Search

To analyze the knowledge and safety of primary health care professionals in the management of chronic kidney disease in its early stages. Integrative literature review carried out in four steps. The search took place in the following databases: MEDLINE via PubMed, Web of Science, Scopus and BVS. The descriptors used were “Primary Health Care” AND “Kidney Diseases” AND “Health Knowledge, Attitudes, Practice” and the quality of the analysis was checked by means of the Hierarchy of Evidence for Intervention Studies”. Fifteen articles were found, with a predominance of qualitative and descriptive method; the results showed insufficient knowledge of health professionals and interest in the best approach in the initial stage of the disease. Thus, it is inferred that the knowledge and security of primary health care professionals depend on individual factors and institutional initiative for the adoption of clinical guidelines and training. Therefore, prepared professionals and organized care, using protocols, would bring benefits both to patients as to the evolution and outcome of the disease and savings to health services.

Vaccines or immunobiologicals have antigenic properties and, in public health, are considered an important strategy in the prevention and control of immuno-preventable diseases. The objective of this study was to carry out review of the nursing staff's role in vaccine care. This is a scoping review, conducted in first semester of 2017, with data collected in 17 national and international databases. To guide the evaluation of the selected materials, an instrument composed of some collection indicators was used. The final sample consisted of eight publications. The data was inserted into the Microsoft Excel 2010 Program, and analyzed in a descriptive way. The identification of a variety of actions of the nursing team in the care with vaccines was verified and grouped in: vaccine room; behavior in the vaccine room; refrigerator care; organization of vaccines inside the refrigerator; monitoring and register of changes in temperature; measures adopted with vaccines under suspect; behaviors regarding vaccines in thermal boxes; professional knowledge in the vaccine room and other important behaviors. Given this evidence, it is essential to detect factors that may compromise the quality and conservation of vaccines. For this, it is understood the need for training aimed at the professionals involved in the immunization and the importance of supervision activities in the vaccine room by the nurse.

Vaccines or immunobiologicals have antigenic properties and, in public health, are considered an important strategy in the prevention and control of immuno-preventable diseases. The objective of this study was to carry out review of the nursing staff's role in vaccine care. This is a scoping review, conducted in first semester of 2017, with data collected in 17 national and international databases. To guide the evaluation of the selected materials, an instrument composed of some collection indicators was used. The final sample consisted of eight publications. The data was inserted into the Microsoft Excel 2010 Program, and analyzed in a descriptive way. The identification of a variety of actions of the nursing team in the care with vaccines was verified and grouped in: vaccine room; behavior in the vaccine room; refrigerator care; organization of vaccines inside the refrigerator; monitoring and register of changes in temperature; measures adopted with vaccines under suspect; behaviors regarding vaccines in thermal boxes; professional knowledge in the vaccine room and other important behaviors. Given this evidence, it is essential to detect factors that may compromise the quality and conservation of vaccines. For this, it is understood the need for training aimed at the professionals involved in the immunization and the importance of supervision activities in the vaccine room by the nurse.

construct and validate an instrument for evaluation and evolution of chronic wounds. The content and apparent validities were appreciated by experts, the reliability by the analysis of concordance between evaluators using the interclass correlation coefficient and to verify the construct validity was used the instrument Pressure Ulcer Scale for Healing. the analysis of the scores of the instrument by the ICC showed an excellent and significant correlation (K = 0.914) and to verify the construct validity of the instrument, the Pearson correlation coefficient, whose result was 0.573, showed a statistically significant and strong correlation between the scores instrument and the Pressure Ulcer Scale for Healing. Most of the concordances of the items were classified as moderate or substantial. The instrument is valid and reliable. It is suggest longitudinal studies in larger populations, semantic validation in a sample of nurses, and an illustrative guide to standardize concepts in order to improve the evaluation of metric properties.

construct and validate an instrument for evaluation and evolution of chronic wounds. The content and apparent validities were appreciated by experts, the reliability by the analysis of concordance between evaluators using the interclass correlation coefficient and to verify the construct validity was used the instrument Pressure Ulcer Scale for Healing. the analysis of the scores of the instrument by the ICC showed an excellent and significant correlation (K = 0.914) and to verify the construct validity of the instrument, the Pearson correlation coefficient, whose result was 0.573, showed a statistically significant and strong correlation between the scores instrument and the Pressure Ulcer Scale for Healing. Most of the concordances of the items were classified as moderate or substantial. The instrument is valid and reliable. It is suggest longitudinal studies in larger populations, semantic validation in a sample of nurses, and an illustrative guide to standardize concepts in order to improve the evaluation of metric properties.

