Gisele Martins

Prevalence and risk factors for urinary incontinence in healthy pregnant Brazilian women

Introduction and hypothesisPhysiological and anatomical changes of pregnancy are risk factors for lower urinary tract symptoms (LUTS). This study aimed to evaluate the prevalence and risk factors for urinary incontinence (UI) in healthy pregnant women.MethodsA cross-sectional study was conducted in pregnant Brazilian women who enrolled in the primary health-care system in Sao Jose do Rio Preto, Brazil. Face-to-face interview and completion of two-part questionnaire were administered and done which evaluated the presence of LUTS pre- and during pregnancy. The data were analyzed by logistic regression.ResultsFive hundred pregnant women were enrolled ranging from first to third trimester. LUTS present in 63.8% in these women; the main associated risk factors were multiparity and prepregnancy LUTS as well as smoking, constipation, and daily coffee intake.ConclusionsThe prevalence of UI during pregnancy is high, highlighting the presence of the risk factors associated with UI during pregnancy.

Clean intermittent catheterization: educational booklet directed to caregivers of children with neurogenic bladder dysfunction.

PURPOSE The purpose of this study was to propose a systematic teaching and learning strategy for Brazilian caregivers of children with neurogenic bladder dysfunction(NBD), by using an illustrated booklet written in Portuguese. DESIGN Descriptive study. SUBJECTS AND SETTING Caregivers of children requiring clean intermittent catheterization (CIC) were approached when attending the pediatric urology outpatient clinic of Hospital de Base in Sao Jose do Rio Preto city, Brazil. METHODS After educational sessions, a supervised procedure was done, with the childs caregiver observing the technique. RESULTS Twenty-three caregivers of children with NBD provided feedback on a CIC teaching booklet. The children were all cared for at the pediatric urology outpatient clinic of a teaching hospital in Sao Jose do Rio Preto city, Brazil. The booklet was evaluated as “excellent” concerning organization and the quality of the illustrations by the majority of the caregivers. All caregivers stated that they had developed the ability to perform CIC successfully; 61% evaluated their learning process as “excellent,” whereas 39% evaluated it as “good.” CONCLUSION The booklet successfully reached the goals and now is implemented in orientations about CIC.

Music listening for anxiety relief in children in the preoperative period: a randomized clinical trial

ABSTRACT Objective: to investigate the effects of music listening, for 15 minutes, on the preoperative anxiety levels in children undergoing elective surgery in comparison with conventional pediatric surgical care. Method: randomized controlled clinical trial pilot study with 52 children in the preoperative period, aged 3 to 12 years, undergoing elective surgery and randomly allocated in the experimental group (n = 26) and control group (n = 26). Anxiety was assessed in both groups by the application of the modified Yale Preoperative Anxiety Scale and measurement of the physiological variables, upon arrival and 15 minutes after the first measurement. Results: there was a statistically significant difference in preoperative anxiety between the two groups only in relation to the physiological variable, since the respiratory rate of preschool children in the experimental group reduced in the second measurement compared to the control group (p = 0.0453). The experimental group showed a statistically significant reduction in anxiety levels after 15 minutes of music listening (p = 0.0441), specifically with regard to the behavioral domains of activity, vocalization, emotional expression and apparent awakening state. Conclusion: music listening emerges as a potential nursing intervention for relief of preoperative anxiety in children undergoing surgical procedures. RBR-7mcr59.1 Artículo parte de la disertación de maestría “Audición musical como una intervención de enfermería para aliviar la ansiedad en niños en situación quirúrgica: ensayo controlado aleatorio”, presentada en la Universidade de Brasília, Brasília, DF, Brasil. 2 MSc, Profesor Asistente, Departamento de Enfermagem, Universidade de Brasília, Brasília, DF, Brasil. 3 Alumna del curso de graduación en Enfermería, Universidade de Brasilia, Brasília, DF, Brasil. 4 PhD, Profesor Adjunto, Departamento de Enfermagem, Universidade de Brasília, Brasília, DF, Brasil. Objetivo: investigar los efectos de la audición musical, durante 15 minutos, en los niveles de ansiedad preoperatoria de niños sometidos a cirugías electivas, comparándolos con el cuidado convencional de una clínica quirúrgica pediátrica. Método: estudio piloto del tipo ensayo clínico, controlado aleatorizado, realizado con 52 niños en el período preoperatorio, de 3 a 12 años, sometidos a cirugías electivas y asignados aleatoriamente para el grupo experimental (n = 26) y grupo control (n = 26). La ansiedad fue evaluada en ambos grupos, por medio de la Escala de Ansiedad Preoperatoria de Yale modificada y por la medición de las dimensiones fisiológicas, al llegar y 15 minutos después de la primera medición. Resultados: hubo diferencia estadísticamente significativa entre los grupos en relación a la ansiedad preoperatoria solamente en la dimensión fisiológica, ya que la frecuencia respiratoria de preescolares del grupo experimental se redujo en la segunda medición si comparada al grupo control (p = 0,0453). El grupo experimental presentó reducción estadísticamente significativa de los puntajes de ansiedad después de 15 minutos de audición musical (p =0,0441), específicamente en relación a los dominios comportamentales de actividad, vocalización, expresión emocional y estado de despertar aparente. Conclusión: la audición musical se presenta como una potencial intervención de enfermería para el alivio de la ansiedad preoperatoria del niño en situación quirúrgica. RBR-7mcr59.

