Mariana Alvina dos Santos

Factors associated to sleep pattern in heart failure patients

The objective of this study was to describe sleep patterns in patients with heart failure (HF) and analyze associations between sleep and the following variables: gender, age, fatigue, fatigue on exertion, physical activity, functional class, drug therapy, dyspnea, and body mass index. The nonprobability sample consisted of 400 patients (mean age 57.8 years; 64.8% were men, average schooling of 6.1 years; 82.5% Functional Class II or III). The prevalence of poor sleepers was 68.5%, and 46.5% rated sleep as poor or very poor. Scores suggest that the bad sleeper category was associated with: female, unemployed, fatigue, fatigue on exertion, dyspnea and higher functional classes of HF. The proportion of poor sleepers among patients with HF is among the highest in chronic diseases. Dyspnea and fatigue, common symptoms of this disease, significantly increase the chance of being a bad sleeper.The objective of this study was to describe sleep patterns in patients with heart failure (HF) and analyze associations between sleep and the following variables: gender, age, fatigue, fatigue on exertion, physical activity, functional class, drug therapy, dyspnea, and body mass index. The nonprobability sample consisted of 400 patients (mean age 57.8 years; 64.8% were men, average schooling of 6.1 years; 82.5% Functional Class II or III). The prevalence of poor sleepers was 68.5%, and 46.5% rated sleep as poor or very poor. Scores suggest that the bad sleeper category was associated with: female, unemployed, fatigue, fatigue on exertion, dyspnea and higher functional classes of HF. The proportion of poor sleepers among patients with HF is among the highest in chronic diseases. Dyspnea and fatigue, common symptoms of this disease, significantly increase the chance of being a bad sleeper.

Self-care in heart failure patients

Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement.Objetivo:describir el comportamiento de autocuidado y sus factores asociados en una muestra de pacientes brasilenos con insuficiencia cardiaca.Metodo:estudio transversal descriptivo, con muestra no probabilistica de 116 pacientes ambulatorios en tratamiento para la insuficiencia cardiaca. El autocuidado se evaluo por la Self-Care of Heart Failure Index, (puntuaciones ≥70 puntos=autocuidado adecuado). Se aplicaron pruebas de asociacion, con un nivel descriptivo de 0,05.Resultados:la edad media de los participantes fue de 57,7 (desviacion estandar=11,3) anos; 54,3% hombres; escolaridad media de 5,5 (desviacion estandar=4,0) anos de estudio y 74,1% en clase funcional II-III. Las medias de las puntuaciones en las subscalas de la SelfCare of Heart Failure Index, indicaron autocuidado inadecuado (mantenimiento del autocuidado: 53,2 (desviacion estandar=14,3), gestion del autocuidado: 50,0 (desviacion estandar=20,3) y confianza del autocuidado: 52,6 (desviacion estandar=22.7)) y bajas frecuencias de participantes con autocuidado adecuado (mantenimiento del autocuidado (6,9%), gestion del autocuidado (14,7%) y confianza del autocuidado (19%). Las puntuaciones mas altas de la Self-Care of Heart Failure Index se asociaron con: fraccion de eyeccion ventricular izquierda reducida (p=0,001), mas larga experiencia con la enfermedad (p=0,05) y acompanamiento conjunto del profesional medico y enfermero (p=0,007).Conclusion:se necesitan inversiones para mejorar la conducta de autocuidado y la enfermeria puede desempenar un papel relevante en esta mejora.Abstract Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement.

