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International Archives of Medicine
Working Groups
A Look at the Practice of Risk Classification: Integrative Review

Introduction: the increase in the number of patients in emergency services / emergency brought the need for screening / risk classification as a way to organize the urgency and emergency care in the health institutions.

Objectives: know how to develop the risk classification practice in the Brazilian reality using the scientific production, the insertion of nurses in risk classification using the Brazilian scientific production.

Methods: an integrative review was carried out, the data occurred during September 2015 in the following databases: Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (Medline), and the Latin American and Caribbean System of Information on Health Sciences (LILACS) “GOOGLE SCHOLAR.”

Results: it found 9,874 articles and selected 33 for analysis. The results were organized in 04 categories: Risk classification as assistance qualifier; risk classification’s organization; operation weaknesses of the risk classification and nurse’s role in risk classification.

Conclusion: We conclude that the risk classification qualifies the assistance in emergency services; there are many difficulties for the risk classification’s operation and the nurse has been established as a professional with technical and legal competence to perform the risk classification.


from International Archives of Medicine

Nursing Care Systematization: A Study At A Teaching Hospital

Objective: Investigate the understanding of nurses who work at a teaching hospital, in relation to NCS and the nursing process; ascertain facilities/difficulties related to the applicability of the nursing process in that service; and verify the opinions of those professionals for the improvement and/or effectiveness of the nursing process at the hospitalization units of the hospital.

Method: Exploratory, descriptive study, with a qualitative approach. The sample consisted of 42 nurses who answered a questionnaire. The empirical material was analyzed and categorized based on the content analysis technique and discussed in the light of the literature.

Results: From the participants’ discourses, two categories of analysis emerged: 1) understanding of NCS as a tool to organize the Nursing work process and improve the quality of care; and 2) applicability of the nursing process at the various hospitalization units of the institution.

Conclusion: The implementation and applicability of that method depend on not only the knowledge and motivation of the nursing professionals, but also on a strategic planning involving management and staff, from the recognition of their importance in order to obtain adherence and effective operationalization in practice.

Descriptors: Nursing; Nursing Process; Professional Practice.

from International Archives of Medicine

Thermal and cardiorespiratory newborn adaptations during hot tub bath

Objective: To evaluate thermal and cardiorespiratory adaptation during hot tub bath and shower in healthy newborns in the first hours of life. Study design: This is a randomized blind controlled trial, registered in ReBEC (No. RBR-4z26f3) with 184 newborns divided into hot tub group (n=84) and shower (n=100). Newborns from intervention group were immersed in a hot tub with warm water up to the neck, without exposure to air flow, and control group received traditional shower. Heart rate, respiratory rate and temperature were measured before and immediately after bath by an investigator blinded to the type of bath.

Results: Groups were similar in gender, gestational age, birth weight, Apgar score at 5th minute and hours of life, p => 0.05. To analyze thermal and cardiorespiratory adjustments, difference between post-bath variables and pre-bath was calculated. In this analysis, it was found statistically significant difference between two types of bath regarding heart rate, respiratory rate and temperature. Hot tub bath decreases heart and respiratory rates and increases temperature, whereas shower provides the opposite effect (0.0001).

Conclusion: This study demonstrates that hot tub baths and shower, in healthy newborns, promote thermal and cardiorespiratory adaptations, reflecting thermal, cardiac and respiratory positive reactions after hot tub bath.

from International Archives of Medicine

Integrative Community Therapy And Its Meaning For Student Life

Objective: Understanding the meaning of ICT (Integrative Community Therapy) in the life of students participating in the Extension Project “O desabrochar de si: a TCI no Centro de Atenção Psicossocial”.

Method: It is an exploratory and descriptive study of qualitative approach that sought to understand the phenomenon in question using an instrument of semi-structured interview applied to students of the Education and Health Center at the Campina Grande Federal University (UFCG), Cuite campus, in the state of Paraiba.

Results: The results found enabled the construction of the following categories: Knowing the (un)known: the meeting with and approach to ICT; ICT and its mobilizing potential; and the following subcategories: Revealing a cycle of discoveries; Unveiling experiences for life. This study revealed that ICT has a relevant impact, bringing forth positive changes in the life of students in question.

Conclusion: It can be said that the participants expressed satisfaction and personal changes, since ICT availed at rescuing essential values for their lives, favoring the discovery and the finding of strengths to face the adversities of daily life. The students found in the Extension Project and in ICT a source of support for personal improvement, besides giving the opportunity for the creation and strengthening of bonds between the team, community and professors.

from International Archives of Medicine

The Care Management In The Family Health Support Core: Technologies Operated In The Professional Dimension

Introduction: The Centre for Health Support Family – NASF has a innovative character with potential to concretize change in the organization of services and in care practices, supporting and expanding the solvability of the actions of the teams of the Family Health Strategy – FHS. To this end, it must operationalize technologies, arrangements and care management devices.

Objective: To describe the care management technologies, particularly in the professional dimension, operated by the teams of the Support Centre for Family Health, in its dialogue with the Health Strategy.

Methods: case study with a qualitative approach, with the 12 professionals from a NASF team of Maracanaú, Ceará, Brazil. Focal group was performed. The empirical material was analysed based on the content analysis.

Results: there is evidence of a proposal for production of integral care based on the use of technologies as host, bond, autonomy and accountability. The user approach is based on the principles of the extended clinic. However, there are difficulties related to the regulation of access, the construction of bonds, the construction of therapeutic projects and intersectional articulation.

