Paula Cristina Nogueira

Profile of patients with spinal cord injuries and occurrence of pressure ulcer at a university hospital

Pacientes con lesion traumatica de medula espinal (LTME) tienen riesgo elevado de desarrollar ulceras de presion (UP). Este estudio retrospectivo identifico a traves de la revision de las historias clinicas en hospital nivel III, caracteristicas de pacientes atendidos y la ocurrencia de UP. La mayoria fue de sexo masculino, blanca y el 36,2% entre 21 a 30 anos de edad. La causa mas frecuente de LTME fue herida por arma de fuego, seguida de choque/volcadura de auto. Hubo predominio de lesion a nivel toraxico, seguido del cervical. Las UP aparecieron en 20 pacientes (42,5%). Las regiones de mayor frecuencia fueron la sacra y los calcaneos. Solo el 25% de las historias tenia registro sobre la dimesion de la UP, el 80% describio el aspecto y el 52,1% no registro el estadio. Se observa la necesidad de un mejor registro de las UP para que las intervenciones utilizadas en el tratamiento puedan ser evaluadas.Patients with traumatic spinal cord injury (TSCI) have an increased risk of developing pressure ulcers (PU). It is a retrospective study done by review of records in order to identify the characteristics of patients who were assisted at a tertiary hospital as well as the occurrence of PU. Most patients were male, white and 36,2% between 21 and 30 years. The most common causes of TSCI were wound by fire weapons followed by vehicle crash/overturn. There was a predominance of injury at the toracic level followed by cervical. The PU occurred in 20 pacientes (42,5%). The most frequent regions of occurrence were the sacral and heels. Only 25% of the records had PUs dimensions charted, 80% stated the aspect, and 52.1% did not state the stage. There is a need for better documentation of PU so that interventions used for treatment can be evaluated.

Burden of care and its impact on health-related quality of life of caregivers of individuals with spinal cord injury

OBJETIVO: analisar a sobrecarga do cuidado e impacto na Qualidade de Vida Relacionada a Saude (QVRS) dos cuidadores de individuos com lesao medular traumatica (LMT). METODO: este e um estudo observacional, de corte transversal, realizado por revisao de prontuarios e aplicacao de questionarios. Foram utilizadas as escalas Short Form 36 (SF-36) para avaliar a QVRS, Caregiver Burden Scale (CBScale) para sobrecarga do cuidado, e os resultados foram analisados quantitativamente. A maioria dos individuos com LMT era do sexo masculino, com media de idade de 35,4 anos, com predominio de lesao toracica, seguida de lesao cervical. A maioria dos cuidadores era do sexo feminino, com media de idade de 44,8 anos. RESULTADO: das caracteristicas clinicas que contribuiram para maior sobrecarga do cuidado e pior QVRS destacaram-se individuos com tetraplegia e com complicacoes secundarias. Ao associar a sobrecarga do cuidado com a QVRS, obteve-se que quanto maior a sobrecarga pior a QVRS. CONCLUSAO: prevenir a sobrecarga do cuidado por meio de estrategias de preparo para alta, integracao da rede de apoio e acesso a servicos de saude, poderia minimizar os efeitos da sobrecarga do cuidado e contribuir para melhor QVRS.OBJECTIVE to analyze the impact and burden of care on the Health-Related Quality of Life (HRQOL) of caregivers of individuals with a spinal cord injury (SCI). METHOD cross-sectional observational study carried out by reviewing medical records and applying questionnaires. The scale Short Form 36 (SF-36) was used to assess HRQOL and the Caregiver Burden Scale (CBScale) for care burden. Results were analyzed quantitatively. Most patients with SCIs were male, aged 35.4 years old on average, with a predominance of thoracic injuries followed by cervical injuries. Most caregivers were female aged 44.8 years old on average. RESULTS tetraplegia and secondary complications stand out among the clinical characteristics that contributed to greater care burden and worse HRQOL. Association between care burden with HRQOL revealed that the greater the burden the worse the HRQOL. CONCLUSION Preventing care burden through strategies that prepare patients for hospital discharge, integrating the support network, and enabling access to health care services are interventions that could minimize the effects arising from care burden and contribute to improving HRQOL.

