FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Checklist validation for care provided to patients in the immediate postoperative period of cardiac surgery

Abstract

Aims and objectives

We created and validated a checklist for nursing care of patients in the immediate postoperative period of cardiac surgery.

Background

Cardiovascular diseases (CVD) account for about 30% of all deaths recorded in Brazil. There is an arsenal of clinical and surgical treatments for CVD, with a significant number of patients evolving to surgical treatment. Thus, health professionals working in the perioperative period of cardiovascular surgeries need to be updated, trained, and qualified to provide adequate and safe care to patients.

Design

We developed a checklist that defined essential parameters for quality care, to ensure greater agility and patient safety.

Methods

This methodology validation study comprised two stages: checklist creation for care provided by nurses to patients in the IPO of cardiac surgery, and content validation using the Delphi method. Participants were selected through an advanced survey conducted on the Lattes Platform website of the National Council for Scientific and Technological Development. The STROBE checklist was used to guide the study.

Results

Three rounds of analysis by specialists resulted in average CVIs of: 95.8% for objectivity, 97.9% for simplicity, 91.0% for clarity, 93.1% for relevance, and 96.5% for variety, suggesting high agreement among specialists.

Conclusions

The checklist focused on nursing care of patients in the IPO of cardiac surgery and was validated with three topics, four categories, 16 items, and 86 sub‐items of care assignments to be applied in clinical practice.

Relevance to clinical practice

This is a validated instrument that guides nurses’ actions by admitting postoperative cardiac surgery patients to the ICU based on evidence, which provides more scientific and professional support to health teams’ performance, with the objective of strengthening roles and establishing routines; thus presenting a powerful tool for planning nursing actions, providing quality care to patients, and facilitating communication between teams, thereby minimizing risks.

Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review

Abstract

Purpose

To identify nonpharmacological clinically effective interventions for constipation in adults.

Methods

A systematic review of experimental studies of nonpharmacological interventions addressing participants’ management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta‐Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693.

Results

This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant’s modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage.

Conclusions

Specific nonpharmacological interventions are crucial for nurses’ clinical practice and of major importance for clients and families. Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence‐based data to support nursing clinical practice.

Clinical Relevance

Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.

Pitfalls in acute febrile illness diagnosis: Interobserver agreement of signs and symptoms during a dengue outbreak

Abstract

Aims and objectives

To compare and evaluate interobserver (nurses and physicians) agreement for dengue clinical signs and symptoms, including the World Health Organization diagnostic algorithm.

Background

Agreement of clinical history defines the capacity of the examiner to measure a given clinical parameter in a reproducible and consistent manner, which is prerequisite for diagnosis validity. Nurses play a major role in the triage and care of dengue patients in many countries.

Study design

This is a sub‐study on interobserver agreement performed as part of a cross‐sectional diagnostic accuracy study for acute febrile illness (AFI) using the checklist STARD.

Methods

A previously validated semi‐structured sign and symptom standardised questionnaire for AFI was independently administered to 374 patients by physician and nurse pairs. The interobserver agreement was estimated using kappa statistics.

Results

For a set of 27 signs and symptoms, we found six interobserver discrepancies (examiner detected red eyes, lethargy, exanthema, dyspnoea, bleeding and myalgia) as identified by regular and moderate kappa indexes. Four signs (patient observed red eyes, cough, diarrhoea and vomiting) and one symptom (earache) had near‐perfect agreement. Most signs and symptoms showed substantial agreement. The WHO (Dengue guidelines for diagnosis, treatment, prevention and control: new edition, World Health Organization, 2009) clinical criteria for dengue comprise a group of symptoms known as “pains and aches.” Interobserver agreement for abdominal pain, retro‐orbital pain and arthralgia exceed that found for headache and myalgia.

Conclusions

During a dengue outbreak, the interobserver agreement for most of the signs and symptoms used to assess AFI was substantial.

Relevance to clinical practice

This result suggests good potential applicability of the tool by health professionals following training. A well‐trained health professional is qualified to apply the standardised questionnaire to evaluate suspected dengue cases during outbreaks.

