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Patient safety strategies in care transitions: Integrative review
Introduction: Patient safety is essential for healthcare quality, especially during care transitions, which are a critical point in healthcare. During these times, responsibilities and information are transferred between different levels of care, with the goal of ensuring continuity of care and patient safety. Objective: Analyze the scientific production on patient safety strategies applied to care transitions. Methods: This is an integrative literature review, with searches in several databases, covering articles published between 2014 and 2024. Only full-text articles in Portuguese, English, and Spanish were included. The analysis involved the selection of articles based on relevance criteria, followed by detailed reading and synthesis of the results. Results: Eight articles were analyzed after applying the inclusion and exclusion criteria, showing that patient safety strategies in care transitions focus on two main approaches. Structured communication, through specific methodologies, promotes the standardization of information and safe decision-making. Risk management is carried out through checklists and protocols, which assist in discharge planning, medication reconciliation, and the engagement of the patient and their support network. Conclusion: It was found that the use of structured tools strengthens safety, reduces risks and readmissions, in addition to optimizing resources and ensuring continuity of care. However, the lack of studies on the transition between levels of care compromises the applicability of the results and the formulation of more comprehensive public policies.
Transitional Care; Patient Safety; Health Strategies; Nursing.
Copyright (c) 2025 Sabrina Martins Vilas Boas , Rejane Santos Barreto , Endric Passos Matos, Simone Santos Souza , Sônia Maria Isabel Lopes Ferreira , Nayara Mary Andrade Teles Monteiro , Nathalie Campana de Souza , Rafaely de Cassia Nogueira Sanches (Autor) https://creativecommons.org/licenses/by/4.0
Negative pressure wound therapy in the treatment of complex wounds: contributions and challenges for nursing practice
Introduction: Complex wound care represents a growing challenge for healthcare systems globally. Several technological innovations have proven effective in treating complex wounds, including negative pressure wound therapy (NPWT). Objective: To describe the contributions and challenges of negative pressure wound therapy (NPWT) in treating complex wounds, with an emphasis on the role of nurses. Methods: A narrative literature review was conducted between February and June 2025, using the Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), and the Medical Literature Analysis and Retrieval System Online via PubMed databases, covering the period 1997 to 2024. Results: Thirty-eight studies and 12 articles were identified, and four institutional documents met the established criteria, totaling 16 data sources. The findings demonstrated that NPWT provides significant benefits, such as reducing exudate, stimulating granulation tissue formation, preventing infections, and accelerating healing. Conclusion: NPT has a positive impact on the evolution of complex wounds, strengthening the role of nursing as a central agent in the application and monitoring of the technique.
Negative-Pressure Wound Therapy; Wounds and Injuries; Nursing.
Copyright (c) 2025 Vanessa Schiavo, Reginaldo Oliveira (Autor) https://creativecommons.org/licenses/by/4.0
Measurement and verification of gastric tube positioning in newborns: comparison between nurses practice and evidence
Introduction: Accurate measurement and verification of gastric tube placement in newborns is essential to ensure patient safety and prevent complications such as aspiration, perforation, and nutritional failures. Despite its importance, studies reveal discrepancies between clinical practice and evidence-based recommendations, highlighting the need to assess the role of nursing professionals in this context. Objective: To describe the practice of neonatal nurses regarding methods of measuring and verifying gastric tube placement in newborns, comparing them with the literature. Methods: Exploratory, cross-sectional, and quantitative study, using a questionnaire applied to neonatal unit nurses. Results: Forty-seven nurses participated, 95.7% women (n=45), with a mean age of 40.3 years; 100% (n=47) were specialized in neonatology. The most used technique for nasogastric tubes (NGT) was NEX (nose–ear–xiphoid appendix), used by 59.6% (n=28), also predominant for orogastric tubes (40.4%, n=19). Although all participants considered their knowledge good or excellent, only 4.3% (n=2) simultaneously employed the recommended strategies. Epigastric auscultation was the most cited verification method (85.1%, n=40), followed by chest-abdominal X-ray (66.0%, n=31) and gastric residuals (40.4%, n=19). None used the pH test. No significant association was found between adequate practices and professional experience or training. Conclusion: A misalignment with evidence was identified, mainly due to the predominant use of the NEX technique. Methods such as NEMU (nose–ear–midpoint between xiphoid appendix and umbilicus) and pH measurement were scarcely adopted, reinforcing the need for training, protocols, and adherence to safe practices.
Enteral nutrition; Newborn; Neonatal Nursing; Intensive Care Units.
Copyright (c) 2025 Victória Braga Quaglia, Keila Kiyomi Seki de Melo (Autor) https://creativecommons.org/licenses/by/4.0
Determinants of Sleep Quality in Final-Year Nursing Students
Introduction: Sleep is a physiological process essential to the body's homeostasis, with a direct impact on physical and mental health, as well as functional performance. Among nursing students, especially those in the final stages of their undergraduate studies, various factors may negatively affect sleep quality, compromising academic performance and clinical practice capabilities. Objective: This study analyzed the association between sociodemographic, economic, and work-related variables and the sleep patterns of final-year undergraduate nursing students. Methods: A cross-sectional study with a quantitative approach was conducted. Data were collected in September 2024 from 250 students enrolled at a higher education institution. Results: The evaluation revealed a predominance of poor sleep classification in 98.8% (247) of participants, with 62.8% (157) scoring within the range indicating the presence of sleep disorders. Students without leisure time were 3.58 times more likely to have habitual sleep efficiency below 65% (p = 0.038). Exhausted participants were 2.55 times more likely to experience significant daytime dysfunction (p = 0.016) and 3.96 times more likely to present sleep disorders (p = 0.016). Conclusion: Regression analysis revealed that fatigue level and leisure time are the main factors impacting sleep quality among students.
Sleep quality; Sleep Deprivation; Students; Nursing; Universities.
