Programa de Pós-graduação em Enfermagem e Saúde
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Item Efetividade do guaraná (Paullinia cupana) para manejo da fadiga em mulheres com câncer de mama em quimioterapia: um ensaio clínico, duplo cego, randomizado(Universidade Federal de Goiás, 2017-03-16) Albarnaz, Marcela Dias; Mota, Dálete Delalibera de Correa de Faria; http://lattes.cnpq.br/1684517331855276; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Freitas Junior, Ruffo de; Malaquias, Suelen GomesFatigue, a symptom of hard treatment due to its multi-dimensionality and multifactoriality, is frequently reported by women with breast cancer undergoing chemotherapy. Researches indicate that guaraná (Paullinia cupana) is a promising intervention for the control of the symptom, but the results still do not show themselves consistent. OBJECTIVE: Assess the effectiveness of 50 mg of guaraná (Paullinia cupana), received twice a day by mouth, for the treatment of fatigue in women with breast cancer under chemotherapy. METHOD: It consists of a randomized clinical trial, double-blind, phase II, placebo controlled. Fatigued women undergoing chemotherapy as the only therapy for the cancer control were randomized in two groups: guarana group (GG) and placebo group (PC). For both groups, an educative program has been conducted in order to uniform the information regarding fatigue. The patients were evaluated in three moments: baseline, 45 and 90 days after the first evaluation. Fatigue was evaluated through the Piper Fatigue Scale- Revised. The analysis of the effectiveness of the intervention and the response rate were adjusted according to age, education level, overweight, medical diagnosis, chemotherapy type, comorbidity, anxiety, depression, alterations on sleep patterns, pain and treatment. RESULTS: 42 women were distributed among the GG (n=21) and PG (n=21) groups. We observed homogeneity in regards to socio-demographic clinical profiles. The inner-group evaluation revealed significant reduction on fatigue scores in GG group, on both total score and behavioral, affective and sensory/cognitive dimensions. The same was not observed on the GP group. The intergroup evaluation revealed a significant statistic difference between the two groups for total scores and behavioral, affective and sensory/cognitive dimensions at the 90th day. A multivariate analyses revealed a reduction of the fatigue rate in 63% (RRA: 0,37; CI 95%: 0,16-0,82) in the GC group. The results of η² revealed a moderate effect on the global fatigue treatment (η² = 0,22), behavioral (η² = 0,13), affective (η² = 0,22) and sensory/cognitive dimensions (η² = 0,16). CONCLUSION: The guarana has shown itself effective in the treatment of fatigue in women with breast cancer undergoing chemotherapy, after 90 days of treatment. The positive effect of the intervention has been observed in both the global fatigue score and in all dimensions evaluated (behavioral, affective and sensory/cognitive).Item Limpeza de feridas: caracterização e validação de protótipo para aquecimento de soro fisiológico e normatização de seu uso em unidades ambulatoriais(Universidade Federal de Goiás, 2015-11-09) Bezerra, Jaqueline Evangelista da Costa; Nerys, José Wilson Lima; http://lattes.cnpq.br/6816730643886734; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Nerys, José Wilson Lima; Vieira, Marcus Fraga; Pereira, Lílian VarandaAlthough the literature evidence the importance of using heated solution to clean injuries while doing a curative, there is not a safe and accessible procedure to heat solutions for this purpose yet. Objective: Test the efficiency of equipment produced to heat saline solution applied to treat injuries at ambulatory of curative; identify the time to cold the heated saline solution when exposed to the environmental temperature. Objective: Test the efficiency of equipment produced to heat saline solution applied to treat injuries at ambulatory of curative; identify the time to cold the heated saline solution when exposed to the environmental temperature. Method: Experimental study of technological innovation accomplished in three stages: the prototype development; efficiency test of heating saline solution flacons; instruction of the using time of the heated solutions. Result: It was developed three prototypes: one of heating by means of Peltier cells, other one of heating by resistance and another one by electromagnetic irradiation, with different results regarding the efficiency.The time of cooling varied from 3 to 35 minutes, depending on the inicial heating,the size of the flacon and the type of wrapper Conclusion: The prototype that best complied with the purpose of safe heating of the solutions was the adapted microwave by reverse engineering, from parameters of standardization created at this research. The prototype was efficient to heat flacons except the 