Sobrecarga do cuidado e impacto na qualidade de vida relacionada à saúde de cuidadores de indivíduos com lesão medular

OBJETIVO: analisar a sobrecarga do cuidado e impacto na Qualidade de Vida Relacionada a Saude (QVRS) dos cuidadores de individuos com lesao medular traumatica (LMT). METODO: este e um estudo observacional, de corte transversal, realizado por revisao de prontuarios e aplicacao de questionarios. Foram utilizadas as escalas Short Form 36 (SF-36) para avaliar a QVRS, Caregiver Burden Scale (CBScale) para sobrecarga do cuidado, e os resultados foram analisados quantitativamente. A maioria dos individuos com LMT era do sexo masculino, com media de idade de 35,4 anos, com predominio de lesao toracica, seguida de lesao cervical. A maioria dos cuidadores era do sexo feminino, com media de idade de 44,8 anos. RESULTADO: das caracteristicas clinicas que contribuiram para maior sobrecarga do cuidado e pior QVRS destacaram-se individuos com tetraplegia e com complicacoes secundarias. Ao associar a sobrecarga do cuidado com a QVRS, obteve-se que quanto maior a sobrecarga pior a QVRS. CONCLUSAO: prevenir a sobrecarga do cuidado por meio de estrategias de preparo para alta, integracao da rede de apoio e acesso a servicos de saude, poderia minimizar os efeitos da sobrecarga do cuidado e contribuir para melhor QVRS.OBJECTIVE to analyze the impact and burden of care on the Health-Related Quality of Life (HRQOL) of caregivers of individuals with a spinal cord injury (SCI). METHOD cross-sectional observational study carried out by reviewing medical records and applying questionnaires. The scale Short Form 36 (SF-36) was used to assess HRQOL and the Caregiver Burden Scale (CBScale) for care burden. Results were analyzed quantitatively. Most patients with SCIs were male, aged 35.4 years old on average, with a predominance of thoracic injuries followed by cervical injuries. Most caregivers were female aged 44.8 years old on average. RESULTS tetraplegia and secondary complications stand out among the clinical characteristics that contributed to greater care burden and worse HRQOL. Association between care burden with HRQOL revealed that the greater the burden the worse the HRQOL. CONCLUSION Preventing care burden through strategies that prepare patients for hospital discharge, integrating the support network, and enabling access to health care services are interventions that could minimize the effects arising from care burden and contribute to improving HRQOL.

Measures of knowledge about standard precautions: A literature review in nursing

BACKGROUND Standard precautions (SP) play an important role in hospital infection control, as well as in issues related to biosafety and security of patients, professionals and students active in direct or indirect health care delivery. OBJECTIVE This research aimed to identify in the literature which instruments nurse researchers have used to evaluate knowledge, attitudes and compliance with SP for infection control. METHODS A literature review was undertaken in the databases Web of Science, Bireme (Medline and Lilacs) and Scopus. RESULTS 91.66% of the studies were ranked as evidence level IV; 66.66% of the instruments were structured questionnaires, 58.33% of which had been validated and half of these instruments presented reliability and validity scores for the instrument used. Publications were concentrated in 2009 (41.66%), mostly in English (75%), in nursing journals with impact factor above 1.60 (83.33%). CONCLUSIONS The instruments nurse researchers most employed were structured questionnaires associated with Likert-type rating scales.

Health-Related Quality of Life Among Caregivers of Individuals With Spinal Cord Injury.

ABSTRACT:The consequences of spinal cord injury (SCI) not only affect patients’ health-related quality of life (HRQoL) but also extend to the entire family. The health condition the injury imposes requires the participation of a family caregiver, who will be responsible for taking care of the individual in a disabling condition. This is an observational, exploratory study using a cross-sectional design that aimed to study the association between HRQoL and gender, age, presence of comorbidities, and characteristics of the care among caregivers of individuals with SCI with the purpose of identifying potential factors that are associated with HRQoL in this population. Participants were 59 caregivers of individuals with traumatic SCI. The data were collected by consulting the patient histories and applying questionnaires. To assess the caregivers’ HRQoL, the Short Form-36 was used. For analysis, exploratory and inferential statistics were used. Most of the caregivers of the individuals with SCI were female, with a mean age of 44.8 years. The domains that most contributed to a worse HRQoL were physical aspects, pain, vitality, and emotional aspects. No statistically significant associations were found between HRQoL and the variables gender, hours per day spent on care, and length of activity as caregiver. The associations between HRQoL and self-reported diseases and age were statistically significant. The results support the planning of nursing interventions from the perspective of aspects of the care demands, which can affect the caregiver’s HRQoL. Relevance to clinical practice: Interventions to prepare the individuals with SCI and their caregivers are a strategy aimed at improving the HRQoL of both.

