Mariana Angela Rossaneis

PRÁTICAS DE ENFERMAGEM EMPREENDEDORAS E AUTÔNOMAS

This descriptive study with a quantitative approach aimed to characterize the business practices in nursing in the state of Parana. An intentional sample was undertaken by invitation to 11 nurses with businesses in the health area, the data collected via an online questionnaire. The results point to a young adult population; with a predominance of females and with varying professional experience. The interest in entrepreneurship arose from the search for professional satisfaction; business management was emphasized as the skill necessary to run a business. In relation to the easy aspects and difficulties for opening one’s own business, support from other professionals and bureaucratic issues stand out; the participants showed themselves to be satisfied with their businesses. It is concluded that nursing has sought and explored a new market, promoting the profession as able to conduct its practice autonomously and innovatively.

Differences in foot self-care and lifestyle between men and women with diabetes mellitus

Objetivo: investigar as diferencas no autocuidado com os pes e no estilo de vida entre mulheres e homens diabeticos. Metodo: estudo transversal realizado com uma amostra de 1.515 diabeticos com 40 anos ou mais. Foram utilizados modelos de regressao de Poisson para identificar diferencas entre os sexos na prevalencia de deficit de autocuidado com os pes e no estilo de vida, ajustando-se por caracteristicas socioeconomicas, clinicas, tabagismo e alcoolismo. Resultados: a prevalencia de deficit de autocuidado com os pes, caracterizada por baixa frequencia de secagem dos espacos interdigitais; da nao avaliacao periodica dos pes; do habito de andar descalco; de higiene insatisfatoria e corte inadequado de unhas foi significativamente maior entre os homens. Contudo, eles apresentaram menor prevalencia na pratica de escaldar os pes e no uso de calcados inadequados em comparacao as mulheres. Em relacao ao estilo de vida, os homens tambem apresentaram comportamentos menos saudaveis pois tem significativamente menor controle alimentar e nao realizam os exames laboratoriais referentes ao perfil lipidico na frequencia recomendada. Conclusao: considerar as diferencas de genero no autocuidado com os pes e no estilo de vida permite a equipe de enfermagem direcionar atividades educacionais e intervencoes nos fatores de risco a ulceracao dos pes.ABSTRACT Objective: to investigate differences with regard to foot self-care and lifestyle between men and women with diabetes mellitus. Method: cross-sectional study conducted in a sample of 1,515 individuals with diabetes mellitus aged 40 years old or older. Poisson regression models were used to identity differences in foot self-care deficit and lifestyle between sexes, adjusting for socioeconomic and clinical characteristics, smoking and alcohol consumption. Results: foot self-care deficit, characterized by not regularly drying between toes; not regularly checking feet; walking barefoot; poor hygiene and inappropriately trimmed nails, was significantly higher among men, though men presented a lower prevalence of feet scaling and use of inappropriate shoes when compared to women. With regard to lifestyle, men presented less healthy habits, such as not adhering to a proper diet and taking laboratory exams to check for lipid profile at the frequency recommended. Conclusion: the nursing team should take into account gender differences concerning foot self-care and lifestyle when implementing educational activities and interventions intended to decrease risk factors for foot ulceration.

Foot ulceration in patients with diabetes: a risk analysis

The study reported in this article aimed to analyse factors associated with the risk of ulceration in the feet of patients with diabetes using a conceptual hierarchic model. It was a cross-sectional study carried out with 1515 people with diabetes mellitus aged 40 years and older. The risk of foot ulceration was of higher significance in male patients with diabetes (adjusted odds ratio (OR)=1.39 (95% confidence interval (CI) 1.11 to 1.73); p=0.020), who did not practise a regular physical activity (adjusted OR=1.58 (95% CI 1.15 to 2.15); p=0.013), with time since diagnosis over 10 years (adjusted OR=1.42 (95% CI 1.10 to 1.86); p=0.011), who used insulin (adjusted OR=1.40 (95% CI 1.09 to 1.84); p=0.012), with retinopathy (adjusted OR=1.84 (95% CI 1.38 to 2.45); p=0.001) and who had had a previous stroke (adjusted OR=1.47 (95% CI 1.09 to 2.04); p=0.018). Mycosis on the nails and the interdigital spaces of the feet was statistically associated with ulceration risk independent of other variables of the model (adjusted OR=2.48 (95%CI 1.70 to 3.63); p=0.001). Finding the factors associated with ulceration contributes to the provision of quality care by nurses.

Self-care into the risk factors in diabetic foot ulceration: cross-sectional study

Objetivo: analisar as implicacoes do autocuidado nos fatores de risco de ulceracao em pes de portadores de diabetes mellitus, relacionados as alteracoes dermatologicas, ortopedicas, neurologicas e vasculares. Metodo: pesquisa transversal, realizada com 1.515 portadores de diabetes mellitus do tipo 2, com idade superior a 40 anos, cadastrados em unidades basicas de saude. Resultados: o predominio do pe com risco de ulceracao foi de 12,3%. As alteracoes nos pulsos tibial e pedioso, o enchimento capilar alterado, a presenca de proeminencias osseas, halux valgus, dedos em garra e em martelo e a perda da sensibilidade protetora nos pes apresentaram associacao com o risco de ulceracao. Discussao: a prevalencia dos pes com risco de ulceracao foi considerada elevada e esta relacionada a diversos fatores dermatologicos, vasculares e neuropaticos permeados pelo fator autocuidado. Conclusoes: a prevencao de alteracoes nos pes de diabeticos envolve manutencao do controle glicemico e cuidados especificos com os pes.

