The experiences of pleasure and suffering determine the subject's relationship with their work,
and can culminate in the production of health and psychological illness among workers.
Pleasure tends to be manifested through feelings such as recognition and affinity with work,
that is, positive experiences. On the other hand, failure, frustration and impotence point to
suffering, when they contradict the expectations of this subject. Given this, the study's general
objective was to analyze aspects of the work process that trigger satisfaction and dissatisfaction
among nurses who work in pediatric services in a capital in northeastern Brazil. This is a
descriptive and analytical study with a qualitative approach, using the Psychodynamics of
Christophe Dejours' work as a theoretical framework. Eighteen nurses working in three public
pediatric services of medium and high complexity in the city of Natal/RN participated in the
study between September and November 2023. Semi-structured face-to-face interviews were
used as a method to obtain data in a preferred location. of each participant, associated with a
field diary. Subsequently, content analysis was conducted with the help of the Atlas.ti 23
software. All research was developed in compliance with Resolution 466/12 of the National
Health Council and the General Data Protection Law n.13.709/2018, having been approved by
CEP/UFRN with opinion no. 6.278.155. The elements of satisfaction exposed were the
development of care due to the affinity with the pediatric specialty, especially when the child
recovers, good relationships with peers, both families and the multidisciplinary team, as well as
the empathy of the immediate supervisor. However, work overload, distancing from
institutional management, related to poor organization of Nursing staffing and staff shortages
with frequent sector reassignments and undervaluation of the specialty, were the main factors
that contributed to job dissatisfaction. It was concluded that the research participants are
partially satisfied with their work and that the factors revealed could be fundamental to
improving their work process in relation to their teams, institutional and political management.

The objective of the study is to compare the clinical and therapeutic characteristics related to the hospitalization course in palliative patients undergoing conventional therapy and hypodermoclysis in a general and oncology hospital. It is a study with a quantitative approach, prospective cohort, to structure it, Strengthening the Reporting of Observational Studies in Epidemiologi was used. It took place in two oncology reference services with exclusive services to the Unified Health System in the state of Rio Grande do Norte. The study population consisted of cancer patients undergoing palliative care who were hospitalized. Therefore, to calculate the sample for this research, it showed a power of 80% and a level of evidence of 0.05, so the overall sample was 84 patients to be evaluated. This research included patients admitted to hospitals that present palliative care procedures or that are beyond therapeutic possibilities, and excluded patients whose at least the main caregiver had no knowledge about palliative care procedures. For the outcomes of this study, death, hospital discharge and transfer to other units will be considered. For data collection, an instrument for sociodemographic and clinical data was used, in addition to the algorithm for eligibility of hypodermoclysis in adult patients, the Edmonton Symptom Assessment Scale and the Palliative Performance Scale. The data was organized in Microsoft Excel and analyzed using the statistical software Statistical Package for the Social Sciences version 22.0, statistical tests were carried out to analyze the data, with a significance level of 0.05 adopted. The study obtained a favorable opinion from the Research Ethics Committee under number 6.289.214 and CAAE 71440423.6.0000.5537, thus following the ethical precepts in research with human beings described in Resolution 466/2012 of the National Health Council. Study was divided into hospital 1 (29 patients) and hospital 2 (55 patients), this is justified by the discrepancy in the number of hospital beds in hospital 2 in relation to hospital 1. The results indicate that in both hospitals the median age They are in the sixty-year-old age group, female (37.0% - 63.0%), and predominantly reside in the interior of the state (36.2% - 63.8%). The types of cancer that prevailed were of gastrointestinal origin (45.9%), followed by lung (11.8%) and breast (8.2%), in addition, the number of days of hospitalization had a median of six days in hospital 1 and four in hospital 2. The study showed that palliative patients used the peripheral venous catheter more frequently (53.3%) with a median of one day in usage time, the central venous catheter had a median in usage time of thirteen days and hypodermoclysis of one day. Therefore, the routes are effective, however, adverse events related to the catheter and assistance were observed, such as: infiltration, erythema, hematomas, venous fragility, which will present different levels of complications in relation to the catheter and puncture site of choice. Furthermore, infusion therapy works to control signs and symptoms, contributing to comfort and quality of life. This study verified the access route that guarantees quality, safety and comfort for patients in hospital, as well as contributing to a safe and cost- effective transition of care for health services and users. 

The migration of nurses is an important phenomenon with varied implications, both for the places of origin and for the destinations. Individual, social and professional factors influence the decision to migrate these workers and the experiences lived by them directly reflect on the construction of their personal and professional identities. The objective of this study was to analyze the decision of nurses who have an employment relationship in a public teaching institution to migrate to another institution in the regions of Brazil. This is an analytical study, with a qualitative approach, mediated by Thematic Oral History. Nurses working in four university hospitals managed by the Brazilian Company of Hospital Services who migrated from these units as well as the other way around were invited to participate in the study. Semi-structured interviews were conducted and their analysis through the categories resulting from the dialogue between the authors studied in the theoretical framework on the theme. The research was approved by the Research Ethics Committee of UFRN with the Opinion number 6.278.154 and CAAE 70566623.5.0000.5537. Thirteen interviews were carried out respecting their availability and preference regarding format. Therefore, there were eleven face-to-face interviews and two through the Google Meet platform. There was a predominance of female employees, aged between 32 and 48 years old. Regarding academic degrees, all reported having at least two Lato Sensu postgraduate degrees and only three reported Stricto Sensu postgraduate degrees at the Residency and Master's level. The initial crisis in the insertion of the labor market of a capitalist society, with its frustrations of unemployment, precarious ties in cooperatives and the lack of recognition in society, stimulated the search for professional qualification as a means of getting out of that reality. This qualification, at all times, was filled with expectations due to the change in the environment in which they were inserted, which influenced the decision of the first migration of eleven of the thirteen collaborators in the study. However, the personal and
professional maturation after their migratory experiences promoted a new identity crisis: the search for identity for themselves. The nurses in the study not only wanted social identity, but also the pleasure of belonging, and thus, of the eleven collaborators who migrated for the first time away from their states, eight decided to migrate once again to be close to their essence, promoting the (re)construction of their professional identities with a new beginning, new environments, new friendships and new work processes. It was found in the research that the professional identity is changeable, directly linked to the individual identity and that when they find their new belonging, through their choices and not only for an economic reason, the employees develop their work activities with satisfaction and pleasure. As nurses, this directly reflects not only on their professional careers, but also on their personal lives and the entire society that depends on their health care. 

Nosocomial Infection are recognized by the World Health Organization as a problem of broad global magnitude. In this context, Brazilian hospitals present an unfavorable scenario in terms of high rates, as they present approximately 6% of HAIs in the context of hospital admission, being triple the percentage of tolerance stipulated by the World Health Organization. When considering that HAIs are a serious public health problem, they can be caused by several risk factors, which vary according to the hospital context, patient profile and health care practices adopted, and can thus be assessed that Carrying out a comprehensive and systematic review to identify risk factors for HAIs will become a useful tool for infection control. Objetive: Identify and map the risk factors associated with healthcare-associated infections in people hospitalized in adult intensive care units. Method: This is a scoping review (DOI 10.17605/OSF.IO/MYEJ5) developed within the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Review, developed in five stages: 1) identification of the research question; 2) identification of relevant studies; 3) selection of studies; 4) data extraction, separation, summarization and reporting of results and 5) communication of results. According to JBI, the Participant, Concept and Context mnemonic was applied to construct the research question, in which Participant corresponds to “People in hospital”, Concept “Risk factors for healthcare-related infections” and the Context “ Adult ICU”, and the guiding question was: “What are the risk factors in the development of HAIs in people admitted to intensive care units?”. The search was carried out in twelve databases, using the following Boolean descriptors and operators, according to the crossing format: (Cross Infection) OR (Nosocomial Infection) OR (Patients) OR (Adult) AND (Risk Factors) AND (Intensive Care Units ) OR (ICU Intensive Care Units), in 2023 on the Federated Academic Community platform. The research inclusion criteria were: articles originating from primary, secondary studies, national regulations and policies, dissertations and theses available in full, without temporal delimitation, in any language and that answer the research question. Reflections, experience reports, editorials and summaries published in the annals of scientific events will be excluded. Results 5533 studies were found, 54 of which were included. 100% of the studies addressed some intrinsic characteristic associated with a risk factor for the development of HAIs, addressing age 62%, sex 53%, use of antibiotic agents in the previous 90 days 9%, use of corticosteroids 1%, diseases priors 29%, smoking 2%, nutrition 22%. For extrinsic risk factors, such as those associated with hospitalization, the study addressed length of stay 71%, ICU admission 42%, APACHE II 33%, APACHE III 27%, night admission 2%, nurse/patient ratio 1% , aseptic measures 19%, use of sedation 21%, blood transfusion 2%. The use of devices was also cited in studies as risk factors, with the following being addressed: central venous catheter, endotracheal intubation, tracheostomy tube, mechanical ventilation, nasoenteral tube, urinary catheter, drains, etc. Conclusion: The mapping of risk factors associated with Nososcomial Infections contributes to the advancement of scientific knowledge about Nosocomial infections in ICU, by providing a comprehensive mapping of risk factors, aiming to join efforts with existing national programs focused on prevention of nosocomial infection. 

The history of nursing contributes to the understanding of its roots,
permeating the trajectory of care, and thus, facilitating the understanding
of the contemporary characteristics of work. Therefore, this look at history
refers to the sociocultural role of this category, which is mostly made up of
female workers, maintaining cultural heritages that structure the
profession. In this way, we have a category that reproduces actions and
values equally inherent to the feminine and, consequently, experiences the
oppressions imposed on the class by an antiquated and prejudiced
culture, originating from the beginning of its formation. As a result, aspects
of the work environment that permeate violence, such as moral
harassment, are observed. Thus, the objective was to analyze moral
harassment towards nursing workers in contemporary times and the issue
of gender. This is a study of a hypothetical deductive method, as a
methodological, quantitative and statistical procedure, making it possible
to cross-reference responses and verify hypotheses. Data collection will
take place in the city of Natal, in the state of Rio Grande do Norte, through
electronic interviews, via Forms, with nursing workers who are linked to
health institutions. To analyze the data, Software R was used. Next, an
analysis will be carried out to verify the associations between the
variables. The project was approved by the Research Ethics Committee of
the Federal University of Rio Grande do Norte, respecting all ethical
premises for studies with human beings. In the results, a total of 44 health
professionals participated in the study, 22 females and 22 males. This
equal sample was due to the need to try to answer the research's guiding
question. The associations between age, length of service, who the
harassers are in contemporary times, perception of moral harassment and
the gender that suffers most from this violence were analyzed. During the
discussion, it was observed that young workers, with little experience and
recently hired, are those who suffer the most from moral harassment.
Another perception was about harassers, which in contemporary times is
still the most common downward harassment. Another point, there is a
hypothetical possibility that, based on the research associations, moral
harassment in nursing may be linked to gender. It is concluded that they have weaknesses in understanding and identifying the characteristics of what is or is not moral harassment, often going unnoticed in the day-to-day activities of services, thus making the reliability of the research difficult. It is still confirmed that the culture in which nursing is down on hierarchy and submission. This reality and other findings in the research contribute to the hypothesis that bullying in nursing is associated with gender.

Objective: Build and validate a serious game as an educational tool in
stomatherapy in hospital care. Method: Methodological study, with a
quantitative approach, carried out in four stages: scoping review, with the aim of

identifying the guidance provided to patients pre-operatively and post-
operatively; research with hospital care nurses, in order to identify the

knowledge and difficulties of these professionals regarding the care of people
with an intestinal ostomy, information that supported the third stage;
construction of the serious game; content validation (narrative, clinical,
contextual aspects and whether the case is appropriate). For evaluation, the
content validity index (CVI) will be used, with a value greater than or equal to
0.8, to be considered valid. An adapted Egameflow instrument was also
applied, with 24 questions, of which two are focused on aspects of contact with
technologies and games, 21 questions related to the game as an educational
strategy, in which its alternative answers were through a score of 1 it was weak
to 7 strong and an open question regarding learning the game. The data was
first passed into Excel and then a descriptive analysis was carried out using the
Statistical Package for Social Science for Windows program, obtaining the
relative and absolute frequencies of the categorical variables. The study was
submitted to the research ethics committee of the Federal University of Rio
Grande do Norte and received a favorable opinion under number 5.736.475,
CAAE: 61762122.9.0000.5537. Results: Given the findings of the scoping
review and research with hospital care nurses, it was possible to build the
serious game with two scenarios, one for the pre-operative period of a surgery
to create an intestinal ostomy and the second, for the postoperative period.
Regarding content validation, the 10 experts experts in the area of
stomatherapy, in the sentence “The narrative of the case/question presented is
adequate and is close to representing reality” obtained a CVI of 0.9; “The
clinical aspects presented in the case are adequate and are close to

representing reality” CVI of 0.8; “The contextual aspects presented in the
clinical case are adequate and are close to representing reality” CVI of 0.9; “Do
you consider this case appropriate for teaching about intestinal ostomy care”
CVI of 0.8, thus obtaining a total CVI of 0.85. In relation to the game as an
educational strategy, the questions that obtained the best scores were “Do I try
to apply my knowledge in the game?” average of 6.8; “I want to know more
about the content presented” average of 6.8; “Does the game improve my
knowledge?” average of 6.7; “Am I motivated by improving my skills?”, average
of 6.6; “Do I receive information about my status such as score level?”, average
of 6.6. Conclusion: Given these results, it is observed that the serious game
represents a real situation that can be found in hospital environments.
Furthermore, the game proved to be a good educational strategy. Furthermore,
it is intended that with this study, the level of knowledge of health professionals,
especially nurses, will increase regarding this topic.

Low self-esteem can frequently occur in undergraduate nursing students, as they are a population vulnerable to mental imbalance and/or a crisis arising from stressors related to academic life. When present, low self-esteem can lead to self-destructive behavior, lower self- efficacy and course dropout. However, there are few studies on this diagnosis in this population. Thus, the present study aims to validate the nursing diagnosis of situational low self-esteem in nursing students. This is a methodological research, developed in three stages, namely: 1) theoretical-causal validation, based on the construction of a medium-range theory; 2) content analysis; and, 3) clinical validation, through a diagnostic accuracy study. Initially, the development of the middle range theory was operationalized through a scoping review. The antecedents, consequences and their respective conceptual and operational definitions were identified, as well as a pictogram, propositions and causal relationships. In the second stage, the elements of the theory were analyzed by 22 judges, with levels of expertise ranging from beginner to experienced. The data were analyzed using the content validity index, based on the collective wisdom approach. In the third stage, the research was carried out with 55 nursing students from a federal public institution, located in the city of Campina Grande- Paraíba. The research was approved by the UFRN Research Ethics Committee, through opinion number 5.632.922 and Certificate of Presentation for Ethical Assessment number 60617922.4.0000.5537. The results showed that in the first stage, 16 antecedents and 21 consequences corresponding to the diagnosis under study were identified, and their respective conceptual and operational definitions were elaborated. The analysis of these elements allowed the development of a pictogram, construction of 8 propositions and establishment of causal relationships. In the second stage, the analysis of the diagnostic content by the judges made it possible to improve the definition and elements previously developed, which resulted in a diagnostic structure consisting of 13 defining characteristics, 15 related factors, 5 associated conditions and 1 population at risk. In the third stage, the prevalence of the nursing diagnosis of situational low self-esteem was 78.18% among the students interviewed. The defining characteristics: Recalls trauma and Anxious symptoms presented the best sensitivity and specificity values. Related factors: Traumatic experiences and Individuals in psychological distress demonstrated a 13.65 times greater chance of developing the diagnosis of situational low self-esteem. It is concluded that the diagnosis Situational low self-esteem is verifiable in undergraduate nursing students and presents two defining characteristics with better accuracy values. Furthermore, it is expected to contribute to increasing the level of evidence for this diagnosis in the NANDA-I taxonomy.

The shift in the age profile of HIV cases and the rising incidence rates among adolescents suggest vulnerabilities in preventive measures. As a refined methodology in health education, Peer Education enables collective interventions with individual reach, fostering significant changes in this scenario. These aspects are incorporated into the Combined Prevention Mandala, representing a modern approach integrating multiple HIV prevention strategies into a unified framework.It is essential to highlight the role of nurses, responsible for implementing and operationalizing health promotion actions, establishing connections between school health and education as a strategy. This study aims to construct and validate an instrument focused on HIV prevention in adolescents through peer education in the context of nursing. It is a methodological study with a quantitative approach, organized into six stages: Concept analysis; Scoping review; Data cross-referencing; Instrument item construction; Instrument content validation, and Instrument appearance validation.The concept analysis followed Walker and Avant's (2019) eight-step framework. The scoping review was guided by The JBI Manual for Evidence Synthesis for the selection of studies identifying items for the instrument. The nine axes of the Combined Prevention Mandala (CPM) underpinned the entire methodological process. For validation stages, judge selection and the Delphi Technique for content validation, Content Validation Coefficient (CVC) utilization, and Kappa Index calculation for judge agreement on the instrument and its items were performed.The study received approval from the Research Ethics Committee (CEP) of UFRN with Protocol No. 6.566.151 and Certificate of Ethical Presentation (CAAE) No. 75835223.2.0000.5537. The constructed instrument had nine main titles corresponding to the CPM axes, with 40 items derived from the scoping review. Validation involved 16 expert judges and the target audience, assessing "Representation," "Importance," and "Clarity," showing excellent agreement levels. Specific evaluation resulted in a Kappa index of 1,00 and CVC of 1,00. Overall evaluation of content yielded a Kappa index of 1,00 CVC of 1,00. Appearance evaluation about culture adequation also achieved Kappa 0.87, CVC of 0,89 indicating excellent concordance among evaluators. In conclusion, the constructed instrument meets HIV prevention needs in adolescents, proving innovative and useful for nurses. This thesis demonstrates the feasibility of building an instrument for HIV prevention in adolescents through peer education, with evidence of content and appearance validity for the nursing context.

