Capacidad funcional y de autocuidado de personas con esclerosis múltiple

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.Objetivo: describir los niveles de autocuidado y funcionalidad de los pacientes con esclerosis múltiple y verificar si las variables sociodemográficas, clínicas y funcionales interfieren en el autocuidado y/o funcionalidad. Método: estudio correlacional, transversal, con enfoque cuantitativo realizado con individuos en seguimiento de un ambulatorio. Se recogieron datos sociodemográficos y clínicos y fueron aplicadas la Escala de Evaluación de la Competencia para el Autocuidado, el Índice de Barthel, la Escala de Lawtton y Brody y el instrumento para investigar la realización de Actividades Avanzadas de la Vida Diaria. Se realizó un análisis descriptivo e inferencial. Resultados: la mayor parte de los pacientes fue clasificada como “Realiza autocuidado” (82,14 %); con moderada dependencia (51,19 %) para las actividades básicas de la vida diaria, dependencia parcial para las instrumentales (55,95 %) y más activos para las avanzadas (85,71 %). Los pacientes con mayor duración de la enfermedad presentaron un mayor número de incapacidades y, en aquellos con mejor perfil socioeconómico y educativo, la funcionalidad se encontraba mejor. Conclusión: la duración de la enfermedad estuvo fuertemente correlacionada con un mayor número de incapacidades y los mejores perfiles socioeconómico y educativo se revelaron factores favorables a la funcionalidad. La planificación del cuidado debe tener en cuenta las necesidades observadas por el equipo multidisciplinario, estimulando el desarrollo del autocuidado, la funcionalidad y la sociabilidad.Objetivo: descrever os níveis de autocuidado e funcionalidade dos pacientes com esclerose múltipla e verificar se as variáveis sociodemográficas, clínicas e funcionais interferem no autocuidado e/ou funcionalidade. Método: estudo correlacional, transversal, com abordagem quantitativa, realizado com indivíduos em seguimento ambulatorial. Coletamos dados sociodemográficos e clínicos e aplicamos a Escala de Avaliação da Competência para o Autocuidado, o Índice de Barthel, a Escala de Lawton e Brody e o instrumento para investigar a realização de Atividades Avançadas da Vida. Realizamos análise descritiva e inferencial. Resultados: a maior parte dos pacientes foi classificada como “Tendo autocuidado” (82,14%); com moderada dependência (51,19%) para as atividades básicas da vida diária, dependência parcial para as instrumentais (55,95%) e mais ativos para as avançadas (85,71%). Os pacientes com a doença há mais tempo apresentaram maior número de incapacidades e, naqueles com melhor perfil socioeconômico e educacional, a funcionalidade encontrava-se melhor. Conclusão: a duração da doença esteve fortemente correlacionada a um maior número de incapacidades e os melhores perfis socioeconômico e educacional mostraram-se fatores protetores para a funcionalidade. O planejamento do cuidado deve levar em consideração as necessidades observadas pela equipe multidisciplinar, estimulando o desenvolvimento do autocuidado, a funcionalidade e sociabilidade

