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Objective: translate and adapt the Facilitator Competency Rubric to the Portuguese language and the Brazilian culture, and analyze the measurement properties. Method: methodological study that completed the steps of translation, synthesis of translations, back translation, review by a Committee of Experts composed of 7 professionals, testing of the pre-final version with 33 simulation facilitators, and submission to the author of the original instrument. For content validation, the Content Validity Index and the modified Kappa Coefficient were calculated. For reliability, Cronbach’s α and the Intraclass Correlation Coefficient were evaluated by 52 and 15 simulation facilitators, respectively. Results: two rounds of content evaluation were carried out, resulting in changes to 19 items in the first evaluation and 3 items in the second. The overall scale achieved a Cronbach’s α of 0.98 and an Intraclass Correlation Coefficient of 0.95 to 0.97. Conclusion: the Facilitator Competency Rubric was translated and culturally adapted to the Brazilian reality and presented content validity, reliability and stability, with safe results for use in teaching and research.

ABSTRACT Objective: to build, evaluate and test two clinical simulation scenarios for the planning and management of infusion therapy by nurses. Methods: methodological study, with construction of scenarios based on the NLN Jeffries Simulation Theory and the theoretical model Vessel Health Preservation; evaluation of the scenario design by judges, with calculation of the Modified Kappa Coefficient (MKC); testing scenarios with the target audience. Results: scenarios built for: 1. Patient assessment and vascular device selection; and 2. Identification and management of deep vein thrombosis. In the evaluation by judges, testing of validated scenarios in relation to educational practices and simulation design, the items evaluated presented MKC values ≥ 0.74. Conclusion: two evidence-based scenarios related to infusion therapy were constructed, with high levels of agreement among judges regarding their design. In testing with nurses, good results were obtained regarding the design and structuring of educational practice.

Nurses play an important role in healthcare, and the Nursing Outcomes Classification is a key tool for the standardization of care. This study aims to validate the nursing outcome “Neurological Status” for patients with cerebrovascular diseases. A methodological study was performed in four phases. In Phase 1, the relevance of the indicators was evaluated by seven specialists and the modified kappa coefficient and content validity index were calculated. In Phase 2, conceptual and operational definitions were formulated. In addition, their content was validated with a focus group in Phase 3. In Phase 4, the results were applied in clinical practice and convergence with the National Institute of Health Stroke Scale was verified. The reliability was measured by Cronbach’s alpha. Of the 22 initial indicators, 6 were excluded. The focus group suggested changes in the definitions and the exclusion of two indicators. In Phase 4, only 13 indicators were validated due to the impossibility of measuring intracranial pressure. A strong correlation between the two scales and agreement among all the indicators were observed. Following the specialists’ review, the nursing outcome was reliable and clinically validated with 13 indicators: consciousness, orientation, language, central motor control, cranial sensory and motor function, spinal sensory and motor function, body temperature, blood pressure, heart rate, eye movement pattern, pupil size, pupil reactivity, and breathing pattern.

BackgroundSurviving a stroke poses a social and economic impact that requires the care system to be reformulated and the patient to be addressed in a comprehensive approach.PurposeThis study aims to investigate if there is a relationship between functional activities performed before the stroke, patients' clinical and hospitalization data, and functionality and quality of life measures in the first 6 months after the stroke.MethodsThis study used a prospective cohort of 92 patients. We investigated sociodemographic and clinical data, the modified Rankin Scale (mRS), and the Frenchay Activities Index (FAI) during hospitalization. The Barthel Index (BI) and EuroQol-5D (EQ-5D) were applied at the following time points: 30 days (T1), 90 days (T2), and 180 days (T3) following postictal state. Statistical analysis was conducted using Spearman's coefficient, Friedman's non-parametric test, and multiple linear regression models.ResultsNo correlation was found between FAI, BI, and EQ-5D average scores. Severe patients, patients with comorbidities, and patients with extended hospital stays showed lower BI and EQ-5D scores □in the follow-up. BI and EQ-5D scores increased.ConclusionThis research found no relationship between activities performed before the stroke and functionalities and quality of life after the stroke, but comorbidities and extended hospital stay were associated with worse outcomes.

Objective: to analyze clinical changes in the breastfeeding process in the Neonatal Intensive Unit Care using the Nursing Outcomes Classification. Methods: this longitudinal and prospective study was conducted in a public hospital at Neonatal Intensive Unit Care in Brazil. The sample consisted of 61 mother-infant dyads evaluated three times during breastfeeding by trained nurses who applied the Nursing Outcomes Classification scales. Statistical analysis was performed using Generalized Estimating Equation Models. Results: most indicators of the two Nursing Outcomes studied presented a similar frequency of scores of 4 and 5. It was observed that in most indicators, there were clinical changes throughout the evaluations over time; however, the indicators related to the mother presented a higher risk of scoring 4 and 5 on the Likert scale. Conclusion: the Nursing Outcomes Classification outcomes and indicators included successfully evaluated the clinical evolution of mother-infant dyads and proved to be applicable for use in Neonatal Intensive Unit Care. Contributions to practice: nurses can use the indicators to assess the quality of the proposed interventions.

ABSTRACT Objectives: to build, validate and verify the reliability of the Scale of knowledge about sexuality of people with spinal cord injury for nursing students. Methods: a methodological study, following the steps: 1) Construction based on literature review; 2) Validation of the content with calculation of the Content Validity Index and the Modified Kappa Coefficient; 3) Pre-test with Nursing students; and 4) Measurement of reliability by internal consistency (Cronbach’s alpha). Results: the first version of the instrument presented 13 items. After validation, the items received values above 0.80 and 0.76 for the Content Validity Index and Modified Kappa Coefficient, and it was suggested to separate three items to contemplate gender-specific aspects. After pre-testing, it was recommended that the writing of two items be revised. The final scale, with 16 items, showed Cronbach’s alpha equal to 0.93. Conclusions: the constructed scale presented valid content and proved to be reliable for application with nursing students.

ABSTRACT Objective: To adapt and validate the content of the Advanced Practice Nursing Competency Assessment Instrument (APNCAI) to Brazilian culture. Methods: This is a methodological study that followed the stages of translation, synthesis, back translation, evaluation by a committee of five specialists, pre-test with 31 nurses, and evaluation by the author of the original instrument. The Content Validity Index (minimum 0.90) and the modified Kappa (minimum 0.74) were calculated to evaluate the content. Result: In the first round of content evaluation, 18 items had to be altered because they did not reach the minimum values established. Three items have not reached a consensus in the second round and had to be sent to the author of the original version. In the pre-test, 13 items were returned to the specialists because they suffered content changes. Conclusion: The Advanced Practice Nursing Competency Assessment Instrument (APNCAI) - Brazilian version was cross-culturally adapted, and its content was validated.

Objetivo: explorar, na literatura científica, práticas atuais de cuidado de enfermagem ou intervenções para pacientes com síndrome respiratório agudo grave (SRAG) submetidos à posição prona. Síntese do conteúdo: revisão integrativa, na qual foram realizadas buscas nas bases de dados PubMed, CINAHL, Scopus, Web of Science e LILACS em setembro de 2020 e janeiro de 2022, sem recorte temporal, por meio da questão deste estudo: “Quais são os cuidados de enfermagem para pacientes com SRAG submetidos à posição prona?”. Foram selecionados 15 artigos, a partir da busca nas bases de dados. Após a leitura, os cuidados encontrados foram categorizados em alinhamento do corpo para a prevenção de lesões neuromusculares, cuidados com equipamentos diversos, cuidados tegumentares e recomendações neurológicas. Conclusões: o enfermeiro deve ter conhecimento sobre as implicações e as complicações de se manter um paciente na posição prona. Tal conhecimento permitirá tomadas de decisões na construção ou no seguimento de protocolos institucionais que contribuam com a prevenção de riscos e resultem em melhores desfechos para o paciente.

