Nursing care for parents who have experienced fetal demise: integrative review

OBJECTIVES

to identify scientific evidence regarding nursing care for parents who have experienced grief following fetal demise.

METHODS

an integrative review of original studies was conducted across six databases. The studies were classified according to the level of evidence.

RESULTS

the qualitative analysis of the nine studies comprising the sample involved thematic categories, exploring the impact of perinatal loss on families, inadequate communication by healthcare professionals, and the importance of a holistic approach in care. The role of the nurse is highlighted in making a positive contribution to the team, emphasizing participation in training and the provision of essential information.

FINAL CONSIDERATIONS

grieving affects not only family dynamics but also the social environment, emphasizing the urgency of a more empathetic and comprehensive approach. Care should be holistic, going beyond technical nursing assistance, and addressing the biopsychosocial context of the parents.

Care for older adults with disabilities in Long Term Care Facility

OBJECTIVE

to analyze the constitution of care offered to older adults with disabilities, from Long Term Care Facility professionals' perspective.

METHODS

this is a discourse analysis based on the post-structuralist framework. Participants in this study are professionals involved in the care for older adults, totaling 14 respondents, 13 women and one man.

RESULTS

from professionals' perspective, there is a fine line between caring for older adults with disabilities and maintaining their autonomy. Care in which autonomy is restricted predisposes older adults to a process of dependency.

FINAL CONSIDERATIONS

caring for older adults with disabilities constitutes the challenge between caring and maintaining independence. Thus, older adult-centered care should be taken as a premise so that their individualities are respected.

Systematization of perioperative nursing care in robotic surgery: instrument validation

OBJECTIVE

To develop and validate an instrument to assist in the systematization of perioperative nursing care in robotic surgery.

METHODS

Methodological study developed in four phases: content survey; textual elaboration; content validation by the group of expert judges and target audience; and elaboration of the electronic instrument layout.

RESULTS

Eleven expert judges and seven evaluators of the target audience participated. For validation, the Content Validity Index (CVI) was used with a 0.78 cutoff point. The instrument total CVI after evaluation was 0.90 by the expert judges and 0.88 by the target audience.

CONCLUSION

The tool built was proved satisfactory for the systematization of perioperative nursing care. The instrument construction was based on the updated scientific literature and validated by the expert judges and target audience.

Nursing microtheory in the prevention of delirium in older adult in the intensive care unit

OBJECTIVE

to describe a microtheory for nursing care in the prevention of delirium in older adult in the intensive care unit.

METHOD

prescriptive theoretical research, based on substruction. Roy's Adaptation Model constructs were deduced and data from the phenomenon of nursing care in the prevention of delirium in older adult in intensive care were induced, based on an integrative literature review.

RESULTS

the microtheory has a theoretical and operational system and a model of care. In the theoretical system, Roy's focal and contextual stimulus constructs were used. From them, the concepts of focal and contextual care and the variable adaptive response to prevention were elaborated. From the relational statements, four axioms, two postulates, eight propositions and an epistemic assumption were elaborated.

TWO EMPIRICAL INDICATORS WERE ESTABLISHED IN THE OPERATING SYSTEM

the Confusion Assessment Method for Intensive Care Units and the demographic/clinical history of the older adult. Subsequently, two transformational statements, four hypotheses and the model of care represented in figure were produced.

CONCLUSION

the microtheory produced prescribes care in the prevention of delirium in older adult in intensive care, through a construct of interest to nursing, and allows interceptions for the development of instruments that guide nursing activities.

The ethics of nursing care for transgender people

OBJECTIVES

to discuss ethical aspects in nursing care for transgender people.

METHODS

reflective study based on the dilemmas that emerges in nursing care for transgender people. The report was structured around the four bioethical principles.

RESULTS

health care for trans people is complex, transversal to many devices and specialties and longitudinal in time, that is why it requires coordinated action. There is an ethical framework in which the nursing care must be observed in the care of this group.

