Prevalence of suicidal behavior in young university students: A systematic review with meta-analysis

Objective: to identify the prevalence of suicidal behavior in young university students. Method: a systematic review with meta-analysis of cross-sectional studies based on the Joanna Briggs Institute proposal, and carried out in the PubMed, Web of Science, Scopus, PsycINFO and LILACS databases and in the Brazilian Digital Library of Theses and Dissertations, with no language or year restrictions. A total of 2,942 publications were identified. Selection, data extraction and methodological evaluation of the studies were performed by two independent researchers. The meta-analysis was performed considering the random effects model. Results: eleven articles were included in this review. The prevalence variation for suicidal ideation was from 9.7% to 58.3% and, for attempted suicide, it was from 0.7% to 14.7%. The meta-analysis showed a 27.1% prevalence for suicidal ideation in life, 14.1% for ideation in the last year, and 3.1% for attempted suicide in life. Conclusion: the high prevalence of suicidal behavior, even with the considerable heterogeneity of the studies, raises the need to implement interventions aimed at preventing suicide and promoting mental health, especially in the academic environment.

Performance of scores in the prediction of clinical outcomes in patients admitted from the emergency service

Objective: to evaluate the performance of the quickSOFA scores and Systemic Inflammatory Response Syndrome as predictors of clinical outcomes in patients admitted to an emergency service. Method: a retrospective cohort study, involving adult clinical patients admitted to the emergency service. Analysis of the ROC curve was performed to assess the prognostic indexes between scores and outcomes of interest. Multivariate analysis used Poisson regression with robust variance, evaluating the relationship between variables with biological plausibility and outcomes. Results: 122 patients were selected, 58.2% developed sepsis. Of these, 44.3% had quickSOFA ≥2 points, 87% developed sepsis, 55.6% septic shock and 38.9% died. In the evaluation of Systemic Inflammatory Response Syndrome, 78.5% obtained results >2 points; of these, 66.3% developed sepsis, 40% septic shock and 29.5% died. quickSOFA ≥2 showed greater specificity for diagnosis of sepsis in 86% of the cases, for septic shock 70% and for mortality 64%, whereas the second score showed better results for sensitivity with diagnosis of sepsis in 87.5%, septic shock in 92.7% and death in 90.3%. Conclusion: quickSOFA showed by its practicality that it can be used clinically within the emergency services, bringing clinical applicability from the risk classification of patients for the early recognition of unfavorable outcomes.

Quality of the documentation of the Nursing process in clinical decision support systems

Objective: to compare the quality of the Nursing process documentation in two versions of a clinical decision support system. Method: a quantitative and quasi-experimental study of the before-and-after type. The instrument used to measure the quality of the records was the Brazilian version of the Quality of Diagnoses, Interventions and Outcomes, which has four domains and a maximum score of 58 points. A total of 81 records were evaluated in version I (pre-intervention), as well as 58 records in version II (post-intervention), and the scores obtained in the two applications were compared. The interventions consisted of planning, pilot implementation of version II of the system, training and monitoring of users. The data were analyzed in the R software, using descriptive and inferential statistics. Results: the mean obtained at the pre-intervention moment was 38.24 and, after the intervention, 46.35 points. There was evidence of statistical difference between the means of the pre- and post-intervention groups, since the p-value was below 0.001 in the four domains evaluated. Conclusion: the quality of the documentation of the Nursing process in version II of the system was superior to version I. The efficacy of the system and the effectiveness of the interventions were verified. This study can contribute to the quality of documentation, care management, visibility of nursing actions and patient safety.

Using structural equation modeling in the understanding of functional disability in older adults

Objective: to analyze functional disability and its associated factors among community-dwelling older adults. Method: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. Results: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. Conclusion: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.

Overview of the actions to combat bacterial resistance in large hospitals

Objective: to analyze, in the clinical practice of large hospitals, how the adoption of measures to prevent and control the spread of bacterial resistance has occurred, and to propose a score for the institutions’ adherence. Method: a cross-sectional study carried out in 30 large hospitals of Minas Gerais, from February 2018 to April 2019, after approval by the Ethics and Research Committee. Interviews were conducted with hospital managers, with Hospital Infection Control Services coordinators, and with the care coordinators of the Inpatient Units and Intensive Care Center. In addition, observations were made of the adoption of preventive measures by the multidisciplinary team in the care units. Results: in the 30 participating hospitals, 93.3% (N=28) had protocols for prophylactic antibiotics, and 86.7% (N=26) performed their audit, 86.7% (N=26) for therapeutic antibiotics and 83.3% (N=25) their audit; 93.3% (N=56) used gloves and cloaks for patients in contact precautions, and 78.3% (N=47) of the professionals were unaware of or answered incompletely on the five moments for hand hygiene. In the score to identify the adoption of measures to control bacterial resistance, 83.3% (N=25) of the hospitals were classified as partially compliant, 13.3% (N=04) as deficient, and 3.4% (N=01) as non-adoption. Conclusion: it was found that the recommended measures to contain bacterial resistance are not consolidated in the clinical practice of the hospitals.