Oxybutynin and tolterodine for treatment of neurogenic detrusor overactivity: a pharmacoeconomic evaluation in the Brazilian context

A terapia antimuscarinica e vista como primeira escolha para o tratamento da hiperatividade detrusora de origem neurologica (HDON). No entanto, a maioria dos antimuscarinicos existentes e amplamente estudada em pacientes portadores de hiperatividade detrusora idiopatica. Assim, existe escassez de pesquisas que avaliam esses farmacos na problematica da HDON, principalmente em termos de estudos de custo-efetividade. Diante isso, um estudo farmacoeconomico foi realizado (baseado no indice de preco maximo ao consumidor) para comparar os custos e a efetividade da oxibutinina e da tolterodina, em duas diferentes formulacoes, capsulas de liberacao imediata (LI) e controlada (LC), para o tratamento da HDON. Uma revisao sistematica da literatura foi conduzida para obtencao de dados urodinâmicos e clinicos relevantes (baseado em opiniao de especialistas), quanto aos efeitos desses farmacos em pacientes com disturbios urologicos de origem neurologica. Apos essa etapa, um estudo farmacoeconomico foi conduzido e os custos envolvidos foram calculados sobre cada percentual de efetividade obtido, num horizonte temporal de 1 mes e 1 ano. A melhor razao de custo-efetividade (RCE) quanto aos parâmetros urodinâmicos foi obtida com uso de oxibutinina LI. Quantos aos parâmetros clinicos, oxibutinina LI e LC tiveram as melhores RCE. Baseando-se nos principais parâmetros urologicos analisados, oxibutinina LI foi considerada o antimuscarinico mais custo-efetivo.

Experiences of Violence Lived by Women of the Federal District: Descriptive Study

Objetivo: Analisar a ocorrencia do fenomeno da violencia fisica no âmbito das relacoes intimo-afetivas envolvendo mulheres de 15 a 49 anos moradoras em uma area economicamente vulneravel do Distrito Federal. Metodo: Estudo transversal com amostra aleatoria simples e modelo ecologico. Utilizados teste qui-quadrado, nivel de significância (5%), odd ratios (OR) ajustadas e intervalo de confianca (95%). Resultado: Mulheres que sofreram algum tipo de violencia fisica ao longo de suas vidas rfoi 58,6% e apenas 5,8% buscaram assistencia nos hospitais e servicos de saude. O uso de drogas (OR 14.27, CI 1.73 – 117.37) e o aumento de comportamentos de controle pelo parceiro (OR 13,39; IC 4.60-38.99) apresentou a maior razao de chance para a violencia fisica contra a mulher. Conclusao: A alta prevalencia do uso da forca nas relacoes intimas sugere a necessidade de uma investigacao de praticas abusivas de poder nas relacoes intimo-afetivas das mulheres atendidas pela enfermeira e profissionais da equipe de saude.

Advanced Practice Nursing in Pediatric Urology: experience report in the Federal District

OBJECTIVE To describe the creation and implementation of the extension program Advanced Practice Nursing in Pediatric Urology, developed in the outpatient clinic of a teaching hospital in the Federal District. METHOD This is an experience report regarding the implementation of an outpatient service aimed at children and adolescents with symptoms of bladder and bowel dysfunction. RESULTS Because it is an extension program linked to the university, it follows a different model of care, valuing empowerment, informed and shared decision making, which results in a stronger bond between patients, family and the Pediatric Urology nursing team. It has also become a privileged space for the production and use of scientific knowledge, associated with the principles of evidence-based practice. CONCLUSION This project shows a different performance of the nurse-specialist-professor-researcher in Pediatric Urology Nursing, and it has become a reference in the Federal District, mainly for undergraduate and graduate nursing students.