Healthcare-Associated Infections are recognized as complex, multifactorial and
encompass all assistance offered to patients in different healthcare settings. They
present themselves as a problem of global magnitude and public health, raising growing
concern among health professionals, care managers and formulators of public health
policies. The health professional who works in the health care-related infection control
sector, infection controllers, focuses on the maximum reduction in the incidence and
severity of infections and active surveillance is the main tool for their work. The
motivation to develop this study is based on the difficulty reported by infection
controllers in structuring and carrying out their active surveillance and the scarcity of
practical materials aimed at supporting their practice. The objective was to develop a
virtual course on active surveillance for healthcare-related infection controllers. This is
a methodological study, subdivided into two stages: 1) identification and mapping of the
strategies used to operationalize epidemiological surveillance of infection, through
active surveillance, at different levels of health care, based on scoping review; 2)
Construction of the virtual infection surveillance course. To construct the virtual
surveillance course, the five phases recommended by Falkembach were used, namely:
Analysis and planning, modeling, implementation, and evaluation and maintenance. The
results obtained were analyzed using descriptive statistics. The Scoping review resulted
in a total of 92 scientific productions, produced predominantly on the European
continent (23.34%) and in the English language (93.48%). The majority of studies
found are observational studies (34.78%) classified at level 4.b of evidence. Regarding
the strategy used to carry out active surveillance, the most frequent found is screening
by culture results (89.13%), with the prospective surveillance method (73.91%) and the
type of microbiological surveillance (84.78 %). The measures adopted also included
hand hygiene (21.73%) and the lack of standardization available in relation to active
surveillance (43.26%) was a difficulty encountered by infection controllers. By
consolidating the course content, it consists of 4 modules (introduction to healthcare-
related infections; active surveillance in infection; active surveillance, epidemiological

surveillance and active search for healthcare-related infections; active surveillance and
nurse's role), arranged in 12 classes, totaling 20 hours, hosted on the Google ClassRoom
platform. In effect, the course constructed is innovative and allows infection controllers
to have access to scientific content that equips their practice and provides the necessary
knowledge for structuring active surveillance in the health service where they work.

The construction of a flowchart, as a management technology, enables a better
understanding of care practices, the organization of health care, and the structuring
of the work process based on the description of the user's therapeutic journey within
the Health Care Networks. The objective was to develop a flowchart for health care
for people with hematologic neoplasms. This is a methodological study, with a mixed
approach, anchored in Pasquali's psychometrics (2010), structured in three
procedures: theoretical, analytical, and empirical. For the theoretical procedures,
literature searches were carried out through an integrative review focusing on
scientific evidence on health care for patients with hematologic neoplasms and a
focus group consisting of health professionals. In the empirical procedures stage, a
compilation of the information collected in the previous stage was made to support
the construction of the flowchart. The validation of the content and appearance of the
flowchart was carried out through the Delphi technique, with the evaluation of the
criteria proposed by Pasquali and the Suitability Assessment of Materials. Finally, the
analytical procedures occurred through the content validation coefficient and
agreement between the judges. The study was approved by the Research Ethics
Committee of the Federal University of Rio Grande do Norte and obtained approval
under CAAE: 67213623.0.0000.5537. The results of the integrative review showed a
final sample of 17 studies and revealed that the care provided to patients with
hematologic neoplasms is more concentrated in the medium and high complexity
levels of health care, since cancer is a pathology with therapeutic complexity that
requires equipment and human resources appropriate for specialized care. The focus
group included the participation of 10 nurses and one physician in different cities in
the Brazilian regions, and all reported the difficulty in accessing treatment, for various
reasons such as social and economic factors, the lack of qualifications of health
professionals, especially in Primary Care, and timely access to specialized care.
Regarding the content validation process, in the Delphi I round the flowchart reached
a final CVC of 0.82 and an agreement of 53% among the judges. After adapting the
flowchart, according to the judges' suggestions, in the Delphi II round, all criteria were
validated, with a final CVC of 0.99 and an agreement of 93%. That said, the flowchart
is considered useful and valid in its content and appearance as a management
technology for the systematization of care and guidance to health professionals with
elements that contemplate the therapeutic itinerary of onco-hematological patients,
from the moment the user enters primary care. In addition to containing important
information about reception, care flows, decision-making, referrals, consultations with
multidisciplinary and nursing teams.

Objective: To develop a Mid-Range Nursing Theory for Ineffective Health Maintenance Behaviors in People with Chronic Conditions. Method: This is a methodological study, based on Lopes e Silva's (2016) referential of Theoretical-Causal Validity, developed in six stages, namely: definition of the approach to construct the Medium-Range Theory; definition of the theoretical- conceptual models to be analyzed; definition of the main concepts of Middle Range Theory; development of a pictorial scheme; construction of the propositions of the Middle Range Theory; and establishing causal relationships and evidence for practice. For the construction of the Middle Range Theory, two approaches were defined: literature review from an integrative review and derivation from the theoretical model of Imogene King (1981). Data collection for the review took place by searching the following databases: SCOPUS, Web of Science, Science Direct, CINAHL and COCHRANE. As a search strategy, the following descriptors were defined, ordered in the Descriptors in Health Sciences (DeCS) and Medical Subject Headings (MeSH): Health Behavior; Chronic Disease; Primary Health Care and Nursing Diagnosis, intermediated by the Boolean operator “AND”. The inclusion criteria adopted were: studies that addressed any element related to Ineffective Health Maintenance Behaviors, complete studies available in the applied data sources and studies in any language. Editorials, letters to the editor, expert opinion, abstracts, reviews, books and book chapters were excluded. Results: Of the 75,154 studies found, after applying the eligibility criteria, 75 studies made up the final sample. Twenty related factors and 14 defining characteristics were identified, in addition to five at-risk populations and two associated conditions. The presentation of the review results started the development of the Middle Range Theory. The derivation from the theoretical model of Imogene King (1981) allowed the extraction of elements that contributed to the development of the Middle Range Theory for the nursing diagnosis of Ineffective Health Maintenance Behaviors in people with chronic conditions. Conclusion: It is concluded that the Middle Range Theory for Ineffective Health Maintenance Behaviors in people with chronic conditions provides the theoretical-causal validation of this nursing diagnosis, supporting the planning of nursing interventions in terms of health promotion and disease prevention. complications related to these conditions.

In order to improve the thirst problem, the technique of providing a little volume of cold liquid in the oral cavity to lubricate the mucosa is used. Therefore, interventions such as iced or mentholated popsicles, menthol chewing gum, wet gauze with cold saline solution, cold water for gargling, and frozen gauze with saline solution are the main methods used to stimulate thirst quenching in patients during the period preceding the surgery. This study aims to evaluate the effects of the use of menthol popsicle in the relief of postoperative thirst in patients undergoing radical prostatectomy in an oncology hospital. This is a randomized, controlled, single-blind clinical trial with a quantitative approach that complied with the standards recommended by the Consolidated Standards of Reporting Trials. This study was registered on the Brazilian Clinical Trials Registry platform. The present study was carried out in the surgical ward of Hospital Doutor Luiz Antônio da Liga Norte Riograndense Contra o Câncer, located in the city of Natal, Rio Grande do Norte. The population consisted of male patients undergoing elective radical prostatectomy who were in the immediate postoperative period. The sample has probabilistic and simple random characteristics. The study consisted of two groups: a control (CG) and an experimental (EG). The CG consisted of patients who received popsicle without the addition of the mentholated substrate and the EG of patients who received the popsicle with the addition of the mentholated substrate of 0.05%. The instrument for data collection is divided into three parts: 1) Patient identification, clinical and sociodemographic data; 2) Data regarding the surgical procedure and anesthetic process; 3) Data regarding thirst intensity using the Numerical Scale (EN) and thirst discomfort using the Perioperative Thirst Discomfort Scale (EDESP). Thirst must be characterized and treated appropriately, especially in the surgical patient, to provide comfort and pain relief, as this sensation has a relevant impact on patient satisfaction and can have a negative impact on anesthetic recovery, especially in the postoperative period. immediate. It is noteworthy that the outcomes were positive during the research, with few reports of complications related to the use of interventions to manage thirst.

Chemotherapy is the main method used to age childhood cancer, which treat childhood cancer from zero to ten years of age. It is noteworthy that the beginning of chemotherapy treatment causes concern in caregivers of children/adolescents, mainly associated with knowledge of the treatment. In this way, the education process is necessary to seek education and the education process to seek education, therefore, with the education and education process seeking to seek the education process to seek education and the reduction of education. In this sense, the study aims to evaluate the effect of a multimedia strategy compared to standard guidelines for acquiring knowledge and reducing anxiety in caregivers of children and adolescents undergoing chemotherapy. This is a randomized and controlled clinical trial, carried out in a Philanthropic Hospital, a reference in the care of children and adolescents with cancer, in Natal-RN. The Experimental Group received the institution's standard guidelines associated with a multimedia strategy on the chemotherapy treatment process - Digital animation film lasting 12 minutes and 22 seconds. While the Control Group received only the standard guidelines that are provided at the institution. The data collection instrument used was the State Trait Anxiety Inventory (IDATE) and a Knowledge Assessment Instrument (IAC). The project was approved by the Central Research Ethics Committee of the Federal University of Rio Grande do Norte nº CAAE 52597121.9.0000.5537 and registered in the Brazilian Clinical Trial Registry (RBR-4wdm8q9). Most caregivers are female, with complete high school, with a family income of one to two minimum wages. It is evident that the intervention with the multimedia strategy contributed to the acquisition of knowledge by caregivers and reduction of the anxiety score. It is noteworthy that in the control and experimental groups, after the interventions, it was possible to prove the increase in the feeling of preparation and confidence to take care of children/adolescents undergoing chemotherapy. In this way, the study reinforces that multimedia strategies such as the digital animation film are technologies that can be used at the beginning of chemotherapy treatment, contributing to the health education process and reducing the anxiety of caregivers of children and adolescents with cancer.

Self-inflicted violence is by practices of violence against oneself, and can be classified as self-harm, an idea of suicide, suicide attempt and suicide. It corresponds to the third leading cause of death among adolescents in the world and in the Brazilian reality, there is an increase in these cases. In this sense, it is essential to map the factors associated with self-inflicted violence in Brazil, as well as the development of efficient strategies for self-inflicted violence in adolescents, with the purpose of contributing to the formulation of specific policies for the care of this public and their families. This study has as its general objective the factors associated with self-inflicted violence and mapping the programs, as strategies and as coping interventions, aimed at developing the adolescents who are cared for. This is a descriptive study that will combine documented-exploratory data with qualitative ones. 20 data by authorship2 were considered as violence injuries by Not data for the identification of
factors associated with adolescents, considering data from 2009 to 1 in Brazil. Data were selected for descriptive and reference analysis using the R Studio software, and Joinpoint for analysis of the temporal trend of the cases, with a significance level of 5%. The proposed methodological qualitative data were necessary for a scoping review, by the Joanna Briggs Institute Manual and following the PRISMA-ScR recommendations. To assist in the analysis of the studies, the Intelligent Systematic Review software was used, and later with the help of the Atlasti 9.0 software, the data were organized and coded for qualitative analysis. This was theoretically based on research by Guy Debord and Byung-Chul Han for understanding today's society. For this study, all the ethical requirements of research with human beings were followed, being appreciated by the Research Ethics Committee under opinion no. 5,521,288. Self-proven violence by adolescents in Brazil was shown to be associated with the female sex, age group from 15 to 19 years old, white color/race, incomplete high school and
the Southeast region. As for the time trend, self-inflicted violence in adolescents showed an increase of 21.4 cases in the year 2009 between 2021. Among the objectives, the inclusion and exclusion criteria were applied, and the study by peers was applied to the study. It is concluded that self-inflicted violence in adolescents is a phenomenon that increases, in addition to health programs, strategies and interventions are still scarce.

The study aims to assess the patient safety culture in a surgical center in different organizational contexts. This research is in line with the national recommendations prepared by the Ministry of Health, inserted in the National Agenda of Priorities in Research, in axis 9 (Programs and Health Policies) regarding the evaluation of adverse events, and their impacts on public health and the evaluation of the National Patient Safety Program (PNPS) of the Unified Health System (SUS). In addition, it internationally supports the Global Patient Safety Action Plan, prepared by the World Health Organization (WHO) to eliminate preventable harm in health care by the year 2030. Within the hospital environment, the operating room is considered a of the places with the highest technological density, with the performance of urgent or elective procedures capable of demanding, in most situations, resources and precise and efficient inputs in the face of the complex practices developed by health professionals. Given its complexity, it is estimated that unsafe surgical care can significantly affect individuals. In the hospital setting, nearly half of all adverse events in hospitalized patients are related to surgical care. It is believed that there are particularities in relation to the different management models (public and private) capable of favoring or hindering CSP, such as the hospital structure, staff dimensioning, number of employment relationships and financial incentives, as identified by researchers in another study. This study aims to evaluate the levels of patient safety culture in surgical centers in a public and a private institution. This is a cross-sectional study carried out in two hospitals, one publicly managed and the other privately managed. A total of 185 health professionals participated in the study, namely: nursing technicians, nurses and physicians from both surgical centers. The E-Questionnaire Software validated and adapted for Brazil, from the Hospital Survery on Patient Safety Culture (HSOPSC) of the Agency for Healthcare Research and Quality (AHRQ) was used as an instrument for data collection. The collected data were exported from the E-questionnaire Software to a database in the Microsoft Office Excel version 2020 program and a descriptive analysis was used containing patient safety indicators. To analyze the results, the statistical software Statistical Package for the Social Sciences (SPSS) temporary version 25.0 was used to compare the findings in the referred hospitals. This study was assessed by the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN) obtaining a favorable opinion with CAAE 61763422.5.0000.5537 and opinion number 5,664,688. When evaluating and comparing the profile of positive responses, it was observed that for the private hospital, four dimensions were strong, with a percentage of positive responses above 75%: 3-Expectations and actions of the direction/supervision of the unit/ services that favor safety (78.1%); 4-Organizational learning/continuous improvement (87.6%); 5- Teamwork in the unit/service (78.4%) and 10- Hospital management support for patient safety (79.4%) were the dimensions with the best results. As for the public hospital, no dimension showed values above 75%, with the best results being 4-Organizational learning/continuous improvement (73.9%); 5- Teamwork in the unit/service (70.8%); and 12-Problems with shift changes and transitions between units/services (52.1%). About the worst scores, for the private hospital, there are the following dimensions: 8-Non-punitive response to errors (33.6%); 1-Frequency of reported events (60.1%) and 12-Problems with shift changes and transitions between units/services (60.2%). In the public hospital we have: 8-Non-punitive response to errors (15.6%); 2-Perception of safety (34.3%) and 1-Frequency of reported events (35.4%). The study concluded that there are differences between the types of public and private management regarding the patient safety culture and guide managers in the actions promoted in the surgical center in both scenarios, allowing better health outcomes, quality of care and reduction of events adverse.

The impact of the new reality and student obligations in higher education can trigger a
series of problems. Thus, university spaces are strategic environments for the
development of health promotion actions for these students. For this, the use of tools is
important to facilitate approximation, interest and collaboration, especially among young
people. Thus, the objective of the present study was to analyze the technologies and their
contributions to the promotion of the health of university students in the health area. The
study developed a Scoping Review based on the JBI. The following research questions
were adopted: “What are the technologies for promoting the health of university students
in the health area present in the literature? What are the advantages and limitations of
these technologies? The sources selected for the study were: Medline/Pubmed,
Cumulative Index to Nursing and Allied Health Literature, Web of Science, Latin
American and Caribbean Literature in Health Science, Nursing Databases, Scopus,
Cochrane, SciElo, Education Resources Information Center, Catalog of Theses and
Dissertations by the Coordination for the Improvement of Higher Education Personnel,
The National Library of Australia's, Academic Archive Online, Digital Access to
Research Theses, Europe E-Theses Portal, Electronic Theses Online Service, Repositorio
Científico de Acesso Aberto de Portugal, National ETD Portal, Theses Canada and
Google Scholar. A total of 42,294 studies were found and 71 articles were selected for
this research. The studies were mostly published in the United States of America, with
the main methodology being experimental studies. Among the target audience, there was
a predominance of nursing and medicine students, aged between 17 and 40 years.
Regarding technologies, the most predominant was light technology (63.4%), the use of
health education, group training and mindfulness/mindfulness were the most used,
followed by light/hard technologies with (19.7 %) and hard technologies with (16.9%).
The main focus was on students' mental health in addition to their physical health. The
most frequent time of application of the technology was up to eight weeks, being applied
mostly in spaces of the university itself, such as classrooms, outdoors and gymnasiums.
Due to the variety of technologies, the materials used were also diverse. Most of the
studies did not consider the previous assessment of the health of the students, being only
applied to technology. The use of these technologies has shown positive effects in
promoting the health of students in the health area, with an improvement in depressive
symptoms, anxiety, stress, as well as an increase in the practice of physical activities and
also an improvement in the ability to deal with academic stressors. Academic stress
experienced by healthcare students can impair health and performance. Thus, these
technologies are important strategies to be adopted by educational institutions to ensure
the health of their students.

Ostomy is the term used to describe the surgical opening that allows the communication
of an internal organ with the surface of the skin. Its making represents a delicate period
for the person with ostomy, where changes in the process of physiological eliminations
can cause vulnerabilities, sadness, fear, shame, withdrawal from social cycles and
routine activities, resulting in social isolation. Faced with this new reality, the nurse
plays an important role in the process of social adaptation of the person and family,
contributing with guidelines, which can be done in different ways, where animation
videos stand out: a strategy with several possibilities to be explored and that help in the
search for the objective of health education that can be applied to any public. In this
perspective, the objective of this research is to develop an animation video about social
adaptation for people with intestinal stomas. This is a methodological study in which
three standardized operational steps were adopted for the production of educational
films: Pre-production, Production and Post-Production. In pre-production, the content of
the script was raised from the literature, the synopsis and argument were created, the
script was constructed and organized. In addition, at this same stage, the script was
validated with content specialists (nurses) and video production specialists (media).
Two rounds of the Delphi technique were applied with the judges, 10 in the first and
eight in the second round with the nurse judges. As for media professionals, three
judges participated in the first round and the same number in the second round. In the
production stage, the final version of the script was made available to the production
team, which continued to build the animation. The Content Validity Index was used to
measure agreement between judges and the Kappa Index. The data were organized in
spreadsheets in the Microsoft Office Excel® program and the analytical procedures in
the program itself and the results presented in the format of charts and tables, in view of
the best presentation. After validation, a Content Validity Index ≥ 0.75 was considered
acceptable, obtaining as a result all the items of the instrument used with the nurse
judges greater than this established value, thus considering the validated material. After
validation, the animation video was made available on online and free video platforms
and shared on social networks in order to disseminate relevant information and help
health professionals to promote health education for this audience.

