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AnteayerInternacionales

Technologies in Intensive Care Therapy and the Obstacles in Nursing Practice: Systematic Review

ABSTRACT

Aim

To identify obstacles faced by nurses when using health technologies in Intensive Care Units (ICUs).

Design

Systematic review following PRISMA and registered in PROSPERO.

Methods

Six databases were searched. Two reviewers independently screened studies and appraised methodological quality using the Joanna Briggs Institute tool. Data were synthesized narratively.

Results

Eight studies met eligibility criteria. Barriers clustered around limited training and technical competence, shorter professional experience, increased workload with multiple devices, organizational culture, and reduced direct patient contact, which may undermine patient-centered care. Heterogeneity of study designs precluded meta-analysis.

Conclusions

Obstacles to technology use in ICUs arise from individual and organizational factors. Addressing these barriers requires structured education, mentoring for novice nurses, workload management, and supportive policies that integrate technology without displacing bedside care.

Linking Evidence to Action

Nursing leaders and educators should implement ongoing, ICU-specific technology training and mentoring. Managers and policymakers must ensure adequate staffing and promote Health Technology Assessment to align device implementation with clinical needs, safeguarding patient safety and the human dimensions of care.

Burnout Syndrome Predictors in Nursing Professionals During and After the COVID‐19 Pandemic: A Prospective Cohort

ABSTRACT

Aim

To analyse predictors of burnout in nursing professionals during and after the COVID-19 pandemic.

Design

Cohort study.

Method

A two-phase study conducted during the COVID-19 pandemic's peak (2020) and post-vaccination period (2022). Data from nursing professionals of four hospitals in southern Brazil included sociodemographic, occupational, lifestyle, and health variables, and Maslach Burnout Inventory responses. Multivariate logistic and linear regression analyses were used to identify independent predictors of burnout syndrome. The study was approved by the Research Ethics Committee (approval no. 4.152.027).

Results

A sample of 163 participants were assessed at two distinct time points. In 2020, 9.2% of nursing professionals experienced burnout syndrome, decreasing slightly to 7.4% in 2022. As for the burnout dimensions, emotional exhaustion was reported by 27% of professionals in 2020 and 26.4% in 2022. Depersonalisation affected 28.2% during the pandemic and 25.2% afterward. Low professional accomplishment was identified in 29.4% of professionals in 2020, increasing to 30.1% in 2022. Distinct predictors were identified for overall burnout and its specific dimensions. The main predictors included: perceiving a mental health impact from the pandemic, previous mental health issues, recent medical leave, and working directly with COVID-19 patients.

Conclusions

Burnout syndrome remained stable post-pandemic. Key predictors were identified, highlighting the need for preventive mental health interventions.

Relevance for Clinical Practice

Identifying predictors of burnout in nursing professionals supports the development of targeted interventions to protect mental health, improve job satisfaction, and enhance the quality of patient care during and after health crises.

Impacts

This study fills a gap in post-pandemic research by identifying predictors of burnout in nursing professionals. It supports the development of policies and interventions to protect mental health and improve working conditions in Brazilian hospitals.

Reporting Method

STROBE guidelines for cohort studies.

Patient or Public Contribution

Participants contributed only through data collection.

Comfort Needs of Renal Transplant Recipients: A Qualitative Analysis Guided by Kolcaba's Theory of Comfort

ABSTRACT

Aim

To analyse the comfort needs of patients following renal transplantation, guided by Kolcaba's Theory of Comfort.

Design

A qualitative design was employed.

Methods

This study was conducted at a Brazilian university hospital's renal transplant outpatient clinic. Forty-six post-transplant patients were purposively sampled by age, transplant time and clinic attendance. Face-to-face interviews were audio-recorded, transcribed and conducted using a semi-structured script. Data were analysed through thematic content analysis, guided by Kolcaba's Comfort Theory and relevant literature.

Results

Participant narratives were categorised according to the contexts outlined by Kolcaba's Theory of Comfort: Physical, Environmental, Sociocultural and Psychospiritual. In the physical context, pain was identified as a major factor diminishing comfort after renal transplantation. In the environmental context, elements such as light, odour, sound, temperature and uncomfortable furnishings contributed to discomfort. In the sociocultural context, family support was highlighted as essential. In the psychospiritual context, religiosity played a key role in enhancing the comfort of transplant recipients.