100-ml -tough wrapper flacon which did not reach the expected temperature, however it does not derail its use at wounds treatment. The heated solutions presented time of use differed in relation to the volume of the flacons. At clinical practice can be recommended the use of the flacons of 100 ml to 250 ml per 10 minutes ( except the 100- ml- tough flacon, which is 3 minutes) and of 20 minutes for larger flacons.Item Práticas de autocuidado de pessoas com úlceras venosas: utilização da teoria de enfermagem de Orem(Universidade Federal de Goiás, 2014-04-30) Carneiro, Diana Alves; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Santos , Iraci dos; Pereira , Lílian Varanda; Brandão , Euzeli da Silva; Souza , Sandra Maria Brunini deSelf-care is addressed to prevent problems, maintenance, control and recovery of health. Thus, the appropriation of Orem’s Theory Self-care by the nurses help to explain self-care practices development and based on this plan, nursing systems and methods needed to help to increase the capacity of people for therapeutic self-care. People with venous ulcers require nursing care and the available research does not provide insight into the self-care practices to this group. The objective in this study is to analyze self-care practices of people with venous ulcers. It was also proposed to identify the information provided by the participants from the health professional guidelines regarding the treatment of injury, identifying these professionals as a source of guidance for treatment for venous ulcers, and the correspondence with actions taken by people with ulcers, such as players in self-care practices, and finally, the attendance rate of this. This is a longitudinal study with cross-sectional descriptive study of quantitative approach, held in Goiânia, Goiás from August 2012 to April 2013. From167 people with vascular ulcers identified in a previous study, after verification of eligibility criteria, 41 were included. Individual interview was done and monitoring of scheduled appearances to dressing rooms in four basic health units. Analysis was performed using descriptive statistics. For the analysis of self-care practices, the actions were compared with the literature and Orem's theory (1995) and for analysis of the correspondence between the practices cited as recommended by professionals and implemented by people's actions were classified into five types according to their nature (desirable or not) and origin (linked or not professional guidance). The study was approved by the Ethics Committee of UFG, protocol 101/2010. Among the participants, they were male (56.1%), 60 years old (51.2%), less than seven years of school (75.6%) and income from one to three minimum wages (80, 4%). All of them reported at least two health self-care practices due to venous ulcers, although these have proved incomplete and / or misleading. The professional guidelines were superficial and sometimes misleading, and the doctor was the professional as a source of guidance. Among the factors, the pain was the limiting factor for most of self-care requirements of health disorders, and for some, the most significant factor. Regarding monitoring , 76.9% were attended by more than 80% of appointments made by the professionals of the dressing rooms. The results show the necessity to reflect about factors that influence the nurse's role in supporting people with venous ulcers for the development of self-care ability, updating professionals in general about treatment and dialogue among professionals for integrated care.Item Diagnósticos, intervenções e resultados de enfermagem à pessoas em tratamento hemodialítico: validação de consenso por especialistas(Universidade Federal de Goiás, 2015-10-20) Lemes, Maria Madalena Del Duqui; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Lemes, Maria Madalena Del Duqui; http://lattes.cnpq.br/8503907944360635; Barbosa, Dulce Aparecida; Brasil, Virgínia Visconde; Munari, Denize Bouttelet; Almeida, Miriam de AbreuINTRODUCTION: Among the health problems experienced by adult and elderly people, who have a strong impact on the quality of life, stands out chronic kidney disease (CKD). The nursing process improves the clinical practice of care in hemodialysis, however, is still in its infancy and the scope of the phenomenas described in the taxonomies of diagnoses, interventions and nursing results, as the focus on hemodialysis scenario has not yet been described. OBJECTIVES: To validate nursing diagnoses as priorities by expert nurses; Validate interventions for diagnosis identified as priority by expert nurses; Validate relevant nursing results for diagnoses identified as priority by expert nurses. METHODOLOGY: A descriptive, cross-sectional study, validation of nursing diagnoses, interventions and priority outcomes for patients with chronic kidney disease on hemodialysis people, from the NANDA-I