Comunicação interpessoal e sua implicação na enfermagem

Introdução: A comunicação é uma ação criativa, utilizada para promover interação, compreender fatores sociais e psicológicos entre indivíduos. Ela permeia a evolução humana. Objetivo: Buscar por estudos que aplicaram a comunicação interpessoal na área da saúde e discutir como ela se aplica na área da enfermagem. Método: Trata-se de um estudo teórico-reflexivo pela sua característica de ser problematizador, antidogmático sem, no entanto, dispensar o rigor lógico-metodológico com coerência de argumentação e o espírito crítico. Utilizou-se como referencial a Teoria de Comunicação Transaccional de Barnlund. Resultado: Visando possibilitar maior compreensão e discussão, optou-se por discutir a comunicação interpessoal em três categorias temáticas: Teoria de Comunicação Transaccional de Barnlund, Caracterizando a comunicação e Comunicação interpessoal na Enfermagem. Conclusão: Na enfermagem é evidenciado ainda a dificuldade de interação e comunicação entre os profissionais e os pacientes, fato que comprova que essa dificuldade compromete a atenção integral ao indivíduo, comprometendo também a qualidade de vida do mesmo.Introduction: Communication is a creative action, used to promote interaction, to understand social and psychological factors among individuals. It permeates human evolution. Objective: To search for studies that applied the interpersonal communication in the health area and to discuss how it is applied in the area of nursing. Method: This is a theoretical-reflexive study due to its characteristic of being problematizing, anti-dogmatic without, however, dispensing with logical-methodological rigor with coherence of argumentation and critical spirit. Barnlund's Theory of Transactional Communication was used as a reference. Result: Aiming to enable greater understanding and discussion, we chose to discuss interpersonal communication in three thematic categories: Barnlund Transactional Communication Theory, Characterizing Communication and Interpersonal Communication in Nursing. Conclusion: In nursing, the difficulty of interaction and communication between the professionals and the patients is also evidenced, a fact that proves that this difficulty compromises the integral attention to the individual, also compromising the quality of life of the same.Introducción: La comunicación es una acción creativa, utilizada para promover la interacción, comprender los factores sociales y psicológicos entre los individuos. Ella permea la evolución humana. Objetivo: Buscar por estudios que aplicaron la comunicación interpersonal en el área de la salud y discutir cómo se aplica en el área de la enfermería. Método: Se trata de un estudio teórico-reflexivo por su característica de ser problematizador, antidogmático pero aplicando el rigor lógico-metodológico con coherencia de argumentación y el espíritu crítico. Se utilizó como referencia la Teoría de Comunicación Transaccional de Barnlund. Resultado: Con vistas a posibilitar mayor comprensión y discusión, se optó por discutir la comunicación interpersonal en tres categorías temáticas: Teoría de Comunicación Transaccional de Barnlund, caracterizando la comunicación y comunicación interpersonal en la enfermería. Conclusión: En la enfermería se evidencia aún la dificultad de interacción y comunicación entre los profesionales y los pacientes, hecho que comprueba que esa dificultad compromete la atención integral al individuo, comprometiendo también la calidad de vida del mismo

Aplicabilidade da teoria de Orem no autocuidado de pessoa com estomia intestinal: estudo reflexivo