The COVID-19 pandemic reached considerable numbers of the Brazilian population with the emergence of critical challenges for public and private health care networks. Plans to deal with COVID-19 within the scope of Primary Health Care (PHC) emerge as an important bridge in disease control, making their continuous monitoring and evaluation relevant so that they are improved and put into practice by nursing and other PHC professionals, based on evidence-based practice. In this sense, the objective was to evaluate the PHC structure and the actions carried out by health professionals in the municipality of Caraúbas/RN in the face of COVID-19 and how the pandemic context influenced these actions based on Callista Roy's theory of adaptation. An evaluative study of the normative type was carried out with emphasis on the degree of implementation in the dimensions of structure and process and of the evaluative research type. The research was developed in the APS of the municipality of Caraúbas, in the interior of Rio Grande do Norte, with professionals who are part of the family health teams directly involved in coping with COVID-19 and health managers. With regard to evaluative research, value judgment was used to analyze the existing relationships between the intervention and the context. The qualitative data obtained were analyzed using the content analysis technique proposed by Laurence Bardin (2011). As results and discussions, regarding the degree of implementation, the Structure dimension was classified as partially implemented. The Process dimension, in turn, was classified as fully implemented, but with some divergences from reality according to what was revealed by the statements of the interviewed professionals when exposing their perceptions. Regarding the perceptions referred to by health professionals who work to combat COVID-19 within the PHC, they raised three thematic categories: (I) influence of the pandemic on the development of actions by PHC professionals; (II) Potentialities and difficulties in professional performance during the pandemic; (III) Characteristics of patients assisted during the pandemic – suspected and confirmed for covid-19; (IV) Attributions of PHC professionals and managers in coping with covid-19. In view of this general panorama regarding the convergences and divergences of the results found between the degree of implementation and the perception of these same professionals involved in the study context, it can be inferred that, even with a partially implemented structure, the professionals, in their work process, as well as the way they idealize their assistance, have their activities based on an intrinsic understanding that corroborates the ideology of Callista Roy's theory. 

With regard to the legal attributions of the nurse, according to the precepts of Law n.
7,498/1986, which provides for the regulation of Nursing practice, the nurse is
responsible for exercising all nursing activities, including private actions: planning,
organization, coordination, execution and evaluation of nursing care services nursing;
nursing prescription; direct care for critically ill patients; and nursing care of greater
technical complexity. The objective was to analyze the temporal trend of the nurses'
workforce in the regions of Brazil in the period 2003-2021. This is an exploratory-
analytical-descriptive research, with a quantitative approach and with a focus on the
ecological study of temporal trends, related to the differences in the employment
relationships of nurses in the five regions of Brazil. The database of the Annual List of
Social Information was used. The analysis, treatment and temporal distribution were
carried out by exporting the database for descriptive and inferential appreciation using
Software R Studio version 4.3.1. Statistical analyzes were extracted regarding frequency
distribution, measures of central tendencies and positions. Trend analyzes were
performed using polynomial equations, which consisted of: simple linear regression,
second-degree or parabolic and third-degree or exponential regression. The choice of
the model that best fitted the data was considered. The temporal trend analysis was
performed in two stages: the Durbin-Watson test to assess the autocorrelation of the
historical series and exploratory analysis using the autocorrelation function. The
adoption of the significance test was also considered as a criterion for choosing the
model, where a significant trend was considered when p-value < 0.05. It was a research
that used public domain information, in a database, without the possibility of individual
identification. The temporal trend of the differential of employment contracts for nurses
was stationary in the Northeast, South, Southeast and Midwest regions, that is, four of
the five regions of Brazil. The North Region was the only one that showed an upward
trend. Based on the analysis of the time series obtained, this study showed a stable

situation in the generation of employment contracts in four of the five regions of Brazil.
It is concluded that in Brazil the trend of employment contracts for nurses is
predominantly stationary, despite the upward growth in the North of the country.

Diabetes mellitus and systemic arterial hypertension are chronic diseases of multiple etiologies, responsible for the main causes of mortality and morbidity among adults and the elderly, becoming a challenge for public and health policies in Brazil and around the world. These challenges, accentuated by the COVID-19 pandemic, are risk factors for both the severity of the infection and the inability to carry out post-COVID activities of daily living. With the aim of analyzing the self-care actions of people with diabetes mellitus and systemic arterial hypertension in post-COVID-19 conditions, in light of Orem's Theory, a descriptive, cross-sectional and exploratory research was carried out, with a quantitative approach, in the municipality of Ceará Mirim, metropolitan region of Natal, capital of the State of Rio Grande do Norte, in 9 Basic Family Health Units, in the urban area of the municipality. The population of 6,932 included diabetic and hypertensive users, registered in the 9 Units and the sample corresponded to 363, obtained from stratified random sampling, considering a 95% confidence interval with a margin of error of 5%. Users registered in these Units, diagnosed with diabetes mellitus and/or high blood pressure, and having been affected by COVID-19, were included. Data were obtained through structured forms, composed of closed questions, “Clinical File for post-COVID condition”, adapted for the research, for demographic data and health condition and the “WHO Disability Assessment Schedule (WHODAS 2.0) Manual”, for data related to self-care. They were applied through structured interviews, carried out in the Units and at the participant's home, depending on their availability. The data were tabulated, organized and analyzed using the Statistical Package for Social Science version 22.0 and the self-care variables were analyzed according to the “WHO Disability Assessment Schedule WHODAS 2.0 Manual” score. All procedures were governed by the ethical precepts of Resolution no. 466/12 of the National Health Council for research with human beings. The results indicate that individuals in a post- COVID-19 condition are mostly male, with an average age of 57 years, with at least one comorbidity, with diabetes mellitus and high blood pressure being more prevalent and also more developed in those who required hospitalization and oxygen support during the acute phase of the infection. In the post-COVID phase, it was identified that self- care actions such as inability to move and limitations in activities were affected. The most frequent physical symptoms were fatigue and dyspnea and the cognitive ones were memory loss, concentration problems and anxiety. In the end, it was possible to identify that the post-COVID-19 condition causes the emergence of symptoms and consequences in the self-care of diabetic and hypertensive individuals. This identification is essential to assist in the rehabilitation of functional disabilities and contribute to defining flows and priorities in health services and nursing care in the post-pandemic scenario.

Occupational stress has affected several workers. The recognition of related factors and symptoms of occupational stress facilitates the development of interventions by nurses, but it is evident that the nursing diagnosis Occupational Stress does not exist in NANDA International. In this sense, the general objective of this study was to develop and validate the content of the proposition of the Occupational Stress as a nursing diagnosis based on a Medium-Range Theory. Therefore, this is a methodological study, which was carried out in two stages, which were: theoretical-causal validation and content validation. The research was approved by the Ethics Committee of the University Hospital Onofre Lopes (HUOL) of the Federal University of Rio Grande do Norte under nº 4.695.488 and amendment under nº 5.498.40 and CAAE: 45570821.7.0000.5292. Data analysis was performed using descriptive and inferential statistics. Initially, a concept analysis was carried out based on the theoretical framework of Walker and Avant, which was operationalized by scoping review using the following data sources: The Cochrane Library, Scopus, Web of Science, National Library of Medicine (MEDLINE /PubMed), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Latin American and Caribbean Literature in Health Sciences,Science Direct, and Google Scholar. The final sample corresponded to 138 studies. Four attributes, 24 antecedents and 28 clinical consequences of the concept Occupational Stress in health professionals were listed. Then, the Medium Range Theory of Occupational Stress in Health Professionals (TMA-EOPS) was built based on the derivation of Betty Neuman's Systems Model, according to the theoretical framework of Fawcett and Gigliotti. Sixteen concepts, 20 propositions and 35 causal relationships between Occupational Stress and the stressors and symptoms present in the TMA-EOPS were identified, in addition to the construction of the pictogram/diagram and C-T-E structure. The second stage included content validation by judges about the elements of the diagnostic proposition. Forty-nine judges participated in this step, who validated the following elements regarding relevance: 04 attributes, 22 related factors and 28 defining characteristics of the proposed nursing diagnosis. Furthermore, they validated 03 attributes, 19 related factors and 25 defining characteristics regarding the clarity and precision of the conceptual and operational definitions of the respective elements of the diagnostic proposition. In this sense, the diagnostic proposal presented after content validation: 02 attributes, 29 defining characteristics, 21 related factors and 01 associated condition. Subsequently, the evaluation of TMA-EOPS was carried out in two rounds. Five judges participated. In the first round, TMA-EOPS was considered adequate for all items related to significance, parsimony, testability and empirical adequacy; only 01 item related to internal consistency and 01 item related to pragmatic adequacy were not considered adequate. In the second round of TMA-EOPS evaluation, items not previously validated were considered adequate. It is concluded that the study contributed to the advancement of knowledge in the discipline of Nursing through the development of a proposal for a nursing diagnosis based on a Medium Range Theory that does not exist in the NANDA International taxonomy.

Faced with the scenario of health complications related to pregnancy, the recognition of risk implies the need for specialized evaluation, with additional tests and services, and for these pregnant women the current strategies focus on improving the quality of care during this critical period. In obstetrics, the reception presents characteristics inherent to the needs and demands related to the pregnancy process that is permeated by several holistic changes. Thus, the objective of this research is to verify the evidence of validity of an educational hypermedia about the embracement and classification of obstetric risk. This is a methodological research, with development by the basic instructional design model that involved the technological production, of the educational hypermedia type, for the teaching of the Acolhimento and Obstetric Risk Classification Protocol, carried out in five stages. Twenty-two judges participated to validate content and usability. For the analysis, the Content Validity Index the System Usability Scale and the binomial test were used. The study was submitted to the Research Ethics Committee with a favorable opinion under protocol number 5.042.351. The research was conducted according to the required ethical standards, with a request for prior signature of the ICF. An educational hypermedia was developed, in the form of a website, entitled "Acolhimento e Classificação de Risco Obstétrico", or simply, ACRO. The theoretical content developed for the educational hypermedia was organized in the following topics: conceptual approach, Module I: Approaching the theme of Acolhimento and Obstetric Risk Classification; Module II: Emergency Obstetric Acolhimento; Module III: Obstetric Risk Classification; Module IV: Decision-making Process in Acolhimento and Obstetric Risk Classification; Module V: Classifying Risk - Classification Exercises, References, Supplementary Material (virtual library) and Presentation of the authors. The content obtained a Content Validity Index of 0.96 and for usability it obtained 91.9. In the global evaluation, all the requirements obtained a 0.98 index. The developed educational hypermedia presents evidence of validity and constitutes an innovative resource for the teaching and learning process in Nursing.

The current student, Student 3.0, is characterized by the demand for technologies that support their teaching-learning process, by making it dynamic and innovative. This student profile is concatenated with social changes understood as cyberculture and cyberspace, which reflect on the relationships between human beings and technologies in different contexts, among them, within the scope of teaching. As an option for this, serious games emerge, which promote an interactive, immersive and safe teaching environment. Thus, the objective is to validate the appearance, usability and effectiveness of SafeCare: serious game to support the teaching of patient safety. It deals with a validation study and a quasi-experiment of the before and after type, divided into two stages. The first consisted of the development of the serious game, based on the Analysis, Design, Development, Implementation, Evaluation model. And in the validation of appearance and usability, using the adapted Suitability Assessment of Materials and the System Usability Scale Validation judges were nursing professors and students. For whom, after agreeing to participate, a link was sent to access SafeCare: serious game and Google Forms to fill in the validation forms. At this stage, the data were tabulated and analyzed in Microsoft Excell 365, according to specific calculations for each instrument. Therefore, the verification of the effectiveness of the serious game was carried out. For this, an extension course was developed to train undergraduate nursing students from the fourth academic period on patient safety. It was structured in four meetings and one of them was dedicated to the use of SafeCare: serious game. In the first moment of the course a pre-test was carried out and at the end the post-test. Data were tabulated and analyzed using descriptive and inferential statistics in the Statistical Package for Social Science for Windows. Furthermore, the study was submitted and approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte with registration number: 4.954.453 and CAAE: 49774921.7.0000.5537. The validation steps were performed in two Delphi rounds, the first with 15 judges and the second with ten. The evaluators were mostly teachers (80%), between 41 and 45 years old (30%) and female (70%). In the first Delphi conference, appearance validation reached agreement of 0.88 and 92.94%, in the second, 0.90 and 100%. As for usability, the Delphi 1 round obtained a score of 90 points and the second 92.5. In the effectiveness test, the sample consisted of 18 students, mostly female (83.3%), aged between 21 and 25 years (55.5%) and attending the fourth period (44.5%). The average score in the pre-test was 4.7 and in the post-test 6.3. Data were analyzed using correlational bivariate analysis between means, Pearson's correlation, which detected a large effect association of 0.456 and a significant p of 0.029. It ends like this. that SafeCare: serious game obtained approval scores in the validation procedures and in the effectiveness test, therefore, it is feasible to infer that the game developed has the capacity to support the teaching of patient safety and, in addition, represents a teaching tool associated with current educational demands, which can promote meaningful learning.

Brazil faces high rates of cases of perinatal morbidity and mortality caused by
congenital syphilis since the 1990s, although actions for the promotion,
prevention and control of diseases are applicable in prenatal programs during
assistance to the binomial. Consultations for pregnant women are carried out as
a priority in Primary Health Care, accompanied by a multidisciplinary team,
including a nurse. However, despite the improvement in access to prenatal
care, important gaps persist, such as: late start of consultations, number of
consultations lower than recommended, deficit of tests performed and,
sometimes, the inefficient conduction of specific treatments and forms of
prevention of illnesses. Therefore, the objective of this study is to build and
validate an instrument for nursing care in the prevention of congenital syphilis in
Primary Health Care. For this purpose, Jean Watson's theory of nursing care
was used, constituting the application of nurses' critical thinking, in a
transpersonal perspective, enabling the recognition of care by the pregnant
woman to support her in the prevention of congenital syphilis. This is a
methodological study consisting of four phases: the first being the
operationalization of the construct, supported by the theory of transpersonal
nursing care and a scope review, containing a final sample of 35 articles that
enabled the categorization of 33 care nursing for the prevention of congenital
syphilis which, together with the ten elements of the Clinical Caritas Process,
made up the first version of the instrument, with ten dimensions and 27 items;
the second phase corresponded to content validation for the analysis of
agreement between the item-dimension and the validation of the instrument
items and its operational guide and took place in two Delphi rounds with the
participation of 12 judges; in the third phase, face validation took place, with 38
judges and a Delphi round to assess the instrument's verbal compression. Both
in the second and in the third phase, the Kappa coefficient and the Content
Validation index were used for the statistical analyses. And, finally, the fourth
phase, which consisted of validating the construct and assessing its reliability;
15 nurses who accompany the prenatal consultation and 138 pregnant women
participated in it. For construct validation, exploratory and confirmatory factor
analysis and Cronbach's alpha were used to assess the instrument's internal
consistency and thus ensure its reliability. The study complied with the ethical
prerogatives required by Resolution nº 466/2012, of the National Health Council
and its complementary ones, being approved by opinion nº. 5,632,945 and
CAAE 61762422.3.0000.5637, issued by the Ethics and Research Committee
of the Federal University of Rio Grande do Norte. From the results obtained, in

the validation of the instrument's content, an agreement between the items and
the dimensions was greater than 0.60 in the first round of Delphi in 77.78% of
the items; however, of the six items that did not show satisfactory agreement, 3
were excluded and the other 3 were adjusted in their allocation and description.
Items validated with a Kappa index of less than 1.00 were submitted to the
second Delphi round, with all of them presenting values higher than those of the
first round and greater than 0.61. Still in this phase, regarding the content
validation of the instrument and the operational guide, all items and their
respective operational descriptions obtained a CVI ≥ 0.80 and a Kappa ≥ 0.60,
giving rise to the second version of the instrument with 24 items. In face
validation, the instrument was submitted to the evaluation of verbal
compression, with all items obtaining a Kappa ≥ 0.80 and a CVI greater than
0.89, not requiring another round or adjustments, moving on to the last phase
validation, with 24 items. The construct validation was carried out through factor
analysis, where in the exploratory analysis the variables generated 9 factors
with a variance greater than 50%, which brings security to the confirmatory
analysis that obtained statistically significant values in the adequacy indices of
the final model (Ratio X2 /g.l, RMR, RMSEA, PCFI, CFI and IFI). Regarding the
verification of reliability, the instrument obtained a Cronbach's Alpha above 0.70
and below 0.90 in all items, that is, the consistency of the data is classified as
adequate. In view of these results, it is concluded that the instrument developed
for nursing care in the prevention of congenital syphilis demonstrated to have
psychometric quality and satisfactory validity to support and qualify nurses'
practice with pregnant women in Primary Health Care.