Terminology / NIC / NOC. Participated 12 hemodialysis units that served 1788 patients and 55 nurses working. From the occupational profile of these nurses was identified 21 experts. Of these, nine validated diagnoses, interventions and nursing outcomes, through a focus group, for people with chronic kidney disease. RESULTS: There were 36 validated diagnostic, 124 interventions and 119 nursing results. Of validated nursing diagnoses, 13 are recognized more often in literature and 23, little mentioned or not mentioned. CONCLUSION: The diagnoses, interventions and nursing outcomes validated by experts in hemodialysis give visibility to a qualified clinical practice proposal for systematization of nursing care in accordance with the reality of unity.Item Competências de Enfermeiros no atendimento de pessoas com úlceras venosas(Universidade Federal de Goiás, 2015-07-30) Loreto , Rayana Gomes Oliveira; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Freitas, Raquel Aparecida Marra da Madeira; Pereira, Lilian Varanda; Vila, Vanessa da Silva Carvalho; Mota, Dálete Delalibera Corrêa de FariaThe customer service of people with venous ulcers requires appropriately trained professionals with knowledge, skills and attitudes compatible with quality care. It is known that professionals don’t always have qualified to serve this population. For the educational activity planning and training of human resources it is necessary to have as a starting point the competencies expected of professionals. There aren’t documents in which are established competencies for nurses in the care of people with venous ulcers. The objective is to map the skills necessary to professional nursing care for people with venous ulcers. This is an integrative review that comes through the five stages second methodological framework adopted. The search was performed using the databases: Source of Nursing and Allied Health Literature (CINAHL), National Library of Medicine National Institutes of Health (PUBMED), and SciVerse Scopus, and guidelines published by organizations with internationally recognized experts in area of assessment and treatment of wounds. For definition of competence adopted the inductive and deductive method. 20 articles and 21 guidelines were included, totaling 41 references. Were identified six general competencies: assessment of people with venous ulcers, venous ulcer assessment, the individual treatment with venous ulcers, treatment of venous ulcers, the person monitoring with venous ulcers, prevention of venous ulcers. For each general competency were identified specific skills and their knowledge, skills and attitudes. CONCLUSION: The identified skills represent a boundary for the teaching of the nursing care of people with venous ulcers. Should be the subject of discussion and reflection among educators, for a decision wherein levels they’ll be addressed in the process of training of human resources.Item Subconjunto terminológico da CIPE® para atendimento de pessoas com hanseníase(Universidade Federal de Goiás, 2017-02-10) Oliveira, Michele Dias da Silva; Garcia, Telma Ribeiro; http://lattes.cnpq.br/5849780347831135; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Nóbrega, Maria Miriam Lima da; Lima, Jacqueline Rodrigues de; Medeiros, Marcelo; Pereira, Lilian Varanda; Bachion, Maria MárciaIntroduction: To take care of people with leprosy, nurses make diagnostic and therapeutic judgments, which must be expressed through special terminology of the profession of theoretical nursing models. Therefore, the International Classification for Nursing Practice usage - CIPE® for the construction of a terminological subset aimed at people with leprosy is necessary to train nurse clinical practice. Objective: To create a terminological subset of nursing diagnoses, results and interventions for the care of people with leprosy, using CIPE® in clinical practice. Method: This is a methodological research study with two phases: one exploratory and the other, a field study. In the exploratory phase, three stages were used to perform terminological research and cross mapping between the terms extracted from Health Ministry publications, related to leprosy and those contained in CIPE® version 2015. In field phase: 1 - Nursing consultation based on Orem's self-care theory with elaboration of nursing diagnosis, results and interventions; 2 - Nursing diagnosis statements validation by three specialists; 3 - Cross mapping of diagnostic statements, results and nursing interventions with CIPE® and the database of terms extracted from the Health Ministry publications; 4 - Creation of the terminology subset of CIPE® to assist people with leprosy. Results: In exploratory phase, 1,041 terms were extracted from the Ministry of Health publications related to leprosy, from which 300 (28.80%) were equal to constant terms in the CIPE® axes; 51 (4.86%) were similar; 49 (4.68%) were larger; 172 (16.45%) were more restricted and 469 (45.00%) were different from the terms of that classification. In field phase, nursing consultations have been carried out on 24 people with leprosy, resulting in 81 nursing diagnoses / results and 303 nursing interventions. In the statements analysis of diagnosis / results and nursing interventions, 564 primitive terms have been evaluated: 342 (61%) were considered constant (equal term, similar, similar more restricted and Similar) in CIPE® and 222 (39.4%) different from CIPE®. From pre-coordinated terms, 384 were evaluated, from which 275 (72%) were considered constant (equal term, similar, more similar, similar and broader) and 109 (28.4%) different from pre-coordinated ICNP terms. Conclusions: The methodology used in this research made it possible to create a terminological subset based on Dorothea Orem self-care theory and CIPE®, and it can be used in clinical practice in nursing care to people with leprosy, in a systematized way, using the steps of nursing process and assisting in the teaching and creation of electronic medical records. In addition, from the results found in this study, it was noticed the need to expand CIPE® in order to better contemplate the phenomena of nursing practice in the care of people with leprosy.Item Análise do registro do processo de enfermagem mediado por tecnologia de informação: estudo de caso(Universidade Federal de Goiás, 2014-09-29) Pereira, Raphael Brandão; Bachion, Maria Márcia; http://lattes.cnpq.br/850390794436063; Bachion , Maria Márcia; Galvão , Maria Cristiane Barbosa; Bezerra , Ana Lúcia Queiroz; Ribeiro-Rotta , Rejane Faria; Barbosa , Maria AlvesThe information and communication technologies havebeen increasingly incorporated to nursing practices, to support the use and the record of nursing process, demanding the monitoring of its results achieved and intervenient factors on a continuous basis. The present study had the objective of providing an analysis of record of nursing process supported by communication and information technologies and the intervenient factors intervenient factors in the nurses’ perception. It is a study of a single integrated case, carried out at the neonatal intensive care unit of a university hospital, located at the Midwest region of the country, from January to April 2014. The new technologies consisted of a data collection/nursing development protocol, specific for a neonatal intensive care unit, and the use of support software to the diagnostic steps, health care planning (target, objective and prescription statements), implementation and evaluation. The data collection was held through the application of a questionnaire and data collected from nurses’ records at patients’ medical files. The study integrated unit consisted of seven nurses, who worked in the section before (from September to November 2010) and after (from September to November 2012) the implementation of the communication and information technologies to support the use and record of the nursing process. The level of application of the nursing process (NAPE) was classified from 1 to 5, according to its accuracy. The records number in each stage of the nursing process was calculated for each day of nursing attendance during the study period. The quantitative data was analyzed through descriptive statistics. The nurses’ statements on intervenient factors were analyzed using the Donabedian health assessment model (1984). There was an increase of records units by nursing service delivery days (UR/DAY), during data collection stages from 55.2 UR/DAE to 80.4% UR/DAE, new nursing diagnostic records to 0.3 UR/DAE, of targets and objectives (1.0 UR/DAE), and of nursing evaluation (0.2 UR/DAE). The stage of nursing prescription had a decrease from 2.1 UR/DAE to 1.9% UR/DAE and the implementation from 4.4 UR/DAE to 3.1 UR/DAE. It was possible to identify the record of more stages of the nursing process if compared with the period before the new technologies started to be used. Nevertheless this increase was not so significant. Among the intervenient factors, time availability was considered enough for the nursing process (PE) application, and besides that, the record remained incipient. Nurses that reported receiving satisfactory or very satisfactory training on the PE or on the use of new communication and information technologies, also reported more stages of the PE. Considering the strategic relevance of adequate record of nursing service delivery and of the legal and ethical requirement of the nursing process, even small improvements may be relevant. However, in general, it is possible to conclude that the insertion of new technologies associated to the training process did not have a significant impact in the stages of the nursing process at the context of the study.Item Resolutividade da assistência a saúde de pessoas com