FINAL CONSIDERATIONS

the nurse as a health worker can assume several general lines in the care of transgender patients. So, complementary training should be provided not only to professionals, but also to students of nursing and other health sciences.

Implementing nursing diagnoses and care for the spiritual dimension of people with cancer: educational actions

OBJECTIVE

To establish the implementation of nursing diagnoses and care for the spiritual dimension of people with cancer.

METHOD

Action research in a university hospital in the north-east of Brazil. Nine nurses and thirteen nursing technicians from the Onco-hematology and Bone Marrow Transplant Unit of this hospital took part. Data collection took place in four phases and involved the talking map technique, pedagogical workshops and a logbook. The groups' speeches were coded using Maxqda software, subjected to Braun and Clarke's thematic analysis and interpreted in the light of Paulo Freire's constructs.

RESULTS

Phase 1 sought to apprehend the participants' prior knowledge on the subject; in phase 2, proposals emerged for spiritual care organized in the Nursing Process; in phase 3, the diagnoses and care plan for the spiritual dimension for clinical practice were contemplated; and in phase 4, through the final evaluation, it was possible to see the transformations that occurred in the nursing team's practice with the proposed implementation.

CONCLUSION

The educational actions provided significant learning for the nursing team and the implementation of diagnoses and nursing care for the spiritual dimension of people with cancer.

Mental health nursing care for people with diabetes mellitus: An integrative review

OBJECTIVE

evaluate the evidence available on mental health nursing care for people with diabetes mellitus at different levels of health care.

METHOD

integrative literature review. The search was conducted in five databases. The sample consisted of 14 studies. The studies were exported to the EndNote manager and their data to a Microsoft Excel spreadsheet. The methodological quality of the studies was evaluated using tools proposed by the Joanna Briggs Institute. Sampling, categorization, evaluation, interpretation of the results, and synthesis of the included studies were carried out by two reviewers independently. The descriptive analysis of the results is presented in three categories.

RESULTS

self-care guidelines enhanced by the social support network, encompassing physical and psychological tools and strategies; therapeutic communication and psychotherapy strategies, focusing on psychotherapy and therapeutic communication; and self-management interventions, addressing self-care based on behavioral theories.

CONCLUSION

the synthesis of knowledge revealed that guidelines for self-care enhanced by the social support network, psychotherapy and therapeutic communication strategies, and self-management interventions are positive interventions that contribute to people with mental disorders and diabetes mellitus in the prevention of diseases.

Continuity of care for patients recovering from Covid-19 under the angle of clinical management principles

OBJECTIVE

To analyze the strategies used by nurses at a university hospital to ensure continuity of care at hospital discharge for patients recovered from Covid-19, under the angle of the principles of clinical management.

METHOD

A descriptive study with a qualitative approach, carried out with seven nurses on duty in the medical and gynecology/obstetrics clinics of a university hospital in the Midwest region of the country. The data was processed using IRaMuTeQ software and analyzed using Content Analysis.

RESULTS

The data resulted in five classes by the Descending Hierarchical Classification (DHC), which made up two categories: "Practices developed by nurses for continuity of care in the hospital environment" and "Continuity of care during discharge to the home". The strategies used by the nurses were: daily care systematized in the nursing process and guidance both for preparation and for the day of discharge.

CONCLUSION

The absence of an institutional protocol for safe discharge, as well as the position of nurse coordinator to manage the discharge of patients with Covid-19, can compromise the continuity of care for these patients.

Transphobia as a social disease: discourses of vulnerabilities in trans men and transmasculine people

OBJECTIVE

to analyze the repercussions of transphobia on trans men's and transmasculine people's health.

METHOD

a qualitative study carried out with 38 participants, 35 trans men and three trans men, who attended specialized transgender health services in Bahia, Brazil. In-depth interviews were carried out between June 2019 and February 2020. The Discourse of Collective Subject technique was used and interpretation based on the theoretical concept of transphobia.