ABSTRACT Objective: To characterize the self-reported adherence of patients with cardiovascular diseases to the use of new oral anticoagulants and to identify factors related to adherence to these drugs. Method: This is a descriptive, correlational, and cross-sectional study, carried out with outpatients. The collection of sociodemographic, clinical, and adherence data, through the Measurement of Adherence to Treatments, was made through telephone calls. Descriptive, correlation, and multiple linear regression analyses were used. Results: A total of 120 patients using new anticoagulants for 32.3 months, on average, participated in the study. More than half of the sample consisted of women, who were professionally inactive, with a mean age of 70.1 years and a mean family income of 6.7 minimum wages. The mean adherence score was 5.7, in a possible range between 1 and 6, indicating medication adherence. Inactive employment status, female sex, higher family income, and follow-up at a public outpatient clinic were related to greater adherence to these medications. Conclusion: The patients showed high adherence to new anticoagulants. Employment status, sex, family income, and type of outpatient follow-up were related to medication adherence, and should be considered in the design of interventions for this public.

Objective: To identify the nursing diagnoses of risk for decreased cardiac tissue perfusion and risk for activity intolerance and establish the association between the components of both diagnoses and the signs and symptoms of acute coronary syndromes. Materials and methods: Observational and associative study with 75 patients diagnosed with acute coronary syndrome in a Brazilian public hospital. Inferential statistics and multiple Poisson regression models were applied. Results: 84% of the patients showed risk for activity intolerance and 80% reported risk for decreased cardiac tissue perfusion. Risk factors were present in more than 50% of the sample. The diagnoses showed a high frequency in patients with acute coronary syndrome. Pharmacological agents, presence of comorbidities, and family and personal history were associated with the diagnoses. Absence of evidence of decreased cardiac tissue perfusion as dyspnea, radiation to shoulder and jaw, and pain time less than ten hours acted as protective factors. Conclusion: There is a high cardiovascular vulnerability of patients with acute coronary syndrome to the proposed nursing diagnoses. Therefore, we recommend further studies to determine the predictive power of the assessed risk diagnoses for those focusing on this health problem.

ABSTRACT Objectives: to build and validate three clinical simulation scenarios and report the application with candidates for the specialist’s degree in stomatherapy. Methods: methodological study, building three scenarios and evaluation checklists; content validation with judges, using content validity index and Modified Kappa Coefficient; pre-test and application. Results: scenarios built based on nursing care for: 1. insufficiency and venous ulcer; 2. demarcation of intestinal stomia; and 3. Clean intermittent catheterization. In the content validation of the 24 items appreciated, 83%, 80%, and 92% were validated without change. In the pre-test, the objectives and checklists were adjusted. In the application, to standardize the evaluation, actors and evaluators were trained previously, and each candidate passed the three stations. Conclusions: scenarios built and with validated content, based on evidence and covering the three areas of stomatherapy. The pre-test allowed for adjustments in the scenarios, and the candidates achieved the expected objectives.

RESUMO Objetivo: Construir e validar instrumento para avaliar o conhecimento do enfermeiro sobre terapia nutricional enteral. Método: Estudo metodológico, com revisão de literatura, validação de conteúdo e pré-teste. Para a revisão, foram incluídos trabalhos publicados de 2008 a 2018 a respeito da terapia de nutrição enteral. O material foi apreciado por 6 juízes, seguindo os critérios da psicometria. Calculou-se percentual de concordância. O pré-teste foi realizado com 30 enfermeiros, a fim de verificar a adequação e o entendimento para uso na prática clínica. Resultados: Instrumento construído continha quatro domínios, com 10 itens cada. Os domínios Indicação da terapia enteral e Monitoramento da administração da dieta enteral apresentaram melhores percentuais de concordância - 0,94 e 0,93, respectivamente. As categorias que obtiveram valores abaixo de 0,90 foram reformuladas ou retiradas, resultando em 38 categorias distribuídas em 4 domínios. No pré-teste, a concordância foi de 0,90, sendo o instrumento considerado de fácil entendimento e adequado para a prática. Conclusão: O instrumento construído foi validado quanto ao conteúdo e à aplicação na prática pelos enfermeiros.

O objetivo foi identificar na literatura os indicadores dos Resultados de Enfermagem relacionados ao “Estabelecimento da amamentação”. Revisão Integrativa da literatura, que abrangeu estudos das bases de dados LILACS, PUBMED, CINAHL, SCOPUS, Web of Science, BDENF e EMBASE, em Português, Inglês e Espanhol, publicados de 2013 a 2017. Identificados 43 estudos, que contemplaram 17 dos 18 indicadores do “Estabelecimento da amamentação: mãe” e 12 dos 13 indicadores do “Estabelecimento da amamentação: lactente”. Quatro indicadores poderiam ser incluídos, segundo a análise dos dados. A maioria dos indicadores propostos pela Classificação dos Resultados de Enfermagem apresentou suporte na literatura, embora alguns demandem ajustes para descrição mais objetiva dos aspectos avaliados. Indicadores podem orientar a avaliação da amamentação de forma contínua, bem como da efetividade das intervenções, além de tornarem o registro padronizado e poderem auxiliar o processo educativo de estudantes e enfermeiros.

ABSTRACT Purpose: To prepare and validate the content of a checklist in order to assure the safety for outpatient surgical procedures. Method: Methodological research, performed between May and December 2018, as per three stages: 1) preparation of the checklist; 2) validation of content by five judges; and 3) preliminary testing of the instrument. The concord, among the judges, was measured by the Content Validity Index and the values over 0.9 were considered as being satisfactory. Results: Initially the instrument was prepared having 58 items, considering the heading and six topics. In the first round, two topics and 27 items had an index below 0.9. After reformulations, in the second round, only two items had values below 0.9 and, in the third, all items reached an index of 1.0. Along the preliminary testing, modifications were realized. The final version it has 43 items, distributed as per five topics. Conclusion: The “Checklist for Safe Surgery regarding Ambulatory Surgical Procedures” was prepared and its contents were validated.

Objective: to construct conceptual and operational definitions of Nursing Outcomes “Breastfeeding establishment: infant (1000)” and “Breastfeeding establishment: maternal (1001)”. Method: integrative literature review in the following databases: PUBMED (United States National Library of Medicine); LILACS (Latin American and Caribbean Health Sciences Literature); CINAHL (Cumulative Index to Nursing and Allied Health Literature); SciVerse SCOPUS; Web of Science; BDENF (Brazilian Nursing Database) and EMBASE (Excerpta Medica Database). The gray literature was explored to elucidate topics not covered by the articles. Of 3242 articles, 96 were selected to be read in full, and 43 were used for constructing the definitions. Five theses, three dissertations, three books and two manuals were selected. Results: all the results were reviewed. The definitions facilitated the improvement of the content proposed by the Nursing Outcomes Classification, favoring its application in clinical practice and supporting the development of research and teaching. Conclusion: it was proposed to change the definition of the two outcomes, as well as to change the title of one of them to “Breastfeeding establishment: newborn & infant” (1000), modifying seven of its indicators and excluding one. For the outcome related to the mother, it was proposed to modify two indicators and exclude one.

