with random effects. Results: municipalities with coverage below 25% showed a 10% higher prevalence of patient distancing, a 33% higher prevalence of attending patients with suspected/confirmed COVID-19 in a separate sector, a 60% higher prevalence of using Telehealth for monitoring mild cases, and a 7% higher prevalence of providing guidance on home isolation, compared to municipalities with coverage between 25% and 49.99%. Conclusion: the reorganization of Primary Health Care occurred differently among Family Health Strategy, with municipalities with lower coverage more frequently implementing prevention and monitoring measures. This finding underscores the need to establish and standardize protocols to guide the reorganization of health services in public health emergencies.
COVID-19; Pandemics; Primary Health Care; Public Health Surveillance; Health Management; National Health Strategies
Artificial Intelligence as an ally to the Nursing Process: pathways and ethical considerations
Failure mode and effect analysis in the indwelling urinary catheterization process
Objective: to analyze potential risks in the adult indwelling urinary catheterization process. Method: exploratory, descriptive and evaluative research in a teaching hospital. Working group with ten health care providers: eight nurses, one physician and one nursing technician. Activity flowchart and description built through process modeling. Potential risk analysis based on the Failure Mode and Effect Analysis method. Results: four sub-processes identified for the indwelling urinary catheterization process. Process review-based proactive health care risk analysis showed 55 potential failure modes, 92 potential failure causes, and 40 potential failure effects. Conclusion: the method applied to review the indwelling urinary catheterization process in the hospital setting supported the proactive health care risk analysis; this issue should be further considered to contribute to the safety culture at the national level. Nurses are strategic in decision-making on health care risk management in said process, throughout catheter introduction, continuous use, and removal.
Patient Safety; Risk Management; Health Care Quality; Healthcare Failure Mode and Effect Analysis; Nursing Care; Urinary Catheters
Factors associated with extensions and withdrawals from stricto sensu graduate programs in Brazil during the COVID-19 pandemic: emphasis on mental health
Objective: to analyze the factors associated with extension of the completion deadline and the course withdrawals by Brazilian students enrolled in stricto sensu graduate programs during the COVID-19 pandemic, with emphasis on mental health. Method: cross-sectional analytical study conducted with 5,286 graduate students enrolled in 2022. Data were collected through an electronic form that contained sociodemographic, academic, and health information, including a history of mental disorders. Descriptive and inferential statistical analyses were performed using logistic regression through R software. Results: the study found that 38% of participants extended their courses and 4.8% withdrew from enrollment. Extension was associated with pursuing a doctorate, studying Engineering or Biological Sciences, reporting training difficulties, and presenting mental health problems. Participation in remote classes and a previous diagnosis of hypertension emerged as protective factors. Withdrawal was associated with having children, studying Engineering, facing pandemic difficulties, presenting mental health problems, and having a history of academic leave. Being a scholarship holder was a protective factor, reducing the chances of withdrawal by 50%. Conclusion: the findings indicate that extensions and withdrawals are related to academic, personal and health factors, highlighting the need for institutional policies that promote comprehensive support, with special attention to mental health and retention in graduate programs.
Graduate Education; Mental Health; COVID-19; Universities; Teaching; Risk Factors
Take Care: development and evaluation of a serious game about violence against children and adolescents
Objective: to develop a serious game for nurses and physicians in Primary Health Care based on clinical cases that address types of violence against children and adolescents, and evaluate the serious game based on player satisfaction. Method: applied research of technological nature. Four stages were carried out: development of fictitious clinical cases as a basis for the serious game; evaluation of clinical cases by eight experts intentionally selected for participating in the Protection Network; development of the serious game by an interdisciplinary team; and evaluation of satisfaction with playing the game, using the e-GameFlow scale, with the participation of 33 nurses and 15 physicians. Results: seventeen clinical cases were developed, representing different types of violence. “Take Care” was developed as a simulation using Unity® software, set in a virtual doctor’s office. The game’s evaluation achieved a Cronbach’s alpha of 0.970. The areas of greatest satisfaction were: improvement in knowledge, concentration, and clarity of objectives. All participants said they would play again, 91% felt safe, 89% would not give up, and 70% finished without reporting the violence. Conclusion: “Take Care” was evaluated positively. It is suggested that it be used for continuing education, as an aid in identifying and reporting situations of violence.
