Eduardo Tavares Gomes

Anxiety in the preoperative period of heart surgery

Objective: to characterize the patients’ anxiety in the preoperative period of heart surgery. Method: We conducted a cross-sectional study in which 106 patients, between one and fi ve days from the date of surgery, were interviewed using a socio-demographic questionnaire and the Beck Anxiety Inventory. Results: The evaluated patients accounted for 59.4% (63) in minimal anxiety and 19.8% (21) in the range considered severe, and the sample had a mean in the mild anxiety level (15.8±19.79). The women had scores (22.13±23.41) signifi cantly (p=0.003) higher than men (10.76±14.71); as well as patients who had undergone previous heart surgery (24.4±28.05 X 13.14±15.74). There was no signifi cant difference between older adults and younger patients, nor in terms of weight variations, presence of diabetes, or alcoholism. Conclusion: We reinforces the importance of nurses in recognizing the preoperative anxiety and intervene through strategies of health education and nursing visits.

Use of the air mattress in the reduction of pressure ulcers: efficacy and perceptions of nursing

Objective: to evaluate the effectiveness of the air mattress in reducing pressure ulcers in the coronary unit of a referral hospital for cardiology. Method: Cross-sectional, retrospective, descriptive, exploratory study with a quantitative approach carried out at the Epidemiology and Infection Control (NEPI-CCIH) and in coronary care units I and II of the University Cardiac Emergency Room of Pernambuco Prof. Luiz Tavares/PROCAPE. The Ethics Committee in Research, CAAE No 12292213.2.0000.5194, approved the research project. Results: the mattresses were effective in reducing the incidence of pressure ulcers, showing a rate of 55.3% when comparing years 2011 and 2012. The opinion of the nursing staff about the effectiveness of the mattress showed positive results in the majority of the interviewed (98.6%), but 48.8% of professionals did not know the technology before the implementation. Conclusion: there is the need to update the teams working in intensive care for the use of air mattresses. Descriptors: Pressure Ulcer; Nursing Evaluation; Nursing; Intensive Care. RESUMO Objetivo: avaliar a eficácia do colchão pneumático na redução de úlceras por pressão nas unidades coronarianas de um hospital de referência em cardiologia. Método: estudo transversal, retrospectivo, descritivo-exploratório, com abordagem quantitativa, realizado no Núcleo de Epidemiologia e Controle de Infecção (NEPI-CCIH) e nas unidades coronarianas I e II do Pronto-Socorro Cardiológico Universitário de Pernambuco – Prof. Luiz Tavares/PROCAPE. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, CAAE no 12292213.2.0000.5194. Resultados: os colchões apresentaram-se eficazes na redução da incidência das ulceras por pressão, apontando uma taxa de 55,3% quando comparados os anos de 2011 e 2012. A opinião da equipe de enfermagem quanto à eficácia do colchão mostrou resultado positivo na maioria dos entrevistados (98,6%), porém foi observado que 48,8% dos profissionais não conheciam a tecnologia antes de sua implantação. Conclusão: há necessidade de atualização das equipes que trabalham em terapia intensiva para o uso dos colchões pneumáticos. Descritores: Úlcera por Pressão; Avaliação em Enfermagem; Cuidados de Enfermagem; Terapia Intensiva. RESUMEN Objetivo: evaluar la eficacia del colchón de aire en la reducción de úlceras por presión en las unidades coronarias de un hospital de referencia en cardiología. Método: estudio transversal, retrospectivo, descriptivo-exploratorio, con enfoque cuantitativo, realizado en el Núcleo de Epidemiologia y Control de Infección (NEPI-CCIH) y en las unidades coronarias I y II de la Emergencia Cardiológica Universitaria de Pernambuco Prof. Luiz Tavares/PROCAPE. El proyecto de investigación fue aprobado por el Comité de Ética en Investigación, CAAE no 12292213.2.0000.5194. Resultados: los colchones se presentaron eficaces en la reducción de la incidencia de las ulceras por presión, mostrando una tasa de 55,3% cuando comparados a los años de 2011 y 2012. La opinión del equipo de enfermería sobre la eficacia del colchón mostró resultado positivo en la mayoría de los entrevistados (98,6%), sin embargo fue observado que 48,8% de los profesionales no conocían la tecnología antes de su implantación. Conclusión: hay necesidad de actualización de los equipos que trabajan en terapia intensiva para el uso de los colchones de aire. Descriptores: Úlcera por Presión; Evaluación en Enfermería; Cuidados de Enfermería; Terapia Intensiva. Nurse, Higher Education Foundation of Olinda/FUNESO. Olinda (PE), Brazil. E-mail: ruana.nobrega@hotmail.com; Nurse, Higher Education Foundation of Olinda /FUNESO. Olinda (PE), Brazil. E-mail: ruana.nobrega@hotmail.com; Nurse, Specialist in Life Advanced Support, Student in the Nursing Specialization Program in Cardiology Residency, Cardiac Emergency Room in Pernambuco/PROCAPE. Recife (PE), Brazil. Email: edutgs@hotmail.com; Nurse, Master degree in Health Science, CCIH of the Cardiac Emergency Room in Pernambuco/PROCAPE. Recife (PE), Brazil. Email: mariliaperreli@gmail.com; Nurse, Master degree in Health Science, ICU of the Clinic Hospital, Federal University of Pernambuco/UFPE. Recife (PE), Brazil. Email: aracelecavalcanti@hotmail.com ORIGINAL ARTICLE Pinho CM, Correia RN, Valença MP et al. Use of the air mattress in the reduction of... English/Portuguese J Nurs UFPE on line., Recife, 8(8):2729-35, Aug., 2014 2730 ISSN: 