RESULTS

transphobia has intra and interpersonal repercussions on the life and health of trans men and transmasculine people who attend health services. There were experiences of violence in the private space, fraying of family ties; discrimination in the school space; limitation in professional/work opportunities; barriers to self-care and access to health services; elaboration of trans identity protection strategies; consequences of transphobia on psycho-emotional health.

CONCLUSION

transphobia is a social disease that affects different life and health dimensions. It causes damage to the socialization of trans men and transmasculine people, in addition to health service spaces as well as in family environments, schools, universities and at work, which result in non-adherence to self-care, distancing from health services and psycho-emotional distress.

Development of educational videos about bathing in bed newborns admitted to a neonatal unit

OBJECTIVE

to develop and analyze evidence of content validity of educational videos about bathing newborns in bed in a neonatal unit.

METHOD

applied and methodological research, carried out from December/2020 to February/2022, in three phases: pre-production, production, post-production. Validity was carried out by nurses specializing in social communication and nursing professionals, including the Brazilian Sign Language and assessment by nursing students. The Content Validity Index and Cronbach's alpha above 0.8 were considered for analysis.

RESULTS

the videos were entitled "Best practices: bathing newborns in the heated crib" and "Best practices: bathing newborns in the incubator", lasting seven minutes each, divided into six scenes that demonstrated the approach to parents, environment and material organization, preparing newborns, bathing and after-bath care.

CONCLUSION

the videos will support permanent education processes, academic training and professional training in nursing.

Topical interventions for preventing hand-foot syndrome resulting from antineoplastic therapy: A scoping review

OBJECTIVE

To map topical interventions used to prevent hand-foot syndrome in cancer patients undergoing antineoplastic therapy.

METHOD

This is a scoping review reported in accordance with the recommendations of PRISMA-ScR (extension for scoping review) and the Joanna Briggs Institute Manual. The searches were carried out in the electronic databases CINAHL, Cochrane CENTRAL, EMBASE, LILACS, LIVIVO, PubMed, Scopus, Web of Science; and gray literature (Google Scholar, Pro-Quest).

RESULTS

The searches resulted in 12,016 references and the final sample consisted of 45 studies. A total of 42 topical interventions were identified, including: moisturizing creams, corticosteroids, acids, mapisal, silymarin, and henna. However, urea was the most cited intervention (62%). As for the presentations of the interventions, they varied among creams, ointments, gels, hydrocolloids, decoctions, patches, powders, oils, and soaps.

CONCLUSION

The results allowed reviewing topical interventions, with emphasis on the use of urea and moisturizing creams. However, most of the interventions identified in this review require evaluation in future studies for better understanding of their benefits.

Self-care guidelines for patients in the post-hematopoietic stem cell transplantation period: a scoping review

OBJECTIVE

To map the evidence on self-care guidelines for patients in the post-hematopoietic stem cell transplantation (HSCT) period.

METHOD

Scoping review supported by Joanna Briggs Institute recommendations, with searches conducted between March and April 2022 in national and international databases and repositories of theses and dissertations.

RESULTS

Of the 11 studies that composed the final sample, the guidelines had a social and personal aspect, as post-transplant patients need to follow numerous essential recommendations for the prevention of infections and complications for successful treatment and improved quality of life.

CONCLUSION

Knowing the self-care guidelines that must be performed by post-HSCT patients is fundamental for the nursing team to provide the necessary information for care outside the controlled environment of the hospital, in addition to minimizing episodes of infection, death, and increasing the survival and quality of life of transplant recipients.

Compliance with central venous catheter infection prevention practices after intervention with simulation

OBJECTIVES

to assess the effect of an educational intervention based on clinical simulation on nursing professionals' compliance with practices to prevent peripherally inserted central venous catheter-associated primary bloodstream infections in a Neonatal Intensive Care Unit.

METHODS

a quasi-experimental study, with preand post-intervention assessment with a single group. The population consisted of 41 nursing professionals, with 31 observations being made before and after the intervention. Analyzes were performed using descriptive statistics and the McNemar non-parametric test. A significance level of 5% was adopted.