Syphilis, a sexually transmitted infection, is considered a serious public health problem, with worldwide rates of 7.1 million cases, being prevalent in the reproductive age group of 15 to 49 years. These indicators motivated the World Health Organization to develop an intervention program for the adequate management of sexually transmitted infections, by the year 2030. This research aims to validate an online course prototype for health education in the context of syphilis in primary health care. Methodological study with a quantitative approach, based on the four fundamental stages of Filatro: analysis, design and development, implementation and evaluation. In the first stage, a scoping review was carried out, mapping the knowledge of users assisted in primary health care about syphilis, subsequently a cross-sectional study was carried out, with 269 users assisted in the municipality of Natal, Rio Grande do Norte. Descriptive and inferential statistics were used, using the Chi-square and Fisher tests, evaluating the significance of p ≤ 0.05; in the second stage, the thematic axes were structured for the content of the online course plan, in the low-fidelity prototype version, using google forms, based on objectives, contents, methodological path, evaluation and curriculum structure. The plan was conceived from the perspective of the Moodle platform and the template provided by the virtual learning environment of the Unified Health System; in the third stage, the educational resources were configured, based on the needs of tools such as: training, setting, teaching-learning situation, modules and evaluation; in the evaluation stage, the content was validated with specialists in the field of nursing, recruited through the Lattes platform and the snowball strategy, according to Fehring's framework, considering a minimum cutoff of 4 points. The sample included 11 specialists. Descriptive and inferential statistics were performed for Kappa values ≥ 0.6 and CVI ≥ 0.8, and adjustments of items, including information, content and grammar. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in compliance with the ethical precepts of Resolution 466/12. The results of the scoping review demonstrated the existence of gaps in the knowledge of syphilis regarding clinical manifestations, deficits in prevention, testing, diagnosis and implemented therapeutic practices, categorized based on Orem's self-care deficit theory. In the cross-sectional study, about the sociodemographic characterization of the participants, users with a mean age of over 30 years (55.02%) were identified, a proportion of women (79.3%) higher than that of men (20.7%) , single (47.21%), mixed race (44.24%), Catholic religion (34.20%), complete high school (41.64%) and self-employed (42.50%). As for knowledge about syphilis, understanding of the importance of using condoms (96.28%), definition of the disease (88.48%), signs and symptoms of syphilis (72.08%) and medication for the syphilis treatment (47.22%). Regarding health education actions in the prevention of syphilis, most users said they had access to educational materials in health services, mainly lectures (27.14%), addressing prevention measures (58.44%). Users who sought information on the internet totaled 94.05%, but with a low percentage for health matters (13.04%). When asked if they would participate in an online course on the subject, 93.31% responded positively that they would join. The analysis and relationship between the variables showed that the definition of sexually transmitted infections was related to the level of education, obtaining p<0.001; as well as for the variable on condom use (p=0.011). A similar proportion was observed between the definition of syphilis according to the service sector (p=0.004), marital status (p=0.001), religion (p=0.026) and education (p=0.008). For the variable identification of signs and symptoms, significance was obtained for the service sector (p=0.0031), marital status (p=0.057), religion (p=0.059) and education (p=0.001). The right answers regarding medications for the treatment of syphilis were related to the service area (<0.001) and religion (p=0.019). The variable participation in lectures was related to sector (p=0.058) and education (0.099). The use of the computer or cell phone in the search for information was related to the sector (p<0.001). Concerning the creation of the online course on syphilis, significance was obtained for education (0.013). Based on the results and these analyses, an online course plan instrument was created, consisting of four modules: sexually transmitted infections and their social impact; clinical aspects of the disease; limitations for self-care; effective self-care and the contribution of technologies. The instrument was validated for the number of 84 items related to the content, in a Delphi round carried out with 11 specialists. Kappa values ≥ 0.6 and CVI ≥ 0.8 were considered for the criteria clarity of language, practical relevance, theoretical relevance and theoretical dimension, reaching satisfactory rates for 80 items, resulting in the exclusion of item 04 from the general aspects; adjustments to items 48 and 50 of module II and item 59 of module III, for the clarity criterion. Given these consensuses greater than 80% and global with satisfactory values, the items could be kept in the instrument and validated with just one Delphi round. It is concluded that the online course plan prototype, with a focus on health education, is relevant and will have an impact on the final development of the online course technology, and may contribute to the knowledge of Primary Health Care users about from syphilis.

The technological age brought new directions to the teaching-learning process. In this sense,
Digital Educational Technologies (TED) have been applied as useful tools in building
knowledge on the subjects of difficult approach to adolescents and young people, such as
human immunodeficiency virus prevention (HIV). The objective of this study was to analyze
the scientific evidence about TED in the prevention of HIV in adolescents and young people.
This is a systematic review developed based on the recommendations of the manual for
evidence synthesis of Joanna Briggs Institute and the Preferred Reporting items for
Systematic Review Sand Meta-Aalyses: The Prism Statement. This study was recorded on the
prosperous platform under the CRD42023418826 identifier. Through peak strategy
(population, intervention, control and outcomes/outcome) the question of research was built:
“What is the effectiveness of digital educational technologies in the prevention of HIV in
adolescents and young people according to the scientific literature?” The search and
collection of this review was performed in the 16 data sources: Scopus elsevier; Medical
Literature Analysis and Retieval System Online via National Library of Medicine; Web of
Science; Science Direct Elsevier; Embrase Elsevier; Scientific Electronic Library Online;
Latin American and Caribbean Literature in Health Sciences; Virtual Health Library;
ClinicalS.gov; International Clinical Trials Registry Platform; Cochrane Library; CAPES
Theses and Dissertations Catalog; Brazilian Portal of Publications and Scientific Data in Open
Access; Federated Network of Institutional Repositories of Scientific Publications; Open
Access Theses and Dissertations; and OpenGrey Database, through the crossing of the
descriptors in Health Sciences/ Medical Subject Headings (decs/ mesh) and keywords:
Educational Technology, Digital Technologies, Information Technology, Mobile
Applications, Technology, Primary Prevention, Prevention, Health Education, , Human
Immunodeficiency Virus, HIV Adolescent, Tenager, Young Adult, Young, using Boolean and
OR and OR operators. Primary quantitative primary studies were included in full and free,
without temporal limit, in any language and answered the research question. Editorial, letters
to the editor, protocols, reflections, experience reports, revisions, summaries published in
scientific events, and studies whose outcome did not evaluate aspects related to TED. Of the
7403 studies found, the sample consisted of 14 articles. The methodological quality of the
studies was verified and the level, importance and recommendation force of evidence used the
grid system. Digital educational technologies represent an important tool in the teaching-
learning process that has generated behavioral changes about HIV prevention in adolescents
and young people. The studies were analyzed regarding the characteristics, implementation
and evaluation of the intervention. The outcomes knowledge about HIV/AIDS and changes in
risk behavior have had a high level of evidence. The general risk of bias was identified as low
for most studies. There was a strong recommendation of TED as conduct for professionals.
The results are encouraging and support the use and development of more educational
technologies for HIV prevention in this population. The study contributes to nursing science
as it drives research and clinical practice, with production or readjustment of available
technological resources.

Introduction: Female incarceration has increased due to several factors, including changes in criminal policies, social and economic inequalities, abuse of psychoactive substances and issues related to gender and mental health. Being a woman and experiencing pregnancy or lactation in the prison system can be an even more challenging and difficult experience due to precarious sanitary conditions, lack of adequate medical care, stigma, isolation and separation from the child. The restrictions of the prison environment can increase the risk of problems related to the mental health of these women. Objective: To evaluate the prevalence of mental disorders among pregnant and breastfeeding women in the female prison system. Method: This is a systematic review, which evaluates and brings together similar studies for statistical analysis. To write this review, the PRISMA checklist guidelines were followed. Furthermore, the protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform, under registration number CRD42022350737. Using the PECOT strategy (Population, Exposure, Control, Outcomes/Outcomes and Types of Studies/Observational), the research question was constructed: “What is the prevalence of pregnant and lactating women with mental disorders in the female prison system?” Included were studies on pregnant women and the development of mental disorders (depression, anxiety, stress and insomnia, postpartum depression) during incarceration in comparison to pregnant women not exposed to incarceration or deprivation of liberty in the prison system. Literature reviews, case series, case reports and qualitative studies were not considered. Searches were carried out in the following databases: PubMed, Web of Science, Embase, Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus and Nursing Database (BDENF), without restriction on the language of the articles or of the year of publication. The search strategy used medical subjective vocabularies (MeSH) and a variety of other keywords. To assess the risk of bias, the Newcastle Ottawa Scale was used to assess the methodological quality of the research, while the Grading of Recommendations Assessment, Developing and Evaluation (GRADE) method was used to classify the evidence into the quality levels of the studies. As these are secondary and public data, submission to the Research Ethics Committee was waived. Results: Of the 2165 studies found, the final sample consisted of four articles. The analysis and level of methodological quality were carried out, as well as the strength of recommendation of the evidence with the GRADE system. The studies were carried out in the last decade, in the United States and Canada and evaluated regarding characteristics, implementation and evaluation of the evidence. The prevalent mental disorders found in pregnant and lactating women in the women's prison system were anxiety, common mental disorders, schizophrenia, self-harm, and postpartum depression. The Risk of Bias assessment of the included studies was essentially classified as low, which demonstrates the quality of the research regarding bias, making the results provocative for carrying out interventions in the scenario. Final considerations: It was concluded that the prevalence of mental disorders in pregnant and lactating women in the prison system indicates a growth trend, as the context of imprisonment increases illness and psychological suffering. However, it is suggested that new studies be carried out to better elucidate the prison scenario, as well as to develop measurement instruments/scales aimed at the prison scenario due to the uniqueness of the environment.

The insertion of the nasoenteral tube, despite being a frequent procedure, is invasive and traditionally inserted ‘‘blindly’’, with the patient’s head in the neutral position and without instrumental assistance or external laryngeal manipulation. This procedure sometimes becomes difficult and traumatic, presenting greater complexity in patients in coma (physiological or induced) and intubated, becoming a challenge in the face of anatomical obstacles. Therefore, its insertion presents no risks, adverse events may occur during this procedure and compromise patient safety. To this end, the objective was to compare the effectiveness of two non-instrumental methods of nasojejunal feeding tube insertion in patients in coma (physiological or induced) and intubated. This is a prospective, planned and controlled clinical trial, carried out in the Intensive Care Unit of Hospital Dr. José Pedro Bezerra, where adult patients in a physiological or induced coma and intubated were selected. They were randomly distributed into two groups: those who had the probe inserted conventionally, with the head in the neutral position (Control Group) and the group with the head positioned laterally to the right (Intervention Group). In both cases, the patients were in a supine position, without a pillow, in a semi-Fowler position and there were no chin, jaw or larynx maneuvers. The following calculations were recorded: (1) Success rate of the selected technique in the first attempt, second attempt and total; (2) Time required for the first successful attempt and the sum of all attempts; (3) Complications during insertion, including probe kinking, twisting, knotting, mucosal bleeding and insertion into the trachea; (4) Mandatory patient signals. The project was assessed by the Research Ethics Committee of the Federal University of Rio Grande do Norte, where it received a favorable opinion and was registered on the Brazilian Clinical Trials Registry platform (RBR-8cktds4). 32 patients were distributed according to randomization and allocated as follows: 16 (50%) in the CG and 16 (50%) in the IG. There was no significant difference in terms of age, sex, weight, height and body mass index between the groups. The overall success rate was 75%. Success in the first attempt to insert in intubated patients was 87.50% in the IG and 62.50% when compared to the CG. The time required for successful insertion
was shorter in the IG (53.31 ± 17.50) compared to the CG (84.38 ± 29.81), showing a statistical difference in the insertion time between the groups (P &lt; 0.001). Complications were higher in the CG (31.25%) compared to the IG (6.25%). There were no cases of serious complications. Furthermore, when evaluating the average hemodynamic parameters (systolic and diastolic blood pressure, heart rate, pulse and oxygen saturation), there was no significant difference between the two groups, before and after probe insertion. It is concluded that the simple neck lateralization maneuver, as a stand-alone maneuver, results in faster and more successful insertion times, with low complication rates, avoiding unnecessary manipulations of the thyroid, larynx and airway instrumentation.

The need for a life connected to the internet and digital communication technologies is strongly perceived in the younger part of the world population. The use of the internet can provide benefits when it is used as a means of communication, education, information, expression and leisure. However, it also becomes an environment of vulnerability in relation to exposure to risks, including that of acquiring HIV and AIDS. The aim of this study was to analyze the influence of social media on the risk perception of young people to acquire HIV. This is a scope review developed in accordance with JBI recommendations. The Participant, Concept and Context (PCC) mnemonic resulted in the research question: "What is the influence of social media on the risk perception of young people acquiring HIV?" The Health Sciences Descriptors/ Medical Subject Headings (DeCS/MeSH) selected were: HIV; Adolescent AIDS; Teenager; Young; Social Networking; Social media; Internet; Risk; Health Risk and Risk Perception. The search was performed in the data sources: Elsevier SciVerse Scopus (Scopus); US National Library of Medicine - NLM (MEDLINE/PubMed), Web of Science, Scientific Electronic Library Online (SciELO), Science Direct, Latin American and Caribbean Literature on Health Sciences (LILACS), Spanish Bibliographic Index of Health Sciences (IBECS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), CAPES Theses and Dissertations Catalog, Open Access Scientific Repositories of Portugal (RCAAP); DART-Europe; Trove from the National Library of Australia; Theses Canada; Digital Library of Theses and Dissertations at the University of São Paulo (USP) and Google Scholar. Original and review articles, complete works, theses and dissertations, available in full, without time limit, in any language and that answered the research question, were included. Data were extracted using an instrument built in Microsoft Excel 2010, which included: title; author(s); year of publication; database/library/database/academic search engine; kind of study; study site, objective(s); methodological design; level of evidence; results; conclusion/recommendations/suggestions. For analysis, a synthesis matrix that included the extracted information. A total of 4135 publications were identified, of which 128 of the full texts were assessed for eligibility, 87 were excluded and 41 made up the final sample. The predominance of publications between 2011 and 2021 was highlighted, with an international coverage of the topic (95.1%). The studies showed that the most accessed social media was facebook, followed by text messaging apps. And that some of these platforms have varied resources that are used to disseminate information about HIV/AIDS prevention. Other research shows that more time accessing social media and being male was associated with an increase in the chances of searching for an online partner, which is also related to the growth in HIV testing. Thus, the risk perception of young people acquiring HIV involves knowledge about the disease, the social context in which it is inserted and their coexistence with social media, which inter-related influences positively or negatively.

The objective was to build a specialized terminology for the care of people with sequelae by COVID-19, based on the Seven Axes Model of the International Classification for Nursing Practice (ICNP®) and on the Roy Adaptation Model (MAR), and validate the terminology content constructed by specialist nurses. Methodological study developed between 2020 and 2021, operationalized by the following steps: 1) Identification and extraction of relevant terms contained in the literature related to people with sequelae by Covid-19; 2) Standardization and standardization; 3) Cross mapping of the identified terms with the terms of the ICNP®, version 2019/2020; 4) Classification of terms found according to Roy's Adaptation Model; and, 5) Validation of the content of terms through a focus group with specialist nurses. The last stage takes place through two meetings lasting around two hours each and composed of eight specialist nurses, members of a research group from a Federal University, who developed research on an ICNP®. It was used in the Content Validity Index (CVI), validating those with a value of ≥0.80. This study was approved by the Research Ethics Committee, under Opinion No. 4,099,646, in accordance with Resolution 466/12, of the National Health Council. There were a total of 2,146 publications, of which 45 were fully examined and met the pre-established criteria. These documents were created by the creation of the corpus, where the information was extracted and grouped in a document in the Word for Windows® program, containing 308 pages. After an analysis process, the PorOnto program was drawn up, extracting a total of 1,659 terms. The extracted terms were organized in an Excel for Windows® spreadsheet and submitted to a normalization and standardization process, resulting in 478 useful terms. In the cross-mapping, each list of terms was submitted, separately, to a crossover process with the terms contained in the ICNP® through the Access for Windows® Version 2016 tool, resulting in constant and non-constant terms in the Seven Axis model of ICNP®. Thus, 157 terms were classified as constant and 321 as non-constant. Regarding the constant and non-constant terms in the ICNP®, it was identified that the most frequent were from the “Focus” and “Judgment” Axis. The study allowed the structuring of a specialized terminology for people with sequelae due to COVID-19, with the constant terms being prevalent, in the Focus and Means axes. However, it is noteworthy that the significance of non-constant terms was notorious, which can be suggested for inclusion in the International Council of Nurses and subsequent updating of the ICNP®. It is believed that the results of this study may contribute to the operationalization of the systematization of nursing care, in addition to contributing to the comprehensiveness of health care for people with sequelae due to COVID-19 and the real demands of these subjects, which will support the steps subsequent to the construction of a Terminology Subset for information and communication to Nursing practice.

Nowadays, the job market has demands due to social, political, economic, and technological needs faced by workers globally. Those requirements also exist in the health sector, which increasingly requires training, updates, and continuous professional improvement. In this manner, lato sensu graduate nursing courses suggest an education aimed at a particular area of knowledge.  These enable updates, learning, and better quality of care for the patient, family, and the community. The study aimed to analyze how nursing managers identify the quality of care in university hospitals based on the inclusion of specialist nurses. It is a descriptive-exploratory study of the qualitative approach. The managers of the nursing division in teaching Hospitals in Northeast Brazil were interviewed for information collection through Google Meet. The data were analyzed following the Content Analysis with the help of the Atlas.ti 9.0 software which helped to visualize the main results. The interview was conducted with fivenursing managers after submission and approval by the Research Ethics Committee of the Federal University of Rio Grande do Norte, opinion nº 5.004.512, under the number 50938721.5.0000.5537.The results found two categories of analysis: effects on nursing care after hiring specialist nurses and factors that promote and impede the insertion of the specialist nurses in the job market. The leading repercussions were: teaching and research improvements; systematized organization of own knowledge; security in performance/knowledge; enthusiasm; targeted treatment/work process; faster care; early identification of risks; reduced morbidity and mortality; shorter hospital stay/bed turnover; decrease in operating cost; user satisfaction; greater emphasis of the institution. The facilitating factors were: opening of vacancies in public tenders; better score in contests; institutionalization of the career plan; institutional incentive for the accomplishment of the post-graduation; same financial investment, in the private market, compared to general nurses; requirement of specialties by regulatory bodies; mastery of knowledge in the area of activit As for the complicating factors: reduced vacancies for specialist nurses; a need for greater financial investment for hiring; devaluation of specializations; inflexibility; female specialist/professional illness; lack of specific regulation and quality of lato sensu postgraduate training; experience in the area and appreciation of specializations by the private network.