Deborah Elaine Caristo Santiago de Farias
Copyright (c) 2025 Italo Everton Bezerra Barbosa, Breno de Souza Mota , Raquel Josefina de Oliveira Lima , Nathalia Rugeri Chinelatto , Glauteice Freitas Guedes , Eliane Caixeta de Lima Lucas , Claudia Dos Santos Oliveira , Deborah Elaine Caristo Santiago de Farias (Autor) https://creativecommons.org/licenses/by/4.0
The use of cartilha as educational technology: trends in national scientific production
Introduction: The card is considered a mild educational technology, capable of dialogue with different audiences and sociocultural realities, favoring the empowerment of subjects and the incentive to autonomy rather than health care. Objective: Identify the trends in Brazilian production of theses and dissertations, in the area of Health Sciences, regarding the construction of books as educational technology. Methods: Narrative review developed from the quest: “What are the national tendencies of Teses e Dissertações sobre da construção de cartilhas como Tecnologias Educacionais?” The queue is based on data Catalog of Theses and Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The end result is due no later than June 2024. The criteria include studies on construction and/or validation of educational technologies in chart format in the hospital context. Studies that do not address the review question and criteria presented are excluded. To analyze two results in a descriptive manner and using absolute (n) and relative frequencies (%). Foram included 22 studies, of these 21 were dissertações and one these. Results: Within the educational cards, forums built for more, countries and/or caregivers of children with some chronic condition (31.8%, n=7) and for adult patients with some chronic disease (22.7%, n=5). Other three studies for patient safety promotion actions, including stay prevention and safe surgery. Conclusion: Construction of cards is a current product, developed, predominantly, in public universities in the area of Child and Adolescent Health and for more, country and/or caregivers of children with some chronic conditions, being developed, predominantly, in Post-Graduation Program in Enfermagem.
Educational Technology; Nursing; Health Sciences.
Copyright (c) 2025 Ana Graciele de Freitas Gomes, Taís Carpes Lanes, Graziele de Lima Dalmolin , Katiane Sefrin Speroni, Mariângela Herzog (Autor) https://creativecommons.org/licenses/by/4.0
Sociodemographic and health profile of people with chronic kidney disease undergoing hemodialysis treatment
Introduction: chronic kidney disease is a noncommunicable chronic condition with increasing prevalence over time. Objective: To identify and describe the socioeconomic profile, lifestyle habits, disease status, and treatment of individuals with chronic kidney disease undergoing hemodialysis. Methods: this was a cross-sectional study involving 142 individuals undergoing hemodialysis at a center in southern Minas Gerais. An adapted participant characterization questionnaire was used, and data were collected during hemodialysis. Data were presented using descriptive statistics, with absolute and relative frequencies for categorical variables and measures of central tendency for numerical variables. Results: most individuals undergoing treatment were male, aged 60 to 69, Catholic, with a monthly family income of up to R$1,500.00, receiving financial benefits, not working, married/in a stable relationship, with incomplete elementary education, owning their own home, not consuming alcohol or smoking, having at least one chronic disease, taking up to five continuous medications, diabetes mellitus as the etiology of chronic kidney disease, having an arteriovenous fistula, and having been undergoing treatment for at least one year. Conclusion: by providing knowledge about sociodemographic and health aspects, such as gender, age, marital status, lifestyle habits, chronic diseases, medications taken, and duration and duration of therapy, there is collaboration in improving knowledge and practices, strengthening the interaction between professionals working in the health care of people undergoing treatment for chronic kidney disease.
Health Profile; Renal Dialysis; Renal Insufficiency; Nursing Care.
Copyright (c) 2025 Ingrid Fernanda de Oliveira Vieira, Denismar Alves Nogueira, Patrícia Scotini Freitas, Fábio de Souza Terra (Autor) https://creativecommons.org/licenses/by/4.0
Prognosis of cardiorespiratory capacity in heart failure by exercise testing: Narrative review
Introduction: Heart disease, such as heart failure, is a global problem with high morbidity and mortality. The six-minute walk test is a useful and low-cost tool for assessing the functional capacity of these patients. This review explores the use of the six-minute walk test, including indications, contraindications, and methodological criteria, to aid in the prognosis of the condition. Objective: To demonstrate the importance of the Six-Minute Walk Test as a tool for assessing cardiorespiratory capacity and predicting outcomes in patients with heart failure. Methods: This is a narrative literature review based on a search of databases Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (Lilacs) and PubMed, using descriptors in both Portuguese and English related to heart disease, heart failure, cardiopulmonary testing, and the six-minute walk test. Studies published between 1999 and 2024 were selected. Results: Predictors in the elderly were observed, protocols were compared in patients with heart disease, and predictive equations were developed for the Brazilian population and the impact of BMI on lung function in children with asthma was analyzed. The findings highlight the importance of the 6MWT in functional assessment, prediction of peak VO2, and identification of performance-related factors in diverse populations. The study categories include heart failure, COPD/asthma, and normative studies. Conclusion: The Six-Minute Walk Test is a practical, accessible, and valuable prognostic tool in clinical practice, particularly for patients with heart failure. Despite its proven effectiveness, it has limitations related to the influence of anthropometric characteristics and the lack of more precise hemodynamic data. Therefore, standardizing the test and encouraging further research to improve its applicability, considering the specificities of cardiac patients, is essential.
Walk Test; Heart Failure; Functional Status; Exercise Test; Prognosis.
Adalgiza Mafra Moreno Adalgiza Mafra Moreno
Copyright (c) 2025 André Custódio da Silva, Adalgiza Mafra Moreno, Luiz Felipe Pereira de Souza, Andrey Rocha Lopes, José Alexandre Odir Golim, Wilson Gomes Costa, Sérgio Chermont, Manoel Gonçalves Neto, Vanney da Silveira Rocha, Marco Orsini (Autor) https://creativecommons.org/licenses/by/4.0
Tuberculosis: what's new in treatment and clinical Monitoring
Introduction: Tuberculosis remains a major global public health problem due to its high incidence and mortality, especially in developing countries. Objective: To analyze new approaches to the treatment and clinical monitoring of tuberculosis in Brazil. Methods: The articles were searched in the Scientific Electronic Library Online (SciELO), US National Library of Medicine (PubMed), and Latin American and Caribbean Literature in Health Sciences (LILACS). Studies published between 2017 and 2025, in Portuguese or English, that directly addressed the topic were included. The search was conducted using the keywords “tuberculosis,” “Mycobacterium tuberculosis,” “innovative treatments,” and “clinical management.” Duplicate articles, publications prior to 2017, and those that did not directly address the pathology were excluded. In the end, 15 studies were analyzed. Results: The studies analyzed highlighted the main innovative approaches to the treatment of tuberculosis, including new pharmacological therapies, clinical monitoring strategies, and advanced diagnostic methods. The development of new therapeutic regimens for multidrug-resistant cases and the improvement of patient monitoring techniques were identified as relevant advances in the area. Conclusion: Innovations in the treatment and clinical monitoring of tuberculosis are essential for disease control, especially in vulnerable populations. The integration of new therapies, early diagnosis and improved clinical monitoring contributes to better outcomes in tuberculosis management.
