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To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).
Qualitative descriptive study.
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.
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.
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.
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.
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.
The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.
None.
This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.
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.
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.
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.
Approximately 25% of the Brazilian population suffers from mental disorders, a prevalence exacerbated by systemic and cultural factors such as socioeconomic inequalities, underfunded mental health services, regional disparities, and persistent stigma. These conditions significantly impact hospital care. Nurses, due to their direct contact with these patients, face challenges ranging from managing physical conditions to handling verbal aggression and psychiatric crises. This study aimed to assess the scientific evidence regarding nursing care for hospitalized patients with psychiatric disorders.
A systematic review with a mixed-methods approach was conducted, registered in PROSPERO (#CRD42022359288) and guided by PRISMA standards. Databases, such as MEDLINE, LILACS, PubMed, Web of Science, Scopus, and BDEnf, were searched using keywords like “Mental disorder,” “Psychiatric health,” “Nursing care,” and “Hospital.” Methodological quality was assessed using JBI and SQUIRE tools. The integration of quantitative and qualitative components occurred through meta-aggregation of qualitative data and frequency-based coding of quantitative themes, allowing thematic convergence across study designs.
Six studies were included. Meta-aggregation revealed frequent terms, such as “Nurse,” “Emergency,” “Screening,” “Patient,” and “Care.” Similarity analysis linked “Nurse” with “perception” and “experience” and “Emergency” with “Screening” and “Mental health,” highlighting the importance of experience and training. Five categories emerged: (1) professional experience (19.05%, showing skill gaps despite experience); (2) caring process (19.05%, stressing efficient screening); (3) barriers and challenges (19.05%, revealing difficulty with comorbidities); (4) training process (19.05%, identifying training deficiencies); and (5) therapeutic interventions (23.81%, discussing restraint use). These percentages refer to the proportional frequency of themes identified across the total number of studies analyzed. For thematic classification, only statistically significant chi-square values (p < 0.05) were considered in the grouping of content.
Nursing care for psychiatric patients in hospitals faces challenges like insufficient training and difficulty managing psychiatric comorbidities. Recommendations include incorporating structured mental health content into nursing curricula and hospital-based continuing education programs. These strategies may guide future healthcare policies in Brazil by improving patient safety, reducing hospital readmissions, and promoting more humane, evidence-based therapeutic interventions.
The findings emphasize the urgent need for targeted education and training to improve nursing care for psychiatric patients in hospital settings.
To provide evidence of the cost savings of a quality improvement (QI) initiative preventing healthcare-associated infections (HAIs) in critical care settings.
A micro-costing study focused on financial data related to a nationwide multicentric project preventing central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI).
Brazilian public healthcare system.
Adult, paediatric and neonatal intensive care units (ICUs) participating in the QI initiative.
This collaborative QI project implemented a multifaceted strategy to enhance infection-control measures. Participating ICUs reported the number of patients with and without HAIs and information on each HAI’s aggregate average cost (AC), which was analysed following the Brazilian Ministry of Health’s micro-costing guidelines. The 1-year preintervention period evidenced an aggregated AC in adult, paediatric and neonatal ICUs, respectively, of Intl$21 763.5 (95% CI 20 683.6 to 22 843.0), Intl$34 062.4 (95% CI 25 819.6 to 42 304.9) and Intl$32 903.2 (95% CI 29 203.6 to 36 602.4) for CLABSI; Intl$25 202.5 (95% CI 24 276.6 to 26 127.8), Intl$44 753.6 and Intl$17 238.4 for VAP and Intl$19 166.3 (95% CI 17 676.2 to 20 656.1) and Intl$55 873.3 (95% CI 43 563.1 to 68 183.1) for CAUTI (not included neonatal ICUs).
The cost savings were estimated using the HAIs prevented—expenses avoided—during the QI intervention period from September 2021 to December 2023. The HAIs prevented were estimated using the difference between observed and predicted infections based on the aggregated preintervention baseline.
Of the 188 participating ICUs, 31 voluntarily completed and provided the requested financial data with 100% accuracy. Considering the prevented 7342 HAIs for adult, paediatric and neonatal ICUs, respectively: 1647, 86 and 205 CLABSI; 3775, 114 and 118 VAP; and 1377 and 20 CAUTI, we estimated a saving of Intl$175.3 million (95% CI 153.2 to 180.9 million) to the Brazilian unified health system and a resultant estimated return on investment (ROI) of 890%.
This QI collaborative is a value-based initiative preventing HAIs in adult, paediatric and neonatal ICUs in South American settings. The substantial cost savings and a remarkable ROI underscore the economic viability of investing in comprehensive QI infection prevention strategies.