A confecção de uma estomia intestinal leva a modificações físicas que podem afetar todas dimensões da vida do ser humano. Acredita-se que por meio da Teoria de Enfermagem do Déficit do Autocuidado é possível promover o cuidado de enfermagem à pessoa com estomia intestinal. Dessa forma, o objetivo deste estudo foi refletir sobre a aplicabilidade da Teoria do Déficit do Autocuidado de Dorothea Orem no cuidado de enfermagem à pessoa com estomia intestinal. Trata-se de um estudo teórico-reflexivo e para tanto, realizou-se uma revisão narrativa com busca do material nas bases de dados LILACS, Pubmed e Google Acadêmico e síntese qualitativa dos trabalhos analisados. Diante das mudanças ocasionadas pela presença da estomia, a pessoa necessita realizar cuidados importantes para seu autocuidado. O planejamento da assistência de enfermagem fundamentado na Teoria do Déficit d Autocuidado contribui para a o retorno às atividades de vida diária, a reinserção social, ao cuidado com a estomia e equipamento coletor e prevenir complicações. Assim, a aplicabilidade desta teoria demonstra o seu potencial para subsidiar o planejamento e a implementação da assistência à pessoa com estomia de modo a promover a sua autonomia e independência para realizar o seu autocuidado, além de subsidiar a Prática Avançada de Enfermagem no cenário nacional.La realización de una ostomía conlleva a modificaciones físicas que pueden afectar todas las áreas de la vida del ser humano. Se piensa que por medio de la Teoría de Enfermería del Déficit del Autocuidado, es posible promover el cuidado de enfermería a la persona con ostomía intestinal. De esta forma, el objetivo de este estudio fue reflexionar sobre la aplicabilidad de la teoría del autocuidado de Dorothea Orem en el cuidado de enfermería a la persona con ostomía intestinal. Se trata de un estudio teórico-reflexivo, por tanto, se realizó una revisión narrativa con búsqueda del material en las bases de datos LILACS, Pubmed e Google Académico y una síntesis cualitativa de los trabajos analizados. Durante los cambios ocasionados por la presencia de la ostomía, la persona necesita realizar cuidados importantes para su autocuidado. El planeamiento de la asistencia de enfermería fundamentado en la Teoría del Déficit del Autocuidado, contribuye para el retorno de las actividades de la vida diaria, cuidado de la ostomía y del equipo recolector, prevenir complicaciones, además, del reintegro a la sociedad. En este sentido, la aplicabilidad de la teoría del Autocuidado de Dorothea Orem, demuestra su potencial para subsidiar el planeamiento y la implementación de la asistencia a la persona con ostomía, de tal forma que promueve la autonomía e independencia para realizar su autocuidado, además, de subsidiar la Práctica Avanzada de Enfermería en el escenario nacional.The making of an intestinal ostomy leads to physical changes that can affect all dimensions of human life. It is believed that through the Nursing Theory of Self-Care Deficit it is possible to promote nursing care to people with intestinal ostomy. Thus, the aim of this study was to reflect on the applicability of Dorothea Orem's Self-Care Deficit Theory in nursing care for people with intestinal ostomy. It is a theoretical- reflective study and for that, a narrative review was carried out with search for the material in the LILACS, Pubmed and Google Scholar databases and a qualitative synthesis of the analyzed works. In view of the changes caused by the presence of the ostomy, the person needs to perform important care for their self-care. The planning of nursing care based on the Theory of Self-Care Deficit contributes to the return to activities of daily living, social reintegration, care with the ostomy and collection equipment and preventing complications. Thus, the applicability of this theory demonstrates its potential to support the planning and implementation of assistance to people with ostomy in order to promote their autonomy and independence to perform their self-care, in addition to subsidizing Advanced Nursing Practice in the national scenario

Relationship between circulating VCAM-1, ICAM-1, E-selectin and MMP9 and the extent of coronary lesions

OBJECTIVES: Inflammatory molecules play a role in the development of atherosclerosis, which is the primary origin of cardiovascular disorders. However, to the best of our knowledge, no study has attempted to investigate the relationship between these circulating molecules and the prediction of cardiovascular risk. The present study aimed to investigate the relationships of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 serum concentrations with the extent of coronary lesions. METHODS: Seventy-four individuals who were undergoing coronary angiography for the first time for diagnostic purposes were enrolled in this study. The extent of the coronary lesion was assessed using the Friesinger Index, and subjects were classified into four groups: no lesions, minor lesions, intermediate lesions and major lesions. Serum biochemical parameters and serum concentrations of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 were analyzed. RESULTS: The vascular cell adhesion molecule-1 concentration was higher than 876 ng/mL in individuals with intermediate and major lesions (

The impact of rehabilitation-oriented virtual reality device in patients with ischemic stroke in the early subacute recovery phase: Study protocol for a phase III, single-blinded, randomized, controlled clinical trial

Stroke is considered the most common cause of adult disability. Intensive rehabilitation protocols outperform nonintensive counterparts. The subacute stroke phase represents a potential window to recovery. Virtual reality (VR) has been shown to provide a more stimulating environment, allowing for increased patient compliance. However, the quality of current literature comparing VR with standard therapies is limited. Our aim is to measure the impact of VR versus standard therapy on the recovery of the upper limb motor function in patients with stroke in the early subacute recovery phase.; This is a randomized, controlled trial that will assign 262 patients to tailor-made standard rehabilitation (TMSR) or TMSR plus immersive VR device. The trial will be conducted in an urban rehabilitation clinic in the United States with expertise in the management of poststroke patients. Patients will be 18 to 70 years of age and in the early subacute period (30-90 days post ischemic stroke). The primary outcome will be the change of Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, measured at baseline and 13 weeks after randomization. The secondary outcome will be the change in the UK Functional Independence Measure and Functional Assessment Measure (UK FIM-FAM) score at the same time points.; If the use of VR in the rehabilitation of patients with stroke proves to have a significant impact on their motor recovery, it will constitute an extremely important step into decreasing the functional impairment associated with stroke and the related health care expense burden

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

É a cronicidade do HIV/aids frágil? Biomedicina, política e sociabilidade em uma rede social on-line

