Objective: To estimate the prevalence and self-reported socio-demographic and health factors associated with functional disability in basic and instrumental activities of daily living among the elderly. Method: A cross-sectional study was carried out, based on a representative sample of elderly people receiving care at a reference unit in the north of the state of Minas Gerais. The data were collected in 2015. Demographic and socioeconomic variables, morbidity, hospitalizations in the previous year, frailty (Edmonton Frail Scale), geriatric depression (GDS-15), and functional disability (Katz Index, Lawton and Brody Scales) were analyzed. Multiple analysis was performed using Poisson regression with robust variance. Results: 360 elderly people aged 65 years and over participated in the study. The prevalence of functional disability for Basic Activities of Daily Living was 21.4% while for instrumental activities it was 78.3%. Functional disability in basic activities was higher among elderly males (p=0.03) who had suffered strokes (p=0.00) and were frail (p=0.00), while for instrumental activities it was higher among older elderly persons (p=0.04); who were illiterate (p=0.00), had less than five years of schooling (p=0.02); had depressive symptoms (p=0.00) and were frail (p=0.00). It was lower among elderly persons who lived alone. Conclusion: A high prevalence of functional disability was identified among the elderly for instrumental activities of daily living, demonstrating the need for an effective and immediate approach by health professionals, who should employ preventive care in order to tackle this problem.
RESUMO Objetivo: identificar os elementos que caracterizam o cuidado clínico de Enfermagem em Saúde Mental no contexto da Reforma Psiquiátrica e da Humanização da Assistência. Método: trata-se de um estudo bibliográfico, descritivo, do tipo revisão integrativa, com busca de artigos na BVS, entre os anos de 1995 e 2017. Realizou-se a sistematização dos dados pela técnica de Análise de Conteúdo. Apresentaram-se os resultados em três categorias “Humanização da assistência e a sua relação com o cuidado de Enfermagem na Saúde Mental”; “Estratégias de cuidado no campo da Saúde Mental: incorporando as novas tecnologias” e “Cuidado clínico de Enfermagem humanizado: resgatando a subjetividade”. Resultados: identificaram-se 16 estudos de acordo com os critérios estabelecidos. Apresentaram-se as características dos artigos selecionados segundo os autores, o ano de publicação, o título do periódico, o Qualis, o fator de impacto e o nível de evidência, o local de publicação, o delineamento metodológico adotado, os objetivos e os principais resultados. Conclusão: constata-se que se devem respeitar, na Enfermagem aplicada à Saúde Mental, os preceitos da Reforma Psiquiátrica Brasileira e da Política Nacional de Humanização. Considera-se, além disso, a interdisciplinaridade como um recurso para a ampliação da clínica. Descritores: Humanização da assistência; Enfermagem; Enfermagem Psiquiátrica; Saúde Mental; Psicanálise; Serviços de Saúde Mental.ABSTRACT Objective: to identify the elements, that characterize clinical nursing care in mental health in the context of Psychiatric Reform and Humanization of Care. Method: this is a bibliographic, descriptive study, of integrative type, with search of articles in the VHL, between 1995 and 2017. The data was systematized using the Content Analysis technique. Results were presented in three categories: Humanization of Care and its implications on Nursing care in mental health; Care strategies in the field of mental health: incorporating new technologies; Humanized nursing care: rescuing subjectivity. Results: 16 studies were identified according to established criteria. The characteristics of the selected articles were presented, according to authors, year of publication; title of the periodical; QUALIS; impact factor and level of evidence; place of publication, methodological design adopted; objectives and main results. Conclusion: the precepts of the Brazilian Psychiatric Reform and the National Humanization Policy must be respected in nursing in mental health. In addition, interdisciplinarity is considered as a resource for the expansion of the clinic. Descriptors: Humanization of Assistance; Nursing; Psychiatric Nursing; Mental Health; Psychoanalysis; Mental Health Services.RESUMEN Objetivo: identificar los elementos que caracterizan el cuidado clínico de Enfermería en Salud mental en el contexto de la Reforma Psiquiátrica y Humanización de la Asistencia. Método: se trata de un estudio bibliográfico, descriptivo, tipo revisión integrativa con búsqueda de artículos en la BVS, entre los años 1995 y 2017. Se realizó la sistematización de los datos por la técnica de Análisis de contenido. Se presentaron los resultados en tres categorías: Humanización de la Asistencia y sus imbricaciones sobre el cuidado de enfermería en la salud mental; Las estrategias de cuidado en el campo de la salud mental: incorporando nuevas tecnologías; Cuidado clínico de Enfermería humanizado: rescatándose la subjetividad. Resultados: se identificaron 16 estudios de acuerdo a los criterios establecidos. Se presentaron las características de los artículos seleccionados, según autores, año de publicación; título del periódico; QUALIS; factor de impacto y nivel de evidencia; lugar de publicación, delineamiento metodológico adoptado; objetivos y principales resultados. Conclusión: se debe respetar en la enfermería en la salud mental los preceptos de la Reforma Psiquiátrica Brasileña y de la Política Nacional de Humanización. Además, se considera la interdisciplinaridad como recurso a la ampliación de la clínicaDescriptores: Humanización de la Atención; Enfermería; Enfermería Psiquiátrica; Salud Mental; Psicoanálisis; Servicios de Salud Mental.
The present study aimed to estimate the prevalence of depressive symptoms and associated factors among older adults treated at a referral center. A cross-sectional study was carried out with a sample of 360 older adults treated at a Referral Center for the Health of Older Adults in the north of Minas Gerais, Brazil. The following data were collected in 2017: demographic, socioeconomic, morbidity, hospital admission in the last year, frailty (Edmonton Frail Scale), functional capacity (Katz Index, Lawton and Brody Scale) and presence of depressive symptoms (Geriatric Depression Scale - GDS-15). Multiple analysis was performed through logistic regression. A prevalence of depressive symptoms was observed in 37.2% of the sample. The variables associated with depressive symptoms were: negative perception about one’s own health (OR=1.9, 95% CI 1.34-2.70); frailty (OR=1.94, 95% CI 1.41-2.66); having suffered falls (OR=1.24, 95% CI 1.01-1.61); having been hospitalized in the last year (OR=1.56, 95% CI, 1.11-2.27); (OR=2.56, 95% CI 1.38-4.77) and residing alone (OR=1.66, 95% CI 1.09-2.53). Thus, a high prevalence of depressive symptoms was identified among the older adults, evidencing the need for an effective and immediate approach by health professionals.
RESUMO Objetivo: refletir sobre a terapia nutricional enteral e a importância da assistência de enfermagem ao paciente. Método: trata-se de um estudo qualitativo, do tipo reflexivo, baseado em revisão de literatura sobre terapia nutricional enteral, entre os anos de 1998 a 2018, além da percepção dos autores a respeito do assunto. Realizou-se a sistematização dos dados pela técnica de Análise de Conteúdo. Apresentaram-se os resultados em duas categorias: “Indicação de terapia enteral e a técnica de introdução da sonda enteral” e “Monitoramento da dieta e controle das intecorrências pela equipe de enfermagem”. Resultados: averiguou-se que a terapia nutricional enteral é a forma de suporte priorizada em pacientes graves, com função digestiva aceitável, porém incapazes de se alimentar por via oral. Constataram-se que o enfermeiro e a equipe desempenham importante papel na prevenção das complicações relacionadas a essa modalidade de dieta, com capacidade de reconhecer complicações potenciais e intervir, contribuindo para a manutenção da vida. Conclusão: deve-se conscientizar e valorizar esse cuidado enquanto assistência de enfemagem ao paciente. Considera-se que o estudo possa enriquecer a prática dos enfermeiros que lidam com a terapia nutricional. Descritores: Nutrição Enteral; Terapia nutricional; Trato Gastrointestinal; Métodos de Alimentação; Enfermagem; Cuidados de Enfermagem.ABSTRACT Objective: to