RESULTS

after the intervention, there was an increase in compliance with prevention practices of surgical antisepsis and professional hand hygiene, skin antisepsis with chlorhexidine, waiting for the time of the effect of alcoholic chlorhexidine and compliance with the sterile technique.

CONCLUSIONS

the educational intervention showed an effect on increasing compliance with catheter-associated infection prevention practices.

Nursing theories in the care of stroke patients: a scoping review

OBJECTIVES

to map and synthesize nursing theories and conceptual frameworks that have been applied in the practice of nursing care for stroke patients in hospital settings.

METHODS

a scoping review was conducted in October 2022 using the MEDLINE (accessed via PubMed), CINAHL, Scielo, and Web of Science databases, following The Joanna Briggs Institute guidelines.

RESULTS

nine studies incorporated six nursing theories and three conceptual frameworks, which were employed to enhance stroke patient care. The objective of these theories and conceptual frameworks was to facilitate the identification of the patient's psychobiological, psychosocial, and psychospiritual needs, elucidate the nurse's role and expand their perspective on rehabilitation, and acknowledge the survivor's process of transition.

FINAL CONSIDERATIONS

this mapping exercise identified major nursing theories, middle-range theories, and conceptual frameworks applied to the care of stroke patients.

Nursing, history, and orthopedics in manuals (1875-1928)

OBJECTIVES

to discuss the content of manuals, with emphasis on orthopedics, in support of the development of nursing care culture.

METHODS

cultural-historical method articulated with document analysis technique. The sources were nursing manuals - Portuguese, French, English, and Spanish - from 1875 to 1928.

RESULTS

this study pointed to 12 works - 6 authored by physicians, 2 by nurses, 3 institutional, and 1 by a Sister of Charity - that presented, in a transversal way, the professionalization process initiated in Europe. The manuals addressed first aid care and immobilization methods, from the simplest, such as improvised splints, to the application of plaster casts.

CONCLUSIONS

the nurses' work, even in a limited capacity, showed that they were able to observe warning signs so that doctors could act, with some exceptions.

Construction of an intercultural care program for international migrants in northwestern Mexico

OBJECTIVE

To describe the construction process of an intercultural care program for international migrants in northwestern Mexico.

METHOD

Report of professional experiences, according to what was suggested by Daltro and Faria.

RESULTS

The development and evolution of care for international migrants has favored the elaboration of a community-like Social Service Program for students of a public university in northwestern Mexico, so that intercultural health and health care for this population become part of the curricular training of the new generations of nursing graduates, in a context in which international migration is a topic of great social and cultural relevance.

CONCLUSION

The construction and application of the Salud-Migrante program will enhance compliance with international recommendations on universal health for migrants, promoting respect for identity and cultural diversity in their actions.

Factors associated with the time to treat breast cancer in the pandemic period: an observational study

OBJECTIVES

to analyze the factors associated with the time to surgical treatment for breast cancer in patients seen at a reference mastology outpatient clinic in the State of Ceará.

METHODS

analytical, longitudinal study with medical charts from the Mastology Outpatient Clinic of Assis Chateaubriand Maternity School. We used 140 medical charts of breast cancer patients with surgeries performed during the pandemic.

RESULTS

the study evidenced associations between schooling and shorter time to treatment in patients who underwent biopsy before the first outpatient visit (p = 0.026; OR: 0.16; CI = 0.03-0.85); in the group who had the biopsy performed by the outpatient clinic, was associated the type of tumor (p = 0.019) and neoadjuvant therapy (p = 0.000).

CONCLUSIONS

the lesser educational level, tumor type, and use of neoadjuvant therapy were factors associated with the time to treatment during the pandemic period.

Sociodemographic profile, diagnoses and nursing care in post-COVID-19 patients in a Brazilian university hospital

OBJECTIVES

to analyze the sociodemographic profile, diagnoses and nursing care of post-COVID-19 patients admitted to a university hospital in southern Brazil.

