to identify the prevalence of smoking in nursing professionals and to determine the relationship of the habit with clinical and socio-demographic characteristics.
nursing professionals of a ...cardiovascular hospital answered a questionnaire on smoking and dependence degree, socio-demographic characteristics, personal and family background, smoking characteristics, motivational stages, depression, perceived and occupational stress. The relationship between the explanatory variables and smoking was investigated.
among 656 participants, 77.6% were non smokers, 12.2% former smokers, and 10.2% smokers. Most were female, with complete high school, Catholic, married, household income between three and five minimum wages, position as nursing assistant, had double shifts, and were responsible for family income. The nicotine dependence of smokers ranged from low to moderate.
the study has shown low prevalence of smoking in nursing professionals. Education level, religion, marital status, job position, responsibility for family income, history of depression and alcoholism, chest "wheezing" and other symptoms were significantly associated with being a smoker or former smoker.
OBJECTIVE
To investigate the association of nursing diagnoses (NDs) identified for patients with heart failure (HF) based on their hemodynamic profiles.
METHOD
Analytical, cross‐sectional study ...conducted in the emergency room of a public hospital in a large cardiology center in Brazil. One hundred medical records of patients with HF whose hemodynamic profile had been established were analyzed.
RESULTS
The main NDs identified were risk of infection, bathing self‐care deficit, risk for decreased cardiac output, risk for falls, and excess fluid volume. There was no statistically significant difference (p > .05) between the different hemodynamic profiles and the ND found.
CONCLUSION AND IMPLICATIONS
Nurses need to develop skills for improving their diagnostic abilities to ensure implementation of consistent interventions.
To define donors' profile of an Organ and Tissue Procurement Center and compare the family consent for tissue donation before and after modification of the Donation Term.
A descriptive, documentary ...and quantitative study performed in an Organ and Tissue Procurement Center, analyzed 111 feasible donors' charts in the period from March 13 to September 13, 2010 (1st period), and from September 14, 2010 to March 14, 2011 (2nd period), based on the modification date.
The mean age of donors was 45.2 years, being 52.3% female. The causes of death included cerebral vascular accident (stroke) (64%), head trauma (27%), anoxic encephalopathy (2.7%), firearm injuries (2.7%) and others (3.6%). The notifications were predominantly of spontaneous origin (91%). Comparing the periods before and after the modification of the Donation Term, the donation consent for cornea increased by 17.2% and the consent for skin, bones, tendons and muscles had a discreet increase by 3.1%, 9.9% and 0.4%, respectively. On the other hand, there was decrease in consent for blood vessel (0.8%) and heart valves (4.1%) between the two periods.
There was increase in family consent for donation of most tissues, but it was statistically significant only for cornea donation.
A trustful relationship between transplant patients and their transplant team (interpersonal trust) is essential in order to achieve positive health outcomes and behaviors. We aimed to 1) explore ...variability of trust in transplant teams; 2) explore the association between the level of chronic illness management and trust; 3) investigate the relationship of trust on behavioral outcomes. A secondary data analysis of the BRIGHT study (ID: NCT01608477; https://clinicaltrials.gov/ct2/show/NCT01608477?id=NCT01608477&rank=1) was conducted, including multicenter data from 36 heart transplant centers from 11 countries across four different continents. A total of 1,397 heart transplant recipients and 100 clinicians were enrolled. Trust significantly varied among the transplant centers. Higher levels of chronic illness management were significantly associated with greater trust in the transplant team (patients: AOR= 1.85, 95% CI = 1.47-2.33,
< 0.001; clinicians: AOR = 1.35, 95% CI = 1.07-1.71,
= 0.012). Consultation time significantly moderated the relationship between chronic illness management levels and trust only when clinicians spent ≥30 min with patients. Trust was significantly associated with better diet adherence (OR = 1.34, 95%CI = 1.01-1.77,
= 0.040). Findings indicate the relevance of trust and chronic illness management in the transplant ecosystem to achieve improved transplant outcomes. Thus, further investment in re-engineering of transplant follow-up toward chronic illness management, and sufficient time for consultations is required.
To assess hospital costs associated with coronary artery bypass grafting performed on elective coronary patients, and the relation of costs with the number of grafts.
Descriptive prospective study ...carried out at Instituto Dante Pazzanese de Cardiologia in April, May and June of 2005. Coronary patients of different ages and both genders were included. Emergency patients, patients with other associated heart conditions and reoperation cases were excluded. Appropriate forms for the operating room, early postoperative period and for the final period in the ward were developed for the initial hospitalization phase preoperatively.
The procedure was performed on 103 patients, at an average cost of R$6,990.00 (US$2,784.98), at a minimum of R$5,438.69 (US$2,166.81), and maximum of R$11,778.96 (US$4,692.81); standard deviation was R$1,035.47 (US$412.54) and the confidence interval was 95%, ranging from R$6,790.33-R$7,190.27 (US$2,705.31-US$2,864.67). The total average cost for three to five bypass grafts was higher (R$7,148.05) than for one and two bypass grafts (R$6,659.29) and the difference was significant (p < 0.05).