Fibrinolytic Therapy (FT) is an important form of treatment for cases of Acute Myocardial Infarction (AMI), especially in those places where Primary Percutaneous Coronary Intervention (PPCI) is not available, which is the main form of treatment and can be used even in the prehospital care. Aimed to describe the clinical outcomes of the use of FT in prehospital care for treating patients with AMI. This research covered a total of 53 patients and was carried out from march to october 2017, referring to the care provided from january 2015 to december 2016 in two stages, in which the first occurred with the Mobile Emergency Service (SAMU) and Walk-in Emergency Care Units (UPA), and the second in the referenced hospital services as gateways to those units. Data were collected from secondary sources. The clinical outcomes of FT considered in the form of absolute and relative frequencies and measures of central tendency were considered. The main signs and symptoms at admission were chest pain (84.62%), sweating (36.54%), dyspnea (26.92%), hypertension (19.23%), nausea (17.31%), malaise (17.31%) and emesis (13.46%). The main characteristic of chest discomfort was chest pain (70.45%). The FT drug administered in all patients was tenecteplase. The median time from symptom-to-door was 180 minutes, while symptom-reperfusion was 300 minutes and door-to-needle 160 minutes. Regarding the outcome, 74.47% had clinical improvement, 19.15% died, 4.25% had refractory AMI and 2.13% had reinfarction. The main characteristic of clinical improvement was the reversal of chest pain (68.57%), characterized as myocardial reperfusion criteria. The present study presented the main outcomes of FT use with improvement of those patients who were treated with it, and shorter times related to chest discomfort and the administration of FT were responsible for increasing the outcomes of clinical improvement and decreasing the outcome of death.

Hematopoietic stem cell transplantation (HSCT) affects serious risks for the patient, including death. For this reason, it is considered a treatment that can cure or can present morbidities and lead to death. In this context, patients experience the first psychological conflicts before this transplant. To describe the psychological suffering developed by patients transplanted with hematopoietic stem cells from a referral service in the state of Rio Grande do Norte. This is a cross-sectional study with a quantitative, descriptive, hospital-based approach developed with patients submitted to HSCT at a referral service in the state of Rio Grande do Norte. Data were collected between March and September of 2016, through the evaluation of the medical records of 43 patients who underwent HSCT and developed some type of psychological distress. Among 43 patients with psychological disorders, 51.16% were female, 62.79% developed anxiety 32.56% developed insomnia and 20.93% developed depression. Of these, 27.91% had a main diagnosis indicating the transplantation of Multiple Myeloma (MM), and 58.14 received autologous transplantation. It was observed that the patient had psychological suffering from the diagnosis until the end. The health professional praxis also must go beyond the resolution of physical human responses and, especially in these cases, it should aim at the early identification of signs and symptoms of psychological distress, being possible to achieve the real health needs and treat them with effectiveness.

The Hematopoietic stem cell transplantation (HSCT) is used in children as a definitive treatment for various oncological, immune deficiencies, hemoglobinopathy, and malignancies diseases that involve the hematological system, congenital metabolism disorders, among others. To characterize the clinical and epidemiological profile of children and adolescents submitted to HSCT at a referral service in the state of Rio Grande do Norte. This is a quantitative, retrospective, observational, descriptive and analytical quantitative approach approaching the medical records of children and adolescents submitted to HSCT in a referral hospital service for this type of transplantation in the state of Rio Grande do Sul North (RN). The final sample consisted of 35 records patients aged between 2 and 18 years old who underwent HSCT from February 2008 to December 2015 and who presented the data necessary for the study. The records analyzed showed a little majority of male patients (51.42%) and 60.00% of these men were students and 71.42% lived in the state of the Rio Grande do Norte. According to the clinical characteristics, 34.3% of the patients had Acute Lymphoblastic Leukemia and 25.71% had Acute Myeloid Leukemia as the main diagnosis. Gastrointestinal toxicities were the most frequent (97.1%) and all patients received antineoplastic/chemotherapeutic and antiemetic treatment. The allogeneic HSCT was the most frequently performed (57.14%) and the most used source of Hematopoietic progenitor cells (HPC) was the peripheral blood (54.29%) and 5.71% of these patients developed the Graft versus Host Disease (GVHD), of which one was affected by acute GVHD and another by chronic GVHD. Septsis was the most frequent cause of death (60%). The profile of the clinical variables presented by the children and adolescents of this study shows that the most prevalent diagnosis was ALL, the most frequent toxicities were gastrointestinal, cardiac, respiratory and hematological, the most common HSCT was allogeneic peripheral blood and the greatest cause of mortality was sepsis. These data are similar to studies conducted in North America, Europe and Asia.

