Clinical and sociodemographic factors associated with time spent sitting in military police

OBJECTIVE

To verify the association between clinical and sociodemographic factors and time spent sitting in military police.

METHOD

This is a cross-sectional study, with 432 military police officers from Eastern Regional Policing Command units of the Military Police of Bahia de Feira de Santana. Data collection took place from August to December 2022 through Google Forms using the International Physical Activity Questionnaire.

RESULTS

Men predominated (82.35%), race/color was black (87.04%), the head of the family had completed higher education (47.69%) and police officers with a partner (81.94%). The risk of time spent sitting ≥ 180 minutes per day was lower in males (IRR < 1). Increasing age was associated with a lower risk of time spent sitting ≥ 180 minutes per day (IRR < 1).

CONCLUSION

Male police officers with more years of experience were less exposed to sedentary behavior. Specific interventions and health policies aimed at combating sedentary behavior become relevant, aiming to promote health and prevent diseases.

Telemonitoring of the Continuum of Care of Hepatitis C During the COVID-19 Pandemic in Brazil

Introduction: To accomplish elimination of hepatitis C virus (HCV) by 2030, as proposed by the World Health Organization, the Brazilian Ministry of Health outlined the Hepatitis C Elimination Plan, which provides coverage of all critical steps in the continuum of care (CoC) of hepatitis C. As expected, the advent of COVID-19 pandemic has disrupted the CoC of hepatitis C worldwide. The Brazilian Liver Institute launched a remote patient monitoring (RPM) program to assist the general population at risk in HCV testing and to provide linkage and retention to care for HCV-positive subjects. The RPM program was also designed to relink HCV-positive patients lost to follow-up during the COVID-19 pandemic due to their limited access to the health care system. Methods: The HCV telemonitoring number was highly advertised in Brazilian media. The RPM program was conducted by dedicated health care personnel trained to follow a predefined script designed to provide awareness, ensure consistent information for educational purposes, and recruit eligible participants to be tested for HCV. Results: From August 2020 to December 2021, 3,738 subjects entered in contact with RPM. There were 26,884 interactions (mean 7.2 interactions per participant), mostly by WhatsApp (78%). Twenty out of those 221 subjects (9%) who tested were HCV positive. Those subjects altogether with 128 other patients with HCV, tested elsewhere, were followed in the HCV CoC. Up to now, 94% of them were linked to care, 24% are undergoing treatment and 8% achieved sustained virological response (SVR). Conclusions: Our preliminary results showed that HCV CoC telemonitoring was a feasible and useful strategy to follow HCV at-risk subjects through all cascade of care until SVR during the COVID-19 health care disruption. It could be used beyond the defervescence of SARS-CoV-2 pandemic to ensure linkage to care of those HCV-positive patients.

Perceived stress by mototaxi drivers and its relationship with sociodemographic and occupational characteristics

OBJECTIVE

To investigate the association of sociodemographic and occupational characteristics with a high level of perceived stress in motorcycle taxi drivers.

METHOD

Cross-sectional study carried out with motorcycle taxi drivers who answered instruments on sociodemographic and occupational variables - Perceived Stress Scale, Job Content Questionnaire and Effort-Reward Imbalance. Descriptive statistics, Pearson's chi-square test and Poisson regression with robust variance were used. Statistical significance was 5%.

RESULTS

Of the 800 motorcycle taxi drivers, 46.8% had a high level of perceived stress. In the multivariate analysis, a high level of stress was associated with low control over work (PR=7.76; 95%CI=5.19-11.61), low social support at work (PR=3.87; 95%CI =2.95 5.08), working hours longer than eight hours a day (RP=1.47; 95%CI=1.21-1.78) and monthly income less than or equal to two minimum wages (PR=1.34;95%CI=1.13-2.58).

CONCLUSION

Long working hours, occupational stressors and low income were associated with a high level of perceived stress. Public policies and interventions to minimize occupational stressors are essential.

Factors associated with decision time to seek care in the face of ischemic stroke

OBJECTIVE

To verify the association between sociodemographic, clinical, environmental, cognitive, and emotional factors and the decision time of people with ischemic stroke to seek a health service after the onset of symptoms or wake up stroke.

METHOD

Cross-sectional study carried out from March to October 2019, with 304 patients, in a public hospital, a reference in neurology. Data obtained through interview and from medical records. Decision time was analyzed as a geometric mean. In the bivariate and multivariate analyses, linear regression was used and the Akaike Information Criterion was used to select the best model. Statistical significance of 5% was adopted.

RESULTS

The geometric mean of decision time was 0.30h (95% CI 0.23-0.39). The final model explained this time in 41%, showing an increase of 0.5 min for people with arterial hypertension; 10.8 min for those who waited for symptoms to improve; 1.4 min for those who were alone at the onset of symptoms; 3.9 min for those at home; 3.2 min for the ones at work; and 2.1 for those on the street/public space.

CONCLUSION

The mean decision time for seeking a health service was high and influenced by clinical, environmental, cognitive, and emotional variables. The results guide nurses regarding health education.

Sociodemographic and academic factors associated with unhealthy lifestyle among Brazilian nursing students

This study aimed to identify sociodemographic and academic factors associated with unhealthy lifestyles among Brazilian undergraduate nursing students. A cross-sectional study was completed by 286 nursing students in Brazil. Multinomial logistic regression was conducted to examine the association between sociodemographic and academic variables with the latent lifestyle indicator. The model fit's validity was assessed using Akaike information coefficient estimation, Hosmer-Lemeshow test, and the ROC curve. A high health risk lifestyle was 2.7 times more likely among students aged 18-24 years than students aged 25 years or older (OR = 2.7, 95% CI = [1.18, 6.54] p = 0.02); 2.3 times more likely among students with ≥400 h of semester time (OR = 2.3, 95% CI = [0.93, 5.90], p = 0.07); and 3.8 times more likely among female students (OR = 3.8, 95% CI = [0.82, 8.12], p = 0.09). A moderate health risk lifestyle was 1.8 times more likely among students from the 6th to 10th semesters (OR = 1.8, 95% CI = [-0.95, 3.75], p = 0.07). Sociodemographic and academic factors were associated with unhealthy lifestyles. Health promotion efforts are necessary to improve nursing students' health behaviors.