Disease Management; Mycobacterium Tuberculosis; Treatment; Tuberculosis.
Copyright (c) 2025 Danielle Camara de Vasconcelos Rios, Vladimir Cavalcanti Rios, Caio Moraes Lins, Fábio Salles Azevedo, Ingrid Pinheiro da Silva, Lívia Fernandes Sardinha, Antonio Carlos de Freitas da Silva, Luciana Armada, Marco Orsini (Autor) https://creativecommons.org/licenses/by/4.0
Nurses' role in prevention and treatment of syphilis during prenatal care: integrative review
Introduction: Syphilis is a sexually transmitted infection (STI) unique to humans, curable with appropriate treatment. It increases the risk of miscarriage and perinatal death and is the disease with the highest rate of transmission during pregnancy. Objective: The role of nurses in the prevention and treatment of syphilis during prenatal care was described. Methods: This integrative literature review was conducted between February and May 2025. The bibliographic search was conducted in the databases that make up the Virtual Health Library and the Scientific Electronic Library Online (SciELO), using the Health Sciences Descriptors (DECS) "Syphilis”," "Prenatal consultation," and "Nurse," and the alternative term "Pregnancy". Articles from the period 2019 to 2024 were included. Microsoft Excel was used for publication selection. Results: The search identified 25 articles, 5 in SciELO and 20 in the VHL databases. After reading, the sample consisted of 10 articles. Studies showed that nurses can perform a series of activities during prenatal care, aiming at the prevention and treatment of syphilis, always guided by health education, humane treatment, and building a bond with the patient and partner. Conclusion: This study identified actions related to the work of nurses in syphilis prevention. gestational and in the treatment of the disease during pregnancy, acting comprehensively from the moment the pregnant woman and her partner are welcomed.
Copyright (c) 2025 Jean Wohnrath, Carolina Elizabete Alves de Sousa (Autor) https://creativecommons.org/licenses/by/4.0
Assessment of child health services in primary care: Literature review
Introduction: The evaluation of child health services in Primary Health Care (PHC) is essential to ensure quality care. Objective: To describe Brazilian postgraduate scientific productions related to the evaluation of child health services in Primary Health Care. Methods: This is a bibliographic research, using a narrative literature review approach, based on a search for information in the CAPES Theses and Dissertations Catalog (Coordination for the Improvement of Higher Education Personnel). The search strategy employed the Portuguese descriptors “saúde da criança” (child health), “atenção primária à saúde” (primary health care), and “avaliação dos serviços de saúde” (health services evaluation), combined using the Boolean operator AND. The search was conducted in June 2024, with no time restriction. The inclusion criteria were: national theses and dissertations, with no restriction on the field of knowledge and without a time limit, that addressed the review question, which allowed the identification of trends in scientific production on the topic. Exclusion criteria included: studies not available in the CAPES Theses and Dissertations Catalog and scientific works not conducted within the scope of PHC. Results: Twelve studies were selected, including eight master's dissertations and four doctoral theses, most of which originated from Nursing postgraduate programs. The Midwest region was the only one that did not present any studies, while the South region concentrated the majority of them. The predominant methodological approach was quantitative, and the main evaluation tool used was the Primary Care Assessment Tool (PCAT). Conclusion: The quality of child health care in Primary Health Care remains below ideal standards, indicating the need to improve the services offered in PHC, including the strengthening of the child care network and the qualification of health professionals.
Child Health; Primary Health Care; Health Services Research.
Copyright (c) 2025 Vanessa Gross, Leonardo Bigolin Jantsch, Nathália Huffell Boézzio (Autor) https://creativecommons.org/licenses/by/4.0
Inequalities in sexual and reproductive health access for migrant and refugee women in humanitarian contexts
Introduction: Migrant and refugee women face multiscale barriers political, organizational and sociocultural that undermine access to sexual and reproductive health (SRH) in humanitarian crises. Objective: This study analyzed the SRH conditions of refugee women in humanitarian crisis settings. Methods: A scoping review was conducted following Joanna Briggs Institute (JBI) guidance and the PRISMA-ScR protocol for scoping reviews. The PCC mnemonic (Population/Concept/Context) guided searches in Latin American and Caribbean Health Sciences Literature (LILACS), International Literature in Health Sciences (Medline/PubMed), CINAHL and Scopus (Elsevier), carried out in February–April 2025 without temporal limits. Studies conducted in Africa, the Americas, Europe, the Middle East and Asia were included. Twenty-four articles met eligibility criteria: 10 observational quantitative studies, 6 controlled trials, 5 qualitative studies and 3 mixed-methods studies. Results: Macro-level barriers (underfunding, restricted security coverage), meso-level barriers (service overload, lack of interpreters, pandemic interruptions) and micro-level barriers (stigma, trauma, partner surveillance) were identified. Low-cost strategies Human Immunodeficiency Virus (HIV) self-testing via mHealth apps, obstetric vouchers, guided self-help showed point efficacy, contingent on confidentiality and cultural mediation. Critical gaps persist in menstrual hygiene, climate-related gender-based violence and cost-effectiveness analyses. Conclusion: Equity in SRH demands multiscale ecosystems that integrate countercyclical funding, culturally mediating services and secure technologies, with active participation of refugees themselves.
Refugees; Sexually Transmitted Diseases; Reproductive Health; Women; Sexual Health.