Hematopoietic stem cell transplantation (HSCT) affects serious risks for the patient, including death. For this reason, it is considered a treatment that can cure or can present morbidities and lead to death. In this context, patients experience the first psychological conflicts before this transplant. To describe the psychological suffering developed by patients transplanted with hematopoietic stem cells from a referral service in the state of Rio Grande do Norte. This is a cross-sectional study with a quantitative, descriptive, hospital-based approach developed with patients submitted to HSCT at a referral service in the state of Rio Grande do Norte. Data were collected between March and September of 2016, through the evaluation of the medical records of 43 patients who underwent HSCT and developed some type of psychological distress. Among 43 patients with psychological disorders, 51.16% were female, 62.79% developed anxiety 32.56% developed insomnia and 20.93% developed depression. Of these, 27.91% had a main diagnosis indicating the transplantation of Multiple Myeloma (MM), and 58.14 received autologous transplantation. It was observed that the patient had psychological suffering from the diagnosis until the end. The health professional praxis also must go beyond the resolution of physical human responses and, especially in these cases, it should aim at the early identification of signs and symptoms of psychological distress, being possible to achieve the real health needs and treat them with effectiveness.

The Hematopoietic stem cell transplantation (HSCT) is used in children as a definitive treatment for various oncological, immune deficiencies, hemoglobinopathy, and malignancies diseases that involve the hematological system, congenital metabolism disorders, among others. To characterize the clinical and epidemiological profile of children and adolescents submitted to HSCT at a referral service in the state of Rio Grande do Norte. This is a quantitative, retrospective, observational, descriptive and analytical quantitative approach approaching the medical records of children and adolescents submitted to HSCT in a referral hospital service for this type of transplantation in the state of Rio Grande do Sul North (RN). The final sample consisted of 35 records patients aged between 2 and 18 years old who underwent HSCT from February 2008 to December 2015 and who presented the data necessary for the study. The records analyzed showed a little majority of male patients (51.42%) and 60.00% of these men were students and 71.42% lived in the state of the Rio Grande do Norte. According to the clinical characteristics, 34.3% of the patients had Acute Lymphoblastic Leukemia and 25.71% had Acute Myeloid Leukemia as the main diagnosis. Gastrointestinal toxicities were the most frequent (97.1%) and all patients received antineoplastic/chemotherapeutic and antiemetic treatment. The allogeneic HSCT was the most frequently performed (57.14%) and the most used source of Hematopoietic progenitor cells (HPC) was the peripheral blood (54.29%) and 5.71% of these patients developed the Graft versus Host Disease (GVHD), of which one was affected by acute GVHD and another by chronic GVHD. Septsis was the most frequent cause of death (60%). The profile of the clinical variables presented by the children and adolescents of this study shows that the most prevalent diagnosis was ALL, the most frequent toxicities were gastrointestinal, cardiac, respiratory and hematological, the most common HSCT was allogeneic peripheral blood and the greatest cause of mortality was sepsis. These data are similar to studies conducted in North America, Europe and Asia.

With the development of new surgical techniques, instrumentation and pharmacological advances, corneal transplant procedures can undergo changes directly in the clinical profile of patients with the indication for penetrating keratoplasty technique. The aim of this study was to identify the clinical profile of patients undergoing penetrating keratoplasty and the main indicating conditions at a university hospital in Northeast Brazil. This is an epidemiological, cross-sectional, descriptive study performed using data from medical records of 241 patients who underwent keratoplasty between January/2010 and December/2014. From the total keratoplasties performed in the hospital during the study period, 88.37% were carried out by penetrating technique. Of these, 50.44% were performed in male patients with an average age of 55.2 years. The main indications were keratoconus, followed by bullous keratopathy and keratitis. Preexisting clinical conditions for penetrating keratoplasty were found, such as changes in vascularization, glaucoma, previous surgery, aphakic and pseudophakic eyes and keratoplasties combined with other types of surgeries. Knowledge of the clinical profile of patients who underwent penetrating keratoplasty enabled identification of the main ocular diagnoses that result in this type of transplant as a therapeutic indication. From this, it is possible to point out the main pre-existing medical conditions of penetrating keratoplasty that may represent potential risk factors for complications in the postoperative period and even lead to graft failure. We suggest that further studies be carried out on a thematic.