Evaluate the devitalized tissue of pressure ulcer

Orientador: Maria Helena de Melo LimaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de EnfermagemResumo: O processo de cicatrização é complexo e muito se sabe sobre o mecanismo molecular e celular da cicatrização de feridas agudas, mas pouco sobre as feridas crônicas, tais como as úlceras por pressão (UP). A UP ocorre em áreas de proeminência óssea, por compressão física externa, fricção e cisalhamento associados ao envelhecimento, imobilidade, doenças neurológicas, incontinência e desnutrição. O Objetivo deste estudo foi avaliar o tecido desvitalizado de UP categorias III e IV por meio da Reação em cadeia da polimerase (PCR). As amostras de pele saudável foram obtidas de pacientes submetidos a cirurgia plástica e as amostras de tecido desvitalizado de úlceras por pressão categorias III e IV de pacientes por meio do desbridamento instrumental conservador. Após a coleta dos tecidos eles foram congelados em nitrogênio líquido e submetidos a método RT2 Profiler PCR Arrays®. O estudo atendeu as normas nacionais e internacionais de ética em pesquisa envolvendo seres humanos, parecer n0 1.069.054 de 2015. A região predominante das UP foi a sacra com dimensões acima de 12 cm2 de área, o esfacelo foi coletado do centro da lesão e provenientes de três pacientes. A análise da expressão gênica identificou cinco genes com aumento da expressão no tecido desvitalizado: Quimiocina (C-X-C motif) ligante 1 (CXCL1), Quimiocina (C-X-C motif) ligante 2 (CXCL2), Interleucina 1 beta (IL-1?), Ciclooxigenase 2 (PGTS2) e Família NLR (NLRP3). O tecido de esfacelo de UP categorias III e IV mostrou a presença de quimiocinas, interleucina, ciclooxigenase e inflamassomo, concluindo-se que clinicamente a expressão destas proteínas indica a persistência da fase inflamatória e reforça que o desbridamento é a chave para o preparo do leito da ferida. A pesquisa translacional para melhor compreensão do processo de cicatrização de feridas crônicas irá favorecer condutas mais efetivas para o seu tratamentoAbstract: The healing process is very complex and much is known about the molecular and cellular mechanisms involved in healing acute wounds but little in the case of chronic wounds, such as pressure ulcers (PU).PU occur in areas with bony prominence, as a result of external physical compression, friction and shear associated with aging, immobility, neurological disorders, incontinence and malnutrition. The purpose of this research was to evaluate the devitalized tissue of category III and IV PU, by means of polymerase chain reactions (PCR). Healthy skin samples were obtained from patients undergoing plastic surgery and samples of devitalized tissue from patients with category III and IV pressure ulcers, using conservative debridement instruments. After collecting the tissues, they were frozen in liquid nitrogen and subjected to method RT2 Profiler PCR Arrays®. The study met the national and international standards of ethics in research involving human subjects, as established in nº 1.069.054 of 2015. The predominant localization of PU was in the sacral region, with sizes exceeding 12 cm2, and slough was collected from the lesion sites of three patients. The gene expression analysis identified five genes with increased expression of devitalized tissue: Chemokine (CXC motif) ligand 1 (CXCL1), chemokine (CXC motif) ligand 2 (CXCL2), Interleukin 1 beta (IL-1?), Cyclooxygenase 2 (PGTS2) and NLR Family (NLRP3). The presence of chemokines, interleukin, cyclooxygenase and inflammasome were found in the slough tissue of Category III and IV PU, leading to the conclusion that the clinical expression of these proteins demonstrates the persistence of the inflammatory phase and reinforcing the conclusion that debridement is the key to wound bed preparation. Translational research to better understand the chronic wound healing process will be beneficial for discovering more effective treatmentsMestradoEnfermagem e TrabalhoMestra em Ciências da Saúd

Clinical simulation to teach nursing care for wounded patients

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

From theory to simulation to teach care for burn victims: case report

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

Clinical simulation to teach nursing care for wounded patients

<div><p>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.</p></div

Capacidade funcional e de autocuidado de pessoas com esclerose múltipla

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 sociability27Descrever os níveis de autocuidado e funcionalidade dos pacientes com esclerose múltipla e verificar se as variáveis sociodemográficas, clínicas e funcionais interferem no autocuidado e/ou funcionalidade. Método: estudo correlacional, transversal, com abordagem quantitativa, realizado com indivíduos em seguimento ambulatorial. Coletamos dados sociodemográficos e clínicos e aplicamos a Escala de Avaliação da Competência para o Autocuidado, o Índice de Barthel, a Escala de Lawton e Brody e o instrumento para investigar a realização de Atividades Avançadas da Vida. Realizamos análise descritiva e inferencial. Resultados: a maior parte dos pacientes foi classificada como “Tendo autocuidado” (82,14%); com moderada dependência (51,19%) para as atividades básicas da vida diária, dependência parcial para as instrumentais (55,95%) e mais ativos para as avançadas (85,71%). Os pacientes com a doença há mais tempo apresentaram maior número de incapacidades e, naqueles com melhor perfil socioeconômico e educacional, a funcionalidade encontrava-se melhor. Conclusão: a duração da doença esteve fortemente correlacionada a um maior número de incapacidades e os melhores perfis socioeconômico e educacional mostraram-se fatores protetores para a funcionalidade. O planejamento do cuidado deve levar em consideração as necessidades observadas pela equipe multidisciplinar, estimulando o desenvolvimento do autocuidado, a funcionalidade e sociabilidad

Clinical Simulation for Teaching of Wound Evaluation and Treatment

Background: Wound evaluation and treatment is a field of knowledge in which nursing has a major role, and the application of a clinical simulation is important for promoting the educational process. Method: This study was a randomized clinical trial with randomization of nursing students into control and experimental groups, which were analysed before and after application of the teaching strategies. Results: The data obtained showed better performance of the experimental group in the Objective Structured Clinical Examination. Conclusion: Clinical simulation is effective in developing clinical reasoning in wound evaluation and treatment but has no significant effect on knowledge acquisition. (C) 2019 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved3851

The challenges and benefits of online teaching about diabetes during the COVID-19 pandemic

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