Incidência de úlceras por pressão em pacientes de Unidade de Terapia Intensiva Cardiopneumológica

Objective Identify and analyze the incidence coefficients of pressure ulcers (PU) and the risk factors for PU development in critical patients with cardiopulmonary diseases. Method A prospective cohort study conducted in the cardiopulmonary intensive care unit (ICU) of a large hospital in the city of São Paulo, from November 2013 to February 2014. In total, 370 patients over 18 years old who did not present PU at admission and who had been in the ICU for less than 24 hours were studied. Data were analyzed by univariate and multivariate analyses (Classification And Regression Tree - CART). Results The incidence coefficients of PU were: 11.0% for total participants, 8.0% for male and 3.0% for female patients (p=0.018); 10.0% for white patients and 6.5% for patients 60 years or older. The main risk factors were length of stay in the ICU for 9.5 days or more, age 42.5 years or older, and being of the white race. Conclusion This study was related to the epidemiology of PU in critical patients with cardiopulmonary diseases, facilitating the planning of specific preventive care for these patients.Objective: Identify and analyze the incidence coefficients of pressure ulcers (PU) and the risk factors for PU development in critical patients with cardiopulmonary diseases. Method: A prospective cohort study conducted in the cardiopulmonary intensive care unit (ICU) of a large hospital in the city of Sao Paulo, from November 2013 to February 2014. In total, 370 patients over 18 years old who did not present PU at admission and who had been in the ICU for less than 24 hours were studied. Data were analyzed by univariate and multivariate analyses (Classification And Regression Tree - CART). Results: The incidence coefficients of PU were: 11.0% for total participants, 8.0% for male and 3.0% for female patients (p=0.018); 10.0% for white patients and 6.5% for patients 60 years or older. The main risk factors were length of stay in the ICU for 9.5 days or more, age 42.5 years or older, and being of the white race. Conclusion: This study was related to the epidemiology of PU in critical patients with cardiopulmonary diseases, facilitating the planning of specific preventive care for these patients.

Incidence of pressure ulcers in cardiopulmonary intensive care unit patients.

Objective Identify and analyze the incidence coefficients of pressure ulcers (PU) and the risk factors for PU development in critical patients with cardiopulmonary diseases. Method A prospective cohort study conducted in the cardiopulmonary intensive care unit (ICU) of a large hospital in the city of São Paulo, from November 2013 to February 2014. In total, 370 patients over 18 years old who did not present PU at admission and who had been in the ICU for less than 24 hours were studied. Data were analyzed by univariate and multivariate analyses (Classification And Regression Tree - CART). Results The incidence coefficients of PU were: 11.0% for total participants, 8.0% for male and 3.0% for female patients (p=0.018); 10.0% for white patients and 6.5% for patients 60 years or older. The main risk factors were length of stay in the ICU for 9.5 days or more, age 42.5 years or older, and being of the white race. Conclusion This study was related to the epidemiology of PU in critical patients with cardiopulmonary diseases, facilitating the planning of specific preventive care for these patients.Objective: Identify and analyze the incidence coefficients of pressure ulcers (PU) and the risk factors for PU development in critical patients with cardiopulmonary diseases. Method: A prospective cohort study conducted in the cardiopulmonary intensive care unit (ICU) of a large hospital in the city of Sao Paulo, from November 2013 to February 2014. In total, 370 patients over 18 years old who did not present PU at admission and who had been in the ICU for less than 24 hours were studied. Data were analyzed by univariate and multivariate analyses (Classification And Regression Tree - CART). Results: The incidence coefficients of PU were: 11.0% for total participants, 8.0% for male and 3.0% for female patients (p=0.018); 10.0% for white patients and 6.5% for patients 60 years or older. The main risk factors were length of stay in the ICU for 9.5 days or more, age 42.5 years or older, and being of the white race. Conclusion: This study was related to the epidemiology of PU in critical patients with cardiopulmonary diseases, facilitating the planning of specific preventive care for these patients.

