Circulación extracorpórea y complicaciones en el período post-operatorio inmediato de cirugías cardíacas

OBJETIVO: Comparar a frequência de complicações apresentadas pelos pacientes, durante o pós-operatório imediato (POI), de cirurgias cardíacas de acordo com o tempo de circulação extra-corpórea (CEC). MÉTODOS: Estudo de natureza quantitativa, descritivo e correlacional com 83 pacientes adultos divididos em dois grupos de acordo com o tempo de CEC. RESULTADOS: Do total de pacientes, 44 (53%) tiveram o tempo de duração da CEC de até 85 minutos e 39 (47 %) tiveram o tempo acima de 85 minutos. As complicações foram comuns para ambos os grupos, sendo as mais frequentes dor e oligúria. No entanto, hemotórax, pneumotórax e infarto agudo do miocárdio ocorreram apenas no grupo com maior tempo de CEC. CONCLUSÃO: A maioria das complicações ocorridas no POI apresentou frequencia semelhante para os pacientes, independente do tempo de CEC

A alta hospitalar para familiares de pacientes com doença arterial coronariana

Fourteen families of coronary artery disease patients were interviewed to describe their perspectives concerning the cardiac disease and hospital discharge. Ten patients had been hospitalized for clinical treatment, and for surgical treatment. The case study method was selected, and the analysis process resulted in the following categories: the disease as a problem, the heart meaning everything and, their coming back home after hospital discharge. We concluded that the heart is the core of the emotions for the relatives and, when the patients return home, there is a concern about keeping them away from potentially damaging emotions that might trigger a new ischemic event.Con el objetivo de describir las perspectivas de los familiares frente a la alta hospitalaria, fueron entrevistados 14 familiares de pacientes con enfermedad arterial coronariana internados para tratamiento clínico (10 pacientes) o quirúrgico (4). La metodologia fue a de estudio de caso y el proceso de análisis resultó en las categorias: la enfermedad como un problema, el corazón significando todo y el retorno al hogar después de la alta hospitalaria. Las conclusiones fueron que el corazón es el centro de las emociones para los familiares y que en el retorno del enfermo al hogar una de las preocupaciones es la de combatir fuertes emociones que puedan resultar en nuevo evento isquémico.Com o objetivo descrever as perspectivas dos familiares frente à alta hospitalar, foram entrevistados 14 familiares de pacientes com doença arterial coronariana internados para tratamento clínico (10 pacientes) ou cirúrgico (4). A metodologia foi a de estudo de caso e o processo de análise resultou nas categorias: a doença como um problema, o coração significando tudo e a volta para casa após a alta hospitalar. As conclusões foram que o coração é o centro das emoções para os familiares e que na volta do doente para casa, a preocupação é poupá-lo de emoções fortes que possam desencadear novo evento isquêmico

Adaptation and validation of the Patient Expectations and Satisfaction with Prenatal Care instrument among Brazilian pregnant women

Objective: to adapt and validate the Patient Expectations and Satisfaction with Prenatal Care instrument for use in Brazil. It contains 41 items divided into two dimensions: expectations and satisfaction. The adapted version was submitted to analysis for stability, convergent construct validity, and internal consistency (Cronbach’s alpha) for distinct groups and dimensions. Method: 119 pregnant women receiving prenatal care were interviewed and 26 of these women answered the instrument twice (retest). Internal consistency was appropriate (Cronbach’s alpha ≥ 0.70); test-retest presented strong correlation (r=0.82; p<0.001) for the domain expectations and moderate correlation (r=0.66; p<0.001) for the satisfaction domain. The analysis confirmed that the instrument’s adapted version is valid in the studied group. Results: there is strong evidence for the validity and reliability of the instrument’s adaptation. Conclusion: the instrument needs to be tested in groups of pregnant women with different social characteristics.CAPESCAPE

Somatic and cognitive-affective depressive symptoms among patients with heart disease: differences by sex and age

OBJECTIVE: this study investigated the association of somatic and cognitive-affective symptoms with sex and age, among patients hospitalized with heart disease. METHOD: this study was a secondary analysis of two previous observational studies totaling 531 patients with heart disease, hospitalized from 2005 to 2011 in two public hospitals in Ribeirão Preto, state of São Paulo, Brazil. Somatic and cognitive-affective symptoms were assessed using the subscales of the Beck Depression Inventory - I (BDI-I). RESULTS: of 531 participants, 62.7% were male, with a mean age 57.3 years (SD= 13.0) for males and 56.2 years (SD= 12.1) for females. Analyses of variance showed an effect of sex (p<0.001 for somatic and p=0.005 for cognitive-affective symptoms), but no effect of age. Women presented with higher mean values than men in both BDI-I subscales: 7.1 (4.5) vs. 5.4 (4.3) for somatic, and 8.3 (7.9) vs. 6.7 (7.2) for cognitive-affective symptoms. There were no differences by age for somatic (p=0.84) or cognitive-affective symptoms (p=0.84). CONCLUSION: women hospitalized with heart disease had more somatic and cognitive-affective symptoms than men. We found no association of somatic and cognitive-affective symptoms with age. Future research for these patients could reveal whether these differences according to sex continue throughout the rehabilitation process

Cultural adaptation and internal consistency analysis of the MISSCARE Survey for use in Brazil

OBJECTIVE: The aims of this methodological research were to culturally adapt the MISSCARE Survey instrument to Brazil and analyze the internal consistency of the adapted version. METHOD: The instrument consists of 41 items, presented in two parts. Part A contains 24 items listing elements of missed nursing care. Part B is comprised of 17 items, related to the reasons for not delivering care. The research received ethics committee approval and was undertaken in two phases. The first was the cultural adaptation process, in which a committee of five experts verified the face and content validity, in compliance with the steps recommended in the literature. The second was aimed at analyzing the internal consistency of the instrument, involving 60 nursing team professionals at a public teaching hospital. RESULTS: According to the experts, the instrument demonstrated face and content validity. Cronbach's alpha coefficients for parts A and B surpassed 0.70 and were considered appropriate. CONCLUSION: The adapted version of the MISSCARE Survey demonstrated satisfactory face validity and internal consistency for the study sample