Copyright (c) 2025 Luciene Rodrigues Barbosa (Autor) https://creativecommons.org/licenses/by/4.0
The first human impression is the one that lasts: a point of view on Artificial Intelligence in Medicine
In the wake of critical and deep thinking, we fear that the use of Artificial Intelligence (AI) tools in medical practice may negatively impact critical thinking skills. Human traits including empathy, social and emotional intelligence, the capacity and willingness to think deeply and apply moral judgment, and mental well-being may reach their nadir in the next decade. This opinion article warns of the risks of a distancing of knowledge and thought in the analysis of care, in addition to the increase in professional autonomy in clinical medicine. Will we be just digital assistants or doctors capable of performing tasks and diagnoses independently?
Artificial Intelligence; Thought; Clinical Medicine; Professional Autonomy; Knowledge.
Copyright (c) 2025 Marco Antônio Orsini, Micheli Verginia Ghiggi, Marcos RG de Freitas, Carlos Henrique Melo Reis, Marco Antônio Araújo-Leite, Acary Souza Bulle Oliveira, Luciana Armada (Autor) https://creativecommons.org/licenses/by/4.0
The role of primary care nurses in the care of agricultural workers exposed to pesticide use: integrative review
Introduction: Nurses working in Primary Care are essential for the management of care for rural workers exposed to the use of pesticides. Objective: The scientific evidence on the performance of Primary Health Care nurses in the care of rural workers exposed to the use of pesticides was described. Methods: this is an integrative review, registered in Figshare, using the question: what is the scientific evidence on the performance of Primary Health Care Nurses in the care of rural workers exposed to the use of pesticides? The inclusion criteria were: primary studies that answered the guiding question, in Portuguese, English and Spanish, and covered the cut-off period from 2012 to 2024. The searches were carried out in the following information sources: LILACS, PubMed, SCOPUS, Web of Science and Cinahl with descriptors and alternative terms/synonyms, such as nursing, rural workers, agrochemicals, among others, both selected in the Science and Health Descriptors, Medical Subject Headings and Cinahl Subject Headings, in addition to keywords, such as rural work and insecticides. The Endnote and Rayyan software were used, maintaining blinding between two reviewers, with the assistance of a third reviewer in cases of conflicts. In addition, the Classification of Levels of Evidence and assessment of methodological quality were carried out. Results: A total of 800 studies were found, 21 were fully evaluated, and finally, seven were included. They were published from 2012 onwards and in English and/or Portuguese, with levels of evidence IV and VI, and four thematic categories were developed. Conclusion: It is concluded that the role of nurses in Primary Health Care is essential in the care of rural workers. However, there is a lack of scientific evidence, requiring further research.
Nursing; Rural Health; Agrochemicals; Primary Health Care.
Copyright (c) 2025 Ana Lyvia da Silva Santos, Bruna Paiva da Silva, Roberta Seron Sanches, Vânia Regina Bressan, Melissa Lúcia Melo, Fábio de Souza Terra (Autor) https://creativecommons.org/licenses/by/4.0
Aquela ciência que aprendemos na escola e, obviamente, na época da adolescência não se insere nesse contexto. Médicos voltados exclusivamente para pesquisa de ponta no Brasil são escassos. A falta de investimentos significativos, associada à instabilidade político-governamental, representa grandes entraves. É impossível que um aluno de mestrado, doutorado e mesmo pós-doutorado produza com o capital ofertado pelas “grandes” fundações, conselhos e instituições brasileiras. Pesquisas que se revelam promissoras são exportadas junto ao pesquisador. Além disso, quando possuímos algum artigo de relevância média, não buscamos nossas revistas entregamos de bandeja ou mesmo pagamos por nossa propriedade intelectual. Posteriormente, compramos com preços mais altos. Podemos nos comparar ao café e à cana-de-açúcar. Faltam laboratórios, equipamentos, insumos e financiamento. Não há um ambiente onde a ciência possa ser feita e, sem isso, não há como formar ou manter médicos-cientistas. Atualmente, a qualidade técnica dos novos alunos de mestrado e doutorado está extremamente fraca com trabalhos que, antes, nem eram considerados para notas mínimas de término de graduação. Existe uma forte tendência de que os programas de mestrado acabem… sabemos disso. A ausência de pensamento científico gera um custo humano e financeiro muito alto para o Brasil. Para que pensar se existem os guidelines e consensos? Infelizmente, alguns partem dessa premissa. Hoje, conselhos brigam por provas de títulos, avaliações de futuros colegas médicos e outras trivialidades. Mas esquecem de um ponto nevrálgico! Deparamo-nos com um volume excessivo de exames e medicamentos prescritos sem critério; pois, por anos, foi criado uma espécie de algoritmo de prática médica, que é baseado apenas em diretrizes, mas sem reflexão crítica, e isso leva à perda de eficácia e, consequentemente, ao empobrecimento do pensamento fora das quatro linhas. O médico precisa entender o contexto e fazer as perguntas certas é assim que se inicia uma pesquisa. Algumas semanas atrás, conversei com um amigo italiano sobre nossas realidades especialmente em relação à fuga de cérebros e à dificuldade de manter talentos no país. Ninguém quer deixar o seu “fruto” científico no Brasil só por amor.
Copyright (c) 2025 Marco Antônio Orsini, Marcos RG de Freitas, Carlos Henrique Melo Reis, Acary Bulle Oliveira, Luciana Armada (Autor) https://creativecommons.org/licenses/by/4.0
Impact of continuing education on medication administration: improvements in nursing practice
Introduction: Continuing education is essential for improving nursing team performance, promoting patient safety and the quality of care. It supports professional development, evidence-based practice, and the reduction of adverse events. Objective: This study evaluated how continuing education influences medication administration by the nursing team, identifying improvements in care practices and patient safety. Methods: This is an interventional study with a structured approach aimed at identifying and solving problems in the context of nursing care. Data were collected through the analysis of adverse events reported by nurses at a philanthropic hospital in southern Minas Gerais, Brazil, between January and December 2023. The study included 8 nurses and 48 nursing technicians, selected for their direct involvement in medication administration processes, ensuring adequate representation of their experiences and perspectives. Results: Of the 74 professionals, 81.08% (n = 60) were nursing technicians and 18.92% (n = 14) were nurses. After the educational intervention, there was a significant increase in knowledge regarding the “nine rights” of medication administration. Issues such as prescription, patient identification, and documentation were widely recognized. The educational intervention proved effective in promoting patient safety. Conclusion: The educational intervention contributed to increasing the nursing professionals’ knowledge of safe medication administration. The results show improvement in responses after the intervention, reinforcing the importance of continuing education in promoting patient safety.