The highest average costs were in the operating room (R$4,627.97), and in the early postoperative period (R$1,221.39), followed by costs incurred in the ward after the early postoperative period (R$840.04) and by the initial preoperative period in the ward (R$300.90).
O número de transplantes de tecidos vem crescendo significativamente nos últimos dez anos. É considerado doador efetivo de tecidos o doador potencial com o diagnóstico de morte encefálica ou coração ...parado, do qual a família autorizou a doação de ao menos um tecido. Objetivo: Analisar o desfecho das notificações de possíveis doadores recebidas por um Serviço de Procura de Órgãos e Tecidos nos anos de 2011 e 2012, com relação à doação de tecidos e caracterizar os doadores efetivos de tecidos viabilizados nesse período. Método: Estudo documental, retrospectivo, descritivo-exploratório de abordagem quantitativa, realizado em um Serviço de Procura de Órgãos e Tecidos da cidade de São Paulo, através da análise das notificações de possíveis doadores recebidas nos anos de 2011 e 2012 e prontuários de doadores efetivos de tecidos viabilizados nesse período. Resultados: Das 785 notificações recebidas, 471 (60%) culminaram em entrevista familiar, e destas, 256 (54,3%) obtiveram consentimento familiar para doação, sendo que 225 (87,9%) consentiram a doação de ao menos um tecido. Houve predominância de doadores do sexo masculino (58,2%), referidos católicos (39,6%), com média de idade de 44,7 anos, e causas-óbito de origem não traumática (60%). Os tecidos mais doados foram: valvas cardíacas (96%), seguido pelas córneas (84%), vasos (55,6%), ósteo-tendinoso (45,3%) e pele (43,6%). Conclusão: Não foi possível estabelecer relação de significância entre as variáveis de caracterização e todos os tecidos doados. Números aquém do esperado para a doação de tecidos fazem necessárias estratégias educativas voltadas à população e capacitação dos profissionais, visando elevar a disponibilidade de tecidos para transplante, contribuindo para o aumento da sobrevida de milhares de pessoas.
O tratamento com Warfarina reduz a capacidade de coagulação do sangue, sendo acompanhado laboratorialmente pelo tempo de protrombina expresso como no índice de normatização internacional(INR). ...Fatores socioeconômicos, culturais e a terapêutica podem influenciar os resultados. Objetivo: caracterizar pacientes em uso de Warfarina e identificar fatores que colaboraram para o INR permanecer fora da faixa terapêutica (INR <2,0 ou >3,0). Estudo descritivo exploratório utilizando instrumento de coleta de dados, com as variáveis: caracterização do paciente, uso da Warfarina e sua forma de utilização, hábitos alimentares, atividade física, controle do INR. Amostra foi de 38 pacientes que recebiam Warfarina há trinta dias com INR fora da faixa terapêutica. Os pacientes apresentavam hábitos alimentares inadequados, interação medicamentosa da Warfarina com antibióticos e antiarrítmicos e adesão prejudicada ao tratamento.
To assess and compare the prevalence of medication nonadherence (MNA) (implementation and persistence) to immunosuppressants and co-medications in heart transplant recipients.
MNA prevalence was ...assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (self-report) and compared using logistic regression in a 4-continent sample of 1397 heart transplant recipients from 36 heart transplant centers in 11 countries.
MNA was significantly (α = 0.05) higher to co-medications than to immunosuppressants (taking nonadherence: 23.9% vs 17.3%; odds ratio OR = 1.5; 95% CI, 1.30–1.73; drug holiday: 5.7% vs 1.9%; OR = 3.17; 95% CI, 2.13–4.73; dose alteration: 3.8% vs 1.6%; OR = 2.46; 95% CI, 1.49–4.06; and discontinuation: 2.6% vs 0.5%; OR = 5.15; 95% CI, 2.36–11.20).
The observed MNA necessitates adherence-enhancing interventions encompassing the entire post–heart transplant medication regimen. ClinicalTrials.gov identifier: NCT01608477.
O tratamento com Warfarina reduz a capacidade de coagulação do sangue, sendo acompanhado laboratorialmente pelo tempo de protrombina expresso como no índice de normatização internacional(INR). ...Fatores socioeconômicos, culturais e a terapêutica podem influenciar os resultados. Objetivo: caracterizar pacientes em uso de Warfarina e identificar fatores que colaboraram para o INR permanecer fora da faixa terapêutica (INR <2,0 ou >3,0). Estudo descritivo exploratório utilizando instrumento de coleta de dados, com as variáveis: caracterização do paciente, uso da Warfarina e sua forma de utilização, hábitos alimentares, atividade física, controle do INR. Amostra foi de 38 pacientes que recebiam Warfarina há trinta dias com INR fora da faixa terapêutica. Os pacientes apresentavam hábitos alimentares inadequados, interação medicamentosa da Warfarina com antibióticos e antiarrítmicos e adesão prejudicada ao tratamento.
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