Ischemic stroke mortality and time for hospital arrival: analysis of the first 90 days

OBJECTIVE

To analyze the association between time of arrival at a reference hospital and mortality of people with ischemic stroke.

METHOD

Descriptive and inferential statistics were used. Modifying and confounding variables between time of arrival and mortality were observed in the multivariate analysis. The Akaike Information Criterion was used to choose the model. Statistical significance of 5% and risk correction using the Poisson Model were adopted.

RESULTS

Most participants arrived within 4.5 hours of symptom onset or wake up stroke to the referral hospital and 19.4% died. The score of the National Institute of Health Stroke Scale was a modifier. In the multivariate model stratified by scale score ≥14, arrival time >4.5h was associated with lower mortality; and age ≥60 years and having Atrial Fibrillation, to higher mortality. In the model stratified by score ≤13, previous Rankin ≥3, and presence of atrial fibrillation were predictors of mortality.

CONCLUSION

The relationship between time of arrival and mortality up to 90 days was modified by the National Institute of Health Stroke Scale. Prior Rankin ≥3, atrial fibrillation, time to arrival ≤4.5h, and age ≥60 years contributed to higher mortality.

Arrival time at a referral hospital and functional disability of people with stroke: a cohort study

BACKGROUND

Stroke is a major cause of death and functional disability worldwide. Knowledge of the associated factors is essential for defining education, management, and healthcare strategies.

OBJECTIVE

To analyze the association between arrival time at a neurology referral hospital (ATRH) and functional disability in patients with ischemic stroke 90 days after the event.

DESIGN AND SETTING

Prospective cohort study conducted at a public institution of higher education in Brazil.

METHODS

This study included 241 people aged ≥ 18 years who presented ischemic stroke. The exclusion criteria were death, inability to communicate without companions who could answer the research questions, and > 10 days since ictus. Disability was assessed using the Rankin score (mR). Variables for which associations showed a P value ≤ 0.20 in bivariate analysis were tested as modifiers between ATRH and disability. Significant interaction terms were used for multivariate analysis. Multivariate logistic regression analysis was performed with all variables, arriving at the complete model and adjusted beta measures. The confounding variables were included in the robust logistic regression model, and Akaike's Information Criterion was adopted to choose the final model. The Poisson model assumes a statistical significance of 5% and risk correction.

RESULTS

Most participants (56.0%) arrived at the hospital within 4.5 hours of symptom onset, and 51.7% presented with mRs of 3 to 5 after 90 days of ictus. In the multivariate model, ATRH ≥ 4.5 hours and females were associated with more significant disability.

CONCLUSIONS

Arrival at the referral hospital 4.5 hours after the onset of symptoms or wake-up stroke was an independent predictor of a high degree of functional disability.

Nursing interventions for people in palliative care, based on the Dignity Model

BACKGROUND

The use of the standardised nursing language aims to accurately represent clinical practice, contributing to proper documentation and the creation of evidence-based practice.

AIMS

To validate nursing interventions (NI) for patients in palliative care, structuring these using the Dignity-Conserving Care Model.

METHODS

A methodological study was conducted, developed according to the recommendations of the International Council of Nurses (ICN) and anchored in the Dignity-Conserving Care Model. The NI were developed in four stages: 1) construction of NI, based in the International Standards Organisation's standard (18.104:2014); 2) content validation by 26 expert nurses; 3) cross-mapping with the NIs contained in the International Classification for Nursing Practice (ICNP^®) catalogue, Palliative Care for Dignified Dying, to identify those already existing in the catalogue; and 4) structuring the NI based on the concepts of the Dignity-Conserving Care Model.

FINDINGS

209 NI were validated and grouped into categories, namely: illness-related concerns; dignity-conservation repertoire; social dignity inventory. Of these, 183 were new and 26 already existed in the ICNP^® Catalogue.

CONCLUSION

The study presents new insights into palliative care in Brazil and presents 183 new NI in addition to those already published by the ICN.

What are the characteristics that influence the sitting time in university students?

Abstract The objective was to estimate the relationship between sociodemographic characteristics, link with the university, behavioral, biological, and self-rated related to health, with time sitting in university students at federal institutions in the state of Bahia, Brazil. This cross-sectional study was carried out with university students from six institutions (Federal University “Recôncavo da Bahia”, Federal University of “Bahia”, Federal University of “Oeste da Bahia”, University of International Integration of Afro-Brazilian Lusophony, Federal University of “Vale do São Francisco” and Federal University of “Sul da Bahia”) in the state from Bahia in 2019. Time sitting in hours per day was investigated and relation sociodemographic, link with the university, behavioral, biological, self-rated of stress and health variables. Path analysis was used to apply multivariate linear regression. The significance status was 5%. A total of 1,217 university students participated of the study. The final model accounts for 6% of sitting time. Self-rated health as positive (β: -0.117; p: <0.001), increasing age (β: -0.115; p: <0.001) and physical activity practice (β: -0.113; p: <0.001) contributed to the decrease in sitting time. The increase in the amount of inadequate eating habits (β: 0.063; p: 0.032) favored the increase in sitting time. The adjustment indices were satisfactory. Concluded that self-rated health as positive, advancing age and physical activities practice were determinants of reduced sitting time, on the other hand, irregular eating behaviors favored sedentary behavior.

Clinical characterization, disability, and mortality in people with strokes during 90 days

OBJECTIVES

to describe clinical characteristics and mortality of people with ischemic cerebrovascular accidents (strokes); to compare disability before the event and 90 days after.

METHODS

longitudinal study with 308 people hospitalized in Salvador-BA. Data collection took place from 03/2019 to 01/2020. Descriptive and inferential statistics were used.

RESULTS

mean age was 64.8 years, and National Institute of Health Stroke Scale score was 10.7. The median length of stay in the hospital was 11 days. Afro-descendants predominated (84%), elementary educational level (68.4%), income up to three minimum wages (89.1%), arrival within 4.5 hours of symptoms (57.9%) and admission to a specialized unit (71.8%). Prevalence of thrombolysis: 26%. The asymptomatic before the event category predominated (85.3%) as did the moderate/severe disability (41.5%) after 90 days. 19.7% of the sample evolved to death. Conclusions: the high mortality and disability generated by the event have implications for health management and care.

Decision making by health professionals during COVID-19: an integrative review

OBJECTIVE

To analyze the scientific production on the decision making of health workers during the COVID-19 pandemic.