Education; Drug Administration Routes; Patient Safety; Medication Errors; Professional Practice.
Copyright (c) 2025 Rodrigo Pereira Castilho, João Paulo Soares Fonseca (Autor) https://creativecommons.org/licenses/by/4.0
The pain that the street silences: inequality, health and vulnerability in a case report
Introduction: Social inequality, resulting from historical structures and power relations, directly influences access to rights and resources, affecting the health conditions of vulnerable populations. Objective: To analyze the impacts of social inequality on health through a qualitative case study. Methods: Case report of a 32-year-old man, homeless and HIV-positive, who developed severe cranial myiasis following a physical assault. Results: The patient went several weeks without medical care and was admitted with advanced infection, bone exposure, and larval infestation (Lucilia sericata), requiring antibiotic therapy and reconstructive plastic surgery. Conclusion: The case highlights how social vulnerability exacerbates clinical conditions and hinders timely access to care, reinforcing the need for a critical and equity-oriented professional approach in health.
Socioeconomic Factors; HIV; Public Health; Health Vulnerability; Social Responsibility.
Copyright (c) 2025 Micheli Verginia Ghiggi, Cesar Vieira Marques Filho, Marco Antônio Orsini, Eduardo Paranhos Jr., Adalgiza Mafra Moreno , Vanney da Silveira Rocha, Marcos RG de Freitas, Marco Antônio Araújo Leite, Carlos Henrique Melo Reis, Luciana Armada (Autor) https://creativecommons.org/licenses/by/4.0
Tele-nursing: a care model for difficult-to-access situations: an integrative review
Introduction: Telenursing, as a practice mediated by information and communication technologies, has proven to be a viable alternative to overcoming these barriers, contributing to continuity of care, clinical monitoring, and strengthening the bond between patient and healthcare team. Objective: To describe the impacts of telenursing as a care model for difficult-to-access situations. Methods: An integrative literature review was conducted in April and May 2025. It searched for publications in the Nursing Database, Medical Literature Analysis and Retrieval System Online, and Latin American and Caribbean Literature in Health Sciences using the Health Sciences Descriptors "telenursing," "information technology," and "telework." National studies published in Portuguese from 2020 to 2025 were included. Results: A number of positive outcomes were identified with the use of telenursing, as well as the technologies used for this purpose. However, some weaknesses in the process were also highlighted. Conclusion: This study identified positive impacts of telenursing, which can be an effective, safe, and sustainable solution for strengthening health care in hard-to-reach settings.
Telenursing; Teleworking; Health Services Accessibility.
Copyright (c) 2025 Maria Vitória Farias Lopes de Oliveira, Laura de Barros França, Rosa Caroline Mata Verçosa de Freitas (Autor) https://creativecommons.org/licenses/by/4.0
Moral distress and burnout syndrome among nurses: qualitative study in the hospital context
Introduction: Nursing is an essential profession, but it is often performed under adverse conditions that compromise the physical and mental health of professionals. Moral distress, resulting from the inability to act according to ethical principles, has proven to be a relevant factor in the development of Burnout Syndrome. Objective: This study analyzed the factors related to moral distress and Burnout syndrome and their manifestations on nurses' health in the hospital setting. Methods: A qualitative, descriptive, and exploratory study was conducted with 20 nurses from a federal public hospital. Data collection was performed through semi-structured interviews, and the data were analyzed using Discursive Textual Analysis. Results: The factors related to moral distress and Burnout syndrome include: working conditions, team relationships, work management, and ethical conflicts arising from inappropriate practices. The manifestations of moral distress and Burnout on health were identified as physical and psycho-emotional exhaustion, characterized as clinical signs of illness. Conclusion: Factors related to moral distress and Burnout syndrome and their manifestations of illness among nurses were identified.
Nursing; Psychological Distress; Psychological.
Copyright (c) 2025 Camila Antunez Villagran , Tais Carpes Lanes, Yasmin Kelly Alves da Silva , Camila Milene Soares Bernardi, Valdecir Zavarese da Costa , Graziele de Lima Dalmolin (Autor) https://creativecommons.org/licenses/by/4.0
High demand on emergency care units and nursing overload: an integrative literature review
Introduction: This study aims to understand the impacts of high demand in Emergency Care Units (UPAs) on the working conditions of the nursing team and its consequences for the physical and mental health of these professionals. Objective: An integrative literature review was carried out to describe how overcrowding in UPAs affects nursing professionals in their health practice. Methods: This is an integrative literature review carried out in the Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database (BDENF), and International Literature in Health Sciences (MEDLINE). Descriptors related to work overload, mental health, and nursing in the context of urgency and emergency were used. Results: The studies analyzed reveal that overcrowding in UPAs, combined with the shortage of professionals, deficient infrastructure, and excessive working hours, compromises the quality of care and causes physical and mental illness in the nursing team. The consequences include stress, exhaustion, and reduced job satisfaction. Conclusion: The findings point to the urgent need for public policies that improve working conditions, reorganize care flows and strengthen primary care, contributing to the valorization of nursing and the quality of care in emergency departments.
Nursing; Emergency Service; Mental Health; Quality of Health Care.
Copyright (c) 2025 Ianna Regina de Almeida Ferreira, Jandson Oliveira Soares, Alessandra Nascimento Pontes (Autor) https://creativecommons.org/licenses/by/4.0
Planned home birth: The main factors influencing the safety and accessibility of Home Birth in Brazil: An integrative review
Introduction: Planned Home Birth (PBD) has gained prominence as an alternative to the hospital model, especially among women seeking greater autonomy and protagonism in the childbirth process. In Brazil, access to this modality is still limited, mainly due to the lack of public policies in the Unified Health System (SUS), socioeconomic inequality, and the shortage of qualified professionals. Objective: This is an integrative literature review aimed at analyzing the main factors influencing the safety and accessibility of PBD in the Brazilian context. Methods: Thirteen articles published between 2014 and 2024 were analyzed, extracted from the Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), and the Nursing Database (BDENF). Results: The results indicate that PDP, when performed by trained professionals and with adequate infrastructure, is safe for low-risk pregnant women, with positive obstetric and neonatal outcomes. However, access to this modality is largely restricted to women from higher social classes, which reveals structural inequalities in the health system. The recent regulation of the role of obstetric nurses, through COFEN Resolution No. 737/2024, represents progress, but remains insufficient given the existing challenges. Conclusion: Strengthening professional training, expanding specific public policies, and valuing humanized care are essential to democratizing access to PDP in Brazil.