Objective: to verify and compare the intrinsic and extrinsic risk factors for falls among older community-dwelling people with and without a stroke history. Methods: a case group and three control groups were established and each group had 15 elderly individuals. Results: the statistical associations were: use of antihypertensive medication among the groups with falls, despite the occurrence of a stroke; use of angiotensin-converting enzyme inhibitor for elderly with a stroke who had an event of fall or not; foot alterations between the case group and people without falls or stroke. Gait difficulty and impaired physical mobility were statistically associated between the case group and people without the occurrence of stroke or falls. Conclusion: the stroke is associated with falls and the intrinsic factors presented greater statistical correlations, supporting the hypothesis that many factors influence the occurrence of falls.

RESUMO Objetivo: analisar as características definidoras do diagnóstico de enfermagem "desobstrução ineficaz de vias aéreas" em crianças com infecção respiratória aguda. Método: estudo transversal, descritivo, desenvolvido em dois hospitais especializados no atendimento a crianças. Realizou-se avaliação respiratória detalhada da criança para a identificação das características definidoras do diagnóstico em estudo. Resultados: foram avaliadas 249 crianças, sendo 55,8% do sexo masculino e com mediana de idade de 13,76 meses. Desobstrução ineficaz de vias aéreas foi identificado em 222 crianças (89,2%). As seguintes características definidoras apresentaram associação estatisticamente significante: dispneia, expectoração, ortopneia, ruídos adventícios respiratórios, sons respiratórios diminuídos e tosse ineficaz. Sons respiratórios diminuídos, tosse ineficaz e ruídos adventícios respiratórios compuseram o modelo de regressão logística. Conclusão: as características sons respiratórios diminuídos, tosse ineficaz e ruídos adventícios respiratórios apresentam melhor capacidade de predição para o diagnóstico "desobstrução ineficaz de vias aéreas" em crianças com infecção respiratória aguda.

A avaliação dos pacientes com feridas embasa a seleção de intervenções apropriadas; no entanto, a existência de instrumentos com diferentes parâmetros pode dificultar a escolha daquele mais adequado a cada necessidade. O objetivo do estudo foi identificarinstrumentos utilizados e seus respectivos parâmetros para avaliação do processo de cicatrização. Trata-se de uma revisão integrativa, realizada nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde, Cumulattive Index to Nursing and Allied Health Literarure, PubMed, Web of Science e Scopus. Foram considerados 35 estudos; o instrumento mais utilizado foi o PUSH, seguido da BWAT, DESING e DESIGN-R. As características mais avaliadas foram tamanho (área, volume, profundidade), exsudato, tipo de tecido, sinais de infecção ou inflamação. Os instrumentos evidenciaram a complexidade do processo de cicatrização e de sua avaliação, assim, o estudo contribui para embasar a escolha do melhor instrumento para cada necessidade.

Abstract Aim: To report the experience of applying different teaching strategies on undergraduate nursing students caring for burn victims. Method: Experience report on the topic, "Nursing care for the patient with burns", for undergraduate nursing student education. Results: Teaching strategies during this course involved theoretical lecture, discussion of clinical cases, use of a virtual environment, and practice in a simulated environment. The students reported satisfaction with the tools used. Conclusion: It is important to incorporate different active teaching strategies, such as clinical simulation practices, e-learning, classes incorporating dialogue, case studies, and others, for undergraduate nursing education on caring for the burn victim.

OBJECTIVE: to develop indicators for the nursing outcome Swallowing Status and the respective conceptual and operational definitions validated by experts and in a clinical setting among patients after having experienced a stroke.METHOD: methodological study with concept analysis and content and clinical validations. The Content Validation Index was verified for the scores assigned by 11 experts to indicators. Two pairs of nurses assessed 81 patients during the clinical validation: one pair used an instrument with definitions and the other used an instrument without definitions. The resulting assessments were compared using Intraclass Correlation Coefficient, Friedman's test, and Minimal Important Difference calculation.RESULTS: All the indicators, with the exception of the indicator Ability to bring food to mouth, presented Content Validation Index above 0.80. The pair using the instrument with definitions presented an Intraclass Correlation Coefficient above 0.80 for all the indicators and similarity was found in all the assessments, according to the Minimal Important Difference calculation. The pair using the instrument without definitions presented a low coefficient (ρ

Objective: to investigate the association of risk factors with the Risk for aspiration nursing diagnosis and respiratory aspiration. Method: cross-sectional study assessing 105 patients with stroke. The instrument used to collect data addressing sociodemographic information, clinical variables and risk factors for Risk for aspiration. The clinical judgments of three expert RNs were used to establish the diagnosis. The relationship between variables and strength of association using Odds Ratio (OR) was verified both in regard to Risk for aspiration and respiratory aspiration. Results: risk for aspiration was present in 34.3% of the patients and aspiration in 30.5%. The following stood out among the risk factors: Dysphagia, Impaired or absent gag reflex, Neurological disorders, and Impaired physical mobility, all of which were statistically associated with Risk for aspiration. Note that patients who develop such a diagnosis were seven times more likely to develop respiratory aspiration. Conclusion: dysphagia, Impaired or absent gag reflex were the best predictors both for Risk for aspiration and respiratory aspiration.

Estudos sobre indicadores de risco cardiovasculares são importantes em escolares. O objetivo do estudo foi associar os valores da pressão arterial sistólica (PAS) e da pressão arterial diastólica (PAD) com os dados antropométricos índice de massa corporal (IMC), relação cintura-quadril (RCQ), pregas cutâneas tricipital e subescapular, sedentarismo, etilismo, tabagismo e história familiar de alterações cardiovasculares nos escolares que mantiveram valores da pressão arterial acima do percentil 90 em três avaliações da saúde cardiovascular. Estudo de coorte, realizado em uma escola pública de Fortaleza, no período de 2004 a 2006. Foram avaliados os indicadores de risco e a pressão arterial de 480 escolares. Os escolares que apresentaram, na primeira avaliação, valores iniciais da pressão arterial acima do percentil 90 foram acompanhados em mais duas avaliações, com vistas a se confirmar alterações da pressão arterial. A amostra foi composta por 85 escolares. Nas crianças os valores da PAS estiveram correlacionados com a idade e a altura. Já a PAD esteve correlacionada com o perímetro do quadril, peso e altura. Nos adolescentes, os valores da PAS e da PAD estiveram correlacionados com a altura. Reforça-se a importância de estudos que avaliem e acompanhem os indicadores de risco e a pressão arterial de escolares.

O estudo teve por objetivo analisar os efeitos da sondagem gástrica em pacientes com acidente vascular cerebral e disfagia. Revisão sistemática da literatura, realizada em seis bases de dados, com os descritores stroke e intubation, gastrointestinal. Foram encontrados 120 estudos e selecionados três ensaios clínicos. Os resultados apontaram diferentes desfechos, entre os quais: aumento do nível sérico de albumina (gastrostomia), prognóstico ruim e risco de morte (gastrostomia), aumento das falhas no tratamento devido a bloqueio, deslocamento e reinserção da sonda nasogástrica, e aumento da incidência de hemorragia gastrointestinal (sonda nasogástrica). A partir dos resultados obtidos nesta revisão sistemática, ressaltam-se as seguintes evidências: a sondagem nasogástrica deve ser adotada precocemente como um método de alimentação enteral; as falhas do tratamento são mais comuns naqueles que utilizam a sonda nasogástrica como método de alimentação; os resultados relacionados à melhora do estado funcional dos pacientes foram semelhantes, independente do método de terapia nutricional empregado.