Describing the epidemiological characterization of patients awaiting cornea transplant (on the waiting list) of a reference service in the state of Rio Grande do Norte. A cross-sectional quantitative study conducted between January and April 2015 with patients on the waiting list (n = 62) registered by the Center for Notification, Collection and Distribution of Organs. Data were analyzed using the Statistical Package for the Social Sciences, version 20.0. Inferential analysis was carried out between the variable 'corneal disorder' and other variables of interest. Mean age of the patients was 49.68 years, and 54.84% were females. Keratoconus was the main initial condition found. The type of corneal disorder had a statistically significant association with the variables of gender and age. The keratoconus was the main indicator for cornea transplant. Factors such as age and gender may be related to the onset corneal endothelium disorders. We suggest that further studies be carried out in order to better evaluate the established association between the types of corneal disorders and the variables of gender and age, considering these may represent important epidemiological indicators for early detection of clinical manifestations and complications affecting the cornea in patients who are waiting for the corneal transplant.

With the development of new surgical techniques, instrumentation and pharmacological advances, corneal transplant procedures can undergo changes directly in the clinical profile of patients with the indication for penetrating keratoplasty technique. The aim of this study was to identify the clinical profile of patients undergoing penetrating keratoplasty and the main indicating conditions at a university hospital in Northeast Brazil. This is an epidemiological, cross-sectional, descriptive study performed using data from medical records of 241 patients who underwent keratoplasty between January/2010 and December/2014. From the total keratoplasties performed in the hospital during the study period, 88.37% were carried out by penetrating technique. Of these, 50.44% were performed in male patients with an average age of 55.2 years. The main indications were keratoconus, followed by bullous keratopathy and keratitis. Preexisting clinical conditions for penetrating keratoplasty were found, such as changes in vascularization, glaucoma, previous surgery, aphakic and pseudophakic eyes and keratoplasties combined with other types of surgeries. Knowledge of the clinical profile of patients who underwent penetrating keratoplasty enabled identification of the main ocular diagnoses that result in this type of transplant as a therapeutic indication. From this, it is possible to point out the main pre-existing medical conditions of penetrating keratoplasty that may represent potential risk factors for complications in the postoperative period and even lead to graft failure. We suggest that further studies be carried out on a thematic.

Describing the epidemiological characterization of patients awaiting cornea transplant (on the waiting list) of a reference service in the state of Rio Grande do Norte. A cross-sectional quantitative study conducted between January and April 2015 with patients on the waiting list (n = 62) registered by the Center for Notification, Collection and Distribution of Organs. Data were analyzed using the Statistical Package for the Social Sciences, version 20.0. Inferential analysis was carried out between the variable 'corneal disorder' and other variables of interest. Mean age of the patients was 49.68 years, and 54.84% were females. Keratoconus was the main initial condition found. The type of corneal disorder had a statistically significant association with the variables of gender and age. The keratoconus was the main indicator for cornea transplant. Factors such as age and gender may be related to the onset corneal endothelium disorders. We suggest that further studies be carried out in order to better evaluate the established association between the types of corneal disorders and the variables of gender and age, considering these may represent important epidemiological indicators for early detection of clinical manifestations and complications affecting the cornea in patients who are waiting for the corneal transplant.

Objective: to determining the intelligibility of the indicators, constitutive and operational definitions of nursing behavior result of fall prevention by nurses in hospital units. Method: methodological research in adaptation to the instructions Hoskins validation model (1989), in order to performing the analysis of the intelligibility of the indicators, constitutive and operational definitions of nursing results NOC behavior of fall prevention. The instrument was therefore subjected to a sieve of nurses in a public teaching hospital of the health of the city of Natal/RN at the discretion of intelligibility chosen Psychometrics. Results: all indicators achieved or exceeded the concordance index of 0,90, except for one indicator, because the concordance was 0,58 and p < 0,05 as a result of the binomial test. It means therefore that this indicator needs to be revised. The other indicators with p values < 0,05 were obtained concordance index between 0,90 and above experts so we were admitted to the final version. Conclusions: it can be concluded that the indicators, the constitutive definitions and the definitions/ operational magnitudes for the result of nursing NOC falls prevention behavior obtained agreement rate statistically higher than 0,90. Considered by the target population, therefore, great intelligibility, similar to that shown in the scientific literature and able to measure the construct behavior prevention of falls in the hospital. From this perspective this study semantically validated a Prevention of falls in order to support nurse, assistant in the development of effective preventive activities, based on an instrument of scientific evidence.