METHODS

Integrative review in the databases CINAHL, MEDLINE, Scopus, ScienceDirect, WoS, and BVS. Inclusion criteria: original articles available in full, in any language, related to the object investigated.

RESULTS

During this pandemic, health workers have been making decisions based on ethical/bioethical principles (utility, beneficence, non-maleficence, autonomy, justice, proportionality, flexibility, clinical prognosis, duration of the need, and fair health attention), values (solidarity, equality, equity, utilitarianism, relational autonomy, reliability, reciprocity, maximization of the benefits and resources, and prioritization of those in worse conditions), beliefs and personal motivation, protocols, directives, tools, algorithms, recommendations, and criteria.

FINAL CONSIDERATIONS

Decision making has never been so necessary as in this pandemic. This article is not a recipe for the professionals, since decision making is based on numerous factors. However, it provides them with a foundation that can be helpful in this difficult process.

The care offered by nurses to elders with coronary artery disease from the perspective of Transitions Theory

OBJECTIVE

To analyze the planning and implementation of the care offered by nurses to elders with coronary disease during the hospital-house transition.

METHODS

Qualitative research that used the Transitions Theory as a theoretical reference. The participants were 12 nurses who work in a hospital that specializes in cardiology, in the city of Salvador-BA. A semistructured interview was carried out from January to February 2018, and the data was analyzed using the Content Analysis technique.

RESULTS

Transition care takes place on the day of discharge. The presence of the family was found to be a facilitator; low adherence, poor financial situations, the low educational levels inhibited its implementation. The rehospitalization is an indicator of the results of the transition of care.

FINAL CONSIDERATIONS

The planning and implementation of transition care is not effective. It must provide safety in the management of self-care in the home of elders with coronary disease and their families.

Avaliação da experiência do telemonitoramento de enfermagem por mulheres com excesso de peso

Resumo Objetivo Avaliar a experiência do monitoramento remoto de enfermagem na perspectiva de mulheres com excesso de peso. Método Estudo descritivo, de abordagem qualitativa, realizado em ambulatório de referência em obesidade em Salvador-Bahia, com 42 mulheres com excesso de peso, as quais haviam participado do grupo intervenção de um ensaio clínico randomizado. Realizaram-se entrevistas semiestruturadas entre janeiro a março de 2017 e os dados foram analisados através da técnica de análise de conteúdo temática. Resultados Dos depoimentos emergiu a categoria central “Aumentando a consciência do cuidado de si”, a qual foi representada por três categorias temáticas: Vivenciando um feedback frequente e interativo com a enfermeira para o controle de peso, Melhorando o cuidado de si e Sentindo satisfação com os resultados alcançados. Conclusão e implicações para a prática As participantes vivenciaram e reconheceram a melhora do conhecimento para o controle do peso e mudanças positivas nos modos de viver ou conviver com o excesso de peso. Os resultados evidenciaram que atividades educativas por meio da telenfermagem, numa perspectiva dialógica, contribuem para potencializar o autocuidado.

Construction and validation of an instrument for the structural assessment of wards for urinary continence in older adults

OBJECTIVE

to build and validate an instrument for structural assessment of wards for the preservation of urinary continence in hospitalized older adults.

METHOD

this is a methodological study divided into two stages. The first corresponded to an integrative literature review that guided the construction of the instrument. The second consisted of the content validation stage of the instrument, by means of expert consensus, using the Delphi technique. The selected experts were recognized in the field and authors of the articles included in the integrative review.

RESULTS

six experts participated in the content validation, which resulted in the "Instrument for Structural Assessment of Wards for the Preservation of Urinary Continence in Older Adults", composed of 27 items, distributed in three dimensions: "physical structure", "human resources", and "material resources". Two Delphi rounds were carried out for validation, resulting in a final version with 83% agreement among the experts.

CONCLUSION

the instrument reached content validity, requiring application for clinical validation. However, it can be used by researchers and health staff in hospital settings, in order to identify structural weaknesses and guide the priority of interventions for the quality and safety of this care.

Nursing Comiittee to Coping with COVID-19 in Bahia

OBJECTIVE

To report the experience of the Nursing Committee for Coping with COVID-19 in Bahia.

METHODS

The experience report describes motivation, objectives, representatives, organization, working groups, activities and impact of the Committee actions.

RESULTS

The Committee consists of educational institutions and class representation. It accepts demands, questions and complaints from nursing workers, acts in favor of safe care and inspection of health and safety conditions at work. Five working groups and six technical support groups were formed. These groups address Communication, Review of Health Services Contingency Plans, Assistance to Long-Term Institutions, Epidemiology and External Activities. An Instagram account was created for quick and reliable access to information, and also an email to meet demands and monitor COVID-19 cases.

CONCLUSION

The results of the Committee work contribute to guide, support, value and defend nursing workers in coping with COVID-19.

Stigma perceived by overweight women

OBJECTIVE

to understand the experience of discrimination perceived by overweight women.

METHODS

a qualitative research conducted at an outpatient clinic in Salvador, Bahia, where eleven women were interviewed. The interviews were transcribed and submitted to thematic content analysis.

RESULTS

the analysis of the statements expressed three categories: Suffering discrimination in different social contexts: denounced disrespect, hostility, veiled and/or explicit exclusion, prejudice, injustice and insults lived in public transport, at work, in the family environment, in social events and commercial establishments; Experiencing negative feelings about discrimination: revealed inferiority, sadness, shame, fear, anger, frustration, low esteem and discouragement faced by women; Reacting to discrimination: expressed isolation of marital intimacy and social encounters, removal from work, concealment of body and feelings and even illness of women.

FINAL CONSIDERATIONS

the discrimination experienced in various settings has caused suffering, embarrassment, negative feelings, shame, isolation and loss in women's lives.

Effect of nursing telemonitoring on the knowledge of obese women: clinical trial

OBJECTIVE

To assess the effectiveness of remote monitoring in the knowledge of overweight women.

METHOD

Randomized clinical trial with 101 women, randomly assigned to the control group (CG=50) and to the intervention group (IG=51). The IG received educational intervention over the telephone, during three months and routine follow-up in the service, while the CG only received conventional follow-up. The knowledge was assessed by a specific questionnaire. Data were analyzed by the Robust Linear Regression Model, adopting a statistical significance of 5%.