RESUMEN
Introducción: El cine moderno debuta en la década de 1940, contradiciendo la estética clásica en sus producciones y dando lugar a una reflexión sobre su validación como teoría artística. Así, esta investigación busca un acercamiento histórico-social a la enfermera religiosa retratada en la filmografía de Hollywood en este período. Objetivos: Describir y analizar el imaginario social sobre la representación de la enfermera religiosa retratada en la película “Uma Historia de una Monja”, de 1959, contextualizada en el período del cine moderno, considerando el contexto cultural, histórico y técnico. Metodología: Se trata de una investigación sociocultural cualitativa, analítica e histórica, sustentada en el marco teórico del "Imaginario Social" y el marco filosófico de la Teoría de los Valores, de Max Scheler, que tiene como objetivo refrendar el carácter emocional y racional de los religiosos. enfermera retratada en la película “Uma Historia de una Monja”, de 1959, desde una perspectiva modernista. Resultados: La enfermera religiosa asume la postura clerical en el cuidado como núcleo del cuidado caritativo. El cine llevó su narrativa emocional propensa al afecto cristiano, pero en la corriente moderna el racional actúa consciente de las limitaciones que le impone el dogma, interfiriendo en su ejercicio científico profesional. Conclusión: El lenguaje del cine nos permite transponer figuras verosímiles a sus narrativas bajo la tutela del imaginario social, la enfermera es una de ellas. En esta producción, la libertad ficcional analiza en formato visual sus valores morales en la sociedad actual, destacando el cine como un arte único por representar contextos atemporales de sus actores sociales.
Objetivo: identificar, nas produções científicas, os fatores relacionados à construção da identidade
profissional do enfermeiro. Métodos: Trata-se de revisão integrativa realizada nas bases de dados
SCIELO, BDENF e LILACS disponíveis na Biblioteca virtual em saúde no intervalo temporal de
2015 a 2019 a partir dos descritores “Papel do profissional de enfermagem” AND “Cuidados de
enfermagem” OR “Competência profissional”. Resultados: A identificação profissional do
enfermeiro está relacionada à sua atuação no serviço de saúde com estratégias de atendimento
domiciliar, empreendedorismo, gerenciamento do cuidado e da equipe, educação em saúde,
consultas de enfermagem, procedimentos técnicos, articulação da rede de atenção, organização do
serviço e qualificação da equipe mas que sofrem algumas limitações individuais, organizacionais,
institucionais e sociais. Conclusão: A identificação dos fatores que caracterizam o enfermeiro e
fomentam sua identidade profissional exerce grande influência no empoderamento da categoria e
melhor autonomia nos diversos campos de atuação.
Descritores: Papel do profissional de enfermagem; Cuidados de enfermagem; Competência
profissional.
To map interventions in the sexuality of men with stomas.
Scoping review, following JBI and PRISMA-ScR guidelines to report results.
Databases consulted were PubMed, via National Library of Medicine, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Embase, Scientific Electronic Library Online, Brazilian Electronic Library of Thesis and Dissertations, CAPES Catalogue of Thesis and Dissertations and Open Access Scientific Repository of Portugal. Texts were read by independent reviewers, with no time or language restrictions.
The final sample included 10 studies. Data were synthesised and grouped for its similarity to approach models, preoperative orientations, self-care promotion, collecting pouch hygiene and safety, sexual health discussion and education, construction of bonds and sexual function evaluation.
Interventions in the sexuality of men with stomas included adherence to models for approaching sexuality, focusing on the permission and coparticipation of the patient, open conversations on the topic, self-care promotion, collecting pouch hygiene and safety, encouragement to the creation of bonds, sexual function evaluation in pre- and postoperative periods and individual and/or collective sexual health education.
This study contributes to the sexuality of men with stomas. It identified recommendations to approach and conduct the topic at hand, addressing the rehabilitation process since the surgery to place the stoma is considered.
This study addressed scientific literature on the sexuality of men with stomas. Most were from Europe and results demonstrated a gap in knowledge. This research will impact the stoma therapy research, affecting teams involved in the care to men with stomas, encouraging reflections on the sexuality of these patients.
This study complies with the PRISMA-ScR.
There was no patient or public contribution.
The protocol of this scoping review was registered in the Open Science Framework, registered under DOI 10.17605/OSF.IO/X9DSC. It can be accessed through the following link: https://osf.io/x9dsc/?view_only=a9c62ef6c11f44499f7b2bfe1fe379f9.
