Renato Mendonça Ribeiro

Estratégias de enfrentamento dos enfermeiros em serviço hospitalar de emergência

Objective: To identify the coping strategies of nurses in hospital emergency services, and relate them to sociodemographic and professional variables. Methods: Cross-sectional study with 89 nurses. Research instruments included a form to characterize the research subjects and the Ways of Coping Questionnaire by Folkman and Lazarus. Results: The most commonly used coping strategies were problem solving and positive reappraisal, whereas the least used was confrontation. The strategies of confrontation, positive reappraisal and escape-avoidance were associated with the male sex, not having a partner and working night shifts, respectively. Conclusion: Coping strategies can be aided by listening, monitoring, educational programs and creation of a space for discussion of work-related difficulties.

Psychological adaptation to and acceptance of type 2 diabetes mellitus

Objective To evaluate individuals’ psychological adaptation to type 2 diabetes mellitus throughout acceptance of the disease and its relation with perceived stress and values of glycated hemoglobin (A1c) before and after group educational intervention. Methods Quasi-experimental study developed at outpatient unit that included 77 participants who fulfilled inclusion criteria. The study instruments were a questionnaire that obtained sociodemographic variables and the Acceptance of Disease Scale and Perceived Stress Scale, both applied during interviews before and after group education intervention using Diabetes Conversations Maps. Results Interviewed patients showed improvements in the acceptance of the disease after educational intervention. We observed an inverse relation between acceptance of the disease, perceived stress, and the mean glycated hemoglobin (A1c) value before and after the intervention. Conclusion Acceptance of type 2 diabetes can improve after a group educational intervention. A high score for acceptance of the disease was related to a low score for perceived stress and lower mean glycated hemoglobin (A1c) value.

Older adults hospitalized in a teaching hospital: clinical characteristics and outcomes

Objective: to investigate the causes of older adult hospitalizations, demographic and clinical profiles, and patient outcome. Method: quantitative cross-sectional study conducted with 14,892 electronic medical records during 12 months. We carried out a descriptive analysis of the variables of the sample characterization, and an associative test using chi-square statistics. Results: most patients assessed were male, had primary education, lived with a partner, were white and Catholics, and had cardiovascular diseases, followed by neoplasms and gastrointestinal diseases in both sexes. The average age of the patients was 72.1 years, and the average length of hospital stay was 5.9 days. There was a significant association between diagnosed diseases, sex (p <0.001), and ethnicity (p = 0.023) of the patients. The most common outcome was hospital discharge. Conclusion: chronic diseases were the main causes of older adult hospitalizations and led to increased length of hospital stay. The assessment of these factors provides subsidies for identifying problems and performing best nursing interventions. Descriptors: Older Adult; Hospitalization; Clinical Evolution. RESUMO Objetivo: investigar as causas de internação dos idosos hospitalizados, o perfil demográfico, o perfil clínico e o desfecho. Método: estudo quantitativo, transversal de análise de 14.892 prontuários eletrônicos, no período de 12 meses. Foi realizada uma análise descritiva das variáveis de caracterização amostral e aplicação do teste associativo pela estatística qui-quadrado. Resultados: a maioria dos pacientes avaliados era do sexo masculino, com grau de instrução fundamental, com companheiro, do lar, brancos, católicos e com doenças cardiovasculares, seguidas de neoplasias e doenças gastrointestinais em ambos os sexos. A idade dos pacientes apresentou média de 72,1 anos e a média da permanência hospitalar foi de 5,9 dias. Houve associação significativa entre as doenças diagnosticadas, o sexo (p <0,001) e a etnia (p = 0,023) dos pacientes. O desfecho mais comum foi a alta dos pacientes. Conclusão: as doenças crônicas foram as principais causas de hospitalização dos idosos, acarretando mais tempo na hospitalização. A investigação destes fatores fornece subsídios para identificação dos problemas e realizar melhores ações de enfermagem. Descritores: Idoso; Hospitalização; Evolução Clínica. RESUMEN Objetivo: investigar las causas de hospitalización de adultos mayores, perfil demográfico, perfil clínico y desenlaces. Método: estudio cuantitativo transversal con análisis de 14.892 registros médicos electrónicos de un período de 12 meses. Se realizó un análisis descriptivo de las variables de caracterización de la muestra y se aplicó la prueba chi-cuadrado. Resultados: la mayoría de los pacientes evaluados eran hombres, con educación primaria, vivían en pareja, eran blancos, católicos y tenían enfermedades cardiovasculares, seguidas de neoplasias y enfermedades gastrointestinales en ambos sexos. El promedio de edad de los pacientes fue de 72,1 años y de la estancia hospitalaria fue de 5,9 días. Hubo una asociación significativa entre enfermedades diagnosticadas, sexo (p <0.001) y etnia (p = 0.023) de los pacientes. El resultado más común fue el alta hospitalaria. Conclusión: las enfermedades crónicas fueron las principales causas de hospitalización de los adultos mayores, llevando a un tiempo más prolongado de internación. La investigación de estos factores proporciona subsidios para identificación de problemas y realizar mejores intervenciones de enfermería. Descritores: Adulto Mayor; Hospitalización; Evolución Clínica. Nurse, Master’s Degree in Nursing, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. E-mails: ca.c.rodrigues@hotmail.com; samaris.enf@hotmail.com; Nurse, Ph.D., Professor at the Department of General Nursing and the Nursing Graduate Program, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. E-mails: ricardo.rita@terra.com.br; claudiacesarino@famerp.br; Nurse, Ph.D., Professor at the União das Faculdades dos Grandes Lagos University (UNILAGO) and the Nursing Graduate Program, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. Email: danielacomelisbertolin@gmail.com; Nurse, Master’s Degree candidate in Nursing, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. E-mail: rib_renato@hotmail.com; Nurse, Ph.D., Professor at the São José do Rio Preto School of Medicine (FAMERP), University of São Paulo (USP). Ribeirão Preto, SP, Brazil. E-mails: mariliapilotto@yahoo.com.br; kusumota@eerp.usp.br ORIGINAL ARTICLE Rodrigues CC, Ribeiro RCHM, Cesarino CB et al. Older adults hospitalized in a teaching...