METHODS

a retrospective cohort study. The sample consisted of 1,467 medical records, from January 2020 to January 2021.

RESULTS

from the analyzed medical records, the most prevalent profiles, respectively, included: males (52.9%); white (81.1%); with Impaired Physiological Balance Syndrome* Nursing Diagnosis (77.3%); nursing care implementing aerosol precautions (94.5%); implementing droplet precautions (93.4%); checking vital signs (91.9%); applying standard disinfectant to equipment and surfaces (89.6%).

CONCLUSIONS

the analysis of the sociodemographic profile, diagnoses and nursing care of patients in this study may contribute to implementing the Nursing Process in the coronavirus pandemic context.

Integrative and complementary practices in health, nurses' profile and care provided to people with hypertension: a mixed study design

to analyze the profile of nurses regarding integrative and complementary practices in health (ICPH) and understand how they are used in the care of people with arterial hypertension. mixed-methods sequential explanatory design. The cross-sectional quantitative stage included 386 nurses who completed an online questionnaire addressing sociodemographic and professional information, training, and practice, with a descriptive and inferential analysis. The qualitative stage was performed via 18 online interviews with professionals who had ICPH training and implemented it in the care provided to individuals with hypertension, with a participatory analysis. Integration occurred through a connecting approach. 36.8% had ICPH training; most were women, Caucasian, married, public servants, aged 37 (+ 9.4) on average; 14.2% incorporated ICPH into the care provided to people with hypertension; predominantly auriculotherapy (28.2%) and bloodletting in hypertensive crises. The results show that nurses integrally approached patients, and their approach was not limited to the vital sign altered at the time, but they also intervened in anxiety, stress, sleep, and rest. A potentiality observed concerns support treatment adherence. the profile of nurses with ICPH training is presented, and such practice has implications for lowering blood pressure. ICPH has been incorporated into the care of people with hypertension, but its use is still incipient, considering its potential in nursing care.

Factors that influence health literacy in patients with coronary artery disease

OBJECTIVE

to investigate the factors that exert an influence on health literacy in patients with coronary artery disease.

METHODS

a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee.

RESULTS

age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy.

CONCLUSION

this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.

Nurses' Work Methods Assessment Scale: a study of content validation

OBJECTIVE

To develop and validate the content of the Nurses' Work Methods Assessment Scale.

METHODS

Methodological study conducted between January and February 2022, based on the Quality Standards for Nursing Care and Imogene King's framework. A literature review was previously undertaken to design the scale. The content validation was carried out by 23 experts.

RESULTS

The initial version consisted of 40 items organized in four work methods identified in the literature. In the first dimension, from ten items, seven were considered, and one was reformulated. Seven of the initial ten items were considered in the second version. The third dimension consisted of seven items. In the fourth dimension, three items were reformulated, and three were excluded, leaving seven items. The final version ended with 28 items, whose Content Validity Index ranged between 0.83 and 1.

CONCLUSIONS

The involvement of experts has become pivotal in the development and validation of the items, providing confidence to the continuity of psychometric procedures.

Nursing care management concepts: scoping review

OBJECTIVES

to clarify the concepts of Nursing Care Management and Nursing Care Administration in the scientific literature, highlighting approximations and distances between the terms.

METHODS

scoping review as per Joanna Briggs Institute protocol and preferred reporting items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR). The searches were performed in LILACS, CINAHL, MEDLINE, and Scopus databases.

RESULTS

the qualitative analysis, through content analysis, counted 49 studies published between 2007 and 2020. Hospital care was the most evident level of care. It was identified that nursing care management aims at the macropolitical performance of nurses and mobilizes skills essentially strategic-cognitive, while Nursing Care Administration aims at the micropolitical performance of nurses, requiring essentially strategic-administrative skills.

FINAL CONSIDERATIONS

the study allowed us to propose the conceptualization of the terms and identify the approximations and distances between them.

Features of the triggering of the yellow code and factors associated with the occurrence of adverse events

Objective:

to analyze the characteristics of the activation of the yellow code in wards and identify the factors associated with adverse events after the Rapid Response Team.