Objetivo: comprender cómo las relaciones entre cronicidad y política configuran la sociabilidad y la ayuda mutua entre las personas que viven con el VIH/SIDA. Método: una etnografía virtual en un grupo cerrado en Facebook. Para recopilar la información, se utilizó la observación participante en línea y el análisis de documentos. Se analizaron 37 publicaciones utilizando el software NVivo 12 Pro y la técnica de codificación temática. Resultados: surgieron dos categorías temáticas: Haga el tratamiento y el tiempo se encargará del resto: ayuda mutua y VIH/SIDA como condición crónica; y Sí, hay peligro en la esquina, cariño: política, conflictos y sociabilidad en el grupo. El aspecto más relevante de este estudio se refiere a la evidencia de la fragilidad del discurso sobre la cronicidad del VIH/SIDA. Conclusión: a través del análisis de la sociabilidad y la ayuda mutua producida entre los miembros del grupo investigado, fue posible comprender las formas en que, en sus experiencias de vivir con el VIH/SIDA como una condición crónica, las relaciones entre salud-enfermedad, política y tiempo mostró la dependencia entre la cronicidad y el Estado, y su impacto en la vida diaria.Objetivo: compreender como as relações entre cronicidade e política modelam a sociabilidade e a ajuda mútua entre pessoas que vivem com HIV/aids. Método: trata-se de uma etnografia virtual em um grupo fechado no Facebook. Para coligir as informações, utilizaram-se observação participante on-line e análise documental. Analisaram-se 37 postagens por meio do software NVivo 12 Pro e pela técnica de codificação temática. Resultados: emergiram duas categorias temáticas: Faça o tratamento e o tempo se encarregará do resto: ajuda mútua e HIV/aids como condição crônica; e Sim, há perigo na esquina, meu bem: política, conflitos e sociabilidade no grupo. O aspecto mais relevante deste estudo diz respeito à evidência da fragilidade do discurso da cronicidade do HIV/aids. Conclusão: por meio da análise da sociabilidade e da ajuda mútua produzidas entre os membros do grupo investigado foi possível apreender os modos como, em suas experiências de viver com o HIV/aids como condição crônica, as relações entre saúde-doença, política e tempo evidenciaram a dependência entre cronicidade e Estado, e seus impactos na vida cotidiana.Objective: to understand how the relationships between chronicity and politics shape sociability and mutual help among people living with HIV/AIDS. Method: This is a virtual ethnography in a closed group on Facebook. To collect the information, on-lineparticipant observation and documental analysis were utilized. 37 posts were analyzed using the softwareNVivo 12 Pro and the thematic coding technique. Results: Two thematic categories emerged: Do the treatment and time will take care of the rest: Mutual help and HIV/AIDS as a chronic condition; and Yes, there is danger around the corner, my dear: Politics, conflicts and sociability in the group. The most relevant aspect of this study concerns the evidence of the fragility of the discourse on the chronicity of HIV/AIDS. Conclusion: Through the analysis of sociability and mutual help produced among the members of the investigated group, it was possible to apprehend the ways in which, in their experiences on living with HIV/AIDS as a chronic condition, the relationships between health-disease, politics and time showed the dependence between chronicity and the State, and its impacts on daily life

Self-care of elderly people with ostomy by colorectal cancer

Objective: To identify in literature the scientific production about self-care in elderly people with ostomies by colorectal cancer. Method: Integrative review, performed with the descriptors “self-care”, “ostomy” and “elderly/aged” with the Boolean operator AND in the following databases: SCOPUS, CINAHL, MEDLINE, LILACS and COCHRANE. For the theoretical basis, Orem's Self-Care Deficit Theory was used. Results: A total of 533 papers were found, however, after applying the eligibility criteria, 16 studies composed the final sample of the review. Conclusion: The nurse is one of the professionals closest to the person with the stoma and his family, and should act as a link between the elderly person, the family and the multi-professional health team. In this sense, health professionals, especially nurses, should be trained and competent in assisting the diverse demands of care of this specific population, so that it is effective, resolutive, integral and, above all, humanized, aiming at the improvement of quality of life. Resumo: Objetivo: Identificar na literatura a produção científica sobre o autocuidado em pessoas idosas com estomia por câncer colorretal. Método: Revisão integrativa de literatura, realizada com os descritores “autocuidado/self-care”, “estomia/ostomy” e “pessoa idosa/idoso/aged” com o operador Booleano and nas Bases de Dados SCOPUS, CINAHL, MEDLINE, LILACS e COCHRANE. Para o embasamento teórico empregou-se a Teoria do Déficit de Autocuidado de Orem. Resultados: Encontrou-se um total de 533 artigos, no entanto, após a aplicação dos critérios de elegibilidade 16 estudos compuseram a amostra final da revisão. Conclusão: O enfermeiro é um dos profissionais mais próximos da pessoa com estomia e de sua família, devendo atuar como um elo entre a pessoa idosa, a família e a equipe multiprofissional de saúde. Nesse sentido, profissionais da área da saúde, especialmente o enfermeiro, devem estar capacitados e ser competentes na assistência às diversas demandas de cuidado dessa população específica, para que ela seja efetiva, resolutiva, integral e, sobretudo, humanizada, visando à melhora da qualidade de vida. Keywords: Self-care, Elderly people, Ostomy, Gerontological nursing, Palavras-chave: Autocuidado, Pessoa idosa, Estomia, Enfermagem gerontológic