O objetivo do estudo foi comparar quatro grupos de idosos com e sem acidente vascular cerebral e quedas. Estudo do tipo caso-controle, desenvolvido na cidade de Fortaleza, em 2010. Dados coletados por entrevista através de um formulário que avaliou variáveis sociodemográficas, percepção de saúde e o índice de massa corporal de 60 idosos. Os grupos eram em maioria mulheres (66,7%), com média de idade de 69,86 a 71 anos. Os que sofreram acidente vascular cerebral apresentaram uma média de 1,4 eventos (±0,67), em um tempo médio de 5,6 anos (±7,5). Quanto aos grupos com quedas, o número de eventos foi ligeiramente maior naqueles com acidente vascular cerebral (1,4 ±0,63). A maioria referiu um estado de saúde regular e encontrava-se com sobrepeso ou obesidade. Conclui-se que os fatores de risco para quedas devem ser continuamente avaliados por profissionais qualificados, no intuito de manter favoráveis as condições de saúde do idoso. ABSTRACT The study aimed to compare four groups of elderly with and without stroke and falls. A case-control study that was performed in Fortaleza city, 2010.Data collected by interview through a form that evaluated demographic variables, health status and body mass index in 60 elderly. Most of the groups were composed by women (66.7%), mean age of 69.86 to 71 years. Those who had suffered a stroke had presented an average of 1.4 events (±0.67) at a time of 5.6 years (±7.5). The number of stroke was slightly higher (1.4 ±0.63) at the groups with fall history. The majority reported a regular health condition and was overweight or obese. This way, the risk factors for falls should be continuously evaluated by qualified professionals, in order to maintain favorable conditions for elderly health. RESUMEN El objetivo del estúdio fue comparar cuatro grupos de ancianos con y sin accidente cerebrovascular y caídas. Estudio de caso-control, desarrollado en 2010, en la ciudad de Fortaleza-CE-Brasil. Datos recogidos mediante entrevista a través de un formulario que evaluó variables sociodemográficas, percepción de salud y el índice de masa corporal de 60 ancianos. Los grupos eran formados por mayoría de mujeres (66,7%), edad media de 69,86 a 71 años. Aquellos con accidente cerebrovascular presentaron una media de 1,4 eventos (±0,67), en un tiempo medio de 5,6 años (±7,5). Cuanto a los grupos con caídas, el número de eventos fue ligeramente superior en personas con accidente cerebrovascular (1,4 ±0,63). La mayoría informó salud regular y tenía sobrepeso u obesidad. Se concluye que los factores de riesgo para caídas deben ser continuamente evaluados por profesionales cualificados, con el objetivo de mantener condiciones favorables para la salud del anciano.

A análise de conceito configura-se importante no intuito de melhorar a compreensão de determinado fenômeno, em auxílio à prática profissional. O objetivo do estudo foi analisar o conceito comportamento de prevenção no contexto de doença crônica com base no modelo preconizado por Walker e Avant, em 2005. Realizou-se, em 2011, uma revisão integrativa em bases de dados usando-se combinações de descritores. Selecionaram-se artigos disponíveis eletronicamente e que respondessem às perguntas elaboradas. Assim, 146 resumos foram lidos e 25 publicações selecionadas. Identificaram-se elementos do fenômeno, como atributos: habilidade, conhecimento e atitude; antecedentes: ocorrência de doença, identificação de fatores de risco, tomada de decisão e rede de apoio; e consequentes: autogestão do indivíduo, domínio de habilidades, adaptação e melhoria na qualidade de vida. Por conseguinte, foi possível elaborar um conceito mais completo do fenômeno comportamento de prevenção que, por sua vez, poderá auxiliar o profissional envolvido com ações preventivas. ABSTRACT: Concept analysis proves important to improving the understanding of a given phenomenon and to supporting professional practice. This study aimed at analyzing the concept of prevention behavior in the context of chronic disease on the basis of the model referred by Walker and Avant in 2005. In 2011 an integrative review on databases was performed with combinations of descriptors. Online articles addressing the questions made were selected. Thereby, 146 abstracts were read and 25 publications were selected. Elements of the phenomenon were identified as attributes: skill, knowledge, and attitude; antecedents: disease occurrence, identification of risk factors, decision making, and support network; and consequences: individual self-management, mastery of skills, adaptation, and improvement in quality of life. As a result, it was possible to formulate a wider concept of behavior prevention, which, on its turn, can help the health professional in preventive action. RESUMEN: El análisis de concepto és importante para mejorar la comprensión de fenómenos específicos a la práctica profesional. El objetivo del estudio fue analizar el concepto comportamiento de prevención en el contexto de enfermedad crónica por el modelo recomendado por Walker y Avant, en 2005. En 2011 se realizó una revisión integrativa en bases de datos utilizando combinaciones de descriptores. Fueron seleccionados artículos disponibles y que respondiesen a las preguntas elaboradas. Así, 146 resúmenes fueron leídos y 25 publicaciones seleccionadas. Los elementos del fenómeno identificados fueron atributos: habilidad, concocimiento y actitud; antecedentes: ocurencia de enfermedad, identificación de factores de riesgo, tomada de decisión y redes de apoyo; y consecuentes: autogestión del individuo, dominio de habilidades, adaptación y mejora de la calidad de vida. Así, fue possible elaborar un concepto más completo del fenómeno comportamiento de prevención que así, podrá ayudar el profesional que participa de acciones preventivas de salud.

The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%), elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8%) and instrumental (80.3 %) activities of daily living, and a low cognitive level (95.1%). Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

O Programa de Atendimento Domiciliar agrega em suas atribuições inúmeras Competências Essenciais, tais como as propostas pela Agência de Saúde Pública do Canadá. Dessa forma, buscou-se avaliar a inserção dessas competências essenciais neste programa. Trata-se de um estudo transversal, realizado de janeiro a abril de 2010, com cuidadores e pacientes assistidos pelo programa. Utilizaram-se formulários e diário de campo para a coleta de dados e posteriormente buscou-se avaliar as atividades exercidas no âmbito das competências essenciais preconizadas. Assim, foi possível perceber que as atribuições exercidas pelo programa ainda se encontram aquém do que é almejado, haja vista a lógica biomédica empregada, que conduziu à implementação parcial de Competências Essenciais como: Políticas de Saúde Pública; Planejamento e Implementação; Parceria, Colaboração e Apoio e Liderança. Tal fato denota a necessidade de maiores esforços governamentais e por parte dos profissionais envolvidos no programa com vistas à melhoria da atenção oferecida.