Home Childbirth; Humanizing Delivery; Obstetric Nursing; Women’s Health.
Copyright (c) 2025 Débora Carolinne Santos Feitosa Santana, Maria Beatriz Cantuaria Melo dos Santos , Larissa Lages Ferrer de Oliveira (Autor) https://creativecommons.org/licenses/by/4.0
Nursing audit in improving the quality of health care: Integrative review
Introduction: Nursing auditing is beginning to develop within healthcare institutions, aiming to ensure the quality of care and control of internal processes through systematic evaluation. Objective: To describe how nursing auditing contributes to the improvement of the quality of healthcare. Methods: This is an integrative literature review conducted through the scientific databases BDENF: Nursing Database, LILACS: Latin American and Caribbean Health Sciences Literature, and MEDLINE: Medical Literature Analysis and Retrieval System Online. A search and analysis of the most relevant studies was carried out to support the selection of the literature. Results: The analyzed articles highlight that health auditing, especially in the nursing field, plays a crucial role in qualifying the care provided, offering legal support for professional practices, and ensuring efficient resource management. Conclusion: Nursing auditing is an essential tool for systematically evaluating the care provided, identifying failures, standardizing processes, and promoting continuous improvements. It helps solve team problems, reinforces patient safety, and contributes to efficient and financially sustainable management. The nurse auditor is a critical and ethical agent, committed to quality and excellence in healthcare.
Nursing Audit; Comprehensive Health Care; Quality Improvement.
Copyright (c) 2025 Thaís Júlia Zumba Batista dos Santos, Sara Emilly Coutinho Alves, Rosa Caroline Mata Verçosa de Freitas (Autor) https://creativecommons.org/licenses/by/4.0
Impact of endometriosis on women's lives and the nursing care: integrative review
Introduction: Endometriosis is a chronic, inflammatory and benign gynecological disease that affects millions of women of reproductive age, compromising their quality of life, a fact that requires special attention from the nursing team. Objective: To describe the impact of endometriosis on women's lives, considering the multiple spheres affected, and to understand how nursing care can contribute to improving the quality of life of these patients. Methods: This is an integrative review, carried out by searching the Scientific Electronic Library Online (SciELO), the Latin American and Caribbean Literature on Health Sciences (LILACS) and Medical Literature Analysis and Retrievel System Online (MEDLINE) databases, and Google Scholar, using the controlled descriptors endometriosis and nursing care, in Portuguese, English, and Spanish. Publications from 2014 to 2024 were included. Results: The sample consisted of 8 publications. The main findings indicate that chronic pain related to endometriosis is the most disabling symptom, interfering with women's daily life and mental health. In addition, impacts on sex life, interpersonal relationships, professional performance, and self-esteem were observed. The role of nursing stands out as essential for welcoming, pain management, health education and psychosocial support. Conclusion: Endometriosis has a great impact on women's lives and nursing, through a humanized and comprehensive approach, is a fundamental agent for promoting the well-being of women with endometriosis, and it is necessary to expand the training of professionals and strengthen empathetic and evidence-based care practices.
Clara Regina de Oliveira Soriano Bomfim Valença
Copyright (c) 2025 Clara Regina de Oliveira Soriano Bomfim Valença, Larissa Lages Ferrer de Oliveira (Autor) https://creativecommons.org/licenses/by/4.0
Perception of the reception provided by health professionals in patients with mental disorders in the interior of Paraná – Brazil
Introduction: Mental health in Brazil, driven by the Psychiatric Reform and Law 10.216/2001, has advanced in the promotion of a more humanized and inclusive care, with a focus on deinstitutionalization and the guarantee of rights. Schizophrenia, which affects about 75 thousand Brazilians annually, requires early start of treatment and qualified reception. Objective: to analyze how the reception provided by the professionals of the CAPS I of Medianeira-PR influences the adherence to treatment of patients with schizophrenia. Methods: Using a mixed approach, with questionnaires and interviews. Results: The survey revealed that 100% (6) of the professionals recognize the importance of humanized care, based on active listening, empathy and family involvement. Among the main challenges pointed out are the limited time of care, resistance from patients and family members, and difficulties in geographic access to the service. The results reinforce that the construction of a therapeutic bond from the first contact is essential for the continuity of treatment. Conclusion: Integrated multiprofessional action and the adoption of empathetic practices are essential to promote greater adherence and better therapeutic outcomes, despite the structural limitations still faced by mental health services.
Psychiatric Reform; User Embracement; Mental Health.
Copyright (c) 2025 Kemilly Gabrieli de Almeida, Heffi Kerolain Schimidt, Augusto Cesar Kappes Sapegienski (Autor) https://creativecommons.org/licenses/by/4.0
Strategic management of obstetric emergencies by nurses: implementation and monitoring: Integrative literature review
Introduction: Nursing plays a strategic role in care delivery, management, and decision-making, especially in urgent situations such as obstetric emergencies. According to COFEN Resolution No. 564/2017, care management is an exclusive responsibility of nurses, who are in charge of coordinating processes, supervising teams, and ensuring the quality of care. Objective: To analyze and discuss how nurses’ practice, grounded in the Systematization of Nursing Care (SAE) and the Nursing Process (NP), contributes to the strategic and qualified management of obstetric emergencies. Methods: This is an integrative literature review, with searches conducted in the Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database (BDENF) and Medical Literature Analysis and Retrieval System Online (MEDLINE. Additionally, searches were also carried out on Google Scholar and ResearchGate, recognized as mechanisms for accessing gray literature, with the aim of locating relevant studies not indexed in formal databases. The descriptors used were: “Emergencies,” “Nursing management,” and “Obstetric nursing.” Original scientific articles published between 2019 and April 2025 were included, with full-text availability in Portuguese, English, or Spanish. Duplicated studies, texts without full access, publications unrelated to the theme, and non-scientific works were excluded. Results: Ten articles were selected to comprise the final sample, grouped into five analytical categories that highlight different aspects of the nurse's role in managing obstetric emergencies. The analysis demonstrated that nurse-led strategic management combines technical competence, organizational vision, and human sensitivity, and is essential for promoting maternal and fetal safety and improving care processes in critical situations. Conclusion: It is concluded that the nurse’s performance in managing obstetric emergencies is crucial for the effectiveness and safety of care. The integration of SAE, the Nursing Process, and managerial leadership strengthens care protocols, improves team functioning, and contributes to reducing risks and adverse outcomes in maternal and newborn health care.