1981-8963 DOI: 10.5205/reuol.6081-52328-1-SM.0808201421 Risk factors predispose the individual to prolonged periods of ischemia induced by pressure reducing the ability of tissue recovery from the ischemic injury and may be associated with intrinsic or extrinsic factors. Injuries by pressure worry and discourage patients and are a gateway to infection, hindering recovery, increasing the time required for nursing care and therefore costs, increasing mortality in some patients. The loss of skin integrity produces significant consequences for the individual, the institution and the community. The prevalence of pressure ulcers has increased in recent years due to increased life expectancy of the population, associated with the advances of modern medicine, making possible the survival of patients with serious diseases and before lethal, transforming into chronic diseases and slowly wasting. Despite these advances in health care, pressure ulcer is still an important cause of morbidity and mortality and impact on quality of life of patients and their families, creating a social and economic problem. More than one million people develop pressure ulcers each year. Taking into account the pressure ulcers, the prevalence in a given sector is defined as the number of clients with at least one pressure ulcer that exists in a population of patients in a given time. Some risk factors are the most important for the development of pressure ulcers, condition imposing physical, emotional and social overload on the patients and their family. The patient feels unmotivated to continue the treatment becoming susceptible to the deterioration in quality of life, implying increased costs for health care, as special dressings and medications, when staying longer in the hospital and predisposing the patient to prolonged periods of ischemia induced by pressure, reducing the ability of ischemic tissue injury recovery and increasing morbidity and mortality by infections. Immobility, malnutrition, anemia, edema, drug vasoconstriction, altered level of consciousness, incontinence and vascular disorders increase the developing of pressure ulcers, causing additional problems such as pain, suffering and increased mortality and morbidity, longer the time and cost of hospitalization. The lack of mobility is one of the risk factors for pressure ulcers, enabling the presence of local pressure on bony prominences without alternations, having tissue malnutrition. Tissue injury by pressure is a wound that causes suffering and discomfort, being avoided and minimized using systematization of nursing care to define the changes in position, protocols for prevention of ulcers with technological covers reducing the risk of friction and shear and the bony prominences, aid risk scales already translated and validated and the use of alternating pressure mattresses helping in the continuous change of pressure in the bony prominences and alleviating blood flow, reducing the possibility of ischemia area. Reducing or relieving pressure is the most important prophylactic measure and it can be achieved by proper positioning of the patient in bed and reducing the use of pressure devices. The position changing is needed to relieving and redistributing pressure on the skin, allowing the flow of blood into the ischemic areas and helping in the recovery of tissue from the effects of pressure. Many times it is necessary the use of pressure relief devices, especially patients for bedridden and who have risk factors as a preventive way to relieve pressure on bony prominences, preventing the development of pressure ulcers. The system can reduce the working time of nurses’ professionals, giving mobility and changing the position of the bedridden often, to allow them to do other activities. Another advantage is the savings in materials and hospital equipment, because with the prevention of pressure ulcers, it is possible to avoid the many complications that would occur in their presence, reducing the consumption and use of resources in the health area. The use of mattresses with redistributed surface of pressure on hospital beds and operating tables decreases the possibility of new lesions. Although it requires more investment, it can be cost-effective decreasing the time of hospitalization. To prevent pressure ulcers, there are various mattresses available in the market using a fluid substance to ease and redistribute the pressure body on a surface. In addition to preventing the diseases, these mattresses also ensure support of the body more comfortably. Among the fluids used in these applications are water, air or special gels. There are also models that use alternating pressure between the body and the mattress by inflation and deflation of air in pneumatic pockets. Pressure control in these pockets is usually by some sort of electronic system. INTRODUCTION Pinho CM, Correia RN, Valença MP et al. Use of the air mattress in the reduction of... English/Portuguese J Nurs UFPE on line., Recife, 8(8):2729-35, Aug., 2014 2731 ISSN: 1981-8963 DOI: 10.5205/reuol.6081-52328-1-SM.0808201421 ● To evaluate the effectiveness of the use of air mattress in reducing pressure ulcers in coronary care units of a cardiology hospital referral. Descriptive, cross-sectional, retrospective study with a quantitative approach carried out at the Epidemiology and Infection Control (NEPI-CCIH) and in coronary care units I and II of the University Cardiac Emergency Room of Pernambuco Prof. Luiz Tavares (PROCAPE). The PROCAPE is a cardiology referral service in th