Percepción de adolescentes sobre sexualidad y salud reproductiva: la escuela como espacio para la educación sexual

Objetivo: Analizar la percepción y el conocimiento de los adolescentes sobre Infecciones Sexualmente Transmisibles (IST's), embarazo y formas de prevención por medio de los métodos anticonceptivos. Metodología: Se trata de un estudio descriptivo con enfoque cualitativo. Para la recolección de datos utilizamos cuestionario autoaplicable en los adolescentes escolares del 6º al 9º año de la enseñanza fundamental y el análisis de los datos fue realizado por medio del análisis de contenido, en su modalidad temática. Resultados: Sobre las informaciones de las IST's y los Métodos anticonceptivos, se observa que los / las adolescentes encuestados son vulnerables, pues la investigación reveló que la mayoría de los adolescentes desconocen sobre el tema o no tienen informaciones necesarias para protegerse. Conclusión: Podemos considerar que hay una laguna en el conocimiento de los adolescentes escolares sobre los métodos anticonceptivos, los tipos de infecciones sexualmente transmisibles y los métodos preventivos, lo que implica aumentar las posibilidades de un comportamiento sexual de riesgo.

Información a los padres durante el tratamiento del cáncer infantil: un estudio descriptivo

Objetivo: Este estudio tuvo como objetivo explorar la perspectiva de los padres de niños con cáncer en la búsqueda de información en diferentes momentos del tratamiento.

Método: Estudio descriptivo, con enfoque cualitativo. Las entrevistas semiestructuradas fueran desarrolladas con 22 padres en dos hospitales públicos de Sao Paulo, Brasil. Los datos se analizaron mediante análisis de contenido inductiva.

Resultados: No se observó un estándar en la búsqueda de información en el curso de la enfermedad, pero diferentes requisitos en cuanto al tipo de información según el avance del niño o adolescente en el plan de tratamiento. Las principales fuentes de información fueron: médicos, otros profesionales de salud que no enfermeras y Internet. El médico sigue siendo la referencia como fuente de información. La enfermera tiene papel muy modesto en relación con sus posibilidades de actuación como proveedora de información. Los padres pusieron de relieve la necesidad de una información clara e individualizada.

Conclusiones: Se espera de los profesionales implicados en la atención a esta clientela la disposición a proporcionar la información y la adopción de estrategias para simplificar la información proporcionada con el fin de preparar los padres para cuidar y para el proceso de toma de decisiones durante el tratamiento.

Informações aos pais durante o tratamento do câncer infantil: um estudo descritivo

Objetivo: Este estudo teve como objetivo explorar a perspectiva de pais de crianças com câncer na busca de informações em diferentes momentos do tratamento.

Método: Estudo descritivo, qualitativo. Realizaram-se entrevistas semiestruturadas com 22 pais em dois hospitais públicos de São Paulo, Brasil. Os dados foram analisados segundo os procedimentos da análise de conteúdo indutiva.

Resultados: Não foi observado um padrão na busca por informações na trajetória da doença, mas necessidades diferentes quanto ao tipo de informação, à medida que a criança ou adolescente avança dentro do plano terapêutico. As principais fontes de informação apontadas foram: os médicos, outros profissionais de saúde que não o enfermeiro e a internet. O médico ainda é a referência como fonte de informação. O enfermeiro apresentou um papel bem modesto em relação às suas possibilidades de atuação enquanto educador e provedor de informações. Pais e mães evidenciaram a necessidade de informações claras e individualizadas. 

Conclusões: Espera-se que os profissionais envolvidos no cuidado dessa clientela estejam dispostos a fornecer informações e adotar estratégias para simplificar as informações fornecidas, a fim de preparar os pais para o processo de tomada de decisão durante o tratamento.

Descritores: Neoplasias, criança, pais, competência em informação, enfermagem.

Contribution of Chinese and French ear acupuncture for the management of chronic back pain: A randomised controlled trial

Abstract

Aims and objectives

To compare the efficacy of Chinese and French ear acupuncture in people with chronic back pain.

Background

Chronic back pain is a common public health problem worldwide. An intervention for this condition is ear acupuncture. Several approaches are used for ear acupuncture, particularly the Chinese and French guidelines.