úlceras vasculares atendidas na atenção básica(Universidade Federal de Goiás, 2014-06-26) Santos, Queiliene Rosa dos; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Torres, Gilson de Vasconcelos; Prado, Marinésia Aparecida doINTRODUCTION: Vascular ulcers are a major public health problem, affecting around 1% of the general population, with a higher prevalence among the aged. Treatment is time consuming and costly, they can cause physical, social, economic and emotional problems. They are considered complex and difficult to heal, have a high number of relapses, and most of them are critically colonized or infected. Service to people with vascular ulcers is challenging to both health professionals and the public administration by virtue of its complexity, including the absence of public policies for this population, structuring services, access to care, professional qualification, and appropriate resources. GENERAL OBJECTIVE: To analyze the outcomes of healthcare for people with vascular ulcers treated in the examination rooms of the primary care system from the perspective of the evolution of healing over a period of six months. METHODOLOGY: Analytic longitudinal study with nested cross-sectional studies, in the examination rooms of the public health service of the city of Aparecida de Goiania, Goias, Brazil, from August 2012 to October 2013. Population consists of users receiving treatment by nurses, and professionals who provided nursing care in the study setting. Data collection occurred through structured nonparticipant observation, interview, physical examination, and use of Pressure Ulcer Scale for Healing (PUSH), planigraphy of ulcers, and photographic record. Absolute frequencies and percentages were used for data collection. The study complies with guidelines for research ethics, being approved under protocol 085/2012. RESULTS: The three rooms designed to care for people with vascular ulcers in the studied scenario showed non-washable walls, windows not screened, without adequate hand hygiene resources, without proper procedures for cleaning and disinfection of the environment, and lack of essential resources and inconsistent supply thereof. As for users, there was gender parity, prevalence among 60 years or older, and social and economic conditions in the lower middle class and below. The majority had lesions for more than one year, which were usually painful. Microbiological examination showed predominantly Gram-negative rods, including Pseudomonas aeruginosa. Among professionals, most were females, aged between 18 and 36 years and "reasonable experience" in treating people with vascular ulcers. CONCLUSION: Conditions were inadequate for serving people with vascular ulcers and contribute to care not compliant with current recommendations, which creates a discontinuity of care and diminished capacity to resolve these issues. Therefore, it is necessary to structure the service with respect to people with chronic ulcers, and maintain supplies and appropriate resources for care.Item Efetividade de um programa de intervenções de enfermagem para conhecimento deficiente do cuidador familiar de pessoas em processo de reabilitação(Universidade Federal de Goiás, 2013-05-10) Souza, Juliana Caldas de; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Vila, Vanessa da Silva Carvalho; Souza, Márcia Maria de; Menezes, Ruth Losada; Lopes, Carmen Luci RodriguesTraumatic brain injury (TBI) has been considered the most important cause of disability among young people and the most common cause of neurological morbidity. It is therefore necessary that health professionals, including nurses, develop specific knowledge about the assistance not only to the victims but also to the caregivers in order to help them cope with the adverse consequences arising from this type of trauma. In the rehabilitation context, there is little research on the clinical management of people with TBI in rehabilitation process and even the use of Models or Nursing Theories to approach to this group. This study aimed to examine the effectiveness of a program in nursing interventions for "Knowledge deficit of family caregivers" of people with TBI rehabilitation sequel. It followed the methodology of convergent care research (PCA), a quantitative approach. The study was developed in the hospital sector of the Rehabilitation Center and Readaptation Dr. Henry Santillo (CRER) in the city of Goiânia/GO through August 2012 to January 2013. The study included eight people with TBI, V ranch or superior, who were hospitalized in the period of the study and their caregivers. During data collection a set of instruments and procedures were used. In the evaluation of people with TBI, a protocol interview and physical examination based on the Theory of Orem were used. In the assessment of family caregivers it was applied a structured interview based on the Calgary