RESULTS

In the intragroup assessment, an increase in the correct answers with a statistically significant difference was observed only for the IG in the domains: "Concept and causes of overweight," "Complications of overweight" and "Eating habits." In the intergroup comparison, an increase in the average knowledge was verified in the same domains for the IG (p≤0.005).

CONCLUSION

nursing telemonitoring contributed positively to the improvement of women's knowledge.

Stress level among undergraduate nursing students related to the training phase and sociodemographic factors

OBJECTIVE

identify the stress level among nursing undergraduates and the associated sociodemographic and academic factors; to compare stress level among college students according to the training phase in the course.

METHOD

cross-sectional study with 286 university students. The instrument of sociodemographic and academic characterization and the stress scale were applied. The overall stress level was assessed by standardized score. In the bivariate analysis, Pearson's chi-square or Fisher's exact test was used, and multiple logistic regression analysis was performed using the Poisson model. Statistical significance of 5% was adopted.

RESULTS

higher proportion of college students presented medium/high level of global stress. Students from 6th to 10th semesters presented higher levels of stress compared to those from 1st to 5th, in the Realization of practical activities, Professional Communication (p = 0.014), Environment (p = 0.053) and Vocational Training (p = 0.000) domains). In the multivariate analysis, they contributed to the highest level of stress the variables attending the 6th to 10th semesters, female gender, monthly income ≤ one minimum wage and income considered insufficient.

CONCLUSION

women in a more advanced stage of education and with low economic condition present a higher level of stress in their academic education.

Estresse e resiliência em discentes de enfermagem de duas universidades públicas paulistas

Objetivo: verificar a relação entre estresse e resiliência em discentes de enfermagem de duas universidades públicas do Estado de São Paulo. Método: trata-se de um estudo transversal realizado em março de 2016 junto a 117 discentes de enfermagem. Aplicaram-se um Formulário para caracterização acadêmica e demográfica, o Instrumento para Avaliação do Estresse em Discentes de Enfermagem e a Escala de Resiliência de Wagnilde Young. Analisaram-se os dados no Statistical Package for Social Sciences, versão 10.0. Resultados: observou-se predomínio de discentes com médio nível de estresse. O gerenciamento do tempo e as atividades teóricas representaram alto nível de estresse para 23,9% e 20,5% da população. 11,1% apresentaram muito alto estresse relacionado ao Ambiente. Os níveis de resiliência foram reduzidos (51%). Não houve correlação significativa entre estresse e resiliência. Conclusão: o ambiente de formação em enfermagem apresenta potencial para o adoecimento dos discentes, embora parte deles já apresente resiliência moderada.

Factors associated with the work capacity of motorcycle taxi drivers

This study evaluated the work capacity of motorcycle taxi drivers and its association with sociodemographic and work and quality of life factors. This is a cross-sectional study realized with 392 motorcycle taxi drivers that used a form containing demographic and labor data, Work Capacity Index, the WHOQOL-bref. We employed a descriptive and inferential analysis. The moderate/good prevalence work capacity was 51%. Motorcycle taxi drivers aged 40 years and over recorded a 31% increase in low work capacity (PR: 1.31; 95% CI: 1.07; 1.61) compared to younger workers. Motorcycle taxi drivers aged 21-29 and 30-39 years evidenced a higher median for absenteeism (p = 0.023) and self-prognosis regarding future work capacity (p < 0.001). A greater proportion of diseases diagnosed among those with five or more years of service (p = 0.003) and of self-prognosis in those with five years or less of service (p < 0.001) was observed. Motorcycle taxi drivers with moderate/good capacity showed better perception of quality of life in the physical realm (p < 0.001). Work capacity of motorcycle taxi drivers was associated with higher exposure to noxious factors that affect their quality of life and work force. Priority public policies and educational actions are required to minimize this exposure.

Psychosocial risk factors at work associated with the level of physical activity among motorcycle taxi drivers

Objective: To analyze the association of psychosocial risk factors at work, sociodemographic, and occupational characteristics with the level of physical activity among motorcycle taxi drivers.Methods: Cross-sectional study with 750 male motorcycle taxi drivers from the municipality of Jequié, Bahia, Brazil. A form containing sociodemographic and occupational characteristics was utilized. The psychosocial risk factors at work were evaluated by the Job Content Questionnaire and the level of physical activity by the International Physical Activity Questionnaire. The adjusted associations were analyzed by means of the Poisson regression with robust variance. Results: the prevalence of an insufficiently active level of physical activity was of 59.6%. The crude prevalence ratios (PR) showed an association between physical inactivity in motorcycle taxi drivers and high strain job (PR: 1.31), with 5 or more years of experience (PR: 1.67), in night shifts (PR: 1.36) and 40 or more years old (PR: 1.77). In the multivariate model, adjusted by income, work in high strain is kept associated to a situation of being insufficiently active (PR: 1.13), duration of employment of five or more years raised by 51.0% the frequency of insufficiently active physical activity (PR: 1.51) and the work in predominantly nocturnal shifts increased it by 26.0% (PR: 1.26). It is made evident that age was an effect modifier (p < 0.001) and its interaction was evaluated by including the corresponding product term (job Demand-Control model), which shows that the association between highly straining work and being insufficiently active was observed only among the youngest (21-39 years old) (PR: 1,21).Conclusions: the age and exposure to unfavorable working conditions, like long duration of employment, night work and work under high psychological demand and low control, have an influence on the insufficient physical activity among motorcycle taxi drivers.

Health alterations in nursing students after a year from admission to the undergraduate course

OBJECTIVE

To identify health alterations in nursing students after a year from admission to a nursing undergraduate course.

METHOD

A longitudinal prospective study with a quantitative approach was carried out in 2016 with first-year nursing students from two universities in the state of São Paulo. The following instruments were applied at the beginning and the end of the first school year: an instrument for Assessment of Stress in Nursing Students, the Center for Epidemiologic Studies Depression Scale, and the Pittsburgh Sleep Quality Index. The ANOVA test for mixed models was used for analysis.

RESULTS

The sample was made up of 117 students in March and 100 students in December. A significant increase in stress in all dimensions of the instrument, a reduction in the duration and subjective quality of sleep, and an increase in general stress and depressive symptoms were observed.