Educational Technology; Violence; Child; Adolescent; Continuing Education; Play and Playthings
Ethical climate in the primary health care workplace: a mixed-method study
Objective: to analyze the ethical climate in the primary health care workplace in a municipality in the Amazon region, combining quantitative and qualitative data. Method: a convergent, parallel, mixed-method study. Qualitative data from interviews with 46 professionals underwent reflective thematic analysis. Quantitative data were obtained from 170 professionals using the Ethical Climate Inventory. Exploratory factor analysis tested the Ethical Climate Inventory model, proposing a new configuration for the items, with greater explanatory power than that maintained in the confirmatory factor analysis. Data integration was independent and presented in a joint display. Results: items with the highest factor loadings of the four factors of the Ethical Climate Inventory (1. principles and rules, 2. benevolence, 3. independence/individualism, and 4. sense of community/social responsibility) were analyzed in conjunction with the qualitative category, with multiple expressions of subjectivity and ethics in the workplace. No divergences were observed between the data, only convergences and complementarity in analytical syntheses by factor. Conclusion: data integration broadened the understanding of the ethical climate in a little-explored scenario, demonstrating the distinction of this reality in terms of the constructs analyzed and the strength of ethical elements as a conceptual and analytical tool for workplace environments.
Primary Health Care; Ethics; Work; Surveys and Questionnaires; Nursing; Health Services
Chemotherapy-induced cardiotoxicity in cancer patients: an observational study at an Oncology reference hospital from southeastern Brazil
Objective: to assess the clinical, inflammatory and electrocardiographic profile of cancer patients undergoing the Pre-chemotherapy phase, with the purpose of early identifying cardiovascular toxicity indicative signs. Method: an observational and cross-sectional study, conducted between November2022 and December2023 with adult cancer patients in stagesI toIII treated at a hospital from southern Brazil. Sociodemographic, clinical and tumor-related data were collected, in addition to laboratory and electrocardiographic tests performed before the first chemotherapy infusion. Descriptive analyses were carried out in the Rsoftware. Results: the participants were 84 patients, mostly women (72.6%) with breast cancer diagnoses(57.1%). Prevalence of systemic inflammation was verified, with high C-reactive protein in 35.7% and increased neutrophil-lymphocyte and platelet-lymphocyte ratios in 23.5% and 27.2%, respectively. A significant association was observed between high Body Mass Index and T-wave alterations (p=0.005). Although 10 patients presented prolonged corrected QT intervals, no other statistically significant associations were identified. Conclusion: the pre-chemotherapy phase revealed relevant inflammatory and electrocardiographic alterations, even in the absence of installed cardiotoxicity. The findings reinforce the importance of baseline cardiovascular evaluations and of multi-professional follow-up in Cardio-Oncology, especially for patients with modifiable risk factors. Longitudinal studies are recommended to elucidate the clinical and prognostic evolution of these alterations.
Neoplasms; Antineoplastic Agents; Heart Disease Risk Factors; Biomarkers; Electrocardiogram; Cardiotoxicity
Effectiveness of auriculotherapy and laser acupuncture in hyperemesis gravidarum: a randomized clinical trial
Objective: to evaluate the effectiveness of auriculotherapy and laser auriculotherapy on nausea, vomiting, and quality of life in pregnant women. Method: a randomized, parallel, factorial, double-blind study was conducted with 100 pregnant women, allocated into four groups (25 in each): intervention (G1- auriculotherapy and G2- laser auriculotherapy), control (G3), and placebo with cotton (G4), all followed for seven days for outcome analysis. The Pregnancy Unique Quantification of Emesis Score and the Degree of Auricular Palpation were used to analyze nausea and vomiting, and the Health-Related Quality of Life Questionnaire for Nausea and Vomiting of Pregnancy was used to assess quality of life. Results: compared to the placebo group, participants in G1 and G2 reduced (p<0.050) their Pregnancy Unique Quantification of Emesis scores by -1.14 (95% CI: -2.11; -0.17) and -1.3 (95% CI: -2.24; -0.41) and the Health-Related Quality of Life Questionnaire for Nausea and Vomiting of Pregnancy by -34.81 (95% CI: -62.98; -0.95) and -31.97 (95% CI: -62.98; -0.95), respectively. The use of antiemetics was higher in the control and placebo groups. Conclusion: both types of intervention demonstrated a significant reduction in nausea/vomiting and the use of allopathic medications, an improvement in quality of life, and potential acceptance of laser auriculotherapy by pregnant women. Brazilian Registry of Clinical Trials RBR-4wtq84v.