Introduction: Prenatal care has the ability to contribute to the health and prevention of maternal-fetal and infant morbidity and mortality. For the Homeless Population, however, the context of vulnerability in which they live makes pregnancy a moment of concern and need for specific health care, since the absence of this continuous and adequate care during pregnancy can have negative impacts on quality of life. Objective: This study aimed to evaluate the implementation of health actions and the influence of the context on pregnancy and childbirth experience of homeless women. Methods: This is a Health Evaluation Research of the Normative Evaluation and Evaluative Research type from a mixed approach parallel convergent in which the quantitative and qualitative elements were collected simultaneously, with the same level of significance, analyzed separately and culminatted in a process of confluence. The research were developed in public places used by homeless people and at Casa Lumen São Felipe Neri, a Foster home for homeless women located in the city of Natal-RN. The population consisted of five homeless women in urban areas of Natal, by spontaneous demand and by women who previously lived on the streets, but who during the period of data collection were residing in the foster home. Data collection took place between September and October 2021 through an instrument designed for the study. Data analysis corresponded to the evaluation of the implementation according to the Starfield Primary Health Care attributes, with the analysis of the implementation of health activities from the perspective of the experience of pregnancy and childbirth by homeless women, according to the Oral History of Life. This research project was submitted to the UFRN Research Ethics Committee, being approved with report  number 4,908,889 and CAAE 48035521.3.0000.556. Results: The study highlighted the inequity in the health care provided to this population, which reported a difficulty in accessing prenatal care, laboratory or gynecological tests, and health education focused on pregnancy. In addition to these, they revealed little care and acceptance by professionals, violation of social rights and unattended births. Such aspects reveal the need for a cohesive care network, attentive to the needs and particularities of this population, and which is covered by ministerial programs. Conclusion: The attributes of primary health care for women whose pregnancy happened on the streets were not covered and the oral life history of these women showed the inequity in the health care provided to women during pregnancy with failures, especially in prenatal care.

Introduction: Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease that mainly affects the human motor system. The patient affected by this disorder gradually loses the ability to perform routine tasks, such as talking, eating or walking. It is believed that in chronic conditions, self-care can improve the quality of life of active patients involved in managing their conditions. From this perspective, technologies can work as a means of promoting this self-care and nursing professionals can act in its management, as they are able to clarify doubts and transmit information, qualifying the patient and their family. Objective: The aim was to develop an application for self-care management of patients with Amyotrophic Lateral Sclerosis. Methods: This is a methodological study of a quali-quanti approach to be carried out through User Centered Design (UCD). This strategy aims at the participation and collaboration of users in the development of applications, promoting the creation of useful products that meet the requirements and characteristics of users and are easy to handle, comprising four stages: analysis, design, construction and evaluation. Results: In the first stage, a Scoping Review was carried out with the aim of mapping the self-care strategies of people with Amyotrophic Lateral Sclerosis; in the second stage, there were investigations and discussions about the interactivity solutions for the user and the application; in the third stage, the application was built. The last stage was not performed during this study. The application was built in partnership with the Laboratory of Technological Innovation in Health at the Onofre Lopes University Hospital (LAIS/HUOL) of the Federal University of Rio Grande do Norte (UFRN). Conclusion: Self-care performed through technologies, such as an application, can be a powerful tool in promoting the quality of life of patients with Amyotrophic Lateral Sclerosis, as well as in self-care for other chronic diseases.

With a high worldwide incidence, Covid-19 consists of a disease transmitted mainly by the respiratory route, and has symptoms that can vary from mild to severe. Thus, the importance of Systematization of Nursing Care is highlighted, since it provides evidence-based care, and consequently an improvement in the quality of care provided to these patients. The objective of this study was to build a standardized nursing terminology for people with Covid-19 in the context of Primary Health Care, based on the Seven Axis Model of the International Classification for Nursing Practice (ICNP®), in the light of the theory of Needs. Basic Humanities by Wanda de Aguiar Horta. This is a terminological study, which was developed in four stages, namely: 1) identification of terms relevant to the care of people with Covid-19 in the context of Primary Health Care; 2) Standardization and standardization; 3) Cross-mapping of the terms identified with the terms of ICNP®, version 2019/2020; 4) Classification of the terms found according to the Horta Model. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with opinion No. 4,099,646, under Presentation Certificate for Ethics Assessment No. 33494920.8.0000.5537. From the process of selection and analysis of articles, a total of 42 publications were identified, among which 20 studies were examined in full and that met the pre-established criteria. In addition, 9 official documents were identified. Such documents went through the creation of the corpus, where the information was extracted and grouped in a document in the Word for Windows® program, containing 250 pages. After the analysis process, they were submitted to the PorOnto program, extracting a total of 18,109 terms. The extracted terms were organized in an Excel for Windows® spreadsheet and subjected to a normalization and standardization process, resulting in 844 useful terms. In the cross mapping, each list of terms was submitted, separately, to a process of crossing with the terms contained in the ICNP® through the Access for Windows® Version 2016 tool, resulting in constant and non-constant terms in the Seven Axis model of the ICNP®. Thus, 145 terms were classified as constants and 699 as non-constants. Among the constant terms, 24 made up the Action axis, 4 made up the Customer axis, 90 made up the Focus axis, 5 made up the Judgment axis, 2 made up the Location axis, 13 made up the Means axis and 7 made up the Time axis. The study allowed the structuring of a standardized nursing terminology for people with Covid-19 in the context of Primary Health Care, which could support the creation of a Terminological Subset of the International Classification for Nursing Practice (ICNP®) for care of nursing. Finally, it is believed that the results obtained will promote an improvement in the clinical practice of nurses for people with Covid-19, and consequently guarantee quality care, especially in the context of Primary Health Care, as it is in this scenario that the longitudinal follow-up of the population with this disease.

Neonatal hyperbilirubinemia has a high worldwide prevalence and affects 84% of healthy newborns in the first week of life. For 60% of them, it is a physiological phenomenon, which appears on the second or third day after birth. However, some neonates present the most accentuated condition that requires treatment with phototherapy as an intervention. Therefore, the present study aimed to determine the degree of implementation in the use of phototherapy for the treatment of neonatal hyperbilirubinemia. It is a normative assessment, with a quantitative approach, with emphasis on the degree of implementation of an intervention. The study took place in a public maternity hospital located in Natal, Rio Grande do Norte. The population consisted of nurses working in neonatal units, who provide direct care to newborns using phototherapy, and the final sample consisted of 20 participants. Data collection took place between December 2021 and January 2022, using an instrument designed for the study. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS)® software, from the perspective of descriptive statistics and attribution of value judgment, according to the degree assigned. The study complied with the ethical and legal principles that govern scientific research in human beings according to Resolution No. 466/2012 of the National Health Council, being approved by the Embodied Opinion of the Research Ethics Committee, No. 5,133,140, under CAAE No. 51872521.0 .0000.5537. It was observed that the degree of phototherapy implantation was classified as partially implanted (58.10%), where the structure (62.79%) and process (80.94%) dimensions are partially and fully implanted, respectively. Only the items checking the newborn's temperature (22.50%) and checking the light irradiance of the phototherapy device (23.75%) are not implanted. It is concluded that the definition of the degree of implementation of phototherapy brings the situational diagnosis of phototherapy in a maternity hospital, since it makes it possible to identify strengths and weaknesses related to the care offered to the neonate under phototherapy, in order to transform them into improvements. We suggest the development of a nursing care instrument for newborns under standardized phototherapy, according to already established norms and criteria.

Systemic Arterial Hypertension (SAH) represents a serious epidemiological problem in Brazil and in the world, both due to its high prevalence and the complications it causes with high rates of morbidity and mortality and relevant impacts on hospital costs. In Brazil, the challenges of controlling and preventing SAH and its complications are, above all, for the teams that provide Primary Health Care (PHC), whose work process presupposes a bond with the community and the attached clientele. Evaluating the performance of PHC in the care of people with SAH is an important need for propositions that seek to improve the quality of care, since the evaluation is an instrument that supports decision-making and guides changes. In this sense, this study aimed to evaluate the attributes of primary health care in the care of patients with Systemic Arterial Hypertension in the city of Parnamirim/RN. This is an evaluative study with a quantitative approach of a normative nature. The evaluation model created by Barbara Starfield was used as a theoretical-methodological framework, which suggests a normative method to measure the achievement of primary health care, evaluating the capacity and performance of attributes at this level of care in relation to the actions developed/offered. The study was carried out in units that offer primary health care services in Parnamirim, a municipality in the Metropolitan Region of Rio Grande do Norte. The study population consisted of nurses and doctors (110 subjects) from the Family Health Strategy teams, responsible for follow-up consultations for patients with SAH within the primary care of the municipality. Medical professionals and nurses who work in the unit surveyed for at least three months were included in the sample. Professionals who were on sick leave and professional leave were excluded. Data collection was carried out between the months of October 2021 and January 2022, using an instrument to assess the capacity and performance of care for hypertensive patients in PHC. This instrument was created based on the Primary Care Assessment Tool in the Brazil version (PCATool-Brasil) and on Caderno de Atenção Básica nº 37, both published by the Ministry of Health. The instrument consists of 5 questions to characterize the professionals and 29 questions that seek to assess the elements related to the capacity and performance of each PHC attribute, namely: first contact access; longitudinality, integrality and coordination. Data were analyzed using descriptive statistics, in which scores were calculated, classified as High (score ≥ 6.6) and Low (score < 6.6), with the High score being characterized by the presence and extent of PHC attributes, revealing services better oriented. The study followed the ethical and legal principles that govern scientific research in human beings, recommended in Resolution No. 466/2012, of the National Health Council, being submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte and approved under the number: 4,954,487. Sixty-nine subjects participated in the research, of which 76.81% were female, 72.46% had a nursing degree, 59.42% said they worked for 1 to 2 years in the current Primary Health Care unit. Of the 4 attributes evaluated in this study, only the attribute Longitudinality had a high score (7.61), the others had a low score, namely: Access to the first contact (5.92), Integrality (5.96), Coordination (5.57) . In this way, it can be seen that the municipality did not obtain a satisfactory score, evidencing the absence of the extension of the PHC attributes in the care of patients with arterial hypertension and improvement in health care processes, qualification of the system's performance, and consequently, impacts on improving the health of this population.

Introduction: Chronic conditions, such as those of people living with the human immunodeficiency virus, cause necessary changes in lifestyle, which sometimes conflict with socially ingrained and apprehended behaviors and beliefs that impact the health-disease process and the way to take care of yourself. The latest version of NANDA International brought changes in the nursing diagnosis Ineffective Health Self-Management, formerly called Ineffective Health Control, a diagnosis that has a high prevalence among people living with this disease, resulting in compromised health. The presence of diagnoses like this infer high care at all levels of health care by nursing, which transposes the biologicist character and refers to a greater need to deepen the issues that influence it. Objective: To develop a mid-range Nursing theory for Ineffective Health Self-Management in people living with the human immunodeficiency virus, in the light of Roy's Adaptation Model. Methods: This is a theoretical, predictive and deductive study based on the theoretical references of Callista Roy. The study was carried out in five stages, namely: definition of the approach to construct the middle-range theory, definition of the main concepts (key concepts), construction of a pictorial scheme, construction of propositions and the establishment of causal relationships and the evidence for practice. Initially, a scoping review was carried out, which served as the basis for the theory with searches in the following databases: Scopus, Web of Sciense, PubMed, CINAHAL, Cochrane, LILACS and Scielo. The following descriptors were used: “Acquired immunodeficiency syndrome”, “HIV”, “Patient acceptance of health care”, and “Cooperation and adherence to treatment” intermediated by the Boolean operators AND and OR. From this search, the essential elements of the validation process (attributes, factors and indicators) were extracted and analyzed in order to establish the causal relationships between them. Results: Of the 5622 articles obtained, after applying the eligibility criteria, 51 articles made up the final sample. The results show the identification of five essential attributes, 37 antecedents and 19 consequents. Finally, a pictogram was constructed representing the establishment involved in causal relationships with seven prepositions. Conclusion: It is concluded that the middle-range theory on the nursing diagnosis Ineffective health self- management in patients living with the human immunodeficiency virus developed in this study provides a consistent theoretical basis for the aid of nurses' diagnostic reasoning.

The diagnostic inference in nursing, because it is something complex, can lead to difficulties for students. Thus, there is a need to develop educational technologies aimed at improving this reasoning. Thus, the objective is: to evaluate the effectiveness of clinical simulation in line with the conceptual map in the diagnostic reasoning ability of nursing students. The research was developed in three stages, the first two being subsidized by a methodological study and the third by a controlled and randomized clinical trial. The first includes the construction of two clinical cases for the pre-test and post-test instruments, two clinical simulation scenarios on diagnostic reasoning in nursing and the elaboration of the students' leveling assessment. The second stage corresponded to content analysis of clinical cases, simulation scenarios and assessment of students' placement by judges. The evaluation of the scenarios had 45 judges in diagnostic reasoning and/or clinical simulation, who analyzed each item using a likert scale. To assess the degree of diagnostic accuracy, the Nursing Diagnosis Accuracy Scale was used. Clinical cases and leveling questions had their content evaluated by 8 judges in a focus group. The third stage included the application of clinical simulation in line with conceptual maps to improve the ability of diagnostic reasoning for undergraduate nursing students. Students were randomized into intervention and control groups. The intervention group was submitted to the use of educational technology and the control group to the traditional class. The following inclusion criteria were adopted: age 18 years or older; being a student of the nursing course at a Federal University of Rio Grande do Norte and having attended or being studying the curricular component referring to the Nursing Process content, specifically, Nursing diagnosis. The following were used as exclusion criteria: students who had any cognitive or behavioral difficulties, which made communication unfeasible and also those who had a grade higher than 7 in the leveling assessment. As discontinuation criteria, the following were considered: withdrawal from participating in the research after the beginning of data collection and/or the appearance of flu-like symptoms during this period. Data were analyzed by descriptive and inferential statistics. For the simulation scenarios, an agreement of 85% of the judges was considered. For the Nursing Diagnosis Accuracy Scale, the S coefficient was calculated for all diagnoses. The students' performance was analyzed using inferential statistics in the pre-test, post-test and Diagnostic Reasoning Inventory instruments, adopting a significance level of 5% (p≤0.05). The research project was approved by the responsible Ethics Committee, under number 3,084,032. It was registered in the Brazilian Clinical Trials Registry database, receiving the number: RBR-7qjpn6. The results show that the scenarios were judged with acceptable agreement by the experts, the proposed diagnoses showed a high degree of accuracy. The clinical cases used in the pre-test and post-test had an average content validity index of 93.7%. In the last stage, the intervention group stands out in the inference of the diagnostic label, which presented a statistically significant difference when comparing the pre- and post-test moments (p = 0.001). The same happened in the correct answers regarding related factors (p=0.004) and defining characteristics (p=0.004). Thus, it is concluded that the educational strategy clinical simulation in line with the conceptual map was effective in improving the diagnostic reasoning of nursing students. Furthermore, the study provides visibility for two active teaching methodologies, clinical simulation and the conceptual map, which represents an advance in the role of students as active subjects in the teaching-learning process.

The gestational period is a phase of complex and unique transformations accompanied by physical, hormonal, psychological and social changes, and there may also be a variation of ambivalent feelings ranging from doubts, apprehension, love, joy, reaffirmation of pregnancy and anxiety and worry, especially when it comes to the pregnancy of a primigravidae. It is a fact that the primiparous pregnant woman has doubts about the right time to go to the maternity hospital, often generating anguish, fear and insecurity, sensations always observed by professionals in the daily routine of health services and are highlighted by the literature. Faced with this reality, it is believed that the use of an animated video on the signs of labor and obstetric risk in prenatal consultations can be a useful technological tool in expanding knowledge about pregnancy and childbirth in women about to be pregnant. to be a mother. The objective is to develop a care-educational technology for primiparous pregnant women about the signs of labor and obstetric risk. Methodological study, carried out through four stages, namely: 1) Construction of the animated video script on signs of labor and obstetric risk; 2) Validation of the animated video script content by expert judges; 3) Construction of the animated video on signs of labor and obstetric risk and, 4) Influence of the animated video on the knowledge of primiparous pregnant women through an EQE. To analyze the data referring to the validation process, the Content Validity Index and the Kappa Coefficient were used; In the quasi-experiment data analysis phase, descriptive statistics, trend measures, data dispersion were applied, in addition to the McNemar, Chi-square and Student's t tests, with a significance level of 5%. The study was submitted to the Research Ethics Committee of the Federal University of Rio Grande of Norte in accordance with the recommendations of Resolution 466/2012, of the National Health Council and its complements, with opinion approved under No. 4,396,786 and CAAE 39211420.4.0000.5537. The validation of the technology was carried out by 21 expert judges, fifteen of them with expertise in obstetric nursing and eleven in primary health care. Most were female (71.4%) with an average age of 35 years; of these, 42.9% were masters with an average of 8 years of experience in the field; The total Content Validation Index of the animated video script was 0.97. All the variables analyzed had an index greater than 0.81, with a lower value of 0.85 in the judgment regarding the adequacy of the material to the sociocultural level of the pregnant women. The Kappa coefficient obtained was 0.55, which corresponded to a moderate agreement. Ninety primiparous pregnant women were interviewed, whose profile corresponds to women with an average age of 23 years; mixed race (64.45%); in a stable union (74.44%) and an average of 10 years of schooling. Most (62.22%) were housewives and 54.45% had a family income of 1 minimum wage; half of the pregnant women (50%) were in the third trimester of pregnancy and 85.56% were undergoing usual risk prenatal care. Only 12.22% of them reported having access to information about signs of labor and obstetric risk. Data analysis using the McNemar test showed a statistical difference (p<0.0005) between before and after the animated video in questions 1, 2, 3, 4, 5 and 6. Regarding the total performance, it was verified if, through the Student's t test, there was a significant difference (p<0.001) between before and after viewing the animated video in the number of correct answers for the questions. Finally, in the evaluation of primigravidae regarding the importance of the video, the average grade attributed was 9.92. At the end of this study, it was concluded that its results confirmed the thesis that the use of a care-educational technology, such as an animated video, on the knowledge of the signs of labor and obstetric risk, had a positive influence on most of the participating pregnant women, indicating its importance and applicability to primary care services during the follow-up of women in prenatal consultations.