Sleeping difficulties reported by patients with heart failure

The study aimed to describe the reports of heart failure patients on the factors that cause difficulties to sleep and the association of these factors with the quality of sleep. This cross-sectional study involved a non-probabilistic sample of 400 patients (mean age 57.8 years, 64.8% were men, average education of 6.1 years, 82.5% in functional class II or III) with heart failure. The main factors associated with sleeping difficulty were: nocturia, interrupted sleep at night and breathing difficulty. Sleeping difficulties in heart failure patients are diverse and there is an association between these difficulties and quality of sleep. Most of these disorders warrant professional nursing interventions.The study aimed to describe the reports of heart failure patients on the factors that cause difficulties to sleep and the association of these factors with the quality of sleep. This cross-sectional study involved a non-probabilistic sample of 400 patients (mean age 57.8 years, 64.8% were men, average education of 6.1 years, 82.5% in functional class II or III) with heart failure. The main factors associated with sleeping difficulty were: nocturia, interrupted sleep at night and breathing difficulty. Sleeping difficulties in heart failure patients are diverse and there is an association between these difficulties and quality of sleep. Most of these disorders warrant professional nursing interventions.

Nursing process documentation: rationale and methods of analytical study

OBJECTIVE to describe the methods used to analyze the associations between variables of service, nursing and the nursing process documentation in institutions of the Department of Health of the State of São Paulo. METHOD multilevel analytical study with data obtained in the domains of institution, units of the institution and nursing professionals who work there, using standardized instruments. The analyses had as axis the degree of completeness of the nursing process documentation in units or institutions and their association with variables of nursing personnel, of units and of institutions. CONCLUSION This study will provide important empirical evidence on the factors involved in the nursing process documentation.

Fatores associados ao padrão de sono em pacientes com insuficiência cardíaca

The objective of this study was to describe sleep patterns in patients with heart failure (HF) and analyze associations between sleep and the following variables: gender, age, fatigue, fatigue on exertion, physical activity, functional class, drug therapy, dyspnea, and body mass index. The nonprobability sample consisted of 400 patients (mean age 57.8 years; 64.8% were men, average schooling of 6.1 years; 82.5% Functional Class II or III). The prevalence of poor sleepers was 68.5%, and 46.5% rated sleep as poor or very poor. Scores suggest that the bad sleeper category was associated with: female, unemployed, fatigue, fatigue on exertion, dyspnea and higher functional classes of HF. The proportion of poor sleepers among patients with HF is among the highest in chronic diseases. Dyspnea and fatigue, common symptoms of this disease, significantly increase the chance of being a bad sleeper.The objective of this study was to describe sleep patterns in patients with heart failure (HF) and analyze associations between sleep and the following variables: gender, age, fatigue, fatigue on exertion, physical activity, functional class, drug therapy, dyspnea, and body mass index. The nonprobability sample consisted of 400 patients (mean age 57.8 years; 64.8% were men, average schooling of 6.1 years; 82.5% Functional Class II or III). The prevalence of poor sleepers was 68.5%, and 46.5% rated sleep as poor or very poor. Scores suggest that the bad sleeper category was associated with: female, unemployed, fatigue, fatigue on exertion, dyspnea and higher functional classes of HF. The proportion of poor sleepers among patients with HF is among the highest in chronic diseases. Dyspnea and fatigue, common symptoms of this disease, significantly increase the chance of being a bad sleeper.

Documentação do processo de enfermagem: justificativa e métodos de estudo analítico

OBJECTIVE to describe the methods used to analyze the associations between variables of service, nursing and the nursing process documentation in institutions of the Department of Health of the State of São Paulo. METHOD multilevel analytical study with data obtained in the domains of institution, units of the institution and nursing professionals who work there, using standardized instruments. The analyses had as axis the degree of completeness of the nursing process documentation in units or institutions and their association with variables of nursing personnel, of units and of institutions. CONCLUSION This study will provide important empirical evidence on the factors involved in the nursing process documentation.