Methods

An open, randomised and controlled clinical trial, followed the recommendations of the CONSORT Checklist. One hundred and eleven people were selected and randomised into three groups: Chinese ear acupuncture, French ear acupuncture and Control. Evaluations were performed before the first intervention session (initial), 1 week after the fifth session (final) and after a fifteen‐day follow‐up period (follow‐up), using the Brief Pain Inventory, Rolland Morris Disability Questionnaire, and a thermal imaging camera. For data analysis, the Generalized Estimating Equation Model was applied, with significance level set at 5%.

Results

Pain severity was significantly decreased by Chinese ear acupuncture throughout intervention period. Both types of ear acupuncture affected pain interference with daily activities. However, in the comparison between initial and final evaluations, only Chinese ear acupuncture produced statistically significant results. A reduction in physical disability was observed in both ear acupuncture‐treated groups during the intervention period and, although Chinese ear acupuncture failed to induce significant changes in tissular temperature at individual time points, a significant increase in cutaneous temperature was detected after the follow‐up period in the dorsal region of individuals treated with Chinese ear acupuncture. Importantly, at this time point, the mean difference between Chinese and French ear acupuncture revealed a more benefic effect of Chinese procedure on this parameter.

Conclusions

The individualised treatment based on the Chinese precepts showed, in an overall evaluation, better results for management of chronic back pain in the present study.

Relevance to clinical practice

Ear acupuncture can be implemented in the nurse's clinical practice to assist the treatment of people with chronic back pain.

Familia conviviendo con una persona con estomía intestinal: un análisis documental

Objetivo: Describir la tendencia de la producción de la enfermería brasileña en las tesis y disertaciones sobre familias que conviven con personas con estomías intestinales.

Método: Investigación documental realizada en mayo de 2017 en el Catálogo de Tesis y Disertaciones de la Coordinación de Perfeccionamiento de Personal de Nivel Superior. La búsqueda de los documentos en línea fue realizada por el término "familia" y posteriormente por los respectivos sinónimos: "estomía OR ostomía OR estoma OR ostoma". El corpus consta de nueve documentos.

Resultados: De los documentos analizados, cinco eran disertaciones y cuatro eran tesis. El cuidado de enfermería en la perspectiva de las familias y de las personas con estomía intestinal, la influencia de la cultura en el sistema de convivencia familiar, la red social de apoyo de la familia, el contexto del familiar cuidador, la relación de la persona con estomía intestinal y la calidad de la vida de las personas con estómago intestinal y sus familiares fue el objetivo de una investigación cada una. Las tecnologías educativas como soporte para la educaciónde familias de personas con colostomía fueron contempladas en dos estudios.

Conclusión: Las lagunas encontradas en el conocimiento producido involucran el desarrollo de estudios que aborden el conocimiento científico y práctico de enfermería en el cuidado a la persona con estomía intestinal ya sus familiares.

Caracterización de la conciliación de medicamentos en urgencias

Objetivo: Explorar los aspectos principales de la conciliación de medicamentos en los servicios de urgencias. Metodología: Revisión panorámica de la literatura que sintetice los conocimientos existentes sobre la conciliación de medicamentos en los servicios de urgencias. Para ello se realizó una búsqueda sistemática de artículos originales publicados en revistas específicas de la ciencia enfermera y ciencias de la salud durante los últimos 10 años, e indexadas en bases de datos y otros recursos en español e inglés, como son: Cuiden Plus, Pubmed, IBECS, SCIELO y Google académico. En cada base de datos, se introdujeron una serie de palabras claves relacionadas con el tema y basadas en las nomenclaturas MeSH y DeCS.  Resultados: Se encontraron 5 artículos que identifican áreas claves en la conciliación de medicamentos en urgencias. En este sentido, las personas mayores de 65 años, polimedicadas y pluripatológicas son las más susceptibles de padecer un error en la medicación, sucediendo entre un 79,3 y un 95,8%. La omisión de la medicación es la discrepancia no justificada más frecuente (23,8 - 71,7%). A pesar del tipo de error y la frecuencia que se produce en un perfil de paciente vulnerable de antemano, en raras ocasiones les produce daño. Las barreras principales para una correcta conciliación se observan en la incorrecta anamnesis y registro en la historia clínica, así como la ausencia de un listado único de medicamentos. Los estudios realizados en urgencias se han centrado en el farmacéutico como profesional para detectar dichos errores. Conclusión: La caracterización de los errores en la conciliación de medicamentos facilita diseñar estrategias específicas que prevengan dichos errores o detectarlos precozmente con el fin de reducir los efectos adversos y la descompensación de patologías con consecuencias para la salud de la población y para el sistema sanitario.