This study has as its research object the development of a Mid-Range Theory (AMR) for nursing on Impaired Health Literacy. The research is consistent with the trend of studies worldwide regarding the encouragement of scientific investigations by considering Health Literacy (HL) as an essential element for the care and improvement of the individual's ability to respond to their health status. The recent inclusion of the SL in Nanda Internacional (NANDA-I) reinforces the importance and the need to work on theoretical and practical aspects of the SL, especially from the perspective of Nursing science. In this way, theorizing on the subject in question provides a framework of knowledge to strengthen nursing as a discipline and science, in addition to providing limits for professional performance based on ethical precepts and guidelines for professional practice. TMA studies have been developed in order to support and contribute to the development of NANDA-I in order to clarify concepts or even insert diagnoses not yet covered. This study aims to develop a Middle Range Theory for Impaired Health Literacy. This is a methodological study of a diagnostic proposal for Impaired Health Literacy from the development of a TMA. Thus, the study was carried out in two stages, namely: 1) Theoretical-Causal Validity for the development of the TMA for Impaired Health Literacy and 2) Content analysis by judges of the proposed nursing diagnosis Impaired Health Literacy. The theoretical-causal validity was operationalized from an integrative literature review, developed in five data sources, namely: SCOPUS, WEB OF SCIENCE, LILACS, MEDLINE AND SCIENCE DIRECT. After applying the inclusion and exclusion criteria, 78 studies made up the final sample of the first stage. The content analysis by judges took place through the participation of 44 judges according to previously established criteria, whose diagnostic proposition constructed from the causal theoretical validity was refined according to criteria of relevance, clarity and precision evaluated. For the descriptive analysis of the characterization of the participants, the frequencies, measures of the distribution center and their variability were considered. The Kolmogorov-Smirnov test was applied to verify the normality of the cases. A statistical analysis was performed to calculate the CVI to identify the proportion of judges who consider the instrument with its respective clinical indicators and etiological factors to be adequate. This study obtained a favorable opinion from the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN) (ANNEX A) with number 4,745,373 and CAAE 46968421.4.0000.5537. In the first stage, 14 etiological factors, eight defining characteristics, two populations at risk and three associated conditions were identified. The TMA made it possible to construct nine propositions and establish causal relationships between the phenomenon and clinical practice, in addition to the construction of the pictogram. In the second stage, the judges considered the diagnostic proposal adequate, considering 15 etiological factors, eight defining characteristics, four associated conditions and five populations at risk. It was concluded that the development of the TMA enabled the construction of a diagnosis focused on the problem until now, non-existent in the NANDA International taxonomy, which was considered valid by the specialists, based on the content analysis.

Venous ulcer is considered a major public health problem due to the socioeconomic impact it causes on society due to the increase in its incidence, as well as the gaps in health services, in particular, the difficulty of professionals in clinical judgment during treatment. choice of injury coverage, which slows down the healing process. In this way, a computer system can help nurses to minimize the difficulties facing the treatment of venous ulcers, through artificial intelligence. Among the intelligent technologies, the Deep Artificial Neural Networks have been standing out for their high power to solve complex problems, which makes it possible to maximize the quality of care offered to patients and contribute to the decision-making of professionals during clinical practice. Given the context, the study aims to provide computational assistance to nurses in decision-making about dressings for venous ulcers, through two neural networks. This is a methodological, descriptive research with a quantitative approach. The study was divided into four phases, according to the Unified Process (UP) methodological model. Phase 1 refers to the design and requirements gathering. In this phase, an integrative review was carried out on dressings used in the treatment of venous ulcers, construction of an image bank and the classification of tissues and coverage suggestions, by expert nurse judges in the treatment of chronic ulcers. Phase 2 comprises the elaboration of the structure of neural networks. Phase 3 refers to building, testing and evaluating the networks. To make it possible to evaluate usability, it was necessary to create a VenoTEC application containing 9 screens, aimed at classifying coverage options from photos taken of venous lesions of patients. Thus, the usability assessment process took place with 13 nurses, in the period of June 2022, using a scale, guided by the System Usability Scale (SUS). Data were analyzed according to a calculation guided by the SUS, as well as exported to the Statistical Package for Social Science 20.0 program, where they were analyzed using relative and absolute frequency statistics. The construction of the neural network aimed at tissue classification obtained an accuracy of 70% of correct answers, while the neural network aimed at the classification of coverage obtained an accuracy of 100% of correct answers. In this way, the networks proved to be effective for the application. Phase 4 refers to the finalization of the product. The result of the usability evaluation obtained an average of 88.07; which characterizes a very good usability. The participating nurses, when using the system, felt satisfied and stated that they would use the technology in their work activity. The development of the two deep ANNs aimed at offering computational support to nurses during VU treatment may bring contributions as a work tool based on scientific evidence and protocols, in order to standardize conduct in health services, which may favor the improvement of care , by minimizing errors, in addition to providing quick and professional decision making.  

Introduction: the construction of paternal identity is a transactional process and requires the involvement of men in the context in neonatal care, when the premature delivery of the child occurs unexpectedly. It involves subjective and complex aspects in addition to new adaptive activities and affective skills, so that it can be participated in the third stage proposed by the Kangaroo Mother Care Method. Objective: to describe the experience of the father in the care of the preterm child in the third stage of the Kangaroo Mother Care Method. Method: descriptive study with qualitative approach, carried out at the Maternity School Januario Cicco, reference in neonatal care, in the municipality of Natal, Rio Grande do Norte, from March to July 2022. Seven parents who experienced care for the premature child in the third stage of the Kangaroo Mother Care Method participated in the participants. For data collection, a questionnaire with sociodemographic data was used and in-depth open interviews were conducted, closed by the criterion of data saturation. The participants' characterization variables were typed into a Microsoft Office Excel spreadsheet and analyzed using descriptive statistics (absolute and relative values). The interviews were recorded, transcribed and transcribed in a LibreOffice document, giving rise to the corpora for processing and analysis. Initially, exploratory reading of the interviews was performed to highlight the main ideas of the participants and preparation of methodological and substantial memoranda.  The corpora were processed in the SOFTWARE IRAMUTEQ, through lexographic analyses: Descending Hierarchical Classification, Similitude Analysis and Factorial Analysis of Correspondence by categorical variable, associated with Bardin content analysis. Study approved by CEP/UFRN, Opinion: 5.269.9903, CAEE: 52591021.9.0000.5537. Results: the integration of the categories allowed the emergence of the central category: "The construction of paternal identity mediated by the love of the premature child in the Kangaroo Mother Care Method" from four dominant categories: Category I (Class 02) - The transition of care experienced by the nursing-mediated father; Category II (Class 01 and 05) - Producing new paternal senses from the routine of child care and the desire to care for the premature child; Category III (Class 03 and 04) - Positive religious/spiritual coping as a coping strategy to deal with the child's prematurity; Category IV (Class 06) - Feeling like a father in child care in the MC. It was identified that the construction of paternal identity is mediated by paternal love for the child, which is built from the maturation and sense of responsibility that arise substantially in the postpartum period.  The early connection established with the premature child, the new care routine initiated in the hospital environment and extended to the family home mediated by nursing in the third phase of the Kangaroo Method and the continuous contact mediated by love and desire to care and contribute to the confrontation of obstacles and acquisition of new paternal competencies in the daily relationship between father and child. Thus, paternal love is propitiated by the intimacy established between father and child in parenting. Final considerations: it was revealed that the construction of paternal identity is based on the relationships established with the child as he acquires a proactive and engaging posture, in the redefinition of personal priorities experienced in daily care and by the love he feels for the child, in the third stage of the Kangaroo Mother Care Method. It is considered that the results support the thesis that the father should be involved early in all phases proposed by the neonatal care of the Kangaroo Method, for the effectiveness of care after hospital discharge. Moreover, the health professionals involved, in particular, nursing should recognize the paternal role in the child's life and in the positive impacts for their growth and development, as well as and promote the use of positive strategies, such as religious coping, in overcoming the challenges of fatherhood.

Introduction: Tuberculosis affects people with low purchasing power and is still seen as neglected. Until 2035, a global reduction of 4 to 5% per year would be necessary for a tuberculosis-free world. The Primary Health Care services are the gateway to a possible suspected case of tuberculosis and after confirmation, the case notification must be carried out and inserted in the Information System for Notifiable Diseases for tuberculosis. Objective: This study aimed to analyze the completeness of the tuberculosis data in the Information System for Notifiable Diseases in the municipality of Parnamirim / RN from 2009 to 2019. Method: This is a descriptive, retrospective, historical series study based on secondary data. The population was composed by the database of the Information System of Notifiable Diseases, with information from the notification forms for tuberculosis in the municipality of Parnamirim / RN, totaling 891 cases. Data collection took place in the second half of 2020. The selected variables are represented by the sociodemographic, clinical, laboratory variables and the outcome of the case. The database was built in Excel format, version 2017, to create descriptive tables and graphs. For the application of statistical tests, the free statistical software R, version 3.6.1, was used. In the qualitative variables, a descriptive analysis was carried out through distributions of absolute and relative frequencies (%). In the comparison of completeness with the time under study, the Spearman’s non-parametric statistical test was applied with a significance level of 5%. After the conclusion of the descriptive analysis, the evaluation of variables was started according to the completeness criterion. The completeness analysis was based on the classification of the Notifiable Diseases Information System for qualitative assessment, establishing the following division: category 1 (bad), when there is 0 to 25% of completeness; category 2 (regular), between 25.1% and 50%; category 3 (good), between 50.1% and 75%, and category 4 (excellent), for completeness between 75.1% and 100%. The study followed the ethical precepts in research with human beings described in Resolution 466/2012 of the National Health Council. Approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, through the report 4,009,967 and Certificate of Presentation for Ethical Consideration 30793920.1.0000.5537. Results: 891 cases were analyzed in the period from 2009 to 2019. It was found that the predominance of reported cases was male (70.93%); between 20 and 29 years (31.09%); as for the level of education, (25.34%) had between the 1st to the 4th grade incomplete elementary school. The situation of the patient's entry into the Health Unit, a new case predominated (78.56%); clinical form was pulmonary (86.76%); (60.20%) underwent chest radiography with a suspicious result (91.15%); (75.59%) performed sputum smear microscopy in a sample for diagnosis, of these (71.90%) had a positive result; only (37.50%) performed the rapid test, with (87.04%) detectable sensitive to rifampicin and (1.23%) detectable resistant to rifampicin; (17.96%) underwent sputum culture, of these (35%) had a negative result. For the situation of closure of the notified case (77.63%) they obtained a cure for tuberculosis. While 8.20% abandoned treatment. Regarding completeness, it was classified as regular: illicit drug, smoking and rapid test, as good education and other conditions and as excellent sex, age, type of entry, clinical form, chest X-ray, AIDS, alcoholism, diabetes, disease mental, sputum smear, sputum culture and outcome of the case. Evidence of a statistically significant correlation was obtained between the time under analysis and the completeness of education level, chest X-ray and the outcome of the case (drop in completeness); illicit drug, smoking and rapid test (increase in completeness). Conclusion: Considering the completeness of the fields of the notification / investigation form for tuberculosis, it was found that of the 17 variables analyzed, 18% were classified as regular, 12% as good and 70% as excellent between the years 2009 to 2019 In the mandatory field variables, a behavior was verified, with the fields being completely filled out. As for the quality of the essential fields, there was a variability in completeness. Thus, it is necessary to establish strategies for the importance of the quality of the registration of notifications.

Congenital syphilis is a multiple system infection, caused by Treponema pallidum and transmitted to the fetus via the placenta, at any time during pregnancy. The State of Rio Grande do Norte has rates above the national average (12.5 cases / 1,000 live births). The general objective of the research was to analyze the spatial distribution of notified cases of congenital syphilis and its temporal trend in the State of Rio Grande do Norte. This is an ecological study, with secondary data for the period from 2008 to 2018, with the population reported cases of congenital syphilis. For this purpose, data reported in the Notifiable Diseases Information System and in the Live Births Information System were used. In the analysis of the data, the maps of the eight health regions of Rio Grande do Norte from the Brazilian Institute of Geography and Statistics were extracted and the local and global Moran was performed with QGIS software version 2.18, being smoothed by the local empirical Bayesian method that resulted in the thematic maps . After calculating the incidences, which were standardized per 1,000 inhabitants, it was possible to carry out the analysis of the temporal trend using the Jointpoint model. The study obtained a favorable opinion from the Research Ethics Committee of the Federal University of Rio Grande do Norte, under Opinion No. 3,775,828 and CAAE No. 25687519.4.0000.5537. The results of this study show that 88% of children were diagnosed during prenatal care or childbirth / curettage, even with 76% of them being considered asymptomatic. On the other hand, the treponemic test was not performed in 81% of them. As for the treatment performed by the mothers, 70% was considered incomplete or inadequate. Moving averages showed a tendency to increase congenital syphilis in the 7th and 3rd health regions. Regarding the temporal analysis, this investigation showed a spatial cluster in the 3rd, 5th and 7th health regions, with an increased risk for congenital syphilis up to 2.65 times. Finally, the temporal trend showed a continuous growth curve across the state. It is concluded that there is a sensitive weakness regarding prenatal care, given the growing incidence in the State with an expectation of increase in the next five years. Finally, we emphasize the importance of implementing strategic and priority actions, as well as expanding the commitment to new partnerships, with a focus on reducing the transmission of congenital syphilis.

Safe and quality care in hemodialysis services aims to reduce or eliminate the occurrence of adverse events. This is because, it is an environment that presents several risk factors because it is an invasive and complex procedure. Thus, it is necessary to implement measures for patient safety in these services, as well as to identify problems and measure the quality of care and management. Thus, this study aimed to build and validate the content and appearance of a protocol for evaluating safe care in hemodialysis. It deals with a methodological study conducted by Pasquali's psychometric framework organized in three procedures, namely: theoretical procedures in which a Scoping Review was carried out to support the definition of the contents included in the protocol; empirical procedures construction of the protocol through scientific evidence and content and appearance validation via Google forms and Delphi steps with expert judges in the area of patient safety and kidney diseases; and, analytical procedures in which the analysis of the data from the previous phase was carried out using the content validation coefficient, items with a minimum agreement of 80% between judges were considered valid. This study is approved by the Ethics and Research Committee of the Federal University of Rio Grande do Norte, under Certificate of Ethical Appreciation No. 3,915,158 and CAAE: 29259020.7.0000.5537. After construction of the protocol, it was submitted to the appreciation of nine judges who responded to all Delphi stages, who made suggestions for improvement and improvement. This achieved a general content validity coefficient of 0.87 and 0.94 for appearance validation. Thus, the graphic protocol for evaluating safe care for patients on Renal dialysis is considered valid in its content and appearance.

Syphilis is considered a sexually transmitted infection, of a systemic and curable character, caused by Treponema pallidum and treatable with antibiotics. It has high rates of vertical transmission, aggravating serious problems of morbidity and mortality as a congenital syphilis. Its general objective is to analyze the factors related to the reported cases of gestational and congenital syphilis in the state of Rio Grande do Norte. This is a research with a quantitative epidemiological approach, of a descriptive and ecological type, derived from secondary data, having the state of Rio Grande do Norte as its coverage area, carried out in 2020. The sample was composed based on the criteria of eligibility and totaled 1892 notifications of syphilis in pregnant women and 2101 notifications for congenital syphilis in the period from 2014 to 2018. Data collection took place between the months of October to December through the bank of the Information System for Notifiable Diseases. The data were organized in the Microsoft Excel program for tabulation and statistical analysis using the software Statistical Package for the Social Sciences version 23.0. For statistical analysis, the Chi-square or Fisher's exact tests were used, as well as Odds Ratio with respective 95% confidence intervals (95% CI), followed by logistic regression to obtain the adjusted values to verify the associations between the variables of interest. The significance adopted was p <0.05. Finally, statistical differences between the values spent (R$) for hospitalization between gestational and congenital syphilis were obtained, when parametric, by independent t test and when the Gaussian assumption was broken by Mann-Whitney and as a measure of the quality of fit of the logistic model was the Hosmer and Lemeshow test was used, in which a p> 0.05 will indicate that the model is adjusted. Inherent to ethical aspects, the research was conducted in accordance with Resolution 510/16 of the National Health Council, which addresses the guidelines and regulatory standards for research involving human beings and how the study made use of secondary data, analysis by the Ethics and Research Committee. During the investigated period, an increase in reported cases was observed in the year 2018. The registered maternal profile points to women with an average age of 20 to 29 years (50,0%), brown (57,9%), with low education (61,2%). The analysis of prenatal care identified a predominance of maternal diagnosis in the third gestational trimester (40,0%) despite the fact that (84,3%) of these pregnant women performed it and the presence of nontreponemal reactive tests in (86,2%) and treponemal tests (49,5%) of women at delivery. With regard to maternal treatment, only (3,3%) of these women were registered with an appropriate treatment scheme and (18,6%) of partners were treated concurrently with pregnant women. In the outcomes related to children, (98,5%) were diagnosed with recent congenital syphilis and a number of (1,1%) of deaths from the disease in the state. Regarding hospitalizations for the notified condition, it presented an average number of 79,2 for congenital syphilis with an average value of R$ 4,217 per child. The results point, moreover, to important gaps in the processes of epidemiological surveillance regarding the filling of notifications regarding ignored and blank information. The analysis of notification of gestational and congenital syphilis made it possible to conclude that vertical transmission was related to missed diagnostic and therapeutic opportunities. The development of strategies for early detection and adherence to the treatment of the disease must be adopted, with a view to strengthening care and breaking the chain of vertical transmission of syphilis, in addition to avoiding and / or minimizing hospitalizations of children as a result of congenital syphilis. We emphasize the need for professional qualification for notification of the disease, as well as care for hospitalization of the newborn affected by the disease and expansion of the provision of information to epidemiological surveillance, in order to allow the continuity of the analysis of the disease.