Methods:

a cross-sectional study with retrospective analysis of medical records of adults admitted to medical or surgical clinic wards of the University Hospital of São Paulo.

Results:

among the 91 patients, the most frequent signs of triggers (n=107) were peripheral oxygen saturation of less than 90% (40.2%) and hypotension (30.8%). Regarding the associated factors the research identified each minute of attendance of the Rapid Response Team in the wards increased by 1.2% odds of adverse events (twenty-four unplanned admission in the ICU and one cardiac arrest) in the sample (p=0.014).

Conclusions:

decreased oxygen saturation and hypotension were the main reasons for the triggering, and the length of care was associated with the frequency of adverse events.

Practical Approach to Care Kit: Innovation for nurses' clinical practice in HIV management

OBJECTIVE

to analyze the use of the Practical Approach to Care Kit as a technology adopted in nurses' clinical practice for HIV management in Primary Health Care.

METHOD

an exploratory and descriptive research study anchored in the methodological framework of the Constructivist Grounded Theory. The participants were defined through initial sampling, with 12 nurses, and theoretical sampling, with five managers, totaling 17 participants. The data were collected by means of intensive interviews and documentary analysis, and they were analyzed in two stages: 1) Initial coding; and 2) Focused coding.

RESULTS

the professionals identified the Practical Approach to Care Kit as a technological innovation that contributed to expanding the clinical practice and to empowering nurses in the clinical management of HIV infection. They also highlighted its importance as a tool for guiding the different responsibilities and duties while sharing care, contributing to the provision of evidence-based practices.

CONCLUSION

The Practical Approach to Care Kit is a technological innovation that has transformed nurses' clinical practice in HIV management, expanding their scope of activities in carrying out the diagnosis, assessing the health condition and counseling, evaluating adherence to the treatment, adverse effects and prescription of exams, medications, and immunobiological.

The Use of the Borg Rating of Perceived Exertion Scale in Cardiopulmonary Resuscitation

BACKGROUND

A cardiopulmonary arrest is a critical event whose survival rate is related to the quality of resuscitation maneuvers combined with the use of technology. It is important to understand the perception of fatigue during this procedure, aiming to improve the effectiveness of compressions to increase the chances of survival.

OBJECTIVES

To apply the Borg rating of perceived exertion scale (Borg scale) to analyze the exertion perceived by nurses during cardiopulmonary resuscitation maneuvers using a feedback device.

METHODS

Experimental study with a randomized distribution of nurses in a teaching hospital. Perceived exertion during simulated cardiopulmonary resuscitation with/without a feedback device was assessed using the Borg scale. The statistical significance level of 5% was adopted.

RESULTS

69 nurses working in critical and non-critical adult care units were included. Perceived exertion and heart rate were lower in the intervention group (p<0.001), influenced by the feedback device, with no significant difference between critical and non-critical units.

CONCLUSIONS

The Borg scale proved to be adequate for the proposed objectives. The feedback device contributed to lower exertion and heart rate reduction during resuscitation maneuvers. The low cost and ease of application favor its use during training and real-time resuscitation attempts to assess performance using a feedback device to reduce exertion and perception of fatigue. It allows reflection on the intervening factors and resources that can influence the quality of resuscitation attempts and the chances of survival.

Cardiac anxiety in the perioperative period of patients undergoing cardiac surgical procedures: an observational study

OBJECTIVE

to compare cardiac anxiety symptoms in patients undergoing coronary artery bypass graft and valve surgery repair in the preoperative period, on the day of hospital discharge and on the first return visit after hospital discharge.

METHODS

an observational study, carried out in inpatient units and in outpatient clinic of a university hospital. Data were collected through interviews. Cardiac anxiety symptoms were assessed using the Cardiac Anxiety Questionnaire.

RESULTS

we observed the effect of time on cardiac anxiety symptoms of patients undergoing coronary artery bypass graft in the total score and in the "Avoidance" domain at discharge and at the first return visit. In patients undergoing valve repair surgery, the effect of time on symptoms was observed only in the first return visit, when compared with the preoperative period.

