Efficacy of Chinese auriculotherapy for stress in nursing staff: a randomized clinical trial

Objective

this randomized single blind clinical study aimed to evaluate the efficacy of auriculotherapy with and without a protocol for reducing stress levels among nursing staff.

Method

a total of 175 nursing professionals with medium and high scores according to Vasconcelos'' Stress Symptoms List were divided into 3 groups: Control (58), Group with protocol (58), Group with no protocol (59). They were assessed at the baseline, after 12 sessions, and at the follow-up (30 days).

Results

in the analysis of variance, statistically significant differences between the Control and Intervention groups were found in the two evaluations (p<0.05) with greater size of effect indices (Cohen) for the No protocol group. The Yang Liver 1 and 2, Kidney, Brain Stem and Shen Men were the points most used.

Conclusion

individualized auriculotherapy, with no protocol, could expand the scope of the technique for stress reduction compared with auriculotherapy with a protocol. NCT: 01420835     

Pain,health perception and sleep: impact on the quality of life of firefighters/rescue professionals

Objective:

to evaluate the quality of life of firefighters and rescue professionals, and characterize their socio-demographic, health, work and lifestyle profile.

Methods:

cross-sectional study that used a socio-demographic, lifestyle, health, work data questionnaire and the WHOQOL-BREF quality of life aspects, in Fire Department bases, Civil Air Patrol Group of the Military Police and Rescue Group of Emergency Services.

Results:

ninety professionals participated in this study - 71 firefighters, 9 nurses, 7 doctors and 3 flight crew members. The average age of the group was 36.4 ± 7.8 years; they worked about 63.7 hours per week; 20.2% reported pain in the last week and 72.7% had body mass index above 25 kg/m2. The average of the WHOQOL-BREF domains was: physical (74.6), psychological (75.2), social (76.5) and environmental (58.7). Significant association was found (Mann-Whitney test and Spearman correlation) between the WHOQOL-BREF domains and pain in the past six months, in the last week, health perception, job satisfaction, hours of sleep, domestic tasks and study.

Conclusion:

the main factors related to quality of life were presence of pain, health perception, sleep and domestic activity.     

Neck circumference as a potential marker of metabolic syndrome among college students

OBJECTIVE:

to relate neck circumference with metabolic syndrome and its criteria among college students.

METHOD:

cross-sectional study conducted with 702 college students in Fortaleza, CE, Brazil from September 2010 to June 2011. Socio-demographic data, waist circumference and neck circumference were collected together with blood pressure, fasting blood sugar, triglyceride levels, and HDL-C.

RESULTS:

1.7% of the studied sample presented metabolic syndrome. Of these, 58.3% presented altered neck circumference (p<0.006). As neck circumference decreases, pressure levels improve (p<0.001). Additionally, college students with high fasting blood sugar (p=0.003) and high triglyceride levels (p<0.001) presented higher values of neck circumference.

CONCLUSION:

neck circumference is a potential predictive marker in the detection of metabolic syndrome and its components among college students.     

Adolescent hypertension identified with correct cuff and its cardiovascular and gestational problems after 29 years

Objective

to identify, in 2011, rates of hypertension, cardiovascular and gestational problems in subjects presenting high blood pressure in 1982, when correct cuff size was used, according to the American Heart Association Arm Circumference/Cuff Width ratio of 0.40.

Methods

high blood pressure was defined in 2011 as systolic = 115 mmHg and diastolic = 80mmHg, resulting in 20 subjects between 39 and 43 years old. (Risk Group). They were compared to 20 subjects from the original sample with lower blood pressure values (Control group).

Results

the rates of hypertension, cardiovascular and gestational problems were significantly higher (Fisher: p=0.02) in the Risk Group, with one case of cardiovascular death. Our findings arouse speculations about whether, if a proper cuff had been used in clinical practice, the complications and death could have been avoided.

Conclusions

data suggest compliance with the use of cuff width corresponding to 40% of arm circumference, despite polemics concerning cuff availability and difficulties of using many sizes.     

Nasal septum injury in preterm infants using nasal prongs

OBJECTIVE:

to assess the incidence and risk factors associated with nasal septum injury in premature infants using reused and new nasal prongs.

METHOD:

the study was a cohort from an open therapeutic intervention. The sample included 70 infants with a gestational age inferior to 37 weeks, who used nasal prongs and were hospitalized at the neonatal service of a hospital in Recife-PE, in the Northeast of Brazil. The data were collected in patient files through the assessment of the application of the device and of the nasal septum. Multinomial Logistic Regression and Survival analyses were applied.

RESULTS:

the incidence of nasal injury corresponded to 62.9%. In the multiple analysis, only the length of the infant''s treatment was a determinant factor for the occurrence and severity of the injuries.

CONCLUSION:

the type of nasal prong does not serve as a risk factor for the nasal injury. The high incidence of nasal injury indicates the need to adapt the nursing care with emphasis on prevention.     

Medication adherence and quality of life among the elderly with diabetic retinopathy

OBJECTIVE:

to investigate the factors related to medication adherence and its relation to Health- Related Quality of Life (HRQoL) in elderly people with diabetic retinopathy.