Perfil de pacientes com lesão traumática da medula espinhal e ocorrência de úlcera de pressão em um hospital universitário

Pacientes con lesion traumatica de medula espinal (LTME) tienen riesgo elevado de desarrollar ulceras de presion (UP). Este estudio retrospectivo identifico a traves de la revision de las historias clinicas en hospital nivel III, caracteristicas de pacientes atendidos y la ocurrencia de UP. La mayoria fue de sexo masculino, blanca y el 36,2% entre 21 a 30 anos de edad. La causa mas frecuente de LTME fue herida por arma de fuego, seguida de choque/volcadura de auto. Hubo predominio de lesion a nivel toraxico, seguido del cervical. Las UP aparecieron en 20 pacientes (42,5%). Las regiones de mayor frecuencia fueron la sacra y los calcaneos. Solo el 25% de las historias tenia registro sobre la dimesion de la UP, el 80% describio el aspecto y el 52,1% no registro el estadio. Se observa la necesidad de un mejor registro de las UP para que las intervenciones utilizadas en el tratamiento puedan ser evaluadas.Patients with traumatic spinal cord injury (TSCI) have an increased risk of developing pressure ulcers (PU). It is a retrospective study done by review of records in order to identify the characteristics of patients who were assisted at a tertiary hospital as well as the occurrence of PU. Most patients were male, white and 36,2% between 21 and 30 years. The most common causes of TSCI were wound by fire weapons followed by vehicle crash/overturn. There was a predominance of injury at the toracic level followed by cervical. The PU occurred in 20 pacientes (42,5%). The most frequent regions of occurrence were the sacral and heels. Only 25% of the records had PUs dimensions charted, 80% stated the aspect, and 52.1% did not state the stage. There is a need for better documentation of PU so that interventions used for treatment can be evaluated.

Technology use for health education to caregivers: An integrative review of nursing literature

Providing caregivers with health education through educational technologies enhances safe care; and stimulates the decision process and communication among professionals, caregivers and patients. This article is an integrative review to identify what educational technologies have been used for health education to caregivers. The databases Web of Science, Bireme and Scopus were consulted. The inclusion criteria are as follows: full papers, published between 2001 and 2011, in English, Portuguese or Spanish. The descriptors used are the following: educational technology, health education and caregivers. Thirty-four papers were found, 27 of which were excluded because they did not comply with the inclusion criteria, resulting in a final sample of 7 papers. The results evidenced the use of light and hard technologies in health education for caregivers, aimed at the therapeutic discussion of care as well as telehealth service delivery. Research is needed which uses and assesses the use of hard educational technologies in health education for caregivers.

Cuidadores de indivíduos com lesão medular: sobrecarga do cuidado

A sectional study that had as its objectives to assess caregiver burden of for caregivers of individuals with Traumatic Spinal Cord Injury (TSCI) and its association with sociodemographic variables (age and sex), health status (self-reported illnesses) and caregiver characteristics (care time in years and daily hours of care). Data were collected by consultation of patient files and individual interviews at home using the instrument, Caregiver Burden Scale (CBScale). The results showed that most burden occurred in the domains: environment, disappointment and general strain. Presenting health problem (for all domains of the CBScale) and spending more hours per day in care (in the domain disappointment) represented the variables associated with burden. Studies of a more confirmatory nature than exploratory between the variables studied can be used to measure the burden obtained in this population of caregivers of individuals with TSCI.Estudio transversal que tuvo como objetivo evaluar la carga del cuidado de los cuidadores de las personas con Lesion Traumatica de Medula Espinal (LTME) y su asociacion con variables sociodemograficas (edad y sexo), estado de salud (auto-reporte de enfermedades) y caracteristicas de la atencion (tiempo de atencion en los ultimos anos y las horas de atencion). Los datos fueron recogidos por los registros hospitalarios y entrevistas en el hogar utilizando el instrumento Caregiver Burden Scale (CBScale). Los resultados mostraron que la mayor sobrecarga ocurrido en areas: ambiente, decepcion y tension general. Problema de salud actual (para todas las areas de CBScale) y pasar mas horas por dia en la atencion (en el campo decepcion) representaran las variables asociadas con a sobrecarga. Estudios de una confirmacion, mas que exploratorio entre variables se pueden utilizar para medir la sobrecarga obtenido en esta poblacion de los cuidadores de los individuos con LTME.