Ulceration risk in diabetic feet: a cross-sectional study

Aim: To identify the prevalence of ulceration risk in the feet of people with diabetes mellitus (DM) living in rural areas. Methods: This is a cross-sectional study, conducted with 293 people suffering from type 2 diabetes mellitus and older than 40 years, considering their socio-economic, demographic and clinical characteristics and lifestyle. Data collection was carried out through interviews, medical record analysis and clinical examination of the feet. Result: There was a risk of ulceration on the right foot in 37.2% of the cases and 35.8% in the left foot, and degree 2 risk was predominant. Complications such as greater age, low levels of education, the use of insulin and other chronic issues related to DM were factors associated with a higher prevalence of ulceration risk with regard to the feet. Conclusion: The need to implement action that considers the specifics of rural populations was evident, especially with regard to changes in lifestyle in order to control the DM.

Diferencias entre mujeres y hombres diabéticos en el autocuidado de los pies y estilo de vida

Objetivo: investigar as diferencas no autocuidado com os pes e no estilo de vida entre mulheres e homens diabeticos. Metodo: estudo transversal realizado com uma amostra de 1.515 diabeticos com 40 anos ou mais. Foram utilizados modelos de regressao de Poisson para identificar diferencas entre os sexos na prevalencia de deficit de autocuidado com os pes e no estilo de vida, ajustando-se por caracteristicas socioeconomicas, clinicas, tabagismo e alcoolismo. Resultados: a prevalencia de deficit de autocuidado com os pes, caracterizada por baixa frequencia de secagem dos espacos interdigitais; da nao avaliacao periodica dos pes; do habito de andar descalco; de higiene insatisfatoria e corte inadequado de unhas foi significativamente maior entre os homens. Contudo, eles apresentaram menor prevalencia na pratica de escaldar os pes e no uso de calcados inadequados em comparacao as mulheres. Em relacao ao estilo de vida, os homens tambem apresentaram comportamentos menos saudaveis pois tem significativamente menor controle alimentar e nao realizam os exames laboratoriais referentes ao perfil lipidico na frequencia recomendada. Conclusao: considerar as diferencas de genero no autocuidado com os pes e no estilo de vida permite a equipe de enfermagem direcionar atividades educacionais e intervencoes nos fatores de risco a ulceracao dos pes.ABSTRACT Objective: to investigate differences with regard to foot self-care and lifestyle between men and women with diabetes mellitus. Method: cross-sectional study conducted in a sample of 1,515 individuals with diabetes mellitus aged 40 years old or older. Poisson regression models were used to identity differences in foot self-care deficit and lifestyle between sexes, adjusting for socioeconomic and clinical characteristics, smoking and alcohol consumption. Results: foot self-care deficit, characterized by not regularly drying between toes; not regularly checking feet; walking barefoot; poor hygiene and inappropriately trimmed nails, was significantly higher among men, though men presented a lower prevalence of feet scaling and use of inappropriate shoes when compared to women. With regard to lifestyle, men presented less healthy habits, such as not adhering to a proper diet and taking laboratory exams to check for lipid profile at the frequency recommended. Conclusion: the nursing team should take into account gender differences concerning foot self-care and lifestyle when implementing educational activities and interventions intended to decrease risk factors for foot ulceration.

MANIFESTAÇÕES PSICOSSOMÁTICAS ASSOCIADAS À SÍNDROME DE BURNOUT REFERIDAS POR TRABALHADORES DE SAÚDE

The work in the area of health has caused great physical and psychological workers who go on to develop defense mechanisms manifested by physical and psychological reactions, leading to the emergence of new diseases. We conducted a descriptive study with quantitative and workers who work in a hospital of medium complexity. The objective was to describe the physical symptoms reported by workers who had signs and symptoms of burnout syndrome. 160 professionals participated in the survey. It was observed that all who had signs and symptoms of burnout syndrome reported the presence of physical symptoms were the most common: headache, feeling of mental fatigue, changes in appetite, hypertension, and sleep difficulties. These symptoms may be severe and have a great impact on both the professional and personal lives of his victims. It is important to identify these symptoms early to ensure a more rapid and effective.