Complementary Therapies; Low-Level Light Therapy; Auriculotherapy; Pregnancy; Morning Sickness; Quality of Life
Self-care and fatigue in individuals hospitalized with decompensated heart failure during the covid-19 pandemic: a cross-sectional study
Objective: to determine the association between self-care and fatigue in patients hospitalized with decompensated heart failure during the COVID-19 pandemic. Method: observational, cross-sectional study involving 132 individuals hospitalized in a university hospital. Data were collected through individual interviews and medical record reviews. Self-care was evaluated using the Self-Care of Heart Failure Index, while fatigue was measured using the Fatigue Pictogram, both of which had been previously validated for use in Brazil. Scores of 70 or higher indicated adequate self-care in the domains of Management, Maintenance and Confidence. Results: most participants were men (n = 73; 55.3%), had a low educational level (n = 98; 74.2%), lived with a spouse and/or children (n = 77; 58.4%) and had a mean age of 62.3 years (standard deviation = 28.7). Inadequate self-care for heart failure was observed in the Maintenance (n = 109; 82.6%), Management (n = 81; 61.8%) and Confidence (n = 57; 48.3%) subscales. In the week before hospitalization, participants reported experiencing fatigue-related exhaustion and limitations. No statistically significant association was found between fatigue intensity or impact and the self-care subscales. Conclusion: during the pandemic, although fatigue was prevalent among participants before hospitalization due to clinical decompensation of heart failure, it was not associated with self-care for the condition.
Self-Care; Fatigue; Heart Failure; COVID-19; Nursing; Cardiology
Transition experiences of patients and families upon discharge from intensive care: a scoping review
Objective: to map available evidence on the experiences of adult patients and family members regarding the transition of care between intensive care and inpatient units. Method: scoping review conducted according to Joanna Briggs Institute guidelines. Primary studies, reviews, dissertations, and theses published in Portuguese, English, or Spanish were included, with no time limit. The final search was conducted on health portals and databases and in digital libraries. The selection was performed by two reviewers in a blind and independent manner. The data were extracted using a script and presented in figures, descriptive and deductive qualitative analysis, categorizing the experiences between the stages of assessment, planning, execution, and follow-up after discharge. Results: thirty articles comprised the sample. The experiences mapped highlight the transition as a critical moment in hospitalization, marked by emotional impact and informational weaknesses. Reports of unpreparedness, feelings of abandonment, and communication failures compromise the continuity of care and the adaptation of patients and family members. Conclusion: the experiences described point to the transition of care between intensive care and inpatient units as a complex and multifaceted process. The gaps identified require structured communication strategies, timely information, and alignment between units.
Patient Discharge; Patient-Centered Care; Continuity of Patient Care; Transitional Care; Patient Participation; Patient Transfer
Copyright (c) 2025 Revista Latino-Americana de Enfermagem https://creativecommons.org/licenses/by/4.0
Pain in Long COVID: A scoping review of clinical characteristics and patterns of manifestation
Objective: to map the available scientific evidence on the clinical characteristics and patterns of pain manifestation (location, frequency, duration, intensity, and quality) in individuals with Long COVID. Method: a scoping review of publications from March 2020 to June 2024, indexed across four databases. Study selection was conducted by two independent, blinded reviewers. Data were extracted using a standardized instrument and analyzed descriptively. Results: nineteen studies were included, indicating that pain affects individuals across all age groups, with higher prevalence among women, primarily involving the head, neck, shoulder, lower back, and hip. Pain frequency ranged from daily to monthly episodes, with duration exceeding one year in some cases. Intensity varied from mild to severe, and pain characteristics were diverse, with descriptors including burning, pressure, colicky, and throbbing pain. Conclusion: the clinical characteristics and patterns of pain manifestation in Long COVID are diverse. However, there is a paucity of studies providing detailed analyses of pain features and the influence of individual variables. These findings should guide future research and clinical practice toward a more comprehensive and contextualized assessment of pain in Long COVID.