Sedentary lifestyle has an increasing curve between adolescents and young adults. In this context, it is essential that the nurse knows in depth this nursing diagnosis. The objective of this study is to build a medium-range theory for the nursing diagnosis Sedentary Lifestyle in adolescents and young adults. This is a methodological study, according to Lopes e Silva's theoretical framework for the development of medium-range theory for nursing diagnoses. The study was made operational through an integrative literature review in the databases: National Library of Medicine and National Institutes of Health; Scopus; Cumulative Index to Nursing and Allied Health Literature and Web of Science. The crossing of the following descriptors Sedentary Behavior; Sedentary Lifestyle; Young Adult; and Adolescent allowed 2974 articles to be obtained. After applying the eligibility criteria, the final sample resulted in 57 articles. The results show the identification of six essential attributes; 23 clinical antecedents and 11 clinical consequents. The essential attributes were aging; excessive screen time on the internet; student; watch television >2h/day; women; and physical activity lower than recommended. The clinical antecedents were live in an urban area; aging; unemployment; excessive screen time on the internet; student; prolonged sitting time; physical inactivity; lower health perception; less satisfaction with life; watch television >2h/day; women; high socioeconomic status; physical activity lower than recommended; mismanagement of free time; insufficient resources for physical activity; insufficient interest in physical activities; high maternal education; air pollution; unfavorable climatic conditions; deficient knowledge; migration; high education level; and family history of physical inactivity. And the clinical consequents were impaired memory; backache; inadequate sleep time; lack of physical conditioning; depression; stress; anxiety; excess adiposity; cardiovascular disease; impaired cognitive function; and less visual attention. It is concluded that the understanding of nursing diagnosis sedentary lifestyle based on a medium-range theory is timely and generates tools that can promote health and quality of life in this specific population.

Peripheral venous access is a common procedure in health care services, becoming a challenge for professionals. It is a procedure performed by nurses that requires precise clinical assessment, skills, mastery of physiology and anatomy, specific skills achieved in professional technical-scientific training, which requires the integration of multiple and complex knowledge. In this sense, the objective was to verify the self-reported knowledge of undergraduate nursing students to perform peripheral venipuncture in the external jugular vein. This is a research developed by a quantitative approach, with a cross-sectional design and descriptive analysis, carried out with students from the sixth to the ninth period, enrolled in the second semester of 2020, of the Undergraduate Nursing Course at the Federal University of Rio Grande do Norte. Data collection was carried out via the Internet, via e-mail and WhatsApp messaging application, through the application of an electronic questionnaire by access link. The data were organized in a Microsoft Excel Software spreadsheet, version 2017 and converted to the free statistical software R for the application of statistical tests. The quantitative variables were analyzed by descriptive statistics of measures of trend and dispersion of data and in the comparison of academic characteristics with the dimensions of the instruments under study, the Mann-Whitney, Friedman and Kruskal Wallis tests were applied, adopting the level of significance was 5%. Study developed through Certificate of Presentation for Ethical Appreciation, CAAE: 36707320.2.0000.5537. Responses were obtained from 59 students, predominantly female (81,36%), age group up to 25 years (72,88%), most singles (84,75%), in which, 22,03% of the students were in the sixth period, 25,42% seventh, 28,82% eighth and 23,73% ninth. As for the learning process, it was found that 35 (59,32%) had no experience of attending an external jugular venipuncture, and even though 12 (20,34%) they did not know how to use flexible intravenous catheters such as polyurethane. In general, students from the last periods presented a higher level of theoretical knowledge, before and during the procedure, with proactive actions (p-valor 0,007) and academics from the ninth post-procedure period. There is no difference in the level of satisfaction when comparing the different periods in academic training. Thus, the domain of knowledge and high level of academic management present in the final periods of training reflects on the quality of the care practice of these graduates, as future professionals.

The use of Hypodermoclysis as subcutaneous therapy presents itself as an effective technique for medication and fluid replacement, when the oral and intravenous routes are not viable in any way. Especially in the fields of geriatrics and oncology, due to the clinical conditions that patients have. Therefore, it is necessary to develop and implement instruments to standardize care in relation to the technique, from its choice to its use, in an attempt to support the decision-making of health professionals, and thus, promote care in a planned manner. . In this perspective, this study establishes the following guiding question: What elements are needed to build and validate the content and appearance of an algorithm that helps in the indication of patients to use hypodermoclysis? And, it aims to develop and validate an algorithm to assist in the indication of hypodermoclysis in an adult patient. This is a methodological study for the construction and validation of the content and appearance of an assistance tool. The research considers the proposal of the Pasquali Model, which is organized in three stages, namely: theoretical procedures, in which a scope review was carried out to identify and map the evidence on the eligibility / indication criteria of adult patients for use hypodermoclysis; empirical procedures, which took place through the construction of the algorithm, which was developed using Bizagi Modeler software, for content and appearance validation via Google Forms and the Delphi steps with expert judges in the area to reach consensus. And, analytical procedures in which the analysis of the data from the previous phase was carried out using the content validation coefficient. Items with a minimum agreement of 80% between judges were considered valid. The study is in line with the ethical precepts, with approval approved by the opinion of the Research Ethics Committee of the Faculty of Health Sciences of Trairí of the Federal University of Rio Grande do Norte, under CAAE: 39785520.6.0000.5568. After the construction of the algorithm, the Delphi I and Delphi II steps were performed to validate the content and appearance. At the end of the stages, the level of agreement between the judges was calculated, which presented values above 80% and content validation coefficient above 0.8. It is concluded that the algorithm is relevant as an instrument to support decision making and the strengthening of evidence-based nursing practice.

        The Ministry of Health, through the Manual of Recommendations for the Control of Tuberculosis in Brazil, warns that control measures be taken to interrupt the chain of transmission of the disease. The objective of this work is to evaluate the positive and negative factors of the implementation of administrative control measures, engineering and individual protection in the control of Mycobacterium tuberculosis in the hospital service, presenting an action plan to minimize the challenges of these measures. It is an integrative review of the literature with a summary of the studies published in the years between 2016 and 2020. Articles available in their entirety for free access in English, Spanish, Portuguese and French were included. Editorials, letters to the editor, review studies, theses, dissertations, duplicate articles and studies that did not correspond to the relevant topic for the purpose of the review were excluded. A research protocol was constructed and the guiding question was elaborated based on the PICO strategy. The search for the studies was carried out in February 2021, on the basis of the US National Library of Medicine, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature and Literatura Latino-Americana e do Caribe em Ciências da Saúde. The research strategy was given by crossing the descriptors "Tuberculosis", "Infection Control" and "Hospitals". For the information analysis, a Microsoft Excel spreadsheet was used, which allowed the compilation and further categorization of the data. The synthesis of the information also allowed the construction of the SWOT matrix with the identification of positive (strengths and opportunities), negative (weaknesses and threats), internal and external factors related to the tuberculosis infection control measures and the strategic planning of actions identified as negative. By preparing the 5W2H matrix, in order to minimize the weaknesses and threats to the tuberculosis infection control process in the hospital service. Of the 22 studies selected in the sample, (63.6%) were included in the US National Library of Medicine (50%) published in 2019, (95.46%) were in English. There was a prevalence in the use of the quantitative approach in (95.46%) of the articles and a predominance of the investigations carried out in the regions of Asia (40.91%) and Africa (36.37%). Regarding the objective and method of the studies, (45.4%) of the studies use the infinite verb "evaluate" in the objective, but they do not use any methodological evaluation tool or methodological framework that defines the study design as evaluative. The data analysis allowed to identify the tuberculosis infection control measures carried out in the hospital service, being (90.9%) administrative measures, (63.6%) environmental measures and finally (54.4%) measures of individual protection. These results were separated by strengths, opportunities, weaknesses, and threats. This data was organized this way, because it was what the SWOT matrix setup required. What later allowed the construction of the 5W2H matrix focused on the negative points (weaknesses and threats) that the studies bring. The measures categorized as internal force were an infection control plan, isolation criteria of the suspected or confirmed case of Tuberculosis, Tuberculosis Infection Control Committee, bacteriological diagnosis, disinfection of potentially contaminated areas, reduction of the patient's stay in the service, promotion of education / training of personnel, education in cough etiquette and respiratory hygiene, screening / identification of tuberculosis cases, screening of the professional tuberculosis team, screening of suspected or confirmed tuberculosis cases, notification of tuberculosis cases , provision of treatment, diagnostic imaging, indication of air isolation, professional responsible for tuberculosis infection control, prioritization of tuberculosis control, hospital discharge after negative result, periodic monitoring of infection control actions, waiting room for tuberculosis cases s Respiratory intomas, sputum collection area and independent entrance for professionals in risk areas with a high tuberculosis burden, existence of ultraviolet lighting in the environment, presence of airborne isolation room, opening of doors and windows, existence of air filter in the rooms, exclusive room for tuberculosis cases and bacteriological analysis laboratory. Regarding external opportunities, the policy / guideline / regulation for the control of tuberculosis infection and communication with sectors / departments external to the service were identified. Regarding internal weaknesses, it was observed under follow-up of mechanical ventilation, lack of training, delay in the start of treatment, low adherence to the use of the N95 mask, limitation in the supply of N95, insufficient number of isolation rooms, delay in patient isolation, isolation in the wrong place, low tuberculosis detection rate, inadequate facilities, incorrect precautionary signs in environments, late diagnosis, under-registration of tuberculosis cases, lack of a professional responsible for tuberculosis infection control Regarding external threats, we find the limitation of financial resources. It was concluded that the construction of the SWOT matrix allowed the organization of the control measures found in the studies, so that they were distributed in positive and negative factors, since these data were presented in the selected investigations. Thus, it was possible to observe which aspects required a strategic action to minimize the weaknesses and threats to the tuberculosis infection control process. From this moment, with the construction of the 5W2H planning matrix, it was possible to outline an action plan, which emphasizes the importance of strengthening these control measures and highlights the need to evaluate the implementation of measures to control Tuberculosis thus contributing towards decision making.

Safety in the care of individuals with mental health problems who have been hospitalized for years has been neglected, therefore, when considering their particularities, it is necessary to qualify professionals and services to minimize the risks associated with care. Thus, nursing plays an important role in the development of safer actions, as it has a continuous role during the hospitalization period. Thus, the importance of carrying out periodic assessments in services to identify weaknesses and potential in assistance is also highlighted, in order to promote the adequacy of units through the implementation of measures that increase safety. From this perspective, the present study has as a guiding question: What should be the content and appearance of a protocol for the assessment of safe nursing care for hospitalized individuals with mental health problems? And, the general objective is to develop a graphic protocol validated in its content and appearance to assess safe nursing care for hospitalized individuals with mental health problems. This is a methodological study with a mixed approach, based on Pasquali's psychometrics, organized into three procedures: theoretical, in which two focus groups were held with 13 mental health professionals and a Scoping Review on the safe care of individuals with mental health problems. mental health to define the contents that make up the protocol; empirical procedures for the construction of the graphic protocol and validation of its content and appearance using the Delphi technique, in two rounds, with the collaboration of seven judges/experts in the area in question; and analytical procedures, aimed at analyzing the data where the Content Validation Coefficient was calculated. The study was approved by the Research Ethics Committee, under Certificate of Ethical Appreciation no 48213421.0.0000.5537. The focus groups lasted 45 minutes each, in which the nurses addressed actions they carry out and that need to be developed in order to obtain safe care. With the data from the focus groups and from the Scoping Review, the graphic protocol was constructed, which was submitted to the judges for their validation. In the Delphi I round, a general content validity coefficient ≥0.95 was reached for all elements of the protocol and checklist, while in the appearance validation for the criteria of the Suitability Assessment of Materials, indices greater than 0.90 were obtained. After adjustments proposed by the judges in round II, the content and appearance validity indices were 0.99 each. Thus, the graphic protocol was considered valid in its content and appearance.

The teaching of diagnostic reasoning in nursing focused on the health of children and adolescents is very relevant for the training of critical, reflective nurses with specific knowledge about these unique periods in the individual's life cycle. In this context, it is believed that realistic simulation is a positive and beneficial teaching strategy for the training of future nurses. This study aims to analyze the effectiveness of realistic simulation in teaching diagnostic reasoning in nursing focused on the health of children and adolescents. Methodological study, carried out in three stages, namely: construction of scenarios for realistic simulation; validation of the content of these scenarios by specialists; and, application of simulation as an educational strategy in the teaching of diagnostic reasoning in nursing aimed at the health of children and adolescents. In the first two stages, four clinical cases were prepared for the pre and post-test and two scenarios for the simulation process, which had their contents analyzed by 25 experts who judged the relevance, specificity and coherence of the clues provided in each case. and nursing scenario and diagnosis, using the Diagnostic Accuracy Scale. In the third stage, the strategy was applied to students in the seventh period of the undergraduate course at a public university in northeastern Brazil. They were randomly divided into the intervention and control groups. The intervention group, in addition to participating in the simulation, also assessed satisfaction with the process. The data were analyzed using descriptive and inferential statistics. The project was approved by the Research Ethics Committee of the responsible institution, under opinion number 3,175,619 and Certificate of Presentation for Ethical Appreciation 07990418.4.0000.5537. The results showed that the four clinical cases (S coefficient: 0.916) and the two scenarios (S = 0.535) created obtained an acceptable coefficient of agreement among specialists. In the experiment, the pre-test indicated homogeneity of the intervention and control groups. In the post-test, there was no statistically significant difference in performance between the groups, however the results showed a slight improvement in the diagnostic reasoning performance of the intervention group compared to the control group. The intervention group was able to infer more diagnoses and their components than the control group. In evaluating the educational strategy, students expressed high satisfaction and relevance to improve diagnostic reasoning skills aimed at the health of children and adolescents. It is concluded that the strategy on teaching diagnostic reasoning in nursing focused on the health of children and adolescents was effective, as well as promising and attractive for undergraduate students

Introduction: The puerperium is a period of physical and mental transformation that begins after childbirth and ends when breastfeeding ends. This process of involution to the pre-gravid condition can cause more severe complications and evolve to death; however, 92% of the cases of maternal deaths in this phase are avoidable, mainly at the hospital level, when related to bleeding, puerperal infection and hypertension. In this context, the evaluation of the quality of puerperal hospital care is fundamental for monitoring possible complications. However, the indicator that evaluates this type of assistance does not include the intercurrences susceptible to complications, or the specific causes related to maternal deaths. Objective: To develop and validate scale for evaluating the quality of hospital care in the puerperium. Method. Methodological study, developed in two stages: theoretical foundation and theoretical analysis. In the theoretical foundation stage, an instrument based on the Theory of General Systems was developed, proposed by Adevis Donabedian and a review of the scope that allowed the construction of the items of the instrument from the constitutive, operational and behavioral definitions. The second stage began with the evaluation of expert judges in the field. They agreed or disagreed with the items based on the following criteria: objectivity, simplicity, clarity, relevance, precision and variety. The inclusion of expert judges was based on the following criteria: having published and researched on the subject and being an expert in the construction of an instrument. Those who presented incorrect or incomplete answers were excluded. To assess the level of agreement between judges on a given item, the Content Validity Index (CVI) and the Kappa Index were used. The relevance criterion of the study was CVI>0.80 and Kappa>0.61. The sample was made up of ten judges. In addition, the instrument was submitted to a lexical and grammatical correction in order to adapt it to another language. After the lexical and grammatical analysis and validation of the expert judges, the evaluation of puerperal women (target population) was carried out. They agreed or disagreed with the items from the following criteria: item easy to understand and I did not understand the item. This step allowed the evaluation by the smallest cognitive stratum of the target population. For convenience and at random, 10 puerperal women admitted to the Flavio Ribeiro Coutinho maternity hospital in Santa Rita, Paraíba, were selected. The inclusion criteria for women were: being over 18, knowing how to read and write and being in the puerperium. Exclusion criteria: puerperal complication, some against medical indication and/or with suspicion of COVID-19. At this stage, the Content Validity Index and the Kappa Index were also used. The relevance criterion was CVI>0.80 and Kappa>0.61. The instrument underwent a second evaluation by expert judges, to validate the final version of the instrument. The method chosen for the construction and theoretical validation of this assessment instrument followed Pasquali's recommendations. It should be noted that this study was submitted to the Research Ethics Committee (REC) of the Federal University of Rio Grande do Norte (UFRN), in accordance with resolution 466/2012 and obtained a favorable opinion under CAAE number 18967519.6.0000.5176. Results: At the end of this stage, eight items were removed from the instrument, 11 were unified and three had the wording modified. Performed the lexical and grammatical correction the scale was submitted to analysis of the target audience and presented CVI ≥ 0.9 in all items, except the items 16, 24, 34, 37, 38 with which presented CVI<80, however they were reformulated was not removed. Finally, a second round was held with the participation of judges and the scale obtained an CVI ≥0.9 on all items. The scale for evaluating the quality of hospital care provided in the puerperium is presented with theoretical validity, average of CVI = 0.99, with 49 items in total, 17 in the structure dimension, 23 in the process dimension, nine in the result dimension. It is concluded that the scale for assessing the quality of hospital care provided in the puerperium has theoretical validity. 

In view of the growing global dimension on the strengthening of Primary Health Care through the expansion and training of human resources, especially nursing, it is essential to present the role of Advanced Practice Nursing and its potential for transformation in Primary Health Care in Brazil. The objective of this study is to understand Advanced Practice Nursing, focusing on the role of Family Nurse Practitioners, in order to assist its implementation in Brazil. This is a multi-method study with three steps, with a conceptual focus on the PEPPA framework, described below: Literature review on the impact of the management of Advanced Practice Nurses on NCDs in Primary Health Care; Case study with Family Nurse Practitioners in the USA; Theoretical-Philosophical Essay in the light of Max Horkheimer's Critical Theory. In step 1, it was possible to verify the positive impact that advanced nursing practice has on the four most frequent categories of Noncommunicable Diseases, namely: Diabetes, Cardiovascular Diseases, Chronic Respiratory Diseases and Cancer. In step 2, from the analysis of the interviews carried out with the Family Nurse Practitioner in the USA, three partitions emerged based on the content of the participants' statements: 1) Being an advanced practice nurse; 2) Educational routes and possibilities of action and 3) Being political: a path for transformation, where it was possible to describe competences and skills considered to be outstanding points in relation to other professional categories, points of improvement in their educational background and the importance of political representation and being active in performing the role. In the last stage of the research, the emergence of a change in the scenario of primary health care in Brazil was highlighted, placing nurses as a primary tool in the struggle for social transformation and the search for autonomy as citizens and professionals in the light of Critical Theory and its concepts. The complexity of the nurse's work dialogues with the concepts of Critical Theory and stimulates the critical behavior towards praxis in knowledge / action, strengthening their function. At the present time, there is a tendency to expand the practice of nurses through the implementation of Advanced Nursing Practice as one of the possible solutions for the reduction of social inequalities caused by the lack of equal access to health. Through this study, it is expected to subsidize the implementation of Advanced Nursing Practice in the context of Primary Health Care, along the lines of the PEPPA framework, by understanding what Advanced Nursing Practice is in the scope of family health, reflecting on the path traveled here and the next steps we need to take, always in the constant search for recognition, autonomy and transformation.