METHOD:

one hundred (n=100) elderly outpatients with diabetic retinopathy taking antihypertensives and/or oral antidiabetics/insulin were interviewed. Adherence was evaluated by the adherence proportion and its association with the care taken in administrating medications and by the Morisky Scale. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was used to evaluate HRQoL.

RESULTS:

most (58%) reported the use of 80% or more of the prescribed dose and care in utilizing the medication. The item "stopping the drug when experiencing an adverse event", from the Morisky Scale, explained 12.8% and 13.5% of the variability of adherence proportion to antihypertensives and oral antidiabetics/insulin, respectively.

CONCLUSION:

there was better HRQoL in the Color Vision, Driving and Social Functioning domains of the NEI VFQ-25. Individuals with lower scores on the NEI VFQ-25 and higher scores on the Morisky Scale presented greater chance to be nonadherent to the pharmacological treatment of diabetes and hypertension.     

Association between overweight and characteristics of young adult students: support for nursing care

OBJECTIVE:

to verify associations between overweight and the characteristics of young adult students to support nursing care.

METHOD:

case-control study conducted with young adults from public schools. The sample was composed of 441 participants (147 cases and 294 controls, with and without excess weight, respectively). Sociodemographic and clinical characteristics were collected together with exposure factors and anthropometrics. Multiple logistic regression was used. The study received Institutional Review Board approval.

RESULTS:

statistically significant association with overweight: non-Caucasian, having a partner; weight gain during adolescence, mother''s excess weight, the use of obesogenic medication, augmented diastolic blood pressure, of abdominal circumference and waist/hip ratio. In addition to these, schooling and weight gain during childhood were also included in the multivariate analysis. After adjustment, the final model included: having a partner, weight gain during adolescence, augmented diastolic blood pressure and abdominal circumference.

CONCLUSION:

the analysis of predictor variables for excess weight among young adult students supports nurses in planning and developing educational practices aimed to prevent this clinical condition, which is a risk factor for other chronic comorbidities, such as cardiovascular diseases.     

Presence and extent of the primary health care attributes among children hospitalized for pneumonia

OBJECTIVE:

to analyze the presence and extent of the primary health care attributes among children hospitalized for pneumonia.

METHOD:

observational and retrospective study with hospital-based case-control design, developed in three hospitals associated to the Brazilian Unified Health System, located in a city of the State of São Paulo, Brazil. The study included 690 children under five years old, with 345 cases and 345 controls.

RESULTS:

both groups scored high for access to health services. In contrast, high scores for attributes such as longitudinality and coordination of care were observed for the controls. Despite low scores, integrality and family counseling were also high for the controls.

CONCLUSION:

knowledge of the aspects involving the primary health care attributes and its provision for child care are very important because they have the potential to support professionals and managers of the Brazilian Unified Health System in the organization of health services.     

Quality of life of coronary artery disease patients after the implementation of planning strategies for medication adherence

OBJECTIVE:

to compare the general and specific health-related quality of life (HRQoL) between the Intervention (IG) and Control (CG) groups of coronary artery disease patients after the implementation of Action Planning and Coping Planning strategies for medication adherence and to verify the relationship between adherence and HRQoL.

METHOD:

this was a controlled and randomized study.

RESULTS:

the sample (n=115) was randomized into two groups, IG (n=59) and CG (n=56). Measures of medication adherence and general and specific HRQoL were obtained in the baseline and after two months of monitoring.

CONCLUSION:

the findings showed that the combination of intervention strategies - Action Planning and Coping Planning for medication adherence did not affect the HRQoL of coronary artery disease patients in outpatient monitoring.     

Home-based nursing interventions improve knowledge of disease and management in patients with heart failure

OBJECTIVE:

to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.

METHODS:

in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.

RESULTS:

overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4.

CONCLUSION:

the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument.     

Systematization of Nursing Care in undergraduate training: the perspective of Complex Thinking

AIM:

to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility

METHOD:

longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed.

RESULTS:

The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035).

CONCLUSION:

the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context.     

Variables associated with peripherally inserted central catheter related infection in high risk newborn infants

OBJECTIVE:

to relate the variables from a surveillance form for intravenous devices in high risk newborn infants with peripherally inserted central catheter related infection.

METHODOLOGY:

approximately 15 variables were studied, being associated with peripherally inserted central catheter related infection, this being defined by blood culture results. The variables analyzed were obtained from the surveillance forms used with intravenous devices, attached to the medical records of newborn infants weighing between 500 and 1,499 g. The statistical association was defined using the Chi-squared and Student t tests. The study was approved by the Research Ethics Committee of the Instituto Fernandes Figueira under process N. 140.703/12.

RESULTS:

63 medical records were analyzed. The infection rate observed was 25.4%. Of the variables analyzed, only three had a statistically-significant relationship with the blood culture - the use of drugs capable of inhibiting acid secretion, post-natal steroid use, and undertaking more than one invasive procedure (p-value of 0.0141, 0.0472 and 0.0277, respectively).

CONCLUSION:

the absence of significance of the variables of the form may be related to the quality of the records and to the absence of standardization. It is recommended that the teams be encouraged to adhere to the protocol and fill out the form.