Dificuldades do sono relatadas por pacientes com insuficiência cardíaca

The study aimed to describe the reports of heart failure patients on the factors that cause difficulties to sleep and the association of these factors with the quality of sleep. This cross-sectional study involved a non-probabilistic sample of 400 patients (mean age 57.8 years, 64.8% were men, average education of 6.1 years, 82.5% in functional class II or III) with heart failure. The main factors associated with sleeping difficulty were: nocturia, interrupted sleep at night and breathing difficulty. Sleeping difficulties in heart failure patients are diverse and there is an association between these difficulties and quality of sleep. Most of these disorders warrant professional nursing interventions.The study aimed to describe the reports of heart failure patients on the factors that cause difficulties to sleep and the association of these factors with the quality of sleep. This cross-sectional study involved a non-probabilistic sample of 400 patients (mean age 57.8 years, 64.8% were men, average education of 6.1 years, 82.5% in functional class II or III) with heart failure. The main factors associated with sleeping difficulty were: nocturia, interrupted sleep at night and breathing difficulty. Sleeping difficulties in heart failure patients are diverse and there is an association between these difficulties and quality of sleep. Most of these disorders warrant professional nursing interventions.

Autocuidado de pacientes com insuficiência cardíaca

Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement.Objetivo:describir el comportamiento de autocuidado y sus factores asociados en una muestra de pacientes brasilenos con insuficiencia cardiaca.Metodo:estudio transversal descriptivo, con muestra no probabilistica de 116 pacientes ambulatorios en tratamiento para la insuficiencia cardiaca. El autocuidado se evaluo por la Self-Care of Heart Failure Index, (puntuaciones ≥70 puntos=autocuidado adecuado). Se aplicaron pruebas de asociacion, con un nivel descriptivo de 0,05.Resultados:la edad media de los participantes fue de 57,7 (desviacion estandar=11,3) anos; 54,3% hombres; escolaridad media de 5,5 (desviacion estandar=4,0) anos de estudio y 74,1% en clase funcional II-III. Las medias de las puntuaciones en las subscalas de la SelfCare of Heart Failure Index, indicaron autocuidado inadecuado (mantenimiento del autocuidado: 53,2 (desviacion estandar=14,3), gestion del autocuidado: 50,0 (desviacion estandar=20,3) y confianza del autocuidado: 52,6 (desviacion estandar=22.7)) y bajas frecuencias de participantes con autocuidado adecuado (mantenimiento del autocuidado (6,9%), gestion del autocuidado (14,7%) y confianza del autocuidado (19%). Las puntuaciones mas altas de la Self-Care of Heart Failure Index se asociaron con: fraccion de eyeccion ventricular izquierda reducida (p=0,001), mas larga experiencia con la enfermedad (p=0,05) y acompanamiento conjunto del profesional medico y enfermero (p=0,007).Conclusion:se necesitan inversiones para mejorar la conducta de autocuidado y la enfermeria puede desempenar un papel relevante en esta mejora.Abstract Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement.