Emergencies; Nursing Care; Obstetric Nursing.
Copyright (c) 2025 Julianne Lourenço Costa, Ana Beatriz Santos Ferreira de Araújo, Vívian Marcella dos Santos Silva, Uirassú Tupinambá Silva de Lima (Autor) https://creativecommons.org/licenses/by/4.0
Epidemiological profile of viral hepatitis from 2019 to 2023 in the municipalities of the 9th Regional Health Division of Paraná, Brazil
Introduction: Viral hepatitis is an infectious disease that affects the liver and represents a significant public health problem in Brazil and worldwide. Objective: The epidemiological profile of confirmed cases of viral hepatitis in the municipalities of the 9th Health Region of Paraná (9th RS/PR) was analyzed between 2019 and 2023, based on data from the Notifiable Diseases Information System (SINAN). Methods: This is a quantitative, descriptive and retrospective study, which evaluated variables such as age group, sex, race/color and geographic distribution of cases. Results: The results indicate an increase in notifications during the period, with a higher prevalence among adults and a predominance of types B and C. Significant variations were also observed between the municipalities of the 9th RS/PR, reflecting inequalities in access to diagnosis and treatment. Conclusion: The analysis allowed us to identify risk groups and propose recommendations for strengthening prevention actions, early diagnosis and epidemiological surveillance, contributing to the formulation of more effective public policies in the region.
Viral Hepatitis; Epidemiological Profile; Survival; Epidemiology; Disease Prevention.
Copyright (c) 2025 Dalvana Cervantes Preis, Karine Acker Godoy Bortoluzzi, Augusto Cesar Kappes Sapegienski, Silviane Galvan Pereira (Autor) https://creativecommons.org/licenses/by/4.0
Meanings of spirituality for family caregivers of patients in palliative care
Introduction: Spirituality provides a form of resilience to face psychological and physical difficulties and is focused on the profound and ever-innovative experience of a living encounter with God. This experience transcends the suffering experienced by attributing meaning to human existence. Objective: To understand the meanings of spirituality for family caregivers of patients in palliative care. Methods: Qualitative, exploratory, and descriptive study carried out at the Geriatrics and Palliative Care Unit of the Hospital de Clínicas de Porto Alegre (HCPA). The subjects of this research were 13 full-time family caregivers of patients admitted to the Palliative Care Service. Professional caregivers and visitors were excluded. Data collection was carried out in August and September 2019, through semi-structured interviews. The information was verified using Bardin's content analysis method and was developed in three stages: pre-analysis, exploration of the material and treatment of results, inference, and interpretation. Results: seven thematic categories emerged: Faith and hope for the family caregiver; Meaning of the participation of beliefs in the situation being experienced; Feelings regarding the role of caregiver/feeling when exercising care; Religiosity and spirituality as a force for overcoming for the family caregiver; Feelings regarding the way in which spirituality manifests itself daily; Religious practices of the family caregiver as relief from suffering; Nursing in supporting the family caregiver. Conclusion: It was found that spirituality has several meanings for family members, as well as practical variations that characterize it. By giving meaning to stressful experiences, the family can transcend it.
Spirituality; Palliative Care; Caregivers.
Copyright (c) 2025 Christofer Silva Christofoli , Marta Georgina Oliveira Goes , Margarita Rubin Unicovsky, Ivana Souza Karl, Maria da Graça Oliveira Crossetti (Autor) https://creativecommons.org/licenses/by/4.0
The challenges faced by mothers in Exclusive Breastfeeding
Introduction: Exclusive breastfeeding offers numerous health benefits for both mother and baby; however, it is associated with physical and social obstacles, such as lack of social and family support, maternal workload, and short maternity leave. Objective: The main challenges faced by mothers in the practice of exclusive breastfeeding were described. Methods: This is a cross-sectional study conducted with 20 women who received prenatal care at the Family Health Strategy in the district of São Roque, Santa Helena, Paraná. Data collection was performed by applying a semi-structured questionnaire about exclusive breastfeeding. Results: 23.8% of the women interviewed had completed elementary school, 38.1% had a family income between 2 and 3 minimum wages, and 81% had paid work outside the home. Regarding the guidance received by women during pregnancy and postpartum, only 68.4% of the women interviewed received this guidance, representing an unsatisfactory result. Regarding the mothers' perception of exclusive breastfeeding, the experience of "strong emotional connection when breastfeeding" predominated. Other foods were introduced at 6 months of age by 20% of the interviewees. Regarding the main challenges faced by mothers in breastfeeding, the following were highlighted: lack of family and social support, financial difficulties, early return to work and the absence of policies to encourage maternity leave. Conclusion: According to the data obtained, the information about exclusive breastfeeding that should have been passed on during prenatal or postpartum monitoring was insufficient. According to the perception of the mothers interviewed, 100% of the women faced challenges in breastfeeding, which hindered the practice of exclusive breastfeeding.
Breast Feeding; Maternal-Child Nursing; Parental Leave.
