Geraldo Magela Salomé

Avaliação de sintomas depressivos em pessoas com diabetes mellitus e pé ulcerado

OBJECTIVE To evaluate the intensity of symptoms of depression in patients with diabetic foot ulcers. METHODS a exploratory, descriptive, analytical and cross-sectional study was held at the wound clinic of a public hospital in Sorocaba, São Paulo State, Brazil. Fifty patients with diabetes mellitus and foot ulcers were enrolled. To assess the intensity of the symptoms of depression, a Beck Depression inventory was used. RESULTS Of the 50 patients evaluated, 41 had some degree of depressive symptoms and 32 (64%) had moderate depression, with symptoms of self-loathing, grief, body image distortion and decreased libido. CONCLUSION Patients with diabetic foot ulcers showed varying degrees of depressive symptoms.

Sentimentos vivenciados pelos profissionais de enfermagem que atuam em unidade de emergência

OBJECTIVE to know the meanings fo the work in an emergency unit for nursing professionals. METHOD qualitative research with phenomenological approach. Data collection was obtained by means of 14 interviews with nursing professionals. RESULTS coexisting feelings of nursing professionals are fatigue, exhaustion, anguish and revolt for the work overload and resources limitations face the situations that involve death risk. CONCLUSION although stress faced by nursing professionals during the daily work, they keep the commitment in assisting with quality and humanization, existing a trend for emotional exhaustion, loss of heart and feelings of anguish, what reaffirms the importance of heath prevention in work environment.OBJETIVO: conocer el significado del trabajo en una unidade de urgencia para los profesionales de enfermeria. METODO: se trato de una investigacion cualitativa con abordaje fenomenologica. La recogida de datos fue por medio de 14 entrevistas con profesionales de enfermeria. RESULTADOS: los profesionales de enfermeria tienen los sentimientos de fatiga, agotamiento, angustia y rebelion para la sobrecarga de trabajo y las limitaciones de recursos frente a las situaciones que implican riesgo de muerte. CONCLUSION: a pesar del estres que los profesionales pasan en el dia al dia de trabajo ellos mantienen el compromiso en asistir con calida y humanizacion, existindo una tendencia para el agotamiento emocional, desaliento emocional y angustia lo que reafirma la importancia de la prevencion en salud en el ambiente de trabajo.OBJETIVO: conhecer o significado do trabalho em uma unidade de emergencia para os profissionais de enfermagem. METODO: tratou-se de pesquisa qualitativa com abordagem fenomenologica. A coleta de dados foi obtida por meio de 14 entrevistas com profissionais de enfermagem. RESULTADOS: os profissionais de enfermagem convivem com sentimentos dispares, como cansaco, esgotamento, angustia e revolta pela sobrecarga e limitacoes dos recursos frente as situacoes que envolvem risco de morte. CONCLUSAO: apesar do estresse que esses profissionais enfrentam durante o cotidiano de trabalho, eles mantem o compromisso de prestar uma assistencia com qualidade e humanizacao, havendo tendencia para exaustao emocional, desânimo e sentimentos de angustia, o que reafirma a importância da prevencao de saude no ambiente de trabalho.

Capacidade funcional dos pacientes com diabetes mellitus e pé ulcerado

Objective: To evaluate and compare the functional capability of patients with diabetes with foot ulceration and patients with diabetes without foot ulceration. Methods: A cross sectional descriptive comparative study was conducted in a public hospital in the district of Sao Paulo. The sample consisted of 20 patients with foot ulceration and 20 patients without foot ulceration. Data were collected from June 2 to July 30, 2008. The heath assessment questionnaire-20 (HAQ-20) was used to collect the data. Results: There were no significant differences regarding demographic and clinical characteristics between the two groups. There were significant differences between the two groups on the total score of the HAQ-20 and items 1, 2, 3, 5, 6, 7, and 8, an in regard to physical functioning and functional capability. Conclusion: Findings suggest that patients with foot ulceration had worse physical functioning and functional capability than those without foot ulceration.Objective: To evaluate and compare the functional capability of patients with diabetes with foot ulceration and patients with diabetes without foot ulceration. Methods: A cross sectional descriptive comparative study was conducted in a public hospital in the district of Sao Paulo. The sample consisted of 20 patients with foot ulceration and 20 patients without foot ulceration. Data were collected from June 2 to July 30, 2008. The heath assessment questionnaire-20 (HAQ-20) was used to collect the data. Results: There were no significant differences regarding demographic and clinical characteristics between the two groups. There were significant differences between the two groups on the total score of the HAQ-20 and items 1, 2, 3, 5, 6, 7, and 8, an in regard to physical functioning and functional capability. Conclusion: Findings suggest that patients with foot ulceration had worse physical functioning and functional capability than those without foot ulceration.