CARACTERIZAÇÃO DO PERFIL DAS EMERGÊNCIAS CLÍNICAS NO PRONTO-ATENDIMENTO DE UM HOSPITAL DE ENSINO

This study aimed to: investigate the demographic characteristics of patients seen in the emergency department of a teaching hospital; identify the most common clinical emergencies; and identify the ultimate destination of these patients (medical discharge, hospitalization or death). This retrospective, cross-sectional, quantitative study. Data were collected from patients’ electronic medical records. Inclusion criteria were: adult patients 18 years or older, with a diagnosis of clinical emergency, seen in the period from January 2009 through May 2010. There was a predominance of: females (56.33%), of white ethnicity (86.95%), and mean age 48.74 ± 7.8 years. The most prevalent age group was 18-29 years. Most of the patients (99.65%) declared themselves to be active workers. 60.23% were married. The most frequent neurologic diseases found were: headache (29.03%); stroke (26.09%); and upper back pain (10.25%) and cardiological diseases were: precordial pain (38.98%), heart failure (25.79%), hypertension (12.29%) and cardiac arrhythmia (8.67%). The ultimate destinations of patients seen in the emergency department were: medical discharge (55.8%) and hospitalization (43.26%). Among those patients who had been hospitalized, medical discharge was the most common outcome (87.99%), followed by death (11.47%). Further research is necessary in order to better understand the various aspects involved in the operation of an emergency department unit and to develop an institutional profile that encompasses other approaches, such as a better and more efficient health care delivery by health professionalsThis study aimed to: investigate the demographic characteristics of patients seen in the emergency department of a teaching hospital; identify the most common clinical emergencies; and identify the ultimate destination of these patients (medical discharge, hospitalization or death). This retrospective, cross-sectional, quantitative study. Data were collected from patients’ electronic medical records. Inclusion criteria were: adult patients 18 years or older, with a diagnosis of clinical emergency, seen in the period from January 2009 through May 2010. There was a predominance of: females (56.33%), of white ethnicity (86.95%), and mean age 48.74 ± 7.8 years. The most prevalent age group was 18-29 years. Most of the patients (99.65%) declared themselves to be active workers. 60.23% were married. The most frequent neurologic diseases found were: headache (29.03%); stroke (26.09%); and upper back pain (10.25%) and cardiological diseases were: precordial pain (38.98%), heart failure (25.79%), hypertension (12.29%) and cardiac arrhythmia (8.67%). The ultimate destinations of patients seen in the emergency department were: medical discharge (55.8%) and hospitalization (43.26%). Among those patients who had been hospitalized, medical discharge was the most common outcome (87.99%), followed by death (11.47%). Further research is necessary in order to better understand the various aspects involved in the operation of an emergency department unit and to develop an institutional profile that encompasses other approaches, such as a better and more efficient health care delivery by health professionals.