COVID-19; Post-Acute COVID-19 Syndrome; Signs and Symptoms; Pain; Chronic Pain; Public Health
Effectiveness of text messages in the adherence to COVID-19 prevention practices: a quasi-experimental study
Objective: to analyze the effectiveness of messages sent by cell phone on adherence to the use of masks, hand hygiene and social distancing during the COVID-19 pandemic. Method: a multicenter quasi-experimental clinical trial conducted in four Brazilian universities between July and October 2020. The sample consisted of 429 people from different Brazilian cities who received messages every two days for seven weeks about individual protection measures. Adherence to the measures was analyzed by an instrument developed by the researchers of the main center and refined in collaboration with researchers from the other centers, consisting of 13 questions and a five-point Likert scale, with the overall score ranging from 13 to 65 points, in which the higher the score, the greater the adherence. Statistical analysis was performed using multivariate analysis of variance (MANOVA), considering p<0.05 as significant. Results: an improvement in the adherence score was observed over the weeks. When compared with the score obtained before the intervention, there was a significant improvement in adherence in the last two weeks (p<0.001). Conclusion: the intervention using messages sent by cell phone showed to be effective in promoting adherence to individual protection practices against COVID-19. However, the observed sample loss may have affected the results, limiting the generalizability of the findings. Therefore, the effects identified should be interpreted with caution. The Brazilian Registry of Clinical Trials (RBR-2s94rb).
Text Messaging; Coronavirus; Social Isolation; Masks; Treatment Adherence and Compliance; Behavior Therapy
Sheila Coelho Ramalho Vasconcelos Morais
Adaptation strategies for nurses with musculoskeletal pain in hospital work: a systematic review
Objective: to analyze the effectiveness of individual coping strategies and hospital work environment adaptations for nurses with musculoskeletal pain. Method: a systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The search was performed in six databases, including experimental and pre-experimental studies. Risk of bias was assessed using the RoB2 (Risk of Bias 2) and ROBINS-I (Risk of Bias In Non-randomized Studies of Interventions) tools. Methodological quality was evaluated using the Joanna Briggs Institute model, the Jadad Scale and the Melnyk, Buck and Gallagher-Ford Levels of Evidence. Results: eight studies were included, identifying individual coping strategies such as stretching exercises, auriculotherapy and mindfulness. Workplace-based strategies were multidisciplinary, integrated and focused on training for identifying and preventing musculoskeletal risks while improving working conditions. Conclusion: the most effective strategies combine workers’ individual actions with improvements in working conditions, addressing physical, psychosocial and ergonomic factors to adapt the work environment, prevent musculoskeletal pain progression and maintain job performance. PROSPERO registration number: CRD42024575014.
Musculoskeletal Pain; Coping Skills; Working Conditions; Ergonomics, Nurse Practitioners; Nursing
Effectiveness of audiovisual interventions in increasing knowledge about sexually transmitted infections: a systematic review
Objective: to analyze the evidence on the effectiveness of audiovisual interventions in increasing knowledge about sexually transmitted infections in different age groups. Method: systematic review, conducted on February 21, 2023, in the Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, Latin American and Caribbean Health Sciences Literature, Nursing Database, Spanish Bibliographic Index in Health Sciences, MEDLINE, Scopus, and Web of Science. Experimental studies that used audiovisual resources to improve knowledge were included, compared with other interventions or none. The synthesis of results was narrative, with assessment of risk of bias and certainty of evidence. Results: the sample consisted of 25 studies (10 randomized clinical trials and 15 quasi-experimental studies). Educational videos were the most widely used resource. Compared to other interventions or no intervention, the intervention group achieved significant improvements in knowledge in the medium and long term, as well as changes in perception and predisposition to reduce risky behavior. The certainty of the evidence was low for randomized studies and very low for quasi-experimental studies. Conclusion: audiovisual interventions have shown effectiveness in different populations and age groups, highlighting the need to consider specific parameters in creating these resources.
Adolescent; Adult; Aged; Audiovisual Aids; Video-Audio Media; Sexually Transmitted Diseases
Breastfeeding strategies following nurslings’ hospitalization: a scoping review
Objective: to map strategies aimed at promoting and maintaining breastfeeding following nurslings’ hospitalization. Method: a scoping review guided by the recommendations of the Joanna Briggs Institute Reviewer’s Manual. The search was carried out in seven databases and in repositories of theses and dissertations. The selection of studies was conducted on a web application by two independent blind reviewers. The data were analyzed descriptively. Results: in total, 1,325 publications were obtained, of which 29 were included in the study. The following were identified as health strategies associated with breastfeeding: education and guidance, support and follow-up, clinical and technical interventions, complementary therapies, technology and innovation, environment and physical conditions, nutrition and hydration, protocol and guidelines. Conclusion: the evidence reinforces that multifaceted strategies are essential post-discharge in order to strengthen self-management and sustain breastfeeding beyond the hospital setting. Primary Health Care can play an important role in care continuity.