Ansiedade no período pré-operatório de cirurgia cardíaca

Objective: to characterize the patients’ anxiety in the preoperative period of heart surgery. Method: We conducted a cross-sectional study in which 106 patients, between one and fi ve days from the date of surgery, were interviewed using a socio-demographic questionnaire and the Beck Anxiety Inventory. Results: The evaluated patients accounted for 59.4% (63) in minimal anxiety and 19.8% (21) in the range considered severe, and the sample had a mean in the mild anxiety level (15.8±19.79). The women had scores (22.13±23.41) signifi cantly (p=0.003) higher than men (10.76±14.71); as well as patients who had undergone previous heart surgery (24.4±28.05 X 13.14±15.74). There was no signifi cant difference between older adults and younger patients, nor in terms of weight variations, presence of diabetes, or alcoholism. Conclusion: We reinforces the importance of nurses in recognizing the preoperative anxiety and intervene through strategies of health education and nursing visits.

Spiritual well-being and hope in the preoperative period of cardiac surgery

OBJECTIVE To characterize relations between spiritual well-being and hope of patients in the preoperative period of cardiac surgery. METHOD Exploratory cross-sectional study with quantitative approach, performed in the infirmaries of a reference hospital in cardiology. We evaluated 69 patients hospitalized in preoperative period of myocardial revascularization, valve repair or replacement. RESULTS We verified that patients hold relevant scores of hope and welfare in all areas, being the existential well-being significantly lower than the religious one. The average of the spiritual well-being score was below the required to be considered high. There was no significant correlation between welfare and hope. CONCLUSION Nurses should develop a watchful eye to these issues, be trained in specific protocols of spiritual anamnese and use the real moments of care to strengthen the patients.