Fatores associados à ulceração nos pés de pessoas com diabetes mellitus residentes em área rural

Objective To analyze the factors associated with the risk of ulceration in the feet of people with diabetes mellitus living in rural areas. Methods This is a cross-sectional study conducted with 293 individuals with diabetes mellitus, aged 40 years or older, living in the south of Brazil, in 2014. We analyzed socioeconomic variables, clinical conditions and foot self-care. We used the Poisson multiple regression model and the Prevalence Ratio (PR) and p-value<0.05 as a measure of association. Results 43.7% of the sample presented risk of foot ulceration. The highest prevalence of foot ulceration risk was associated with people with lower purchasing power (PRadjusted=1.62/IC95%:1.52-2.22), with retinopathy (PRadjusted=1.30/IC95%:1.12-1.68) and alteration in foot moisture (PRadjusted=1.57/IC95%:1.22-2.01). We identified low education level (64.2%), high prevalence of arterial hypertension (86.3%) and onychomycosis in the feet (72%). Conclusions Diabetic patients need an assessment of the risk of foot ulceration, especially those with longer diagnosis, chronic complications and low socio-educational level.Objective To analyze the factors associated with the risk of ulceration in the feet of people with diabetes mellitus living in rural areas. Methods This is a cross-sectional study conducted with 293 individuals with diabetes mellitus, aged 40 years or older, living in the south of Brazil, in 2014. We analyzed socioeconomic variables, clinical conditions and foot self-care. We used the Poisson multiple regression model and the Prevalence Ratio (PR) and p-value<0.05 as a measure of association. Results 43.7% of the sample presented risk of foot ulceration. The highest prevalence of foot ulceration risk was associated with people with lower purchasing power (PRadjusted=1.62/IC95%:1.52-2.22), with retinopathy (PRadjusted=1.30/IC95%:1.12-1.68) and alteration in foot moisture (PRadjusted=1.57/IC95%:1.22-2.01). We identified low education level (64.2%), high prevalence of arterial hypertension (86.3%) and onychomycosis in the feet (72%). Conclusions Diabetic patients need an assessment of the risk of foot ulceration, especially those with longer diagnosis, chronic complications and low socio-educational level.

Validation of instrument to assess software of patients’ risk classification

OBJECTIVE Validate the content of an instrument that assesses the quality of a software applied to the risk classification of patients. METHOD Methodological study, conducted in three stages: adaptation of the instrument, content validation through Delphi technique and pre-test. The results were analyzed through Content Validity Index, Overall Content Validity Index and Inter-rater Reliability. RESULTS The final version of the instrument comprises 8 characteristics and 28 sub-characteristics, being 37 general questions to computer experts and nurse and 7 specific questions to computer experts, including 1 question and excluding 3 questions of the original instrument. We obtained Overall Content Validity of 92% and Inter-rater Reliability of 100% in the second Delphi round. Final considerations: The instrument has content validity, allowing to assess the technical quality and functional performance of the software applied to the risk classification of patients.

Protótipo de escala informatizada para busca ativa de potenciais doadores de órgãos

Objetivo: desenvolver prototipo de escala informatizada para busca ativa de potenciais doadores de orgaos e tecidos. Metodo: pesquisa metodologica, com analise de 377 prontuarios eletronicos de pacientes que evoluiram a obito, por morte encefalica, ou parada cardiorrespiratoria, nas unidades de terapia intensiva de hospital terciario. Nos obitos por parada cardiorrespiratoria, buscou-se identificar fatores que indicassem subnotificacao de morte encefalica. Nos protocolos, foram aplicados os indices de gravidade Acute Physiology and Chronic Health Evaluation II e Sepsis Related Organ Failure Assessment. A partir disso, construiu-se a escala que foi encaminhada a cinco especialistas, para avaliacao de conteudo, e, posteriormente, foi informatizada por modelo de prototipacao. Resultados: foram identificadas 34 subnotificacoes de morte encefalica nos prontuarios dos casos de parada cardiorrespiratoria. O teste de Wilcoxon demonstrou diferenca estatisticamente significativa entre os escores de admissao em unidade de terapia intensiva e abertura do protocolo de morte encefalica, para ambos os indices de gravidade. Conclusao: o prototipo foi efetivo para identificacao de potenciais doadores, bem como o grau de disfuncao orgânica de pacientes em morte encefalica.ABSTRACT Objective: to develop a prototype of a computerized scale for the active search for potential organ and tissue donors. Method: methodological study, with the analysis of 377 electronic medical records of patients who died due to encephalic death or cardiorespiratory arrest in the intensive care units of a tertiary hospital. Among the deaths due to cardiorespiratory arrest, the study aimed to identify factors indicating underreported encephalic death cases. The Acute Physiology and Chronic Health Evaluation II and Sepsis Related Organ Failure Assessment severity indexes were applied in the protocols. Based on this, a scale was built and sent to five experts for assessment of the scale content, and subsequently, it was computerized by using a prototyping model. Results: 34 underreported encephalic death cases were identified in the medical records of patients with cardiorespiratory arrest. Statistically significant differences were found in the Wilcoxon test between the scores of hospital admissions in the intensive care unit and the opening of the encephalic death protocol for both severity indexes. Conclusion: the prototype was effective for identifying potential organ donors, as well as for the identification of the degree of organ dysfunction in patients with encephalic death.