CONCLUSION

the findings revealed increased cardiac anxiety symptoms in the postoperative period, discharge and first return, when compared to the preoperative period.

Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study

OBJECTIVE

to investigate the effect of using different agents (topical hyaluronidase, photobiomodulation, and the association of photobiomodulation with topical hyaluronidase) in preventing the formation of lesions caused by doxorubicin extravasation, as well as in the reduction of lesions formed by extravasation of this drug.

METHOD

a quasi-experimental study conducted with 60 Wistar rats, randomized into four groups with 15 animals each. Group 1 (Control); Group 2 (Hyaluronidase); Group 3 (Photobiomodulation); and Group 4 (Hyaluronidase + Photobiomodulation). A wound was induced by applying 1 mg of doxorubicin to the subcutaneous tissue of the back of the animals. The concentration of topical hyaluronidase was 65 turbidity units/g and the energy employed was 1 joule of 100 mW red laser per square centimeter. With macroscopic evaluation every two days for 28 days, the following variables were observed: skin integrity, presence of blisters, hyperemia, exudate, bleeding, edema, crust, peeling and granulation tissue.

RESULTS

the animals from the groups subjected to photobiomodulation obtained better results in the assessment of the following variables: bleeding, hyperemia, exudate, intact skin and edema.

CONCLUSION

it was evidenced that the association of photobiomodulation with topical hyaluronidase was effective in reducing the local effects and assisted in the wound healing process, and that PBM alone was able to prevent appearance of lesions.

Nursing Care during the Perioperative within the Surgical Context

The study describes basic nursing care during the perioperative. Introduces the origins of perioperative nursing, general care that must be practiced with patient in this context. During the preoperative, care related with risk assessment and preparation of patient from the emotional and physical point of view are important. The trans-operative is related with the anesthesia used, surgical position, preparation of the skin, maintenance of normothermia, among many others. The postoperative depends on the type of anesthesia and surgical procedure, emphasizing on airway permeability, hemodynamic stability, pain, and symptomatology being presented by patients until they are stable and suitable for transfer to another service or their home.

Evolution of self-care in patients with heart failure at the first outpatient return and three months after hospital discharge

OBJECTIVE

to analyze the evolution of self-care in hospitalized patients with decompensated heart failure, between the first return after hospital discharge (T0) and three months after this assessment (T1).

METHOD

an observational, analytical and longitudinal study carried out in the cardiology outpatient clinics of two public hospitals in Ribeirão Preto, São Paulo. The sociodemographic and clinical data were collected through interviews and consultation of medical records. Self-care was assessed using the Brazilian version of the Self-Care of Heart Failure Index-SCHFI instrument. The data were analyzed by means of the Student's t test and paired distribution (McNemar) with a significance level of 0.05.

RESULTS

we verified an increase in the mean scores of the three subscales of SCHFI (Maintenance, Management and Confidence), when comparing the values of T0 and T1, these differences being statistically significant (p<0.001). When comparing the positive changes in self-care actions over these months, we found statistically significant changes in the Maintenance (6 out of 10 items), Management (5 out of 6 items) and Confidence (4 out of 6 items) subscales.

CONCLUSION

self-care for heart failure improved in the period between the first return after discharge and the end of three months of follow-up. Further studies are needed to verify the variables associated with improved self-care after hospitalization.

Nursing and society: Evolution of Nursing and of capitalism in the 200 years of Florence Nightingale

OBJECTIVE

to analyze the relationships between the development of the Nursing labor and of capitalism over the 200 years of Florence Nightingale.

METHOD

a logical-reflective and theoretical exposition based on interpretations of historical facts and Marxist theories. The analysis categories were the following: the creation and expansion of the Nightingalean Nursing Teaching System; the subsumption of the Nursing labor to capital; imperialism and international health; and the flexibilization of the Nursing labor.