Breastfeeding; Patient Discharge; Nursing Care; Health Strategies; Primary Health Care; Lactation
Complementary therapies for the management of attention deficit hyperactivity disorder in children: a scoping review
Objective: to map the scientific literature regarding complementary therapies used by health professionals for children with Attention Deficit Hyperactivity Disorder. Method: this scoping review was based on the recommendations proposed by the Joanna Briggs Institute. Five data sources were searched. Inclusion criteria comprised articles published in English, Spanish, or Portuguese; children aged one to nine years diagnosed with Attention Deficit Hyperactivity Disorder, regardless of additional age ranges covered; and no restrictions on publication date, study design, or bibliographic type. Therapies were grouped into four categories: mind-body therapies, supplementation, herbal therapy, and dietary therapy. Results: a total of 1,444 publications were identified, with 133 peer-reviewed articles selected for analysis. Sixty-five complementary therapies were identified, with neurofeedback (n=38) being the most frequently cited mind-body therapy. Other interventions included a prevalence of polyunsaturated fatty acid supplementation (n=14), Ginkgo biloba use (n=6) in phytotherapy, and oligo-antigenic diet (n=5) in dietary therapy. Conclusion: complementary therapies show potential for alleviating symptoms of Attention Deficit Hyperactivity Disorder in childhood. However, some therapies still lack scientific validation, highlighting the need for targeted experimental studies to ensure safe and effective use.
Attention Deficit Disorder with Hyperactivity; Complementary Therapies; Child; Infant; Child Health; Health Personnel
Quality of life assessment instruments for radiodermatitis in cancer patients: scoping review
Objective: to map the literature on skin-related quality of life questionnaires and assessment tools applied to cancer patients undergoing radiotherapy who developed radiodermatitis. Method: scoping review conducted in accordance with JBI recommendations. The search was conducted in seven sources of information and in the grey literature. There were no restrictions on the publication period or language of the articles. A qualitative synthesis of the data was performed, presented descriptively and through tables and figures. Results: thirty-two studies were included, most of which were from North America (n=14). The instruments used to assess skin-related quality of life were: the Dermatology Life Quality Index (n=17), Skindex-16 (n=11), Skindex-29 (n=1), and Padua Skin-Related Quality of Life (n=1). The most frequently applied instruments were the Dermatology Life Quality Index and Skindex-16, used predominantly in patients with breast cancer. Conclusion: different instruments used to assess skin-related quality of life in patients with radiodermatitis were identified, with emphasis on Skindex-16 and DLQI. The diversity of tools points to the absence of consolidated guidelines on the choice of the best instrument to be implemented in this clinical context.
Quality of Life; Skin; Radiodermatitis; Radiotherapy; Neoplasms; Review
Validity evidence of the Brazilian version of the Assessment Interprofessional Collaborative Leadership Scale
Objective: to seek evidence of validity of the Assessment Interprofessional Collaborative Leadership Scale for Brazilians, in Portuguese, and to analyze evidence of content, response process and internal structure. Method: psychometric evaluation study, with translation, back-translation, and evaluation by a committee of experts regarding linguistic and content equivalence. The pre-test was carried out with 40 participants and, subsequently, the final version was applied to 318 health workers. Exploratory factor analysis and reliability testing were performed using Cronbach’s alpha and McDonald’s omega. Results: in the content validation, four items presented scores below the critical value. Of the participants, the majority were nurses (81%) and physiotherapists (10%), and were female (79%). The factorability obtained was Kaiser-Meyer-Olkin = 0.94 and Bartlett’s sphericity = 2991.4 with p < 0.05. Parallel analysis indicated a one-dimensional model, with variance explained by 63.71%. The model’s adequacy indices showed satisfactory levels. And adequate reliability indices (Cronbach’s alpha = 0.97 and McDonald’s omega = 0.97). Conclusion: the Interprofessional Collaborative Leadership Assessment Scale, with a unidimensional structure and 28 items, presented good evidence of content validity, response process and internal structure, considered adequate to measure interprofessional collaborative leadership.