Quality of life and self-esteem of patients with intestinal stoma

The aim of this study was to investigate the quality of life and self-esteem in patients with intestinal stoma. This is a clinical, primary, descriptive, analytical study, conducted at the Ostomized Peoples Pole of Pouso Alegre, after approval by the Ethics Committee of the Faculdade de Ciencias da Saude Dr. Jose Antonio Garcia Coutinho under opinion No. 23,227. Three instruments – a questionnaire on demographics and stoma, Rosenberg Self-Esteem Scale/UNIFESP-EPM and Flanagan Quality of Life Scale – were used in the data collection. The following tests were used for statistical analysis: chi-squared and Kruskal–Wallis tests and Spearman correlation. For all statistical tests, the level of significance of 5% (p < 0.05) was considered. Most participants were older than 60 years, of male gender and attended support groups. Twenty-one (30%) of respondents were illiterate. Neoplasia was the most frequent of the causes that led patients to receive an ostomy; permanent colostomy was the type of ostomy used. Individuals were not submitted to stoma demarcation and did not make irrigation. Regarding the type of complication, 34 (48.60%) had dermatitis; 14 (20%) showed retraction. The mean of Rosenberg Self-Esteem Scale/UNIFESP-EPM was 10.81 and the mean of Flanagan Quality of Life Scale was 26.16. It was concluded that individuals with intestinal stoma participating in the survey showed impaired self-esteem/quality of life.

Functional capability of patients with diabetes with foot ulceration

Objective: To evaluate and compare the functional capability of patients with diabetes with foot ulceration and patients with diabetes without foot ulceration. Methods: A cross sectional descriptive comparative study was conducted in a public hospital in the district of Sao Paulo. The sample consisted of 20 patients with foot ulceration and 20 patients without foot ulceration. Data were collected from June 2 to July 30, 2008. The heath assessment questionnaire-20 (HAQ-20) was used to collect the data. Results: There were no significant differences regarding demographic and clinical characteristics between the two groups. There were significant differences between the two groups on the total score of the HAQ-20 and items 1, 2, 3, 5, 6, 7, and 8, an in regard to physical functioning and functional capability. Conclusion: Findings suggest that patients with foot ulceration had worse physical functioning and functional capability than those without foot ulceration.Objective: To evaluate and compare the functional capability of patients with diabetes with foot ulceration and patients with diabetes without foot ulceration. Methods: A cross sectional descriptive comparative study was conducted in a public hospital in the district of Sao Paulo. The sample consisted of 20 patients with foot ulceration and 20 patients without foot ulceration. Data were collected from June 2 to July 30, 2008. The heath assessment questionnaire-20 (HAQ-20) was used to collect the data. Results: There were no significant differences regarding demographic and clinical characteristics between the two groups. There were significant differences between the two groups on the total score of the HAQ-20 and items 1, 2, 3, 5, 6, 7, and 8, an in regard to physical functioning and functional capability. Conclusion: Findings suggest that patients with foot ulceration had worse physical functioning and functional capability than those without foot ulceration.

Avaliação da qualidade de vida em pacientes com diabetes mellitus e pé ulcerado

BACKGROUND: Diabetic foot is considered as one of the most devastating chronic complications of diabetes mellitus due to the large number of cases that eventually require amputation. In the present study, we aimed to assess the quality of life of patients with diabetes and foot ulcers compared to that of patients with diabetes but without foot ulcers. METHODS: An analytical, cross-sectional, controlled, and comparative study of patients who visited 2 wound clinics in Sao Paulo was performed. Fifty patients with diabetes mellitus but without foot ulcers were selected as the control group and 50 patients with diabetes and foot ulcers were selected as the study group. The Short Form-36 Health Survey (SF-36) questionnaire was used to assess the quality of life. Patients were included consecutively in the same order that they visited the clinic. RESULTS: The mean SF-36 score was 69.38 ± 21.90 in the control group and 30.34 ± 14.45 in the study group (P < 0.001). Mean scores across all SF-36 domains were lower in the study group than in the control group (P < 0.001). CONCLUSIONS: Patients with diabetes and foot ulcers experience changes in the quality of life in the physical, social, and psychoemotional domains.

Vivências de acadêmicos de enfermagem durante o cuidado prestado às pessoas com feridas