Blended learning program for the development of skills in the aspiration of artificial airways

Objective: to develop and validate a blended learning program, of the inverted classroom type, on the aspiration of artificial airways. Method: applied and methodological research that involved technological production for teaching a Nursing Intervention, based on Vygotsky’s theoretical frameworks and on the Nursing Process. For elaboration and validation, a classic instructional design model was followed. The general and pedagogical requirements were validated, as well as those for videos and interface. For the analysis, the Content Validity Index and the First-order agreement coefficient were used. Results: 34 experts participated, 27 of whom were nurses and seven were professionals in Information Technology. In the nurses’ opinion, the general and pedagogical requirements obtained a Content Validity Index of 0.99 and 0.98 was obtained for the videos and for the interface. The interface for the IT professionals was 0.94. All requirements showed almost perfect agreement. Conclusion: the teaching program was elaborated and validated by experts and constitutes an innovative proposal to train nurses. The mediation of teaching by means of duly validated technologies can favor learning and reaching positive results in the development of skills in the practice of aspiration of artificial airways.

Self-evaluation and evaluation of nursing leaders’ Leadership Styles

Objective: to evaluate the concordance between the leadership styles self-evaluated by the Nursing managers and evaluated by their subordinates in a private hospital. Methodology: an observational, cross-sectional, quantitative, and analytical study, with population of 31 managing nurses and 125 subordinates. Herman Bachenheimer’s instrument of Situational Leadership was employed, adapting it to the subordinates. The concordance between self-evaluation and evaluation by the subordinates was analyzed in the four leadership styles (Directing, Guiding, Participating, Delegating), with the Kappa coefficient statistical test, test statistic (Z) >1.96, 95% confidence interval and PASW Statistics, version 18. Results: the self-evaluation of the Nursing managerial staff has a tendency for the Guiding Style and, according to the evaluation by their subordinates, there is a minimum difference among the four styles. Their concordance is low, but significant, with 19.3%. It was identified that the subordinates perceive that they possess the necessary competences to autonomously perform the tasks assigned, and that there is trust and assertive communication between both groups, which facilitates knowledge exchange. Conclusion: the Nursing managers and their subordinates perceive various leadership styles, and concordance is low. To attain superior leadership styles, the subordinates must develop autonomy and empowerment.

Antenatal care in Mozambique: Number of visits and gestational age at the beginning of antenatal care

Objective: 1)to assess the gestational age at the beginning of antenatal care and its covariates; 2)to assess the number of antenatal visits and its covariates; and 3)to identify the reasons for the late initiation of antenatal care and for attending less than four visits among postpartum women living in Nampula, Mozambique. Method: cross-sectional study conducted with 393 mothers who answered a structured instrument in face-to-face interviews. Logistic regression was used to analyze the covariates of having initiated antenatal care up to the 16thgestational week, having attended four or more antenatal visits, and reporting both situations simultaneously. Results: all postpartum women underwent antenatal care, but only 39.9% started it until the 16thgestational week, 49.1% attended four or more visits, and 34.1% reported both events. Having concluded high school (ORadj=1.99; 95%CI=1.19-3.31) or college (ORadj=3.87; 95%CI=1.47-10.18) were aspects associated with reporting both situations. The reasons for the late initiation of antenatal care and attending less than four visits were as follows: not finding it important to attend several visits, not having easy access to the health facility, not being aware about pregnancy, and not having a companion for the visits. Conclusion: the gestational age at the beginning of antenatal care and the number of antenatal visits are lower than the current recommendations in the country.

Indicators of Good Nursing Practices for Vulnerable Groups in Primary Health Care: A Scoping Review

Objective: to map the indicators of Good Nursing Practices in Primary Health Care, from the perspective of Collective Health, reported to the vulnerable social groups. Method: this is a scoping review according to the PRISMA Extension for Scoping Reviews. The searches were carried out in2020 in six databases and in a virtual library. Independent reviewers performed the reading of the full texts, as well as treatment, analysis and synthesis of the content. Results: a total of 13 articles were found, the first from 2007 and the last from 2020. The data were classified according to the following empirical categories: assessment and control of health conditions(3 indicators); assessment of knowledge about health(3 indicators); use of sociodemographic characteristics to estimate risks or vulnerabilities(3 indicators); assessment and monitoring of health needs(5 indicators); promotion of safety and trust in health services(6 indicators); and assessment of the care process(4 indicators). Conclusion: the articles showed a variety of indicators that assess the interventions carried out in the context of Nursing in Primary Care with vulnerable social groups. These indicators are related to health conditions, especially those of the biopsychological body, reported to vulnerable populations, especially women, children, adolescents and older adults.

Burnout, daytime sleepiness and sleep quality among technical-level Nursing students

Objective: to evaluate the association of the burnout syndrome with daytime sleepiness and sleep quality among technical-level Nursing students. Method: a cross-sectional, analytical and quantitative study, conducted with 213 students from four technical Nursing courses in a city of Paraná, Brazil. Data collection was carried out using an instrument containing characterization information, the Maslach Burnout Inventory - Student Survey, the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive statistics and logistic regression. Results: the prevalence values of the burnout syndrome, excessive daytime sleepiness and poor sleep quality were 4.7%, 34.7% and 58.7%, respectively. Excessive daytime sleepiness significantly increased the chances of high emotional exhaustion (ORadj: 5.714; p<0.001) and high depersonalization (ORadj: 4.259; p<0.001). Poor sleep quality, especially sleep disorders, was associated with all dimensions of the syndrome (p<0.05). Conclusion: high levels of the burnout syndrome dimensions were associated with excessive daytime sleepiness and poor sleep quality. Educational institutions should include sleep hygiene and psychosocial support in their student health promotion programs.