Leadership; Patient Care Team; Interprofessional Relations; Validation Study; Health Personnel; Healthcare Crew Resource Management
Risk Assessment Scale for the Development of Medical Adhesive-related Skin Injuries
Objective: to develop and validate the Risk Assessment Scale for the Development of Medical Adhesive-related Skin Injuries in hospitalized adults. Method: methodological study consisting of the development, face validity, content validity, predictive criterion validity, and interobserver reliability analysis of the scale. It was developed using risk factors obtained in an integrative review and underwent face and content validation by seven judges. Three hundred and twenty-nine patients participated in the predictive criterion validity and 32 in the reliability analysis. Results: the scale consists of 48 items and eight domains. Scores < 11 classify patients as low risk and ≥ 11 as high risk for developing medical adhesive injuries. In face validity, there was 100% agreement among the judges, and in content validity, a total content validity coefficient of 0.94 was obtained. In predictive criterion validity, there was a statistically significant association (p < 0.001) between the score generated by the scale and the occurrence of medical adhesive injuries. The reliability analysis obtained an intraclass correlation coefficient of 0.92. Conclusion: the scale developed is a valid and reliable tool for identifying the risk of injury from medical adhesives in hospitalized adults.
Adhesives; Wounds and Injuries; Skin; Patient Safety; Evidence-Based Nursing; Secondary Prevention
Cross-cultural adaptation and validation of the Person-centered Practice Inventory-Staff for Brazilian culture
Objective: to translate, cross-culturally adapt and validate the Person-centered Practice Inventory-Staff into Brazilian Portuguese. Method: the methodological study followed the stages of translation, synthesis, back-translation, expert evaluation and pre-testing. Content validity was assessed using the Content Validity Index and the Content Validity Ratio. Convergent and discriminant construct validity was verified using confirmatory factor analysis. Internal consistency was checked by Cronbach’s alpha, Composite Reliability and McDonald’s Omega. Results: 15 professionals took part in the content validation and 307 in the evaluation of the construct and reliability. Content validity obtained values above 0.87 for the Content Validity Index and 0.73 for the Content Validity Ratio. The confirmatory factor analysis distributed the 59 items in the 17 original domains, with average variance extracted greater than 0.49 and factor loadings greater than 0.61. Internal consistency showed Cronbach’s alpha between 0.56 and 0.85; composite reliability between 0.75 and 0.89; and McDonald’s Omega between 0.61 and 0.88. Conclusion: the Brazilian version of the Person-centered Practice Inventory-Staff demonstrated satisfactory validity and reliability to assess the perception of person-centered care practice among nursing professionals in the hospital context.
Translating Process; Transcultural Studies; Validation Studies; Patient-Centered Care; Psychometrics; Reproducibility of Results
Trends and spatial distribution of precarious work conditions for nurses in Brazil based on the type of employment bond
Objective: to analyze the tendencies and spatial distribution of precarious work for nurses in Brazil, based on the type of employment relationships, between 2010 and 2023, according to the level of health care. Method: ecological study with data extracted from the National Registry of Health Establishments. The indicator analyzed was the percentage of precarious work relationships. The temporal tendency was assessed by the Prais-Winsten regression model and the spatial distribution was assessed by means of choropleth maps. Results: there was an increasing tendency in the precarious work of nurses in Brazil based on the type of employment relationships, regardless of the level of health care. The North region showed the highest percentages of increase in the indicator in Primary Health Care, Secondary Health Care, and Tertiary Health Care. The North and Northeast regions had the highest numbers of municipalities with a high percentage of precarious work conditions. Conclusion: the precariousness of nursing employment relationships showed an increasing tendency at all levels of health care, being higher in Primary Health Care and increasing more in Tertiary Health Care within the time horizon analyzed.