Religiosidade prejudicada e sofrimento espiritual em pessoas vivendo com HIV/aids.

Objetivo: Verificar a inferencia dos Diagnosticos de Enfermagem, Religiosidade prejudicada e Sofrimento espiritual em pessoas vivendo com HIV/AIDS. Metodos: Trata-se de um estudo transversal, com abordagem quantitativa, realizado em um Servico de Assistencia Especializada de Recife, Pernambuco, de junho a novembro de 2015. Os resultados relacionados as 52 pessoas vivendo com HIV/AIDS entrevistadas foram analisados por tres juizes enfermeiros. Resultados: Estimou-se em 73,1% (38) a incidencia de Sofrimento espiritual, 36,5% (19) de Religiosidade prejudicada, com numero medio de caracteristicas definidoras de 3,88±2,05 e 2,55±0,69. A principal caracteristica definidora para a Religiosidade prejudicada foi: “relata necessidade de reconectar-se com crencas anteriores” (92,3%); e para Sofrimento espiritual: “expressa falta de finalidade na vida/expressa falta de significado na vida” (86,5%). Conclusoes: Os resultados apontam para a necessidade de considerar a dimensao religiosa-espiritual nos protocolos assistenciais e de pesquisa em enfermagem. Palavras-chave: Espiritualidade. HIV. Diagnostico de enfermagem.

Estrategias de afrontamiento religioso y espiritual en personas que viven con VIH/SIDA

OBJECTIVE evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. METHOD descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA) participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL), and the Religious/Spiritual Coping Scale (RCOPE). RESULTS the sample presented high indices of organizational religiosity (4.23±1.66), non-organizational religiosity (4.63±1.50), and intrinsic religiosity (13.13±2.84). Positive RCOPE was used in high mean scores (3.66±0.88), and negative RCOPE had low use (2.12 ± 0.74). In total, use of RCOPE was high (3.77±0.74), having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46). CONCLUSION it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

Coping religioso e espiritual em pessoas vivendo com HIV/Aids

OBJECTIVE evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. METHOD descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA) participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL), and the Religious/Spiritual Coping Scale (RCOPE). RESULTS the sample presented high indices of organizational religiosity (4.23±1.66), non-organizational religiosity (4.63±1.50), and intrinsic religiosity (13.13±2.84). Positive RCOPE was used in high mean scores (3.66±0.88), and negative RCOPE had low use (2.12 ± 0.74). In total, use of RCOPE was high (3.77±0.74), having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46). CONCLUSION it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

Religious and spiritual coping in people living with HIV/Aids

OBJECTIVE evaluate the religiosity and the religious/spiritual coping of people living with HIV/Aids. METHOD descriptive, cross-sectional study with quantitative approach, conducted in a reference HIV/Aids outpatient clinic in a university hospital of Recife-PE, Brazil, from June to November 2015. At total of 52 people living with HIV/Aids (PLWHA) participated in the research, which employed own questionnaire, the Duke University Religion Index (DUREL), and the Religious/Spiritual Coping Scale (RCOPE). RESULTS the sample presented high indices of organizational religiosity (4.23±1.66), non-organizational religiosity (4.63±1.50), and intrinsic religiosity (13.13±2.84). Positive RCOPE was used in high mean scores (3.66±0.88), and negative RCOPE had low use (2.12 ± 0.74). In total, use of RCOPE was high (3.77±0.74), having predominated the positive RCOPE (NegRCOPE/PosRCOPE ratio=0.65±0.46). CONCLUSION it is evident the importance of encouraging religious activity and RCOPE strategies, seen in the past as inappropriate interventions in clinical practice.