Compreender e apreender os sentimentos vivenciados pelos academicos do curso de enfermagem quando realizam curativos, durante o estagio curricular e extracurricular. Trata-se de uma pesquisa qualitativa, com fundamentacao fenomenologica. Teve como questao orientadora: Descreva os sentimentos vivenciados por voce durante a realizacao do curativo? Este estudo revelou que os discentes de enfermagem sentem-se despreparados para a execucao do curativo. Tambem tem varias dificuldades como tocar uma pessoa que lhes e desconhecida, dificuldade para associar a teoria a pratica. Vivenciaram emocoes positivas como prazer e negativas como angustia, inseguranca, medo e vergonha. Acreditamos que o relacionamento docente e discente sera enriquecido se houver a criacao de um espaco para discussao de suas vivencias. Isso pode configurar-se como uma das formas de apoio que observamos ser necessaria ao aluno frente as dificuldades enfrentadas nesse periodo de sua formacao academica.To learn about and understand the feelings experienced by nursing students when making bandages during curricular and extracurricular clinical practice. This is a qualitative study, with a phenomenological framework. The guiding question used was: What did you feel while making the bandage? This study revealed that nursing students feel unprepared for making bandages. Students also reported various difficulties; like touching a stranger and associating theory to practice, for instance. They experienced positive emotions, like pleasure, as well as negative feelings, such as distress, insecurity, fear, and embarrassment. We believe that the teacher-student relationship would be improved if a space is created to discuss these experiences. In fact, such as space would represent one form of support, which students need due to the difficulties they have to deal with in this period of their academic education.

Original articleQuality of life and self-esteem of patients with intestinal stomaQualidade de vida e autoestima em pacientes com estoma intestinal

The aim of this study was to investigate the quality of life and self-esteem in patients with intestinal stoma. This is a clinical, primary, descriptive, analytical study, conducted at the Ostomized Peoples Pole of Pouso Alegre, after approval by the Ethics Committee of the Faculdade de Ciencias da Saude Dr. Jose Antonio Garcia Coutinho under opinion No. 23,227. Three instruments – a questionnaire on demographics and stoma, Rosenberg Self-Esteem Scale/UNIFESP-EPM and Flanagan Quality of Life Scale – were used in the data collection. The following tests were used for statistical analysis: chi-squared and Kruskal–Wallis tests and Spearman correlation. For all statistical tests, the level of significance of 5% (p < 0.05) was considered. Most participants were older than 60 years, of male gender and attended support groups. Twenty-one (30%) of respondents were illiterate. Neoplasia was the most frequent of the causes that led patients to receive an ostomy; permanent colostomy was the type of ostomy used. Individuals were not submitted to stoma demarcation and did not make irrigation. Regarding the type of complication, 34 (48.60%) had dermatitis; 14 (20%) showed retraction. The mean of Rosenberg Self-Esteem Scale/UNIFESP-EPM was 10.81 and the mean of Flanagan Quality of Life Scale was 26.16. It was concluded that individuals with intestinal stoma participating in the survey showed impaired self-esteem/quality of life.

Using transparent polyurethane film and hydrocolloid dressings to prevent pressure ulcers.

OBJECTIVE To compare the performance and effectiveness of a hydrocolloid dressing (HD) and a transparent polyurethane film (PF) in preventing pressure ulcer (PU) development. METHOD The study was conducted in the intensive care unit, coronary care unit and medical clinic of the Holy House of Mercy of Passos, Brazil. Data were collected 48 hours after admission and during hospitalisation. The Braden scale was used for PU risk assessment. Consecutive eligible patients without PUs were randomly assigned by lottery to the two groups, either the HD or PF group. RESULTS Of the 160 eligible patients, significant between-group differences were found in the mean total number of dressing changes (HD, 6.09±1.655 changes; PF, 5.59±2.036 changes; p=0.010), and mean number of dressing changes in the sacral region (HD, 2.50±0.871; PF, 2.05±0.825; p=0.001), with the PF group requiring significantly fewer changes than the HD group. The most common reasons for changing dressings in both groups were moisture (PF 51.1%; HD 47.9%) and shear (HD 43%; PF 38.9%), with a significant difference in shear between groups. The incidence of PUs was significantly lower (p=0.038) in the PF group (8.7%) compared with that in the HD group (15%). CONCLUSION The results suggest that the transparent polyurethane film had a better performance and was more effective than the hydrocolloid dressing in preventing PU development.

Qualidade de vida em pacientes com úlcera venosa em terapia compressiva por bota de Unna

BACKGROUND: Venous ulcers are a major public health problem worldwide and are responsible for considerable economic impact because of their high incidence. In addition to restricting daily living and leisure activities, they may result in changes in quality of life and self-esteem, and even lead to depression. The aim of this study is to evaluate the quality of life in patients with venous ulcers who are being treated with Unnas boot compression therapy. METHODS: Fifty patients with venous ulcers treated at the Conjunto Hospitalar de Sorocaba were enrolled. Data were collected using the Short Form-36 (SF-36) health survey upon inclusion in the study and after 4, 8, and 12 months of compression therapy. RESULTS: Initial mean SF-36 scores were low (15.10), indicating decreased quality of life. After 12 months of Unnas boot compression therapy, the mean SF-36 score was 95.38, indicating improved quality of life (P = 0.0001). CONCLUSIONS: Patients with venous ulcers at the beginning of data collection had lower quality of life but improved after 8 months of treatment with Unnas boot compression therapy.