Objetivou-se avaliar o processo de validação clínica de diagnósticos, intervenções e resultados de enfermagem em revisão de literatura. Selecionaram-se dois artigos, seis dissertações e oito teses, dos quais 14 correspondiam a trabalhos sobre os diagnósticos e dois a estudos com resultados de enfermagem. Os delineamentos dos estudos e as análises são aspectos ainda frágeis. Quanto aos referenciais metodológicos identificados, o modelo de validação de Fehring foi o mais usado. A etapa de validação clínica foi executada predominantemente por enfermeiros expertos. Ressaltou-se a importância da realização do teste piloto, utilização de um padrão-ouro e uso de variados testes estatísticos. Apesar das diferenças metodológicas, os autores enfatizaram a necessidade de novas validações com populações maiores e diferentes. Conclui-se que a etapa de validação clínica é fundamental, embora ainda não haja um percurso metodológico uniforme no concernente ao seguido pelos estudos. É necessário desenvolver e aprimorar as taxonomias e seus componentes. ABSTRACT The study aimed to evaluate the clinic validation process of diagnoses, interventions and nursing outcomes. Were selected two articles, six master dissertations and eight PhD thesis, fourteen of wich corresponded to researches about diagnoses and two were about Nursing Outcomes. Was realized that the studies design and the data analisis were aspects already weak. The Fehring validation model was the most common methodological reference identified. The clinic validation fase was preformed mainly by experts nurses. It can hightlight the importance of accomplish pilot testing besides to use a gold standard and variable use of statistical tests. Despite methodological diferences the authors emphasized need for futher validations with larger and different populations. The conclusion is that the clinic validation is essential, although there isn’t an uniform methodological course followed by the studies. It is necessary to develop and improve the taxonomies and its components. RESUMEN El objetivo fue evaluar el proceso de validación clínica de diagnósticos, intervenciones y resultados de enfermería. Fueron seleccionados dos artículos, seis disertaciones de mestría y ocho tesis doctorales, 14 trabajos abordaron diagnósticos y dos estúdios abordaron resultados de enfermería. Se observó que el diseño de los estudios y los análisis de datos son aun frágiles. Sobre los referenciales metodológicos, el modelo de validación de Fehring fue lo más utilizado. La etapa de validación clínica fue hecha predominantemente por enfermeros expertos. Se destacó la importancia del desarrollo de test piloto, utilización de un patrón-oro y variados tests estadísticos. A pesar de las diferencias medotológicas, los autores hicieron hincapié a la necesidad de nuevas validaciones con publaciones más grandes y distintas. Se concluye que la etapa de validación clínica es fundamental, aunque no exista un curso metodológico uniforme seguido por los estudios. Es necesario desarrollar y mejorar las taxonomías y sus componentes.

La ocurrencia de caídas representa obstáculo en la salud de ancianos y aumenta su dependencia. El objetivo fue investigar los factores de riesgos intrínsecos y extrínsecos, además de posibles asociaciones estadísticas para caídas en ancianos en los últimos seis meses. Estudio caso-control con enfoque cuantitativo, desarrollado en tres Asociaciones de Rehabilitación y un Centro de Asistencia Social, con dos grupos con treinta ancianos cada, un grupo con caídas (caso) y otro sin caídas (control). Datos recogidos de enero hasta abril de 2010, por formulario. Los datos fueron organizados en plantillas y analizados por programa estadístico. El grupo caso presentó peores condiciones intrínsecas y más factores extrínsecos. Entre los factores de riesgo intrínsecos estadísticamente significativos, se señalan: alteraciones en los pies, equilibrio perjudicado y alteraciones propioceptivas. Por el refuerzo de la hipótesis de multicausalidad para ocurrencia de caídas, la posibilidad de actuación del enfermero.

OBJECTIVE: to analyze the impact that caring has on a member of the family caring for a patient after a cerebrovascular accident, correlating life modifications and mental suffering with the perceived burden. METHOD: a cross-sectional, quantitative study, undertaken in January-April 2010 in Fortaleza, Ceará, Brazil. RESULT: 61 individuals were investigated, monitored by three hospitals' Home Care Program. Data collection was through interviews for identifying life changes, and through the application of three scales for investigating perceived burden, mental state and mental suffering. Respectively these were the Caregiver Burden Scale (CBS), the Mini-Mental State Examination (MMSE) and the Self Reported Questionnaire (SRQ). The majority of the carers were female, married, and the children of the stroke patients. The average age was 48.2 years (±12.4). The most-cited life modifications referred to the daily routine, to leisure activities, and to exhaustion or tiredness. Regarding burden, the dimensions of General tension, Isolation and Disappointment stood out. It was ascertained that overload was more severe when the carer presented more symptoms of psychological distress, in the absence of a secondary carer, and when the principal carers reported perceiving changes in their bodies and health. CONCLUSION: an association between burden and the carer's mental state was not observed. Understanding the care, through analysis of the burden and of the knowledge of the biopsychosocial situation will provide support for the nurse's work in reducing the overload for family caregivers.OBJETIVO: analizar el impacto del cuidar para el cuidador familiar de paciente después de accidente vascular cerebral, correlacionando modificaciones de vida y sufrimiento psíquico con la sobrecarga percibida. MÉTODO: estudio transversal, cuantitativo, realizado de enero a abril de 2010, en Fortaleza, Ceará, Brasil. RESULTADO: se investigaron 61 individuos, acompañados por el Programa de Servicio Domiciliar de tres hospitales. La colecta de los datos ocurrió mediante entrevista para identificar modificaciones de vida, y con la aplicación de tres escalas para investigar la sobrecarga percibida, estado mental y sufrimiento psíquico. Son ellas, respectivamente: Caregiver Burden Scale (CBS), Mini Examen del Estado Mental (MEEM) y Self Reported Questionnaire (SRQ). Los cuidadores, en su mayoría, eran del sexo femenino, casados (as) e hijo (as) de los pacientes después del AVC. Edad Media de 48,2 años (±12,4). Las modificaciones de vida más citadas fueron referentes a la rutina diaria, a las actividades de ocio y agotamiento o cansancio. En cuanto a la sobrecarga, se destacaron las dimensiones Tensión general, Aislamiento y Decepción. Se verificó mayor sobrecarga cuanto más síntomas de sufrimiento psíquico el cuidador presentase, en la ausencia de cuidador secundario y cuando los cuidadores principales relataron percibir modificación en el cuerpo y en la salud. CONCLUSIÓN: no fue observada asociación de la sobrecarga con el estado mental del cuidador. Entender la coyuntura del cuidado, mediante análisis del recargo de trabajo, y del conocimiento de la situación biopsicosocial, suministrará subsidios para la actuación del enfermero para reducir la carga generada para los cuidadores familiares.OBJETIVO: analisar o impacto do cuidar para o cuidador familiar de paciente após acidente vascular cerebral (AVC), correlacionando modificações de vida e sofrimento psíquico com a sobrecarga percebida. MÉTODO: estudo transversal, quantitativo, realizado de janeiro a abril de 2010, em Fortaleza, Ceará, Brasil. RESULTADO: investigaram-se 61 indivíduos, acompanhados pelo Programa de Atendimento Domiciliar (PAD), de três hospitais. A coleta dos dados ocorreu mediante entrevista para identificar modificações de vida, e com a aplicação de três escalas para investigar sobrecarga percebida, estado mental e sofrimento psíquico. São elas, respectivamente: Caregiver Burden Scale (CBS), Miniexame do Estado Mental (MEEM) e Self Reported Questionnaire (SRQ). Os cuidadores, na sua maioria, eram do sexo feminino, casados(as) e filho(as) dos pacientes após AVC. A média de idade era de 48,2 anos (±12,4). As modificações de vida mais citadas foram referentes à rotina diária, às atividades de lazer e esgotamento ou cansaço. Quanto à sobrecarga, destacaram-se as dimensões tensão geral, isolamento e decepção. Verificou-se maior sobrecarga quanto mais sintomas de sofrimento psíquico o cuidador apresentasse, na ausência de cuidador secundário e quando os cuidadores principais relataram perceber modificação no corpo e na saúde. CONCLUSÃO: não foi observada associação da sobrecarga com o estado mental do cuidador. Entender a conjuntura do cuidado, mediante análise da sobrecarga de trabalho, e do conhecimento da situação biopsicossocial fornecerá subsídios para a atuação do enfermeiro para reduzir a carga gerada para os cuidadores familiares.