Ansiedad en el período preoperatorio de cirugía cardíaca

Objective: to characterize the patients’ anxiety in the preoperative period of heart surgery. Method: We conducted a cross-sectional study in which 106 patients, between one and fi ve days from the date of surgery, were interviewed using a socio-demographic questionnaire and the Beck Anxiety Inventory. Results: The evaluated patients accounted for 59.4% (63) in minimal anxiety and 19.8% (21) in the range considered severe, and the sample had a mean in the mild anxiety level (15.8±19.79). The women had scores (22.13±23.41) signifi cantly (p=0.003) higher than men (10.76±14.71); as well as patients who had undergone previous heart surgery (24.4±28.05 X 13.14±15.74). There was no signifi cant difference between older adults and younger patients, nor in terms of weight variations, presence of diabetes, or alcoholism. Conclusion: We reinforces the importance of nurses in recognizing the preoperative anxiety and intervene through strategies of health education and nursing visits.

Caracterização dos pacientes portadores de insuficiência renal atendidos na emergência de um hospital geral [Characterization of patients with renal failure treated at a general hospital emergency department]

As unidades de saude que prestam atendimento de emergencia devem estar preparadas para o atendimento a pacientes em insuficiencia renal aguda, visto que o diagnostico, escolha do metodo dialitico, preparo do paciente e acesso venoso adequado precoces sao decisivos. Objetivou-se caracterizar os pacientes atendidos em uma emergencia geral com insuficiencia renal aguda. Trata-se de um estudo descritivo, retrospectivo, de abordagem quantitativa, de dados de 78 prontuarios de pacientes atendidos em julho e agosto de 2012, na emergencia do Hospital Otavio de Freitas, Recife, Pernambuco. As queixas que motivam os pacientes a procurarem a emergencia podem ser diversas e inespecificas em relacao a patologia renal, mas a investigacao apos a admissao finda por indicar o grau de lesao e indicar a necessidade de tratamento dialitico. Um grupo significativo chega aos servicos de emergencia ja com perda da funcao renal ou em estagio terminal de doenca e necessidade de transplante renal. ABSTRACT Health facilities that provide emergency care must be prepared to handle patients in acute renal failure, since early diagnosis, choice of dialysis method, patient preparation and suitable venous access are crucial. This study characterized patients with acute renal failure treated at an general hospital emergency department. This retrospective, quantitative, descriptive study examined data from the medical records of 78 patients treated in July and August 2012 at the Emergency Unit of Otavio de Freitas Hospital, Recife, Pernambuco State. The complaints that bring patients to emergency services can be diverse and unspecific as regards renal pathology, but the post-admission investigation ends by indicating the degree of injury and need for dialysis. A significant number arrive at emergency services already with loss of renal function or end-stage disease, and needing a kidney transplant. RESUMEN Los centros de salud que brindan atencion de urgencia deben estar preparados para atender a los pacientes con insuficiencia renal aguda, ya que el diagnostico, la eleccion del metodo dialitico, la preparacion del paciente y el acceso venoso adecuado tempranos son cruciales. Este estudio tuvo como objetivo caracterizar a los pacientes con insuficiencia renal aguda atendidos en el servicio de urgencias de un hospital general. Se trata de un estudio descriptivo, con enfoque retrospectivo, de abordaje cuantitativo, cuyos datos fueron recolectados de las historias clinicas de 78 pacientes atendidos en julio y agosto de 2012, en el servicio de urgencias del Hospital Otavio de Freitas, en Recife, Pernambuco. Las quejas que motivan a los pacientes a buscar los servicios de urgencia pueden ser diversas e inespecificas en relacion con la patologia renal, pero la investigacion tras la admision indica el grado de lesion y muestra la necesidad de dialisis. Un grupo significativo ya llega a los servicios de emergencia con perdida de la funcion renal o en una fase terminal de la enfermedad y necesita un trasplante de rinon. DOI: http://dx.doi.org/10.12957/reuerj.2015.5095