Role of diffusional kurtosis imaging in grading of brain gliomas: a protocol for systematic review and meta-analysis

Por: Abdalla · G. · Sanverdi · E. · Machado · P. M. · Kwong · J. S. W. · Panovska-Griffiths · J. · Rojas-Garcia · A. · Yoneoka · D. · Yousry · T. · Bisdas · S.
Introduction

Central nervous system (CNS) gliomas are the most common primary intra-axial brain tumours and pose variable treatment response according to their grade, therefore, precise staging is mandatory. Histopathological analysis of surgical tumour samples is still deemed as the state-of-the-art staging technique for gliomas due to the moderate specificity of the available non-invasive imaging modalities. A recently evolved analysis of the tissue water diffusion properties, known as diffusional kurtosis imaging (DKI), is a dimensionless metric, which quantifies water molecules’ degree of non-Gaussian diffusion, hence reflects tissue microenvironment’s complexity by means of non-invasive diffusion-weighted MRI acquisitions. The objective of this systematic review and meta-analysis is to explore the performance of DKI in the presurgical grading of gliomas, both regarding the differentiation between high-grade and low-grade gliomas as well as the discrimination between gliomas and other intra-axial brain tumours.

Methods and analysis

We will search PubMed, Medline via Ovid, Embase and Scopus in July 2018 for research studies published between January 1990 and June 2018 with no language restrictions, which have reported on the performance of DKI in diagnosing CNS gliomas. Robust inclusion/exclusion criteria will be applied for selection of eligible articles. Two authors will separately perform quality assessment according to the quality assessment of diagnostic accuracy studies-2 tool. Data will be extracted in a predesigned spreadsheet. A meta-analysis will be held using a random-effects model if substantial statistical heterogeneity is expected. The heterogeneity of studies will be evaluated, and sensitivity analyses will be conducted according to individual study quality.

Ethics and dissemination

This work will be based on published studies; hence, it does not require institutional review board approval or ethics clearance. The results will be published in peer-reviewed journals.

PROSPERO registration number

CRD42018099192.

Protocol for a scoping review on nursing care and the autonomy of disabled persons

Por: Schoeller · S. D. · Lima · D. K. S. · Martins · M. M. · Ramos · F. R. S. · Zuchetto · M. A. · Bampi · L. N. d. S. · Roos · C. M. · Tholl · A. D. · Tonnera · L. C. J. · Machado · W. C. A. · Vargas · C. P.
Introduction

Considering the limitations that disabled persons experience, our understanding of caring for these people has evolved over time worldwide. Because nursing care is dependent on the choices made by patients, nurses can play an emancipatory role by empowering patients with disabilities to become the primary agent in their rehabilitation. Objective was to conduct a range analysis protocol proposing the mapping of conceptual elements for a nursing care model based on the autonomy of disabled persons.

Methods and analysis

A protocol was developed in corporating insights from recent innovations and applying the scope review method of Arksey and O’Malley as a reference using their scoping review methodology as a guide. For the construction of research guiding question, the patient, intervention, comparison and outcomes strategy was adapted. Considerable research in online databases (14) from 2000 to 2018 will be integrated by bibliographical research. Proceed a consult in the Annals of the Brazilian Congress of Nursing, Brazilian Nursing Association and Portuguese Rehabilitation Nursing Association, as well as professional Portuguese and Brazilian nursing legislation. The entire reference list of the covered studies searched manually to detect considerable additional studies. In addition to these searches, stakeholders, including nurse experts in the rehabilitation field and disabled persons, will be requested and included.

Ethics and dissemination

This study does not require ethical approval because it is a review and collection of data on publicly available materials. The results of this research will be published in a relevant journal on the subject of rehabilitation and presented at international scientific events in the area of rehabilitation nursing. Thus, the elaboration of this protocol further maps the gaps and strengthens the concepts capable of presenting strong evidence which assists and supports safer, smarter and more objective care for those living with permanent daily care obligations.

❌