RESULTS

the expansion of the Nightingale Teaching System has trained nurses on a global scale. The capitalist system transformed the Nursing labor in the twentieth century, culminating in the twenty-first century with precarious and intense turnover of nurses in their jobs.

CONCLUSION

the Nursing labor, made professional by Nightingale, has assumed in the last 200 years a dialectical relationship with capitalism in which it both determines and is determined by it. New challenges, such as the Industry 4.0 technologies, are constantly imposed on the profession.

Breastfeeding in the first six months of life for babies seen by Lactation Consulting

OBJECTIVE

to identify breastfeeding patterns, survival of exclusive breastfeeding and factors associated with its interruption, in the first six months of life of babies seen by Lactation Consulting.

METHOD

a prospective cohort, with 231 mother-babies in a Baby-Friendly Hospital. An initial questionnaire was applied after 24 hours of birth, after consulting, as well as a follow-up questionnaire, applied by telephone at 15, 30, 60, 120 and 180 days, with sociodemographic and obstetric variables, maternal habits, father's schooling, birth data and baby feeding. Survival Analysis was carried out.

RESULTS

at 180 days of age, exclusive breastfeeding was 12.7% and the probability was 19.6% in the analysis of the survival curve. The factors associated with its interruption were smoking during pregnancy (HR 1.66; CI 1.05 - 2.61), age ≥ 35 years old (HR 1.73; CI 1.03 - 2.90), difficulty in breastfeeding after hospital discharge (HR 2.09; CI 1.29 - 3.41), search for professional assistance (HR 2.45; CI 1.69 - 3.54) and use of a pacifier (HR 1.76; IC 1.21 - 2.58).

CONCLUSION

lactation consultancy contributed to the improvement of the exclusive breastfeeding rates, although there are opportunities for advances.

Validation of an educational manual for breast cancer patients undergoing radiotherapy

OBJECTIVE

to validate the content and appearance of an educational manual for breast cancer patients undergoing radiation therapy.

METHOD

methodological research, which had the Theory of Psychometry as a theoretical-methodological reference. The minimum 80% Concordance Index was considered to ensure the adequacy of the material. The sample consisted of 17 experts in the subject area of the educational manual and 12 patients previously submitted to radiotherapy due to the diagnosis of breast cancer.

RESULTS

two items of the expert evaluation tool were found to have a concordance index <80%. The other items were considered adequate and/or totally adequate in the three blocks of analysis proposed for the experts: objectives - 89.07%, structure and presentation - 92.94%, and relevance - 93.13%; and good and/or very good in the five blocks of analysis proposed for the patients: objectives, organization, writing style, appearance, and motivation, all with 100% agreement rate.

CONCLUSION

the educational manual, after having been perfected based on the suggestions of the sample and the scientific literature, was considered valid according to its content and appearance, suggesting its contribution to the clinical practice of nursing and to the understanding of the treatment to which patients with breast cancer are submitted.

Care technologies to prevent and control hemorrhage in the third stage of labor: a systematic review

OBJECTIVE

to identify evidence concerning the contribution of health technologies used to prevent and control hemorrhaging in the third stage of labor.

METHOD

systematic review with database searches. First, two researchers independently selected the papers and, at a second point in time, held a reconciliation meeting. The Kappa coefficient was used to assess agreement, while the Grading of Recommendations, Assessment, Development and Evaluation was adopted to assess risk of bias and classify level of evidence.

RESULTS

in this review, 42 papers were included, 34 of which addressed product technologies, most referred to pharmacological products, while two papers addressed the use of blood transparent plastic bags collector and the contribution of birth spacing and prenatal care. The eight papers addressing process technologies included the active management of the third stage of labor, controlled cord traction, uterine massage, and educational interventions.

CONCLUSION

product and process technologies presented high and moderate evidence confirmed in 61.90% of the papers. The levels of evidence confirm the contribution of technologies to prevent and control hemorrhaging. Clinical nurses should provide scientific-based care and develop protocols addressing nursing care actions.