Assessment Model and Families Intervention, a cognitic assessment using the Mini-Mental State Examination and anxiety assessment by the State-Trait Anxiety Inventory. Based on this initial assessment of patients and their family caregivers, it was developed knowledge evaluation protocols necessary to caregivers with specific focus such as: facilitation of communication, memory training, cognitive stimulation and disease process. The rating scales were inspired by NOC. Then, a program of individual and group intervention was applied to the family caregivers based on NIC (individual and group learning, learning: the health illness process) and in the Learning Theory significant. At the end of the specific intervention program, 72 hours were waited and knowledge post-intervention tests were applied. Sociodemographic data analysis was done by simple descriptive statistics. The diagnoses were identified by consensus of two professionals and checked by a third researcher. To evaluate the results it was used the scores of the NOC indicators (Nursing Outcomes Classifications) and made a comparison of the data obtained before and after 72 hours of interventions through the use of Descartes signals test. The interventions protocol for poor knowledge was effective for training Memory (p = 0.008) and instruction: disease process (p = 0.008). Despite positive clinically results, the program effectiveness of interventions for cognitive stimulation (p = 0.07) and communication improvement (p = 0.12) they could not be statistically proven. Based on these results, it was possible to: highlight the success of intervention program for the diagnosis of insufficient knowledge of the family caregiver training on memory and on the disease process.Item Efeito da lanolina anidra comparado ao leite materno combinado à concha de proteção para tratamento da dor e do trauma mamilar em lactantes: ensaio clínico randomizado(Universidade Federal de Goiás, 2013-04-30) Vieira, Flaviana Vely Mendonça; Mota, Dálete Delalibera Correa de Faria; http://lattes.cnpq.br/1684517331855276; Bachion, Maria Márcia; http://lattes.cnpq.br/8503907944360635; Bachion, Maria Márcia; Abrão, Ana Cristina Freitas Vilhena; Almeida, Ana Maria de; Costa, Paulo Sérgio Sucasas da; Guimarães, Janaína ValadaresINTRODUCTION: Women often experience nipple trauma when they start breastfeeding, and this is one of the predictive factors of early weaning. There is no sufficient evidence to date supporting one best treatment for nipple trauma. OBJECTIVE: Assess the effect of lanolin anhydrous in the treatment of nipple pain, compared to mother’s breast milk combined with nipple protection shells during breastfeeding. METHOD: Randomized clinical trial, controlled with 100 puerperal women with nipple trauma, who had delivered at a public maternity hospital of Goiânia, Goiás, Brazil. Fifty women were randomized to group 1 and 50 to group 2. In group 1, a total of 97 breasts with nipple trauma were treated with lanolin anhydrous, and in group 2, 95 breasts with nipple trauma were treated with breast milk combined with nipple protection shells, and followed for up to 10 days. Both groups received educational instructions regarding breastfeeding. The outcome variables were: nipple trauma healing – determined by the Nipple Trauma Score (NTS) and pain in the nipple-areolar region – determined by a numerical pain scale. The research proposal was approved by the Research Ethics Committee of the University Hospital at Federal University of Goiás, and was recorded on the Brazilian Record System of Clinical Trials. Data analysis was performed using chi-square test, Fisher’s Exact Test and ANOVA MR, with significance at p<0.05. RESULTS: In the baseline assessment, the groups were homogenous in terms of sociodemographic, obstetrical and neonatal characteristics. The onset of nipple trauma was on the 2nd day postpartum, in average. Intervention was initiated on the 2nd day of nipple trauma. There was a variation of traumas, with the crust being the most frequent. Nipple depigmentation improved with time, with a difference between the groups on day 7 (p=0.013) and 10 (p=0.001). There was no difference between groups for the NTS before the intervention (p=0.642). The analysis of variance over time (ANOVA MR) indicated lower NTS in group 2 with a difference between the groups on days 3 (p=0.026), 5 (p=0.004), 7 (p<0.001) and 10 (p<0.001) of follow-up. Regarding the intensity of pain in the nipple-areolar region, a 5.5 mean was found for group 1 and 5.8 for group 2, on day 1, with no difference between the groups. The intensity of pain was smaller in group 2 compared to group 1 on days 5 (p=0.001), 7 (p<0.001) and 10 (p<0.001). CONCLUSION: Compared to lanolin anhydrous, breast milk combined with nipple protection shells proved more effective in reducing pain and healing nipple trauma in breastfeeding puerperal women.