reflect on enteral nutritional therapy and the importance of nursing care to the patient. Method: this is a qualitative, reflexive study, based on a review of the literature on enteral nutritional therapy, between 1998 and 2018, in addition to the authors' perceptions about the subject. The data was systematized using the Content Analysis technique. The results were presented in two categories: "Indication of enteral therapy and the technique of introduction of the enteral catheter" and "Monitoring of diet and control of the occurrences by the nursing team". Results: it was verified that enteral nutritional therapy is the form of support prioritized in severe patients, with acceptable digestive function, but unable to be fed orally. It was verified that the nurse and the team play an important role in the prevention of complications related to this diet modality, with the capacity to recognize potential complications and intervene, contributing to the maintenance of life. Conclusion: this care should be made aware of and valued as a patient's nursing care. It is considered that the study can enrich the practice of nurses who deal with nutritional therapy. Descriptors: Enteral nutrition; Nutritional therapy; Gastrointestinal Tract; Feeding Methods; Nursing; Nursing care.RESUMEN Objetivo: reflexionar sobre la terapia nutricional enteral y la importancia de la asistencia de enfermería al paciente. Método: se trata de un estudio cualitativo, del tipo reflexivo, basado en la revisión de literatura sobre terapia nutricional enteral, entre los años 1998 a 2018, además de la percepción de los autores al respecto. Se realizó la sistematización de los datos por la técnica de Análisis de Contenido. Se presentaron los resultados en dos categorías: "Indicación de terapia enteral y la técnica de introducción de la sonda enteral" y "Monitoreo de la dieta y control de las competencias por el equipo de enfermería". Resultados: se comprobó que la terapia nutricional enteral es la forma de soporte priorizada en pacientes graves, con función digestiva aceptable, pero incapaces de alimentarse por vía oral. Se constató que el enfermero y el equipo desempeñan un importante papel en la prevención de las complicaciones relacionadas con esta modalidad de dieta, con capacidad de reconocer complicaciones potenciales e intervenir, contribuyendo para el mantenimiento de la vida. Conclusión: se debe concientizar y valorar ese cuidado como asistencia de enfermería al paciente. Se considera que el estudio puede enriquecer la práctica de los enfermeros que tratan con la terapia nutricional. Descriptores: Nutrición Enteral; Terapia Nutricional; Tracto Gastrointestinal; Métodos de Alimentación; Enfermería; Atención de Enfermería.
Background Critically ill patients are susceptible to the development of dry eye. Few studies have been conducted on how to best prevent and treat this condition. Objective To compare the effectiveness of 2 nursing interventions in preventing dry eye in adult intensive care unit patients: liquid artificial tears (Lacribell; Latinofarma) and artificial tears gel (Vidisic Gel; Bausch and Lomb). Methods In this randomized controlled trial, 140 participants were randomly assigned to 1 of 2 treatment groups: a liquid artificial tears group (n = 70) and an artificial tears gel group (n = 70). The study inclusion criteria were as follows: admission to the intensive care unit, age of 18 years or older, no diagnosis of dry eye at admission, receipt of mechanical ventilation, blink rate of less than 5 times per minute, and a score of 7 or less on the Glasgow Coma Scale. On 5 consecutive days, a single researcher who was unaware of the treatment assignment assessed the participants’ eyes using the fluorescein eye stain test and the Schirmer test for dry eye. Results Dry eye developed in 21% of participants who received liquid artificial tears versus 9% of participants who received artificial tears gel (P = .04). Conclusions In this study, artificial tears gel was superior to liquid artificial tears in preventing the development of dry eye. These results may help nurses deliver evidence-based eye care aimed at reducing the risk of dry eye in critically ill patients.
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