Final thoughts: it appears necessary to overcome the challenges, strengthen mechanisms for coordination and for negotiation of labour, as well as rethinking the NASF linking logic to a seemingly high number of FHS teams complicates the organization of work processes, building of agendas, weakens the bonds with the users and even the solvency.

from International Archives of Medicine

User embracement in practices care in psychosocial care centers the perspective of local managers

Introduction: Psychosocial care centres (CAPS), strategic IN articulation of psychosocial care network and health system gateway, propose to the reorganization of health practices, by adopting a new ethic of care, based on respect to the singularity of the subjects and in the reception to the health needs of the users. Reception is a device for transforming practices and humanizing health care. 

Objective: To analyse the operation of the host users of CAPS from the perspective of local coordinators in Fortaleza, Ceará, Brazil. 

Method: Qualitative research with case study design, performed with CAPS coordinators of the city of Fortaleza, Ceará, Brazil. Data were collected through semi-structured interviews and observation, being submitted to the analysis of thematic content. 

Results: The host constituted innovative device in mental health practices, as triggered the construction of new ways of dealing with the subject in psychological distress, by incorporating technologies such as qualified listening, building autonomy, with attention focused on the user. Provided a reorientation of work and service processes, requesting the articulation for network care. In addition, it was configured as a strategy for humanization in the CAPS. Was presented, however, operational difficulties related to the environment and to the effectiveness of the network of attention. 

Final considerations: The host device configured for reorienting health practices, enhancing the consolidation of psychosocial care model, with humanization and increased solvability. However, challenges remain to be overcome, related to the environment and to the effectiveness of the network of care.

from International Archives of Medicine

Information and communication technology for obstetric good practices

Objective: to investigate the use of information and communication technologies in good obstetrical practices.

Results and Discussion: the studies found have dealt with the use of different information technologies, demonstrating that they are essential to good obstetrical practices because they provide security and greater access to information, as well as provide a more efficient diagnosis and consequently an adequate treatment.

Conclusion: It is essential to use the technologies to achieve good obstetric practices throughout the health team. However, it is still necessary to carry out studies, as well as the creation of software that gives greater security to the welfare practices.  

Descriptors: Information Technology; Obstetrics; Software; Professional Practice.

from International Archives of Medicine

Factors Associated With Diabetic Neuropathy In Rats: A Systematic Review With Metanalysis

Diabetic neuropathy refers to a group of symptoms associated with the nerve’s damaged ability to perform its functions correctly. Symptoms may vary from paresis to pains that mainly affect sensitive or motor long nerves of feet and hands. Hence, experiments and analysis carried out with rodents, especially rats, allow several clinical interfaces to be known. Therefore, the aim of this study was to analyze the factors associated with diabetic neuropathy in rats. This is a systematic review with metanalysis. Data collection followed some prior
election criteria. The sources of information for the researched data are the databases MEDLINE/PubMed and Scopus. The research was conducted using the keywords found in descriptors/MeSH: rats, diabetic neuropathies, and risk factors with the Boolean operator “AND”.

The BioEstat 5.3 was used for statistical analysis, and the Odds Ratio was calculated with a 95% confidence interval (CI). Eighty-three references were found, of which 17 followed the criteria and were then included in the present review. Some factors like nerve morphology, blood hypertension, oxidative stress, diabetes period, hypoglycemic effect, vascular complications, and insulin parameters represent the main risk factors for the development of diabetic neuropathy, as well as diabetes induction in rats by using drugs. Such factors are very
similar to those from humans, thus requiring a deeper analysis of the theme in a considerable human sample.

from International Archives of Medicine

Advance directives of patient’s will: A study among resident physicians

Introduction: The advance directives of the patient’s will are a tool that prioritizes the will, intention and discernment of the patient, it was conducted in the form of a document that expresses the types of treatments that the individual wishes to receive in the instant that he or she is not able to make their own decisions anymore.

Objective: To investigate the level of agreement of resident physicians in a public hospital, about the Resolution 1995/2012 of the Federal Council of Medicine of Brazil which deals with Advance Directives.

Methods: This is a descriptive and exploratory study with a quantitative approach. To collect data, an adapted questionnaire containing socio-demographic questions and also questions about the subject was used, using the Likert scale. It was performed a descriptive and inferential statistical analysis by the Chi square adherence test.

Results: It was found that about 98% of the participants fully or partly agree to respect the wishes of the patients or their representatives, if they are unable to express themselves. However, 73% of participants reported to disregard the wishes of the patient if they contravene the Medical Ethics Code and 76.9% of physicians agree that advance directives should be recorded in the medical record. It is noteworthy that expressed favorable that the wishes of the patient prevails over the wishes of the family.

Conclusion: It is noticed that the physicians participating in the research, understand and agree with the assumptions of Resolution 1995/2012 of the Federal Council of Medicine of Brazil, which guides as the Advance Directives, considering it adequate and appropriate to direct medical action against dilemmas and conflictive situations that commonly arise in the management of patients in terminal condition.

from International Archives of Medicine

Night Work And Its Implications In The Quality Of Life Of Nurses

Objective: to know the consequences that night work can bring to the quality of life of nurses, identifying the strategies adopted by nurses to stay healthy.

Method: descriptive, mixed-approach (quanti-qualitative) research, carried out with nine Nursing professionals. Data were collected in June 2016.

Results: The male gender (77.7%) prevailed, the working time in the sector was between 1 and 5 years (55.5%), with the majority still working overtime (66.6%). Most participants report being dissatisfied with the quality of their sleep, although 88.8% of professionals say they are satisfied with their quality of life. From the testimonies, we obtained the meanings that were grouped in the categories: “It is something related to my health”, “It interferes with my work, family and leisure …”, Night work and basic necessities.

Conclusion: It was found that night work has negative social impacts that affect workers’ personal and social lives. These negative aspects are compounded by poor working conditions, double working hours, overtime, among other factors.

from International Archives of Medicine