Copyright (c) 2025 Talita da Silva Fribel , Kauana Ferreira de Moura, Jacqueline Ramos da Silva, Daniela Munarini Almeida, Silviane Galvan Pereira (Autor) https://creativecommons.org/licenses/by/4.0
The benefits of adherence to chemotherapy treatment using elastomeric continuous infusion pumps in patients with lung and colorectal cancer
Introduction: Cancer has been a highly prevalent pathology in recent decades. In 2020, approximately 19 million new cases of cancer were discovered worldwide, resulting in 9.9 million deaths. The highest incidence is due to lung cancer, with 2.2 million cases, followed by colon and rectal cancer, with 1.8 million cases. The therapeutic regimen for treating these cancers is continuous, prolonged, and invasive. In this context, the use of the elastomeric continuous infusion pump represents an effective alternative, promoting greater comfort and autonomy for cancer patients. Objective: to verify the benefits of using the elastomeric continuous infusion pump in patients with lung and colorectal cancer. Methods: This is a prospective, exploratory, descriptive, and quantitative-qualitative study carried out at the Hospital do Câncer de Cascavel, Paraná, involving patients of both sexes, undergoing home chemotherapy treatment using the elastomeric infusion pump. Data collection was performed through a questionnaire and semi-structured interviews. Results: There was a prevalence of reports of benefits: improvements in quality of life, reduced need for hospitalizations, comfort and convenience in carrying out treatment in a family environment. Conclusion: The implementation of the elastomeric continuous infusion pump is an efficient tool, with a high safety profile, which allows patients undergoing chemotherapy infusion greater comfort, reduced anxiety and problems resulting from hospital exposure, minimized costs to the health system, and other advantages. The use of new technologies applied to the health area allows the multidisciplinary health team to experience humanization in oncological care and contribute to patient safety, increased life expectancy and physical and emotional well-being of patients.
Neoplasms; Antineoplastic Agents; Health Sciences; And Innovation Management.
Copyright (c) 2025 Julio Cezar Tenório, Silvana Rodrigues dos Santos, Augusto Cesar Kappes Sapegienski, Silviane Galvan Pereira, Beatris Tres (Autor) https://creativecommons.org/licenses/by/4.0
Drug-Resistant Tuberculosis in Alagoas: an epidemiological Study
Introduction: Tuberculosis (TB) is an infectious and contagious bacterial disease that can present in pulmonary and extrapulmonary forms. Its development is associated with endogenous factors, such as immune response, and exogenous factors, such as socioeconomic conditions. Objective: To analyze the situation of drug-resistant tuberculosis (DR-TB) in the state of Alagoas from 2019 to 2024. Methods: This is an epidemiological, descriptive, retrospective study with a quantitative approach, based on secondary data. To analyze epidemiological characteristics, the following variables were selected: gender, race/skin color, education level, city of residence, age group, start and end of treatment, type of entry (new case, recurrence, after abandonment and treatment failure), type of resistance (primary or acquired), initial and current resistance pattern, clinical form, treatment outcome, Directly Observed Treatment (DOT), previous treatments, sputum smear microscopy diagnosis, and culture result. Results: There was a predominance of males 82.40% (n=61), brown skin color 86.50% (n=64), age between 30 and 44 years 29.73% (n=22), and education level of 4 to 7 years of schooling 32.43% (n=24). Regarding clinical aspects, 98.65% (n=73) of individuals presented with the pulmonary form, which is the clinical form responsible for the transmission of the disease. As for outcomes, only 25.68% (n=19) were discharged as cured, and 36.48% (n=27) abandoned treatment. The findings highlight the complexity of managing DR-TB, especially regarding healthcare barriers, low cure rates, and high treatment abandonment, emphasizing the need for more effective and integrated strategies for diagnosis, follow-up, and patient support. Conclusion: Tuberculosis remains a serious public health issue in Alagoas, particularly due to treatment abandonment, which contributes to the emergence of resistant strains and reinforces the need for public policies focused on early diagnosis, treatment adherence, and proper disease management.
Tuberculosis; Epidemiology; Drug Resistance; Treatment Interruption.
Copyright (c) 2025 Rogério Rodrigues Feitosa, Ákila Kauana Lima Santos, Marlene de Souza Lima, Maria da Glória Freitas, Uirassú Tupinambá Silva de Lima (Autor) https://creativecommons.org/licenses/by/4.0
Epidemiological Profile of Gestational Syphilis in the 20th Health Region From 2019 to 2023
Introduction: Syphilis is a Sexually Transmitted Infection (STI) caused by the bacterium Treponema pallidum and can be transmitted through sexual contact or from mother to child. The infection occurs in two forms: acquired, through sexual contact, and congenital, when the infected mother transmits the bacterium to the fetus. Syphilis progresses through three stages: primary (with a hard chancre lesion), secondary (skin rashes), and tertiary (serious complications). Vertical transmission is high in the early stages and can result in severe complications for the fetus. The effective treatment for gestational syphilis is benzylpenicillin, which should be initiated as early as possible during pregnancy. Proper diagnosis and treatment are essential to prevent congenital syphilis, which can have early or late clinical manifestations. Nurses play a crucial role in the screening, diagnosis, and follow-up of pregnant women. Analyzing the epidemiological profile of pregnant women with syphilis is important for planning actions to reduce vertical transmission and address inequalities in access to maternal and child healthcare. Objective: To analyze the epidemiological profile of gestational syphilis in the 20th Health Region during the period from 2019 to 2023. Methods: This is a descriptive, exploratory, and retrospective study, with a quantitative and indirect approach. Data were collected from confirmed cases of gestational syphilis through the Information System for Notifiable Diseases (SINAN), covering the period from 2019 to 2023 in the 20th Health Region of Paraná. Results: A total of 649 cases of gestational syphilis were reported, with a predominance among women aged 20 to 39 years. Among the pregnant women, 49.61% (322) were white, 32.51% (211) had completed high school, and 47.61% (309) were residents of Toledo. The “ignored/blank” classification was observed in 44.53% (289) of cases, indicating deficiencies in notification reporting. Treponemal tests were positive in 96.61% (627) of cases, while 74.26% (482) of the pregnant women had reactive results in non-treponemal tests, indicating active infection and the need for effective control. Conclusion: Gestational syphilis predominantly affected pregnant women aged 20 to 39 years, white, with a high school education, and residing in the municipality of Toledo, Paraná. The high rate of underreporting and failures in clinical classification highlight the need to improve epidemiological surveillance and the training of healthcare professionals.
Epidemiologic Surveillance Services; Pregnant People; Syphilis.
Copyright (c) 2025 Tamires Fruet, Bruna Letícia Konradt, Jacqueline Ramos da Silva, Daniela Munarini Almeida, Silviane Galvan Pereira (Autor) https://creativecommons.org/licenses/by/4.0