CONCLUSION

The nursing academic environment presents the potential for students to become ill. Institutions should rethink their curricular elements, promote resilience, and create spaces to promote students' health.

Comparison of stress in freshman and senior nursing students

OBJECTIVE

To compare stress levels in freshman and senior nursing students.

METHOD

A cross-sectional study was carried out in a public federal university of the state of Bahia, with students who answered questionnaires about sociodemographic variables, academic life, and a scale for assessing stress in nursing students. Chi-square and Fisher's exact tests were applied to analyze the relationship between variables. To assess proportional trends between ordinal variables and groups, a chi-square test for linear trend was applied. The significance level was 5%.

RESULTS

One hundred and fifty-four students participated in the study. There was a tendency to higher stress levels among students in the last year compared to those in the first year, in four out of six domains: Performance of Practical Activities (p=0.00), Professional Communication (p=0.00), Environment (p=0.00) and Professional Education (p=0.00).

CONCLUSION

High levels of stress were observed in students taking the last year. There is a need for broader research that includes other years of the course, an institutional reflection on stress factors and the adoption of an institutional policy that favors a better confrontation of stress factors.

Effect of remote nursing monitoring on overweight in women: clinical trial

OBJECTIVE

to evaluate the effect of remote nursing monitoring on the improvement of anthropometric measurements of overweight women.

METHOD

controlled, randomized clinical trial, carried out in a reference outpatient clinic for treatment of obesity. The baseline sample was composed of 101 women randomly assigned to two groups, 51 in the intervention group (IG) and 50 in the control group (CG). The IG received remote monitoring through telephone calls and conventional monitoring, and the CG received conventional monitoring. Women were assessed at the baseline and after three months of intervention. A paired t-test and analysis of covariance were used to evaluate intragroup differences in anthropometric measurements, and the statistical significance of 5% was adopted. Eighty one women completed the study.

RESULTS

in the intergroup comparison after the intervention, a reduction of 1.66 kg in the mean weight (p = 0.017) and of 0.66 kg/m2 in the mean BMI (p = 0.015) was found in the intervention group. There was a borderline statistically significant (p = 0.055) reduction of 2.5 cm in WC with in the intervention group.

CONCLUSION

the remote monitoring was beneficial in reducing anthropometric measurements. RBR-3hzdgv.

NURSING PROTOCOL FOR REMOTE MONITORING OF WOMEN WITH EXCESSIVE WEIGHT

ABSTRACT Objective: to describe the construction and implementation of the nursing protocol for remote monitoring of overweight women. Method: report of experience with 50 women who participated in an intervention study developed in a reference outpatient clinic for obesity in Salvador, Brazil. The steps involved in the development of the protocol consisted of structuring the theoretical content and defining the form of operationalization. Results: the definition of the theoretical content of the protocol was guided by the main guides and guidelines of the Ministry of Health and Scientific Societies and discussion with specialists. A thematic weekly script was developed for phone calls, including content on obesity, its causes and complications, feeding and practicing physical activity for weight control. The protocol was performed in ten weeks, with scheduled weekly connections and duration of five minutes. To guide the team in the operation of telephone calls, a Telephone Call Guide was developed. The information was offered in a flexible way, providing moments for the participant to clarify doubts and to add information, being observed the understanding of the contents. Women noted that monitoring, as well as guiding how they could take better care of themselves, helped to avoid giving up treatment and solving problems with health consultations and procedures. Conclusion: the use of remote nursing monitoring focused on educational actions, has proved to be a tool to support the care of overweight women.

Cross-cultural adaptation of the General Comfort Questionnaire to Brazilian patients with myocardial infarction

OBJECTIVE

Describe the first stages of the cross-cultural adaptation process of the General Comfort Questionnaire for myocardial infarction patients in intensive care units.

METHOD

This is a study of qualitative and quantitative research and analysis techniques. Conceptual, item, semantic and operational equivalence was performed. Fifteen items were added to the original instrument to better represent the comfort experienced by myocardial infarction patients in intensive care units. The content validity index was applied to analyze the answers of the experts; it was considered adequate above 0.78.

RESULTS

Some changes suggested by the experts for better understanding were adopted. All items were kept, obtaining a scale of sixty-three items. In the pre-test conducted with 30 subjects, the instrument was considered adequate to the target audience.

CONCLUSION

The adapted version of the General Comfort Questionnaire for people with myocardial infarction is adequate to the target audience.

Short version of the "instrument for assessment of stress in nursing students" in the Brazilian reality

Goal:

validate a short version of the Instrument for assessment of stress in nursing students in the Brazilian reality.

Method:

Methodological study conducted with 1047 nursing students from five Brazilian institutions, who answered the 30 items initially distributed in eight domains. Data were analyzed in the R Statistical Package and in the latent variable analysis, using exploratory and confirmatory factor analyses, Cronbach’s alpha and item-total correlation.

Results:

The short version of the instrument had 19 items distributed into four domains: Environment, Professional Training, Theoretical Activities and Performance of Practical Activities. The confirmatory analysis showed absolute and parsimony fit to the proposed model with satisfactory residual levels. Alpha values ​​per factor ranged from 0.736 (Environment) to 0.842 (Performance of Practical Activities).

Conclusion:

The short version of the instrument has construct validity and reliability for application to Brazilian nursing undergraduates at any stage of the course.

Validation of the Comfort scale for relatives of people in critical states of health

OBJECTIVE

this methodological study aims to present the construct validity of the Comfort scale for family members of people in a critical state of health (ECONF).

METHOD

this is a methodological study. The sample was made up of 274 family members of adults receiving inpatient treatment in six Intensive Care Units (ICU) in the State of Bahía responded to 62 items distributed in 7 dimensions. The validation procedures adopted were based on the techniques of the Classical Test Theory.

RESULTS

the analysis of dimensionality was undertaken through principal components analysis, a scale being obtained with 55 items distributed in four factors: Safety, Support, Family member-relative interaction and Integration with oneself and the everyday. The analysis of the items' , discriminative power, undertaken by the item-total correlation-coefficient showed a good relationship of the items with their respective factors. From the ECONF's reliability test, from the analysis of internal consistency, a raised Alpha Cronbach coefficient was obtained for the 4 factors and the general measurement.

CONCLUSION

the comfort scale presented satisfactory psychometric parameters, thus constituting the first valid instrument for evaluating the comfort of family members of people in a critical state of health. The advance made by the study lies in its theoretical framework on comfort, and provides the health team with a scale based on empirical evidence.