Autocuidado de los pacientes con insuficiencia cardíaca

Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement.Objetivo:describir el comportamiento de autocuidado y sus factores asociados en una muestra de pacientes brasilenos con insuficiencia cardiaca.Metodo:estudio transversal descriptivo, con muestra no probabilistica de 116 pacientes ambulatorios en tratamiento para la insuficiencia cardiaca. El autocuidado se evaluo por la Self-Care of Heart Failure Index, (puntuaciones ≥70 puntos=autocuidado adecuado). Se aplicaron pruebas de asociacion, con un nivel descriptivo de 0,05.Resultados:la edad media de los participantes fue de 57,7 (desviacion estandar=11,3) anos; 54,3% hombres; escolaridad media de 5,5 (desviacion estandar=4,0) anos de estudio y 74,1% en clase funcional II-III. Las medias de las puntuaciones en las subscalas de la SelfCare of Heart Failure Index, indicaron autocuidado inadecuado (mantenimiento del autocuidado: 53,2 (desviacion estandar=14,3), gestion del autocuidado: 50,0 (desviacion estandar=20,3) y confianza del autocuidado: 52,6 (desviacion estandar=22.7)) y bajas frecuencias de participantes con autocuidado adecuado (mantenimiento del autocuidado (6,9%), gestion del autocuidado (14,7%) y confianza del autocuidado (19%). Las puntuaciones mas altas de la Self-Care of Heart Failure Index se asociaron con: fraccion de eyeccion ventricular izquierda reducida (p=0,001), mas larga experiencia con la enfermedad (p=0,05) y acompanamiento conjunto del profesional medico y enfermero (p=0,007).Conclusion:se necesitan inversiones para mejorar la conducta de autocuidado y la enfermeria puede desempenar un papel relevante en esta mejora.Abstract Objective: to describe self-care behavior and its associated factors in a sample of heart failure Brazilian patients. Method: descriptive cross-sectional study with non-probabilistic sample of 116 ambulatory patients undergoing heart failure treatment. Self-care was evaluated using the Self-Care of Heart Failure Index, (scores ≥70 points=appropriate self-care). Association tests were applied, considering a descriptive level of 0.05. Results: the mean age of participants was 57.7 (SD =11.3) years; 54.3% were male; the mean schooling was 5.5 (SD = 4.0) years; and 74.1% had functional class II-III. The mean scores on the subscales of the Self-Care of Heart Failure Index indicated inappropriate self-care (self-care maintenance: 53.2 (SD =14.3), selfcare management: 50.0 (SD = 20.3) and self-care confidence: 52.6 (SD=22.7)) and it was found low frequencies of participants with appropriate self-care (self-care maintenance, 6.9%), self-care management (14.7%) and self-care confidence (19%). Higher scores of the Self-Care of Heart Failure Index were associated with: reduced left ventricular ejection fraction (p=0.001), longer time of experience with the disease (p=0.05) and joint monitoring by physician and nurse (p=0.007). Conclusion: investments are needed to improve the self-care behavior and the nursing can play a relevant role in this improvement.

Rasch análisis del Power as Knowing Participation in Change Tool - Versión Brasileña

OBJECTIVES the objective of this study was to evaluate the items contained in the Brazilian version of the Power as Knowing Participation in Change Tool (PKPCT). METHOD investigation of the psychometric properties of the mentioned questionnaire through Rasch analysis. RESULTS the data from 952 nursing assistants and 627 baccalaureate nurses were analyzed (average age 44.1 (SD=9.5); 13.0% men). The subscales Choices, Awareness, Freedom and Involvement were tested separately and presented unidimensionality; the categories of the responses given to the items were compiled from 7 to 3 levels and the items fit the model well, except for the following/leading item, in which the infit and outfit values were above 1.4; this item has also presented Differential Item Functioning (DIF) according to the participants role. The reliability of the items was of 0.99 and the reliability of the participants ranged from 0.80 to 0.84 in the subscales. Items with extremely high levels of difficulty were not identified. CONCLUSIONS the PKPCT should not be viewed as unidimensional, items with extremely high levels of difficulty in the scale need to be created and the differential functioning of some items has to be further investigated.OBJETIVOS: o objetivo do estudo foi avaliar os itens da versao brasileira do Power as Knowing Participation in Change Tool (PKPCT). METODO: investigacao das propriedades psicometricas do instrumento por meio da analise Rasch. RESULTADOS: foram analisados dados de 952 auxiliares de enfermagem e 627 enfermeiros (idade media 44,1 (DP=9,5) anos; 13,0% homens). As subescalas escolhas, consciencia, liberdade e envolvimento foram testadas separadamente e apresentaram unidimensionalidade; as categorias de resposta dos itens foram colapsadas de 7 para 3 niveis, os itens se ajustaram bem ao modelo, com excecao do item de liderado/de lider, cujos valores de infit e outfit ficaram acima de 1,4; esse item tambem apresentou DIF (differential item functioning) para funcao do respondente. A confiabilidade dos itens foi de 0,99 e a confiabilidade das pessoas variou de 0,80 a 0,84 nas subescalas. Nao foram identificados itens nos extremos de dificuldade. CONCLUSOES: o PKPCT nao deve ser tratado como unidimensional, e necessario que sejam criados itens nos extremos de dificuldade da escala e investigado o funcionamento diferencial de alguns itens.