O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.

O estudo teve como objetivo identificar os diagnósticos de enfermagem da classe atividade/exercício da North American Nursing Diagnosis Association (NANDA), edição de 2008, em pacientes com acidente vascular cerebral (AVC). Estudo exploratório, desenvolvido em unidades de reabilitação de Fortaleza-CE, no período de 2007 a 2008, por meio de entrevista e exame físico. Os dados foram compilados no Excel e analisados pelo Statistical Package for the Social Sciences versão 16.0. Adotou-se o nível de significância de 5%. As recomendações éticas foram seguidas. Avaliaram-se 121 pessoas, com idade média de 62,1 anos, sendo 52,3% homens, com média de 1,5 episódios de AVC em 3,4 anos. Em média, os participantes apresentaram 6,7 diagnósticos de enfermagem, com 25,1 características definidoras e 4,6 fatores relacionados. Todos os diagnósticos da classe em estudo foram identificados. O estudo permitiu o conhecimento aprofundado da classe atividade/exercício da NANDA em portadores de AVC. ABSTRACT: The study surveyed North American Nursing Diagnosis Association (NANDA), 2008 edition, Activity/Exercise class nursing diagnoses among stroke patients. This exploratory study was conducted at rehabilitation units in Fortaleza from 2007 to 2008, through interviews and physical examination. Data were compiled in Excel and analyzed using Statistical Package for the Social Sciences version 16.0. A 5% level of significance was adopted. The ethics recommendations were followed. Participants evaluated totaled 121; mean age was 62.1 years; 52.3% were men; and mean stroke events was 1.5 in 3.4 years. Participants displayed a mean of 6.7 nursing diagnoses, besides 25.1 defining characteristics and 4.6 related factors. All the diagnoses studied were identified. The study provided in-depth knowledge of NANDA Activity/Exercise class diagnoses in stroke patients. RESUMEN: El estudio tuvo como objetivo identificar los diagnósticos de enfermería de la clase actividad/ejercicio de la North American Nursing Diagnosis Association (NANDA), edición 2008, en pacientes con accidente vascular cerebral (AVC). Estudio exploratorio, desarrollado en unidades de rehabilitación, de 2007 hasta 2008, en Fortaleza-CE-Brasil, por medio de entrevista y examen físico. Los datos fueron compilados en el Excel y analizados por el programa Statistical Package for the Social Sciences versión 16.0. El nivel de significación fue de 5%. Las recomendaciones éticas fueron seguidas. Participaron 121 personas, con edad media de 62,1 años, 52,3% eran varones, con media de 1,5 episodios de AVC en 3,4 años. En media, los participantes tenían 6,7 diagnósticos de enfermería; 25,1 características definitorias y 4,6 factores relacionados. Todos los diagnósticos de la clase en el estudio fueron identificados. El estudio permitió un conocimiento detallado de la clase actividad/ejercicio de la NANDA en pacientes con AVC.

Estudo proposto para verificar a presença do diagnóstico de enfermagem (DE) "Risco de quedas de idosos com acidente vascular cerebral (AVC)". Trata-se de estudo observacional, exploratório, transversal, com análise descritiva, realizado em uma associação beneficente de reabilitação em Fortaleza/CE, Brasil, de janeiro a março de 2010, por fonte primária, com entrevista e exame físico, com idosos que tiveram pelo menos um episódio de AVC. Participaram 37 indivíduos: 20 (54,1%) mulheres, média de 70,6 anos; 18 (48,6%) residiam com companheiro, média de 5,2 anos de estudo. O Risco de quedas foi identificado em todos os idosos. Dentre os fatores de risco identificados, destacaram-se: Equilíbrio prejudicado (100%), Idade acima de 65 anos (83,7%) e Déficit proprioceptivo (83,7%). Os enfermeiros devem considerar o risco de quedas como um dos enfoques do cuidado de enfermagem, bem como implementar e avaliar os resultados de intervenções relativas à prevenção de quedas.El propósito del estudio fue evaluar la presencia del diagnóstico de enfermería riesgo de caídas en pacientes ancianos con accidente cerebrovascular. Observacional, exploratorio, descriptivo y transversal. Desarrollado en asociación de rehabilitación en Fortaleza, de enero hasta marzo del 2010 por entrevistas de fuentes primarias y examen físico, hecho en personas con por lo menos un episodio de accidente cerebrovascular. 37 personas participaron, de los cuales 20 (54,1%) eran mujeres, con 70,6 años como promedio, 18 (48,6%) vivían con compañero, promedio de 5,2 años de estudio. El riesgo de caídas se encuentra en todas las personas mayores. Entre los factores de riesgo identificados se resalta: alteración del equilibrio (100%), Mayores de 65 años (83,7%) y Déficit propioceptivo (83,7%). Las enfermeras deben considerar el riesgo de caídas como el foco de atención de enfermería, así como desarrollar y evaluar los resultados de intervenciones para la prevención de caídas.The purpose of this study was to verify the presence of a nursing diagnosis of fall risk in elderly with stroke. Observational, exploratory and cross-sectional study with descriptive analysis. Performed in a charitable rehabilitation association in Fortaleza city, from January to March 2010, by primary source, by interviews and physical examination with elderly people who had at least one episode of stroke. 37 individuals participated, of which 20 (54.1%) were women, with mean age of 70.6 years, and 18 (48.6%) lived with a partner and had an average of 5.2 years of study. The risk of falls was found in all elderly. Among the risk factors identified, it is possible to highlight: Impaired balance (100%), Age above 65 years (83.7%), and Proprioceptive deficit (83.7%). Nurses must consider the risk of falls as a nursing care focus and implement and evaluate the results of interventions for fall prevention.

Investigación exploratoria desarrollada de noviembre/2010 a febrero/2011 con muestra de 38 sujetos con hipertensión. El objetivo fue identificar el diagnóstico de enfermería Falta de adhesión en pacientes con hipertensión arterial acompañados en la atención básica de Caucaia/Ceará, Brasil. Los datos fueron recogidos por encuesta basada en características definidoras y factores relacionados del diagnóstico y sometidos a evaluación por dos enfermeras para inferencia diagnóstica. La mayoría de los participantes era mujer, anciana, jubilada, con baja escolaridad y renta familiar, presencia de comorbilidad y polifarmacia. Se identificaron 36,8% entrevistados con diagnóstico estudiado. Las características más presentes fueron comportamiento indicativo de fracaso en adhesión y manejo inadecuado del tratamiento no farmacológico, y el factor más percibido fue conocimiento deficiente para seguimiento del régimen terapéutico farmacológico o no. El diagnóstico investigado fue frecuente en la población en cuestión, lo que puede contribuir para mejorar acciones del enfermero en la atención primaria.