Construction and validation of nursing diagnoses for people in palliative care

Objective:

to construct and validate nursing diagnoses for people in palliative care based on the Dignity-Conserving Care Model and the International Classification for Nursing Practice.

Method:

a two-stage methodological study: 1) construction of the database of clinically and culturally relevant terms for the nursing care for people in palliative care and 2) construction of nursing diagnoses from the database of terms, based on the guidelines of the International Council of Nurses.

Results:

the 262 terms validated constituted a database of terms from which 56 nursing diagnoses were developed. Of these, 33 were validated by a group of 26 experts, and classified in the three categories of the Dignity-Conserving Care Model: illness-related concerns (21); dignity-conserving repertoire (9); and social dignity inventory (3).

Conclusion:

of the 33 validated diagnoses, 18 of them could be included in the update of the Catalog of the International Classification for Nursing Practice - palliative care for a dignified death. The study contributes to support the clinical reasoning and decision making of the nurse.

Cumulative sitting time as discriminator of overweight, obesity, abdominal obesity and lipid disorders in nursing university

DOI: http://dx.doi.org/10.5007/1980-0037.2017v19n1p40 There is evidence demonstrating that prolonged sitting time is relevant risk factors for metabolic and cardiovascular disorders. The aim of this study was to identify the discriminatory power and propose cumulative sitting time cutoff points for overweight, obesity, abdominal obesity and lipid disorders in nursing university students. A cross-sectional study of 137 women, nursing students from a public university in Salvador, Bahia, Brazil. Data were obtained by applying specific forms, laboratory and anthropometric measurements. The predictive power and cutoff points of sitting time for the outcomes of interest were identified by receiver operating characteristic curves (ROC). A 95% confidence interval was established. Sitting time for a day of the week was a good discriminator of abdominal obesity: area under the ROC curve (AUC) = 0.66 (0.57-0.75). No AUC with statistical significance were found to discriminate overweight and total obesity. Sitting time over the weekend showed no discriminatory power for overweight, obesity or abdominal obesity. Sitting time during the week or weekend did not discriminate lipid abnormalities. Sitting time for 8 hours or more a day during the week discriminates the presence of abdominal obesity. The sitting time during the week of 8 hours accumulated per day discriminates abdominal obesity in undergraduate nursing. It is suggested that educational institutions establish measures to encourage a reduction in this sedentary behavior.

Fatores relacionados à inatividade física no lazer em mulheres obesas

Resumo Objetivo Verificar os fatores relacionados à inatividade física (IF) no lazer em mulheres com excesso de peso. Métodos Estudo transversal, recorte de um projeto matriz denominado “Monitoramento remoto de enfermagem de mulheres com excesso de peso”, desenvolvido em ambulatório de referência para obesidade, em Salvador, Bahia, Brasil, no qual uma equipe multidisciplinar cerca de 300 usuários do Sistema Único de Saúde, sendo 91% mulheres, razão pela qual foram selecionadas para o estudo. Mediante consulta aos prontuários 174 mulheres foram recrutadas atendendo aos critérios de inclusão para o projeto matriz: ter excesso de peso (IMC ≥25 kg/m2), idade superior a 18 anos, comparecido a consulta médica nos últimos doze meses e telefone fixo e/ou celular. Foram critérios de exclusão: ausência de condições físicas para medidas antropométricas e cognitivas para responder aos instrumentos da pesquisa, distúrbios psiquiátricos, uso de drogas para perda de peso e realização de cirurgia bariátrica. Obedeceu-se as orientações do processamento e de análise dos dados do IPAQ. Resultados Houve alta prevalência de IF (85,2%) e associação significante entre IF e índice de massa corporal, autoeficácia para atividade física, percepção do ambiente, dependentes no domicílio, estado de saúde percebido e número de comorbidades. Na regressão, a IF associou-se ao número de comorbidades (RP:1,31; IC 95% 1,06;1,64); a autopercepção de saúde ruim (RP: 1,28; 1,01;1,61); a baixa autoeficácia (RP:1,27; 1,06; 1,51) e a percepção do ambiente ruim (RP:1,27; IC 95% 1,01;1,60). Conclusão A IF no lazer associou-se a variáveis individuais e ambientais.

Tempos de acesso a serviços de saúde face ao infarto do miocárdio

Resumo Objetivo Analisar os tempos relacionados ao acesso de homens e mulheres com infarto do miocárdio a hospitais referência em cardiologia e a correlação entre eles. Métodos Pesquisa transversal, com 100 pessoas com infarto entrevistadas em hospitais referência em cardiologia. Dados analisados por estatística descritiva e inferencial, adotando-se significância estatística. Resultados Os tempos foram elevados (decisão para atendimento, chegada ao primeiro serviço de saúde, permanência na rede de atenção e admissão em hospitais referência em cardiologia), exceto o de transporte, sobretudo para mulheres. Houve maior contribuição do tempo de decisão na composição do tempo de chegada ao primeiro serviço de saúde e do tempo de permanência na rede na composição do tempo de chegada aos hospitais referência em cardiologia. Conclusão A longa espera por atenção especializada reflete a falta de estrutura dos serviços de saúde, e o tempo de decisão elevado reflete a falta do não reconhecimento do infarto pelos participantes.

Fatores associados ao descontrole da pressão arterial em homens

Resumo Objetivo Verificar os fatores associados ao descontrole da pressão arterial em homens. Métodos Estudo exploratório, de corte transversal, realizado em centro de referência para doenças cardiovasculares, em Salvador-BA, lócus para o núcleo de referência do programa de saúde do homem do Ministério da Saúde. Amostra foi selecionada por conveniência totalizando 130 homens atendidos em centro de saúde, submetidos a entrevista, avaliação clínica e antropométrica. Na análise bivariada empregou-se o Qui-quadrado de Pearson ou Exato de Fisher realizando-se posteriormente análise de regressão logística múltipla sendo a OR corrigida pelo modelo de Poisson. Adotou-se significância estatística de 5%. Resultados Constatou-se alta prevalência de descontrole da pressão arterial (65,4%), de hábitos de vida inadequados e de excesso de peso. Não houve associação estatisticamente significante entre descontrole dos níveis pressóricos e variáveis sociodemográficas, hábitos de vida e medidas antropométricas. Na regressão, o descontrole da pressão arterial associou-se ao uso inadequado da medicação (RP: 1,35, IC 95%: 1,03; 1,76). Conclusão O uso inadequado da medicação foi reforçado como importante fator associado ao descontrole. Medidas efetivas para mudança deste panorama são emergenciais e desafiam profissionais e autoridades públicas.