Conclusion

Spirituality, strengthened social support networks and non-pharmacological comfort measures are essential for promoting comfort among patients following renal transplantation. These findings underscore the importance of integrated care approaches that address physical, emotional and social aspects to improve quality of life for this population.

Implications for the Profession and/or Patient Care

Conceptual models in nursing provide a critical perspective for care and support the delivery of effective, evidence-based interventions. By identifying the multidimensional comfort needs of post-renal transplant patients, this study informs the development of targeted, holistic strategies for nursing and multidisciplinary practice in outpatient settings.

Impact

This study examined the multidimensional comfort needs of post-renal transplant patients and found that comfort is shaped by physical, environmental, sociocultural and psychospiritual factors. The results may guide global nursing and multidisciplinary outpatient care by informing integrated approaches that enhance the quality of life of transplant recipients.

Reporting Method

This study was reported according to the COREQ framework.

Patient or Public Contribution

No patient or public contribution.

Social Representations of Bedside Milk Expression Among Mothers of Preterm Newborns in Neonatal Intensive Care Units

ABSTRACT

Aim

To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).

Design

Qualitative descriptive study.

Methods

The study was conducted from July to August 2024 in two NICUs of a referral maternity hospital in Fortaleza, Brazil. Nineteen mothers of hospitalised premature newborns participated. Semi-structured interviews were conducted and subjected to thematic content analysis.

Results

Mothers perceived BME as a meaningful act of protection and bonding, though some were unfamiliar with the practice. Emotional ambivalence was common, shaped by prior breastfeeding experiences and the context of prematurity. Discomfort related to privacy and shared spaces was noted. Support from healthcare professionals was essential to promote understanding and adherence.

Conclusion

Social representations of BME are shaped by emotional, social and institutional experiences. Anchored in prior breastfeeding experiences and cultural meanings of maternal care, the practice is objectified through both gestures of affection and tangible barriers.

Implications for the Profession and/or Patient Care

Healthcare professionals, particularly nurses, should receive training to support mothers in BME. Structural improvements, privacy and emotional support are essential for fostering maternal autonomy and confidence.

Impact

This study highlights the barriers to BME, emphasising the role of healthcare support and the need for better infrastructure, privacy and training to enhance maternal confidence and breastfeeding.

Reporting Method

The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.

Patient or Public Contribution

None.

What Does This Paper Contribute to the Wider Global Clinical Community?

This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.

What Already Is Known?

Fresh breast milk is considered the gold standard for reducing complications and improving survival in preterm infants. BME is recommended as an effective strategy to ensure the availability of fresh breast milk. Mothers' social representations of this practice remain underexplored within the neonatal intensive care context.

What This Paper Adds?

Explores mothers' social representations of BME in NICUs, addressing a significant gap in qualitative research. Reveals how emotional, social and institutional factors shape mothers' perceptions, motivations and challenges related to BME. Highlights the need for targeted professional support, improved infrastructure and privacy to enhance maternal autonomy and adherence to milk expression practices.

Implications for Practice

Healthcare professionals, particularly nurses, should receive specialised training to provide technical guidance and emotional support, enhancing mothers' confidence and autonomy in BME. Improving infrastructure and ensuring privacy in NICUs are crucial to creating supportive environments that facilitate milk expression and strengthen maternal–infant bonding. Institutional policies should integrate maternal-centred strategies to support breastfeeding continuity and promote humanised neonatal care.

Using Digital Technology to Promote Patient Participation in the Rehabilitation Process in Hip Replacement: A Scoping Review

imageThe purpose of this scoping review was to identify and summarize how technology can promote patient participation in the rehabilitation process in hip replacement. We conducted a scoping review following the steps outlined by the Joanna Briggs Institute. The PRISMA Checklist (Preferred Reporting Items for Systematic reviews and Meta-Analyses) was utilized to systematically organize the gathered information. A thorough search of articles was performed on PubMed, Scopus, and CINAHL databases for all publications up to December 2022. Twenty articles were included in this study. Various technologies, such as mobile applications, Web sites, and platforms, offer interactive approaches to facilitate total hip replacement rehabilitation. The analyzed studies were based on the rehabilitation of total hip arthroplasty, which in most of them was developed in mobile applications and Web sites. The studies identified reflect trends in the application of digital health technologies to promote patient engagement in the rehabilitation process and provide risk monitoring and patient education.
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