Workforce; Work Conditions; Precarious Work; Job Security; Nurses; Health Care Levels
Effect of antiretrovirals on renal function in people taking HIV pre-exposure prophylaxis
Objective: to evaluate the effect of antiretrovirals on renal function in individuals receiving HIV pre-exposure prophylaxis. Method: a descriptive, longitudinal survey design was used in a retrospective cohort study for 48 weeks. The sample consisted of 203 participants. Non-probabilistic convenience sampling was used. Sociodemographic, clinical, and laboratory variables were analyzed. Absolute and relative frequencies, mean, standard deviation, minimum and maximum values, Fisher’s exact test, and Friedman test were used, with a significance level of <5%. Results: the participants were predominantly cisgender men (86.2%), white (69.1%), highly educated (76.7%), and had a mean age of 34 years. The presence of markers of renal damage was low. Proteinuria increased until the 12th week (2.6%), maintaining a small variation until the 48th week. The decline in estimated Glomerular Filtration Rate (eGFR) ≥25% from baseline was 4.4%, 3%, 4.4%, and 3% at weeks 12, 24, 36, and 48, respectively. There was no significant association between eGFR decline ≥25% and the presence of any of the markers of renal damage. Conclusion: the low incidence of events characterizing renal dysfunction, such as eGFR decline ≥25% and the presence of mild and isolated events of proteinuria, glycosuria, uricosuria, and cylindruria, was confirmed at 48 weeks of follow-up.
Pre-Exposure Prophylaxis; Anti-Retroviral Agents; Tenofovir; Kidney Diseases; Physiologic Monitoring; Glomerular Filtration Rate
Transcultural adaptation, validity, and reliability of the SINBAD System Classification for Brazilian Portuguese
Objective: to perform the cross-cultural adaptation of the SINBAD System Classification for Brazilian Portuguese and analyze its content validity and reliability. Method: clinimetric study, including cross-cultural adaptation of the SINBAD System Classification, used to assess foot ulcers in people with diabetes. Verification of semantic and cultural equivalence and clinical usability using the inter-rater reliability (IRR) index (≥ 0.80); content validity using the Content Validity Ratio (CVR) p < 0.05, and internal consistency using McDonald’s omega (> 0.70). The sample involved nurses, physicians, and people with diabetes-related foot ulcers. Data collection was performed using online forms and in-person clinical evaluation of patients treated at referral services in Goiânia, Jataí, São Paulo, Belo Horizonte, and primary care center in Palmas. Results: fifteen nurses participated in the cognitive debriefing; 20 experts (physicians and nurses) participated in content validation; and 113 patients with 120 diabetes-related foot ulcers participated. Eight items (terms and expressions) from the SINBAD System underwent cross-cultural adaptation. CVR = 0.84 and McDonald’s omega = 0.635 were obtained. Conclusion: the SINBAD system is adapted to Brazilian Portuguese and has satisfactory content validity indices, but it needs investment to achieve greater robustness in terms of reliability and internal consistency.
Translating; Validation Study; Foot Ulcer; Diabetic Foot; Nursing; Brazil
Frailty and nursing care demand in hospitalized older adults: a cross-sectional study
Objective: to analyze the relation between nursing care demand and frailty condition and markers in hospitalized older adults. Method: analytical cross-sectional study with a sample of 400 older adults. Data collection used a sociodemographic questionnaire, frailty phenotype tests, and a nursing care complexity assessment scale. Fisher’s exact test, Kruskal-Wallis test and Dunn’s test were applied, considering statistical significance for p≤0.05. Results: there was a predominance of pre-frail (48.7%), followed by frail (35.8%) and non-frail individuals(15.5%). Most frail older adults required high-dependency nursing care (44.8%). The minimum nursing care demand was 80.6% for non-frail, 60.5% for pre-frail, and 14% for frail older adults. Frail older adults required higher nursing care level than the non-frail in the areas: mental state, oxygenation, motility, ambulation, elimination, and therapy (p<0.001). There was association between minimal to intensive nursing care demand and reduced hand grip strength (p<0.001), reduced gait speed (p<0.001), fatigue/exhaustion (p<0.001), reduced physical activity level (p<0.001), and unintentional weight loss (p<0.019). Conclusion: higher nursing care demand was associated with worse frailty condition and markers. Frailty assessment is indispensable to trace specific needs and support nursing care planning.