Consumo de bebidas alcóolicas entre estudantes de enfermagem

Objetivo Comparar o consumo de bebida alcóolica entre estudantes de Enfermagem ingressantes e concluintes do curso. Métodos Estudo transversal, com 154 estudantes de enfermagem. O instrumento de pesquisa foi um questionário com dados sociodemográficos e da vida acadêmica, e o Alcohol Use Disorders Identification Test (AUDIT). Na análise dos dados, empregaram-se estatísticas descritivas, teste Qui-quadrado de Pearson, exato de Fischer e de tendência linear. Adotou-se significância estatística de 5%. Resultados Predominaram mulheres, na faixa etária de 20 a 24 anos, solteiros, da raça negra e classe socioeconômica C. Consumiam bebida alcoólica 57,1% da amostra. Constatou-se maior frequência de consumo e de doses de bebida alcoólica para estudantes concluintes e maior proporção destes nas Zonas AUDIT II, III e IV. Não houve diferença estatisticamente significante na análise entre zonas e ano em curso. Conclusão Estudantes concluintes apresentaram maior consumo prejudicial de bebidas alcoólicas.

Pre-hospital delay in acute myocardial infarction: judgement of symptoms and resistance to pain

OBJECTIVE

To estimate the time of decision (TD) to look for medical care and the time of arrival (TA) at the health service for men (M) and women (W) suffering from acute myocardial infarction and to analyze the influence of the interpretation of pain and pain resistance behaviors during these times.

METHODS

This is an exploratory research, performed at the university hospital in Salvador/Bahia. 43 W and 54 M were interviewed. To study the dependence among sociodemographic and gender variables, the Fisher Exact Test was used. To analyze times, a geometric mean (GM) was used. In order to verify the association between the GM of TD and TA and the judgment of pain, and between the GM of TD and TA and the behavior of resistance to pain, as well as to test the time of interaction between the gender variable and other variables of interest, the robust regression model was used. The statistical significance adopted was 5%.

RESULTS

The GM of the TD for M was 1.13 h; for W, 0.74 h. The GM of the TA was 1.74 h for M and 1.47 h for W. Those who did not recognize the symptoms of AMI and presented behavior of resistance to pain had higher TD and TA, being the associations significant. Gender did not change the associations of interest.

CONCLUSION

The findings demonstrate the importance of health education aiming at the benefits of early treatment.

Sociodemographic and clinical factors associated with the decision time for seeking care in acute myocardial infarction

OBJECTIVE

this study aimed to analyze the interaction of gender in the association between decision time for seeking healthcare services and the sociodemographic and clinical variables.

METHOD

this exploratory, cross-sectional study was performed with 100 individuals interviewed in hospitals in Salvador, Bahia. The chi-square test or Fisher's exact test and the robust linear regression model were used in the analysis. A statistical significance of 5% was adopted.

RESULTS

men and women presented long decision times. The decision time was less for smokers and those with constant and/or severe pain. There was an interaction between gender and smoking and between gender and pain radiating to the neck or jaw for the decision time outcome.

CONCLUSION

decision times were long and were influenced by clinical and gender variables. The study provides support for nursing care practices focused on the specificity of these factors and of the genders aiming to reduce the decision time.

Social representations of adolescents on quality of life: structurally-based study

This study sought to conduct a comparatively analysis and describe the contents of the structure of the social representations of adolescents on quality of life. It involves descriptive, quantitative research, with the benchmark of a structural approach to social representations. The informants included 316 adolescents from three public schools in Jequié in the State of Bahia. The Spontaneous Word-Choice Eliciting Technique using the key expression "Quality of Life" was used for data collection. The responses were processed using Evoc 2003 software, which generated the Four-House Chart. The results reveal the core nucleus of the terms: healthy eating; physical activity; money; and sex. In the 1st outer circle, the words absence of disease, condoms, liberty, marijuana, housing, work and living well are featured. In the 2nd outer circle, there appeared the words difficulty, family, peace and power, and the contrasting elements of well-being and soccer. The overall consensus is that adolescents associate quality of life with sports and other healthy behavior activities, and are influenced by the desires and curiosities of adolescence.

[Environmental factors associated with the decision time for seeking care in myocardial infarction]

The purpose was to estimate the decision time (DT) for searching for attendance for men and women suffering from acute myocardial infarction (AMI); and to analyze the influence of surrounding variables in the DT. Transversal study, involving one hundred patients interviewed in hospitals of Salvador-BA, Brazil. For data analysis, it was used the chi-squared or Fisher's exact test, and the Robust Linear Regression Model. AMI at the home predominated, with family members and patients receiving mistaken actions. A high DT was observed both, for women (0.9h) and men (1.4h). Those at home during the initial symptoms had higher DT, compared to those at work; and lower in relation to those in public spaces (p=0.047). Statistically significant interaction occurred among gender and the fact of living with company; and among gender and having a companion and children, for the outcome of the DT. Nursing care focused on the specificity of surrounding factors and gender can optimize early attendance.

Acesso de usuários com infarto do miocárdio a hospitais referência em cardiologia

Objetivo Caracterizar o acesso de usuários com infarto do miocárdio a hospitais referência em cardiologia. Métodos Estudo transversal, realizado em dois hospitais referência em cardiologia. A amostra de 100 usuários, com diagnóstico de infarto, foi entrevistada empregando-se instrumento específico. Na análise utilizou-se médias, desvio padrão e percentuais. Resultados Predominaram homens, raça negra; casados; baixo nível socioeconômico, idade média de 56,4 anos. Prevaleceu início dos sintomas no domicílio, uso de meios de deslocamento inadequados, procura de serviço de emergência como primeiro local de atendimento, admissão nos hospitais referência em cardiologia até o terceiro atendimento. Dos 67 usuários com infarto com supradesnível do segmento ST, 12% receberam terapias de reperfusão miocárdica. A insuficiência de recursos foi a principal razão para a peregrinação na rede de saúde. Conclusão Constatou-se uso de meios de transporte inapropriados, baixa proporção de reperfusão miocárdica e falta de estrutura da rede para atendimento ao infarto.