O objetivo desse estudo foi identificar a ocorrência do diagnóstico de enfermagem Risco de quedas em indivíduos idosos acometidos por acidente vascular encefálico. Estudo do tipo exploratório, realizado em unidades de reabilitação, no período de novembro de 2007 a março de 2008, por meio de entrevista e exame físico. Utilizou-se a Taxonomia II da Nursing American North Diagnosis Association quanto à nomeação diagnóstica. A população foi composta por 73 idosos com idade média de 69,5 anos, predominância do sexo feminino, baixo nível de escolaridade e renda financeira. Encontrou-se média de 1,6 episódio de acidente vascular encefálico em 2,4 anos. O diagnóstico esteve presente na totalidade dos participantes, e os fatores de risco mais percebidos foram: Força diminuída nas extremidades inferiores, Mobilidade física prejudicada, Dificuldades na marcha e Equilíbrio prejudicado. Assim, a avaliação diagnóstica contínua e individualizada faz-se imprescindível para nortear ações preventivas aos problemas de saúde dos idosos.El estudio tuvo como objetivo identificar la ocurrencia del diagnóstico de enfermería Riesgo de caídas en ancianos con enfermedad cerebrovascular. Estudio exploratorio, desarrollado en unidades de rehabilitación, de noviembre de 2007 a marzo de 2008, por medio de entrevista y examen físico. Se utilizó la Taxonomía II de la Nursing American North Diagnosis Association para la designación del diagnóstico. La populación fue compuesta por 73 ancianos con 69,5 años en media, predominancia de mujeres, bajo nivel educacional y renta financiera. Se encontró media de 1,6 episodios de enfermedad cerebrovascular en 2,4 años. El diagnóstico fue presente en la totalidad de los participantes y los factores de riesgo más percibidos fueron: Disminución de la fuerza en las extremidades inferiores, Movilidad física perjudicada, Dificultades en la marcha y Equilibrio perjudicado. La evaluación diagnóstica continua e individualizada es imprescindible para direccionar las acciones preventivas a los problemas de salud de los ancianos.The aim of the study was to identify the occurrence of the nursing diagnosis Risk of falls in elderly who suffered a stroke. Exploratory study realized in rehabilitation units from November 2007 to March 2008 through an interview and physic examine. The Taxonomy II of Nursing American North Diagnosis Association was used for the nursing diagnosis nomination. The population was composed by 73 aged with an average age of 69,5 years, mostly women, beyond low school grade and low financial income. It was found an average of 1,6 stroke episodes in 2,4 years. The diagnosis was present at all participants and the risk factors more identified were: Decreased strength in the lower limbs, Impaired Physical Mobility, Gait Difficult and Balance Impaired. Thus, a continuos and individualized diagnosis evaluation is very important to improve preventive actions to health problems of elderly.

O estudo teve como objetivo investigar a ocorrência do diagnóstico de enfermagem Mobilidade Física Prejudicada em pacientes com AVE. Estudo exploratório, desenvolvido em unidades de reabilitação, de novembro de 2007 a março de 2008, por meio de entrevista e exame físico. A Taxonomia II da NANDA foi utilizada para a identificação do diagnóstico. Foram avaliados 121 indivíduos, com idade média de 62,1 anos, 52,3% homens, com média de 1,5 episódio de AVE em 3,4 anos. O diagnóstico esteve presente em 90%, com média de 5,8 características definidoras. Dificuldade para virar-se foi a característica mais presente, e 3,4 fatores foram relacionados por paciente, com destaque para a Força muscular diminuída, além de Prejuízos neuromusculares (100%). Destaca-se a necessidade de enfocar-se esse diagnóstico no planejamento das intervenções após o AVE, com vistas à promoção da saúde desses pacientes.El estudio tuvo como objetivo investigar la ocurrencia del diagnóstico de enfermería Movilidad física disminuida en pacientes con AVE. Estudio exploratorio, desarrollado en unidades de rehabilitación, desde noviembre de 2007 a marzo de 2008, a través de entrevistas y exámenes físicos. Para la identificación del diagnóstico se utilizó la Taxonomía II de la NANDA. Fueron evaluados 121 individuos, con edad media de 63,1 años, 52,3% hombres, con un promedio de 1,5 episodios de AVE en 3,4 años. El diagnóstico se verificó en el 90%, con una media de 5,8 características distintivas. La dificultad para darse vuelta fue la característica más presente, con 3,4 factores relacionados por paciente, con relevancia de la fuerza muscular disminuida, además de trastornos neuromusculares (100%). Se destaca la necesidad de enfocarse ese diagnóstico en el planeamiento de las intervenciones posteriores al AVE, en vistas a la mejoría de la salud de dichos pacientes.The study aimed to investigate the occurrence of Nursing Diagnosis Impaired Physical Mobility in patients with stroke. This exploratory study was developed at rehabilitation units from November 2007 to march 2008, through an interview and physical examination. Nursing diagnoses were made using NANDA Taxonomy II. A total 121 patients were evaluated. Subjects' average age was 62.1 years, 52.3% were males with an average 1.5 stroke events in 3.4 years. The diagnosis was present in 90%, with an average of 5.8 defining characteristic. Difficulty turning was the most present characteristic and there were 3.4 related factors per patient, and most reported decreased strength and endurance besides neuromuscular impairment (100%). There should be a closer look towards this diagnosis when planning interventions after a stroke with aiming at health promotion for these patients.

Estudos sobre indicadores de risco cardiovasculares são importantes em escolares. O objetivo do estudo foi associaros valores da pressão arterial sistólica (PAS) e da pressão arterial diastólica (PAD) com os dados antropométricosíndice de massa corporal (IMC), relação cintura-quadril (RCQ), pregas cutâneas tricipital e subescapular,sedentarismo, etilismo, tabagismo e história familiar de alterações cardiovasculares nos escolares que mantiveramvalores da pressão arterial acima do percentil 90 em três avaliações da saúde cardiovascular. Estudo de coorte,realizado em uma escola pública de Fortaleza, no período de 2004 a 2006. Foram avaliados os indicadores de risco e apressão arterial de 480 escolares. Os escolares que apresentaram, na primeira avaliação, valores iniciais da pressãoarterial acima do percentil 90 foram acompanhados em mais duas avaliações, com vistas a se confirmar alterações dapressão arterial. A amostra foi composta por 85 escolares. Nas crianças os valores da PAS estiveram correlacionadoscom a idade e a altura. Já a PAD esteve correlacionada com o perímetro do quadril, peso e altura. Nos adolescentes,os valores da PAS e da PAD estiveram correlacionados com a altura. Reforça-se a importância de estudos que avalieme acompanhem os indicadores de risco e a pressão arterial de escolares.

The occurrence of falls represents an obstacle in the health of the elderly, and it contributes to increase their dependence. This study aimed to investigate the intrinsic and extrinsic risk factors, and possible statistical associations for falls in elderly people in the last six months. A case-control study with quantitative approach developed in three Rehabilitation Associations and one Social Assistance Center, with two groups with thirty participants each, a group with falls (case) and another group without falls (control). The data were collected from January to April 2010 by a form, and were organized is spreadsheets and analyzed by a statistical program. The case group presented worst intrinsic conditions and more extrinsic factors. Feet alterations, impaired balance and proprioceptive deficit were highlighted among the intrinsic risk factors that were statistically significant. The conclusion is the reinforcement of multifactorial hypothesis for falls occurrence with possibilities for nurse’s performance.