Nursing Care; Hospitalization; Frailty; Nurses Improving Care for Health System Elders; Frail Elderly; Cross-Sectional Studies
Prevention of intraoperative hypothermia: a descriptive-exploratory study
Objective: to analyze the measures implemented in practice for the prevention of hypothermia during the intraoperative period in public and private hospitals. Method: quantitative, descriptive-exploratory study. The sample consisted of 201 nurses, invited via social media, Facebook, Instagram, and email. Data collection was performed using an online form created on the Survey Monkey® virtual platform. For analysis, descriptive statistics and association tests were applied to investigate the differences between the defined groups in relation to the study variables. Results: in both types of institutions, most participants were female and married/in a stable relationship. There was a significant difference between the types of hospitals in terms of operating room temperature control (p<0.001), patient body temperature monitoring (p=0.027), and use of active skin warming methods (p=0.009). Conclusion: the forced-air warming was the active method most frequently used, and nursing staff were the professional category most often indicated as responsible for implementing prewarming and using active methods in the types of institutions investigated. There is still a need to increase the daily implementation of measures to prevent hypothermia, pointing out to managers the need for investment and training of human resources.
Perioperative Nursing; Hypothermia; Intraoperative Period; Body Temperature; Hospitals; Patient Safety
Use of personal protective equipment among nurses in the pre- and post-COVID-19 vaccination periods
Objective: compare the use of personal protective equipment among nurses in the pre- and post-COVID-19 vaccination periods in the state of Paraíba, Brazil. Method: cross-sectional, analytical study with nurses from the state of Paraíba, Brazil. Data collection in two periods (pre- and post-COVID-19 vaccination), online, using a survey instrument. Descriptive and comparative analyses. Comparative analysis of variables for combined use of personal protective equipment in direct care and aerosol-generating procedures for people with suspected or diagnosed COVID-19 using the Z-test for proportions. Results: participation of 579 nurses in period 1 and 734 nurses in period 2. Gloves, face shield, N95 mask, surgical cap, and gown were the pieces of equipment most used by nurses in the care of people with suspected and/or diagnosed COVID-19. The combined use of personal protective equipment was higher in the pre-vaccination period compared with post-vaccination period. Conclusion: combined use of personal protective equipment by nurses decreased after the introduction of the COVID-19 vaccine. Thus, it is necessary to implement educational strategies and trainings on the proper use of these pieces of equipment.
Personal Protective Equipment; Nurses; COVID-19; Pandemics; Personal Protection; Disease Prevention
Motivations, benefits, and barriers to the use of HIV pre-exposure prophylaxis based on the health belief model
Objective: to understand the motivations, benefits, and barriers to the use of HIV pre-exposure prophylaxis. Method: a qualitative study grounded on the Health Belief Model. Sixteen people using HIV pre-exposure prophylaxis were followed up at two Testing and Counseling Centers in a large municipality in the interior of the state of São Paulo, Brazil. Data were collected through individual audio-recorded interviews. Data analysis followed Rosenstock’s Health Belief Model and Bardin’s Content Analysis. Results: susceptibility to HIV was influenced by uncertainty about partners’ serology and condom failure. The severity of HIV is perceived as greater due to its incurability. Benefits include greater protection, safety, and well-being. Barriers involve difficulties in access, side effects, and social stigma. Conclusion: the study revealed that the motivation for using Pre-Exposure Prophylaxis was the perception of susceptibility to HIV, the severity of the disease, and benefits such as protection and psychological well-being, while barriers involved difficulties in access, complexity of the clinical protocol, and stigma. Knowing the beliefs and barriers can favor more effective interventions by the health team.
HIV; Pre-Exposure Prophylaxis; Disease Prevention; Health Belief Model; Nursing; Sexually Transmitted Diseases
Anxiety and vital signs in cancer patients and music students before and after a music intervention: a quasi-experimental pilot study
Objective: to analyze the level of anxiety and variation in the vital signs of cancer patients and performers (music students) before and after a live musical intervention. Method: quasi-experimental pilot study with no control group. An interdisciplinary musical intervention was carried out between Nursing and Music Performance students. The level of anxiety was assessed with the Hamilton scale and the variation in vital signs before and after the intervention in a day hospital in cancer patients and in interpreters, in the latter the variables were also analyzed before and after the intervention. The Wilcoxon test was used to analyze the data. Results: 18 patients and 10 music students took part. Variations in vital signs were observed in both groups, as well as a decrease in the level of anxiety in the patients at the post-intervention moment. In the students, the level of anxiety was higher at the beginning of the dress rehearsal compared to the rest of the evaluated moments at the hospital. Conclusion: live music interventions could improve anxiety levels in both cancer patients and performers.
Integrative Oncology; Holistic Nursing; Interdisciplinary Placement; Music; Anxiety; Vital Signs