[SCIENTIFIC PRODUCTION ON THANATOLOGY IN NURSING JOURNALS: SYSTEMATIC REVIEW]

OBJECTIVE

Analyze the scientific production on Thanatology published in nursing journals.

METHODOLOGY

Systematic review, with quantitative approach, that aimed the characterization of the articles with regard to the year and journal of publication, and its Qualis CAPES, thematic approach, methodological focus, description of training area and qualification of authors.

RESULTS

According to the selection criteria of the sample, 36 articles whose publication period was between the years 1986 and 2011 were extracted for analysis. It was noted the predominance of studies published in journals with high quality strata (A1 and A2), use of qualitative method and nurses educators as authors. The focus of the studies encompassed six central themes, and the prevailing ones were: "Thanatology in the academic training" and "The nurse in face of the dying process of patients and families under their cares".

CONCLUSION

It is clear that the issue still presents itself in a timid manner, requiring an increased production on the subject.

[Comfort of the patient's family in an Intensive Care Unit related to welcoming]

This study aimed to identify the level of comfort of families of patients in a critical health condition related to the welcoming practices performed by the hospital staff. Interviews were conducted with 250 relatives in hospitals of the state Bahia, using a Likert scale. Data were analyzed as percentages and quartiles. For nine of the 12 statements of the scale, most relatives scored their comfort level between very and totally comfortable, median of 4,revealing kindness, tranquility and friendly communication with family members. More than half of the sample scored its level as not at all to more or less comfortable, median of 3, for statements about demonstration of interest towards the relative by the staff and flexible visiting of the patient. The necessity of greater interest of the team in the condition and needs of the family was observed. Promoting comfort from the dimension of welcoming demands interdisciplinary actions grounded in humanistic philosophy, in which the nurse has an important role to play.

[Factors associated with the decision to seek health care in myocardial infarction: gender differences]

Analyze cognitive and emotional variables between genders in terms of the decision time (DT) to seek care when experiencing symptoms of myocardial infarction. One hundred adults were interviewed at two hospitals in Salvador-BA. The analysis used percentage means, the chi-square test, and a robust linear regression model. Most participants were male, with a mean age of 58.78 years and a low socioeconomic status. The geometrical mean of the sample was 1.1h (0.9h for men, and 1.4h for women). A shorter decision time was found for those who considered their symptoms to be severe, and a longer decision time for those who expected symptoms to improve and took something to feel better, with statistically significant associations. An interaction was observed between gender and the following variables: waiting for symptoms to improve (p=0.014), concealing symptoms (p=0.016) and asking for help (p=0.050), thus an association was observed between the variables of interest and DT. The decision times were long and were affected by cognitive, emotional and gender variables. Nursing care may promote early assistance.

Prática de atividade física entre estudantes de graduação em enfermagem

OBJETIVO: Comparar a prática de atividade física entre estudantes de graduação em enfermagem ingressantes e concluintes. MÉTODOS: Estudo transversal desenvolvido com amostra de 154 estudantes. Os instrumentos de pesquisa foram um questionário com dados sociodemográficos e da vida acadêmica e para os dados sobre a prática de atividade física utilizou-se o questionário internacional sobre atividade física. Para a análise dos dados empregou-se estatísticas descritivas e para as análises bivariadas o teste de Qui-quadrado de Pearson, Exato de Fischer. RESULTADOS: Identificou-se predomínio de ingressantes do sexo feminino com idade entre 20 a 24 anos, solteiros. Houve predominância do padrão sedentário. Houve diferença estatisticamente significante para tempo gasto sentado e ano em curso (p=0,010). CONCLUSÃO: O padrão sedentário mostrou-se predominante para os grupos de estudantes ingressantes e concluintes do curso. Houve diferença estatisticamente significante para tempo gasto sentado e ano em curso, com maior percentual para ingressantes.

Desconfortos vividos no cotidiano de familiares de pessoas internadas na UTI

Trata-se de uma pesquisa qualitativa que objetivou conhecer os desconfortos vividos no cotidiano de familiares de pessoas internadas na unidade de terapia intensiva (UTI). Foi realizada na UTI geral de um hospital público, em Salvador-BA, no segundo semestre de 2009. Nove familiares de pessoas internadas foram entrevistados. Empregou-se a técnica de análise da Teoria Fundamentada em Dados. Os resultados mostraram que a interação das famílias com a ameaça à vida de um de seus membros na UTI produziu, como desconforto central, a descontinuidade da vida cotidiana, a qual foi caracterizada por quatro categorias: vivendo a angústia da possibilidade de perda, vivendo uma cisão na vida familiar, sofrendo mudanças na vida social e profissional, tendo dificuldade para cuidar de si. Tais desconfortos podem ser minimizados com abordagem multiprofissional sensível às demandas das famílias e apoio de sua rede social.

Crenças e comportamentos de pessoas com doença arterial coronária

O estudo descreveu crenças e comportamentos sobre causas e medidas de controle da doença arterial coronária (DAC). Cem adultos foram entrevistados em ambulatório público, em Salvador (BA). Os resultados foram analisados em percentuais, médias e por técnica de análise de dados qualitativos. Predominaram homens, idade < 60 anos, cor negra, baixas escolaridade e renda, casados e sem ocupação. A média de crenças para a causa da DAC foi de 1,53 por participante incluindo fatores comportamentais, biológicos, relacionais e religiosos e representaram sobretudo acúmulo de excessos quanto às tensões cotidianas e alimentação. A maioria dos participantes não considerou a enfermidade de caráter crônico acreditando que o tratamento não duraria a vida toda e na cura da doença. A média de crenças para medidas de controle foi de 1,45 prevalecendo seguimento do regime alimentar e uso das medicações. Predominou sedentarismo, redução do tabagismo e consumo de bebida alcoólica, preparo de alimentos com menos sal e gordura saturada, maior consumo de carnes brancas, alimentos cozidos e industrializados. Apenas 66% cumpriam a receita médica. O entendimento insatisfatório sobre causas e medidas de controle da DAC torna essencial a implementação de cuidados contemplando as distintas condições de vida e saúde e projetos para o cuidar de si.