Objective: to determining the intelligibility of the indicators, constitutive and operational definitions of nursing behavior result of fall prevention by nurses in hospital units. Method: methodological research in adaptation to the instructions Hoskins validation model (1989), in order to performing the analysis of the intelligibility of the indicators, constitutive and operational definitions of nursing results NOC behavior of fall prevention. The instrument was therefore subjected to a sieve of nurses in a public teaching hospital of the health of the city of Natal/RN at the discretion of intelligibility chosen Psychometrics. Results: all indicators achieved or exceeded the concordance index of 0,90, except for one indicator, because the concordance was 0,58 and p < 0,05 as a result of the binomial test. It means therefore that this indicator needs to be revised. The other indicators with p values < 0,05 were obtained concordance index between 0,90 and above experts so we were admitted to the final version. Conclusions: it can be concluded that the indicators, the constitutive definitions and the definitions/ operational magnitudes for the result of nursing NOC falls prevention behavior obtained agreement rate statistically higher than 0,90. Considered by the target population, therefore, great intelligibility, similar to that shown in the scientific literature and able to measure the construct behavior prevention of falls in the hospital. From this perspective this study semantically validated a Prevention of falls in order to support nurse, assistant in the development of effective preventive activities, based on an instrument of scientific evidence.

This study was ubdertaken to investigate the content validity of an instrument about knowledge on nasogastric intubation, based on the Pasquali model of content validation. Methods: methodological study developped with 23 nurses judges, teachers from public higher education institutions in the state of Rio Grande do Norte, by the application of Content Validity Index (CVI) and the Kappa index. The majority of the research judges were female (87%), age between 25 and 57 years-old, teaching time experience between 1 and 34 years and experience in the discipline of Nursing Semiology and/or Semiotics between 1 and 32 years. Of the total judges, 78.3% had master's degree as the maximum degree and 69.6% exercised exclusively the teaching. In the overall evaluation, the instrument obtained CVI values above 0.75, 0.94 the total CVI and 0.88 the total Kappa. However, some changes were made and focused on the requirements: vocabulary, clarity, updating and accuracy. The instrument showed reliability and trustworthy to observe the nursing care quality, however requires the resubmission of instruments to the same judges to retest, beyond its clinical application, for a more precise and specific content validation.

This study was ubdertaken to investigate the content validity of an instrument about knowledge on nasogastric intubation, based on the Pasquali model of content validation. Methods: methodological study developped with 23 nurses judges, teachers from public higher education institutions in the state of Rio Grande do Norte, by the application of Content Validity Index (CVI) and the Kappa index. The majority of the research judges were female (87%), age between 25 and 57 years-old, teaching time experience between 1 and 34 years and experience in the discipline of Nursing Semiology and/or Semiotics between 1 and 32 years. Of the total judges, 78.3% had master's degree as the maximum degree and 69.6% exercised exclusively the teaching. In the overall evaluation, the instrument obtained CVI values above 0.75, 0.94 the total CVI and 0.88 the total Kappa. However, some changes were made and focused on the requirements: vocabulary, clarity, updating and accuracy. The instrument showed reliability and trustworthy to observe the nursing care quality, however requires the resubmission of instruments to the same judges to retest, beyond its clinical application, for a more precise and specific content validation.

Estudos epidemiológicos sobre Síndromes Mielodisplásicas (SMD) não são encontrados na literatura brasileira, o que requer investigação dessa doença prevalente em idosos e com incidência maior com o aumento da idade. Esse trabalho objetivou investigar o perfil sociodemográfico e clínico dos pacientes portadores de SMD. Trata-se de um corte transversal, desenvolvido no Rio Grande do Norte, realizado de janeiro de 2000 a dezembro de 2010. Para análise descritiva foi utilizado o programa Epi Info 2002, versão 3.5.2. Os cálculos da probabilidade de associação entre as características analisadas e o gênero foram realizados pelos Testes do qui-quadrado, de Fisher e Exato de Fisher. O nível de significância considerado foi de 0,05. O trabalho foi aprovado em seus aspectos éticos e metodológico pelo Comitê de Ética em Pesquisa CEP/HUOL protocolo 432/10. Dos 29 pacientes selecionados, houve predomínio de idosos, do sexo masculino, com baixa escolaridade, que apresentaram anemia como sintoma inicial. A maior parte foi de pessoas de pele branca, residentes em casa própria, moradores em zona urbana e com renda inferior a dois salários mínimos. Todos utilizaram terapia com hemoderivados, principalmente o concentrado de hemácias, numa frequência de quatro ou mais unidades por mês de consumo, sendo que 20% realizou dosagem de ferritina sérica, todos com valores acima do normal referenciado. Conclui-se que se faz necessário a realização de pesquisas com maiores populações, de caráter multicêntrico a fim de melhor evidenciamento dos dados sociodemográficos e clínicos com possibilidade de avaliação por regiões do país.