Introducción: La pandemia ha debilitado el vínculo entre las personas con hipertensión arterial y/o diabetes mellitus y el sistema de salud. Objetivo: reflexionar sobre los desafíos del manejo de la hipertensión arterial y la diabetes mellitus en la atención primaria de salud en tiempos de pandemia por COVID-19. Metodología: Se trata de un estudio teórico-reflexivo, cuya fundamentación se dio mediante la realización de una revisión narrativa de la literatura. La trayectoria teórico-metodológica se estructuró a través de la fenomenología interpretativa. Resultados: La coexistencia de problemas estructurales, operativos y de gestión se encuentran entre las principales razones para la no superación de los desafíos revelados para mantener prácticas de atención efectivas a pacientes con enfermedades crónicas, frente a la pandemia de COVID-19. De los desafíos estructurales enumerados, se destacan la insuficiencia tecnológica, la debilidad de los dispositivos efectivos y los profesionales poco calificados. En el contexto operativo, se destacó el aumento de la demanda de asistencia. Y, en cuanto al manejo, el cribado y seguimiento de estas enfermedades siguen siendo retos a superar. Consideraciones finales: las reflexiones planteadas pueden ser útiles para el establecimiento de procesos de gestión más eficaces, en el contexto de la atención primaria de salud, para la atención dirigida a personas con enfermedades crónicas.
Dysmenorrhea, or menstrual pain, is a subjective experience, and can only be assessed by patient-reported outcomes. These instruments should be reliable, valid and responsive.
To identify and critically appraise the available evidence for the measurement properties of specific patient-reported outcome measures used for dysmenorrhea.
The PRISMA statement was used to report this systematic review. Databases searched were PubMed, SCOPUS, CINAHL, Web of Science, ScienceDirect and Google Scholar (April 2021; updated on February 2023). Original studies with primary data collection, with no restriction on language and publication date that reported psychometric properties of one or more dysmenorrhea-related patient-reported outcome measure. The literature searches, selection of studies, data extraction and assessment of the risk of bias were performed independently by two reviewers and followed the COSMIN guidelines.
Thirty studies were analysed in this review, and 19 patient-reported outcome measures were evaluated. The instruments varied in relation to the measured construct and measurement properties (validity, reliability and responsiveness). The methodological quality of the studies and the quality of evidence of the patient-reported outcome measures were variable. Among the 13 studies that reported the development of patient-reported outcome measures, most had inadequate methodological quality, and the overall rating was insufficient or inconsistent.
The Dysmenorrhea Symptom Interference (DSI) scale was the only identified patient-reported outcome measure that has the potential to be recommended because of its sufficient rating combined with moderate quality of evidence for content validity. Future studies should further evaluate the measurement properties of the existing patient-reported outcome measures, or develop new patient-reported outcome measures following the COSMIN methodology.
Not applicable as this is a systematic review.
PROSPERO protocol: CRD42021244410. Registration on April 22, 2021.
Objetive: analizar las percepciones, motivaciones y dificultades de los técnicos de enfermería titulados en enfermería. Metodología: Me-todología: Se trata de una investigación cualitativa, exploratoria descriptiva, la recolección de datos se realizó en un Hospital Municipal del Noroeste de Paraná, durante el primer semestre de 2020, mediante la aplicación de un guión semiestructurado con preguntas orien-tadoras y un cuestionario sociodemográfico. Resultados: El conocimiento adquirido en la graduación de enfermería fue uno de los facto-res facilitadores que contribuyó a una mejor ejecución de la atención brindada, y la mayor dificultad está relacionada con la aceptación de los colegas y supervisores, en relación a las opiniones y sugerencias sobre los procedimientos u organización de la Servicio. Las razones que llevaron a los técnicos de enfermería a cursar una carrera en el área en la que trabajan se deben a la necesidad de cono-cimientos y la búsqueda de un mejor futuro financiero. Conclusión: cuando el profesional tiene un título, se desarrolla con mayor destreza y eficacia en la asistencia proporcionada.
Objetivo: caracterizar las producciones científicas sobre atención integral de salud, promovidas a través de políticas públicas para perso-nas que conviven con el Virus de Inmunodeficiencia Humana. Metodología: Revisión integrativa de literatura, a través de la búsqueda en las bases de datos PUBMED, LILACS y la biblioteca virtual SCIELO, utilizando los descriptores “Políticas Públicas de salud”, “Síndrome de inmunodeficiencia adquirida”, “Atención integral de salud” y el operador booleano “Y”, resultando en una muestra, después de leídos, de 12 artículos. Los resultados de este estudio nos permitieron identificar y clasificar el estado de las políticas públicas para la atención de esta población, en tres categorías: A: políticas y / o directrices insuficientes; B: Necesidad de mejoras e inversiones en políticas existentes; C: éxito de los programas, siendo imprescindible una articulación internacional de gobiernos y organismos no gubernamentales para la elaboración de políticas más ajustadas a las realidades y objetivando la atención integral de salud de esta población.
FreshRSS 