This study aimed to evaluate the effect of the spiritual support intervention on spirituality and the clinical parameters of women who have undergone mastectomy. This is a pilot study of a randomized clinical trial. The spiritual support intervention was composed of meditation, guided imagery, music, and respiratory relaxation. The outcomes were: spirituality, blood pressure, heart rate, and oxygen saturation. A total of 27 patients were recruited for the study (intervention group, n = 13; control group, n = 14) (Clinical Trials: NCT 01866670/CAE: 00896312.0.0000.5393). The intervention helped patients with breast cancer to increase expression of their spirituality (p = 0.040) and it also decreased heart rate on the first (p = 0.038) and third day (p = 0.017). There was a difference in oxygen saturation on the second day in the control group (p = 0.039). Patients reported that their participation in the research was positive. This intervention had an effect on the sample of women who had undergone mastectomy.

Exploratory research conducted from November/2010 to February/2011with a sample of 38 patients with hypertension. The objective was to identify the nursing diagnosis of noncompliance in patients with hypertension treated by Primary Health of the County of Caucaia/Ceará. Data was collected based on defining characteristics and related factors to the diagnosis and submitted for evaluation by two nurses for diagnostic inference. Most participants were women, elderly, retired, with low education and family income, presence of comorbidities and polypharmacy. 36.8% of evaluated patients were diagnosed. The most frequent characteristics were indicative behavior of failure in adhesion and inadequate management of non-medication treatment and the most outstanding factor was the insufficient knowledge to the sequence of drug treatment regimen and non-medication treatment. We conclude that the diagnosis has been quite prevailing in this population, which may contribute to better guide the actions of nurses in primary care.

ABSTRACT Objective: To present the concept and development of teaching strategies and the assessment tools regarding clinical reasoning for accurate practice. Method: This is a theoretical reflection based on scientific studies. Results: Comprehension of the essential concepts of the thought process and its articulation with the different teaching strategies and the assessment tools which has allowed presenting ways to improve the process of diagnostic or therapeutic clinical reasoning. Conclusion: The use of new strategies and assessment tools should be encouraged in order to contribute to the development of skills that lead to safe and effective decision making.

Objective: To identify the knowledge produced from the outcomes of the Nursing Outcomes Classification (NOC). Method: A literature review using the integrative databases: Latin American and Caribbean Health Sciences (LILACS), US National Library of Medicine (PubMed), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Scopus Info Site (SCOPUS), during the months of August and September 2014. Results: The review consisted of 21 articles that addressed different issues: Translation and Cultural adaptation (4.77%); Applicability in clinical practice (33.33%); and, Validation (63.90%). Analysis of these articles showed that the knowledge produced from the Nursing Outcomes Classification includes translation and cultural adaptation, evaluation of applicability and validation of its items. Conclusion: Considering the continuous evolution of this classification, periodic reviews should be carried out to identify the knowledge, use and effects of the NOC.

O objetivo do estudo foi avaliar as escalas disponíveis na literatura para medir a sobrecarga de cuidadores de pacientes acometidos por acidente vascular encefálico. Realizou-se uma revisão bibliográfica nas três bases de dados: LILACS, CINAHL e SCOPUS. Selecionaram-se 23 trabalhos e identificaram-se 24 diferentes escalas. Destas, as mais citadas foram o Caregiver Strain Index, a Caregiver Burden Scale, a Caregiver Reaction Assessment, o Sense of Competence Questionnaire, a Relatives Stress Scale e a Zarit Burden Interview. O uso de escalas para mensurar a sobrecarga é uma ferramenta importante para avaliar o contexto no qual está inserido o cuidador, entretanto é mais fidedigno quando associado a outros instrumentos de mensuração. Portanto, é fundamental pesquisas de validação de escalas para essa população.

ABSTRACT Objective: to report the experience of constructing and applicating clinical simulation scenarios for the evaluation and treatment of wounds. Method: experience report on two simulation scenarios for nursing care of wounded patients applied to nursing undergraduates. We structured simulations based on the model from the National League for Nursing/Jeffries Simulation Framework. The scenarios were evaluated by the instrument Simulation Design Scale and the students by the experience with the simulation. Results: the scenarios reproduced nursing care situations with the application of role play and moulage, which allowed us to evaluate and discuss the wound treatment. Reflections on the debriefing were important for the teaching-learning process and association between theory and practice, these factors determined the satisfaction of students with the activity. Conclusion: using clinical simulation scenarios to teach students favored the clinical reasoning and decision-making in the evaluation and treatment of wounds.

Objective: describe the self-care and functionality levels of patients with multiple sclerosis and determine whether sociodemographic, clinical and functional variables interfere with self-care and/or functionality. Method: correlational, cross-sectional study with a quantitative approach performed with individuals in outpatient follow-up. We collected sociodemographic and clinical data and applied the Appraisal of Self-care Agency Scale, the Barthel index, the Lawtton and Brody Scale, and the instrument to investigate the performance in Advanced Activities of Daily Living. We performed descriptive and inferential analysis. Results: most patients were classified as “having self-care” (82.14%); with moderate dependence (51.19%) for the basic activities of daily living, partial dependence for the instrumental activities of daily living (55.95%), and more active for the advanced activities of daily living (85.71%). Patients with longer disease duration had a higher number of disabilities and, in those with better socioeconomic and educational profile, the functionality was better. Conclusion: disease duration was strongly correlated with a higher number of disabilities and better socioeconomic and educational profiles showed to be protective factors for functionality. Care planning should consider the needs observed by the multidisciplinary team, stimulating the development of self-care, functionality and sociability.

ABSTRACT Objectives: to comprehend the perception of undergraduate nursing students about learning to care for the child and family through clinical simulation. Methods: this is a qualitative research conducted with ten nursing students through semi-structured interviews. Data were analyzed through content analysis. Results: data were organized into two categories: “learning a new way to learn,” in which students describe their experiences during the simulation, and “learning a new way to care,” in which they reflect on learning through simulation. Final considerations: we believe that clinical simulation practice in teaching should be encouraged because of the benefits it can offer to the students, faculty, patients and their families. However, we recommend further studies to validate scenarios of child and family healthcare.

RESUMO Objetivo Avaliar na superfície ocular de pacientes adultos internados em unidade de terapia intensiva os fatores clínicos preditores para o ressecamento ocular e para o diagnóstico de enfermagem Risco de ressecamento ocular. Método Estudo transversal, realizado entre janeiro e julho de 2016, com 206 pacientes (412 olhos). A inferência quanto à presença do diagnóstico nos pacientes avaliados foi executada por enfermeiros diagnosticadores. A estatística descritiva e inferencial subsidiou a análise dos dados. Resultados 47,6% dos pacientes apresentaram o Risco de ressecamento ocular, e 52,4% já estavam com o diagnóstico de ressecamento ocular. Foram identificadas diferenças estatísticas entre o diagnóstico de ressecamento ocular no olho direito com a hiperemia, secreção mucosa, edema palpebral e lagoftalmia. Além disso, observaram-se diferenças estatísticas entre a hiperemia e edema palpebral com o ressecamento ocular no olho esquerdo e com o diagnóstico de enfermagem Risco de ressecamento ocular. Conclusão A hiperemia, secreção mucosa, edema palpebral e lagoftalmia são fatores clínicos preditores do diagnóstico de enfermagem de risco e também do ressecamento ocular no ambiente da unidade de terapia intensiva que merecem especial destaque na avaliação preventiva.