The nurse is paramount in caring for people living with AIDS. To this end, in view of the peculiarities of this clientele, the professional needs to provide systematized care during hospitalization in order to meet biological to psychosocial nuances, reduce complications during treatment, assist in adaptation and self-care, and even carry out appropriate interventions according to the presented problem. In addition, the standardization of the nursing process aimed at this clientele enables agile reasoning in decision-making for specialized and scientific care. Thus, health services, including those that care for people with AIDS, need an instrumentalized nursing process. The study aims to construct and validate an instrument to operationalize the nursing process for AIDS patients in the context of hospital admission in the light of Wanda Horta’s Theory of Basic Human Needs. This is a methodological research. The instrument was systematized according to the model proposed by Pasquali et al., namely: theoretical, empirical and analytical procedures. The theoretical procedures aimed at the construction of the instrument, being divided as follows: two scoping reviews, the first for the research stage and the second for diagnosis, followed by cross-mapping to check the diagnoses extracted with the NANDA-I 2018-2020 Nursing Diagnoses version, with subsequent consultation to the books Nursing Outcomes Classification and Nursing Interventions Classification to extract the results and interventions referring to the planning and implementation stages of the instrument respectively. After that, the Alafaro-LeFevre book was consulted for insertion of the items of the evaluation stage. It is worth underlining that the instrument followed the five steps of the Alfaro-LeFevre nursing process and the principles of Wanda Horta’s Theory of Basic Human Needs. In the empirical procedures, the content validation steps were conducted with nurse judges by means of the Delphi technique using Google Forms. Finally, in the analytical procedures, in order to validate the content of the instrument, the content validity coefficient for validation (≥ 0.7) was calculated. Kappa (>0.80) was applied to evaluate only the degree of agreement of the judges on the evaluation of the analyzed items. Cronbach’s alpha (≥ 0.7) was used to evaluate the internal conscience among the items of the instrument. Regarding the global validation of the instrument, Delphi 1 obtained the items: investigation (Content Validity Coefficient 0.97 and Kappa 0.97), diagnosis (Content Validity Coefficient 0.95 and Kappa 0.94), planning (Content Validity Coefficient 0.93 and Kappa 0.82), implementation (Content Validity Coefficient 0.91 and Kappa 0.78) and evaluation (Content Validity Coefficient 0.88 and Kappa 0.73); in turn, Delphi 2: investigation (Content Validity Coefficient 0.99 and Kappa 0.99), diagnosis (Content Validity Coefficient 1.00 and Kappa 1.00), planning (Content Validity Coefficient 0.97 and Kappa 0.94), implementation (Content Validity Coefficient 0.97 and Kappa 0.94) and evaluation (Content Validity Coefficient 0.96 and Kappa 0.87). As for the overall reliability of the instrument, Delphi 1 obtained the items: investigation (Cronbach’s alpha 0.94), diagnosis (Cronbach’s alpha 0.81), planning (Cronbach’s alpha 1.00), implementation (Cronbach’s alpha 1.00) and evaluation (Cronbach’s alpha 0.98); with regard to Delphi 2: investigation (Cronbach’s alpha 0.96), diagnosis (Cronbach’s alpha 1.00), planning (Cronbach’s alpha 1.00), implementation (Cronbach’s alpha 1.00) and evaluation (Cronbach’s alpha 1.00). The instrument based on a validated theory represents a care technology for nurses who work in the care of AIDS patients in the context of hospital admission, in addition to having valid content and reliability to safely adopted in care practice.

Introduction: Outpatient nursing care for individuals undergoing percutaneous transluminal coronary angioplasty needs a care structure for self-management of care. Self-management of this individual provides better results in the therapeutic process, such as mitigation of complications and the acquisition of well-being and quality of life. Objective: to develop an outpatient nursing care model for self-management of individuals undergoing percutaneous transluminal coronary angioplasty. Methodological path: This is a methodological, theoretical research, with a qualitative approach carried out through the process of deductive-inductive logical reasoning and based on Betty Neuman's Systems Model and The Individual and Family Self-Management Theory. The study was carried out in three stages, namely: the first corresponded to the selection of concepts, based on the framework, and the integrative literature review, which identified the strategies used by nurses in the care of individuals in post-coronary angioplasty for support to self-management; the second was conducted at the Alcides Carneiro University Hospital, located in Campina Grande, Paraíba, through interviews with nurses, individuals undergoing coronary angioplasty and their families; in the third moment, the previous results were analyzed and integrated under the light of the theoretical framework, which allowed the elaboration of a graphical representation of the care model that culminated in the development of a conceptual structure in the form of a model. The study received a favorable opinion from the Research Ethics Committee under number 4.630.775 and CAAE 43329321.8.0000.5182. Results: The research developed the “Ambulatory Nursing Care Model for Self-Management of the Individual in Percutaneous Transluminal Coronary Post-angioplasty”. The integrative review data showed three strategies used by nurses to support self-management, namely: educational, emotional support and social support network. In the field phase, two categories emerged: participants' perceptions about aspects of care for self-management and factors that interfere with support for self-management with their respective subcategories. Nurses, individuals and their families understood that the following aspects are essential in self-management care: strategies for monitoring care, dialogue with the nurse, importance of the nurse in care, family support, management support and the need to guide the family for continuity of care. Final considerations: The nursing care model from the perspective of self-management developed in this study offers a guiding and strategic theoretical framework for assistance to people with coronary artery disease undergoing angioplasty and represents a contribution to the knowledge of nursing in secondary prevention in health . Thus, it is believed that the present study contributes to the advancement of nursing knowledge and the direction of care provided by this professional to post-angioplasty patients.

Introduction: Adherence to tuberculosis treatment is one of the main challenges for the control of the disease. The strategies adopted so far are not considered effective enough to ensure therapeutic success, and the lack of a theory that adequately explains this adherence are reasons that impede progress in research and development of this action. For the systematic development of effective interventions and evaluation, it is necessary to investigate what barriers may still exist to achieve better adherence to this therapy. Objectives: to understand how the process of adherence to tuberculosis treatment occurs in Primary Health Care, based on the experience of adherent people and to build a theoretical model on the process of adherence to tuberculosis treatment. Method: qualitative study that followed the Straussian strand of Grounded Theory as a methodological framework and Symbolic Interactionism as a theoretical framework. Twenty people participated in the study, distributed into three sample groups, which: first – eleven people who underwent complete tuberculosis treatment between 2018 and 2019; second – seven professionals from Basic Health Units in the city of Cajazeiras, Paraíba, Brazil, being three doctors, three nurses and one community health agent; and third – two relatives of participants from the first group. Data were collected through in-depth interviews from 2019 to 2021, with concomitant data collection and analysis, considering open, axial and integration coding procedures, construction of diagrams and memos. Data were analyzed for context and process. A theoretical-explanatory model was developed considering the paradigm, an analytical tool that helps to classify concepts and establish relationships. The NVivo® software version 12 was used as a technological support to help organize the data. Study approved by CEP/UFRN under opinion nº 3.246,634 of April 5, 2019. Results: from the data analysis, three major themes were listed that represent the conditions (feeling with threatened recovery: treatment context - explained by the categories physical threats; psychological threats and programmatic threats), actions-interactions (performing the treatment: the recovery process - explained by the categories strategic actions related to the diagnosis; guided recovery actions and self-initiated recovery actions) and the consequences (recovering: the resignification of life - explained by the categories improvement; achieving healing and new life), all aspects of the paradigm. The nine categories, each with its subcategories and their respective concepts, were all interconnected and represented by the theoretical model whose central category was “Threats, treatment and recovery from tuberculosis: transmuting suffering into a new life”. The main objective of the people who adhered to the tuberculosis treatment was to recover, to solve the threats to health and recovery, for this they needed to change the circumstances experienced and transformed circumstances that caused suffering into circumstances that promoted a new life. Final considerations: The interaction with the data, theoretical and methodological procedures showed that adherence to tuberculosis treatment is based on the desire for health recovery, but also on aspects of life that existed prior to the illness, in the individual and family spheres. , social and labor. Advances in knowledge about this phenomenon make it possible to design policies and intervention strategies that meet the specific realities of the treatment of tuberculosis. It is considered that the results support the thesis: people with tuberculosis act in relation to their care, anchored in what it represents for them. However, it is the action-interaction with people and with themselves that allows them to signify and re-signify their perspectives in relation to care, which progressively lead them and help them to make decisions.

        Nurses are prone to alterations in the sleep-wake cycle, with prejudices to their performance, not work and health. can run through long working days, modifications to our sleep and reposition hours, inappropriate eating habits, irregular physical activity and stress. Objective-to analyze the level of stress in relation to the prevalence of obesity, quality of sleep, obstructive apnea of sleep in nurses two shifts day and night. Cross-sectional study with a quantitative approach, of the analytical type. The target Audience was composed by nurses of the Hospital university Onofre Lopes, 122, do Hospital University Ana Bezerra 53 and of the  maternity scholl Januário Cicco 30 not total to show was of 205 professionals in both shifts. At the data collection period from December 2020 to April 2021 the nurses prepare the instruments: to obtain two sociodemographic data, assessment of the stress level, the quality of the sound that is or the Quality Index of the Sound of Pittsburgh-Brazil, o Berlim questionnaire to verify obstructive apnea of sleep and questionnaire on feeding behavior to verify obesity. To organization two dice are due in spreadsheet. It provides a descriptive analysis to assess the profile of the sample, second to the individual characteristics, sociodemographic and eating habits of the two research subjects, including the frequency of categorical variables, with absolute (n) and percentual (%) frequency values and descriptive statistics of position. (average and median) and dispersion of two dice (standard deviation) for the numerical and order variations. It was submitted to the Brazil platform and endorsed by the Research Ethics Committee of the Federal University of Rio Grande do Norte, respecting the normatization of Resolution No. 466/12 of the National Health Council, regarding the ethical aspects of research involving human beings. The subjects involved will be requested to assassinate the Term of Free and Informed Consent. The results will show statistically significant data in relation to stress and the characteristics of two interviewees as not having sons (0.008) and who at a non hourly night (<0.001). For the quality of those who use medications daily (0.002), that at no hour of the night (<0.001) and those who feed on TV (0.049). How many years were the nurses stressed (56.10%) two interviewees presented a median level of stress, how much the quality of sleep (66.38%) was bad and how many year of sleep disturbance (81.46%) did not appear disturbed. Concerning sleep disturbance, age and obesity, the logistic regression showed the chance of a professional meal of at least 35 years, presenting sleep disturbance, decreased in 66%, compared to professional years eating over 35 years. At a chance of professionals classified as obesity, they have a sleep disorder that is 19.77 times higher, compared to professionals who do not have obesity. It confirms that the same cross-sectional structure study ratifies the interface of stress, quality of sound and obstructive apnea of sound in nurses, the established objectives. As statistically significant associations affirmed the difficulty of facing professional hairs that act not night shift.

The immunodeficiency virus infection has changed since the beginning of the epidemic, currently, it is considered a chronic and potentially controllable disease. This evolutionary character brings with it a complexity of factors that requires continuous health care, quality of life and investment in integrality. In this context, health care for people living with Acquired immunodeficiency syndrome makes interdisciplinary and intersectoral work necessary. Therefore, a challenge to seek and create health technologies that respond to this population’s needs is found. The study aims to develop and validate a flowchart of care for people living with HIV and acquired immunodeficiency syndrome (AIDS) for existing health services in the city of Natal, Rio Grande do Norte. This is a methodological study for construction and content validation. The study is based on Pasquali's Model (2010), and follows the steps of theoretical pole, namely: theoretical procedures, in which a search of the theoretical basis was carried out through documentary research; experimental procedures. in which the instrument was validated for content validation via Google Forms and the Delphi steps; analytical procedure, in which the calculation and analysis of the content validation coefficients and level of agreement was performed. The sample size considers Pasquali, who suggests from six to twenty subjects, and the selection of judges used criteria adapted from Fehring (1994) to support inclusion. The Content Validity Coefficient (CVC) evaluated the agreement between the judges, and the analysis comprehends the concept of language clarity, practical and theoretical relevance. The study agrees and respects ethical precepts, having approval certified by the opinion of the Research Ethics Committee of the Federal University of Rio Grande do Norte (CEP / UFRN), under CAAE nº 17815219.4.0000.5537. 16 documents were listed in order to compose the constitutive and operational definitions. The study found out that the theme addressed was mainly related to the protocols that guide assistance within the scope of Brazil’s public health system. In this scenery, this research proposed to elaborate the items and build the flowchart. After construction, Delphi steps were performed to validate the content. At the end of the stages, the level of agreement between the judges was calculated, it was found that during the two Delphi rounds, the judges agreed that the constructed material had valid content, which consists of CVC values equal to or greater than 0.8. Therefore, we concluded that the instrument is relevant and favors the success for its use in the managerial and assistance practice to which it is proposed.

The aim of this study was to analyze the quality of sleep and investigate whether it influences the BMI of professional nurses during the day and night shifts. This is an analytical study with a quantitative approach. The study was carried out at the University Hospital of Rio Grande do Norte. Data were collected between January and March of the year 2020, using the following instruments: Pittsburgh Sleep Quality Index Questionnaire and socio-demographic data to characterize their subjects. 268 nurses will be surveyed in their work shifts. The instruments were made available according to the work shift of each professional. 120 nurses participated in the research. The data, after being coded and tabulated, underwent statistical analysis using the SPSS version 2.0 program. The study obtained a favorable opinion from the Ethics and Research Committee of the Federal University of Rio Grande do Norte, under Opinion with CAAE nº 25693119.4.0000.5537. For qualitative variables, descriptive analysis was carried out by means of distributions of absolute and relative frequencies (%) and quantitative variables were analyzed descriptive statistics of measures of trend and data dispersion, such as: minimum, maximum, average and standard deviation The sociodemographic profile was characterized by a predominance of females, 85.00% of nurses, and in the work shift, 75.00% in the night shift and 92.65% in the day shift. When grouped in relation to the age group, up to 35 years old (58.33%) and over 35 years old (41.67%), the majority were aged up to 35 years. As for the PSQI, the nurses on the night shift, totaling 84.62% had poor sleep quality, while the subjects on the day shift, only 17.65% had poor sleep quality. We also found that 84.62% of night shift nurses have an inadequate BMI, that is, they are overweight, with statistical significance (p = <0.001). It was concluded that night work causes losses in sleep quality and changes in the weight of professional nurses

This study aimed to validate the Dry Eye Severity Nursing Outcome in adult patients admitted to an intensive care unit. Methodological study developed in three steps: content validation, semantic validation and clinical validation. In the first stage, content validation, 23 experts captured through the Lattes Curriculum and 10 nurses participated in the composition of the consensus group belonging to the research group Clinical Nursing Studies and Research Group. The second step, semantic validation, consisted of 15 clinical clinic nurses from a university hospital located in northeastern Brazil. to verify the understanding of the instrument items. The third stage, clinical validation, consisted of 72 patients admitted to the intensive care unit of this hospital unit. The collected data were organized and stored in a database built in Microsoft Office Excel 2016 and analyzed by a specific statistical program. This study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte by CAAE nº 71452817.5.0000.5537 and opinion nº 2444761 and followed the Resolution nº 466/12, approved by the National Health Council of the Ministry of Health, in 12 December 2012. In the first stage of the 14 indicators evaluated by the experts, seven presented content validity index below 0.80. Then, in the consensus group validation six indicators were reformulated. In the semantic validation stage, of the 15 nurses 86.67% were female, 73.33% are up to 40 years old. Regarding the degree, 46.67% are specialists, while masters and graduates had the following percentages: 40.00% and 13.33%. At the time of operation, 40.00% with up to 10 years and 60.00% over 10 years. At this stage, the 14 indicators presented Kappa coefficient ≥ 0.80 and were considered semantically valid. Regarding clinical validation, 72 patients were selected and 144 eyes were evaluated by two pairs of evaluators: one with the Nursing Outcomes Classification Dry Eye Severity Nursing Outcome indicators without definitions and the other with the indicators validated in previous stages with their constitutive definitions, operational values and operating magnitudes. The evaluations were compared by the intraclass correlation coefficient. The evaluators who used indicators with the definitions agreed in the evaluation of the results. From this, the indicators with constitutive, operational definitions and operational magnitudes of the Dry Eye Gravity nursing result are valid for adult patients admitted to the intensive care unit.

Breast cancer is a public health problem due to the high morbidity and mortality rates and the physical and psychological sequelae. In this context, nursing consultation subsidized by specific instruments for women with breast cancer is strengthened as an effective strategy for comprehensive care, a fact that justifies this study. The objective of this study is to develop a mobile application for nursing consultation for women with breast cancer in light of Roy's Adaptation Model. This is a methodological study developed in four steps: 1) Review of the national and international literature for the search for empirical indicators performed in the Web of Science, Lilacs, Pubmed, Care and Cinahal databases, with the descriptors breast cancer, disorders adaptation, social adjustment and psychological adaptation, previously selected in the Health Sciences Descriptors and Medical Subject Headings; 2) Elaboration for the construction of the nursing consultation instrument for women with breast cancer in the light of the Roy Adaptation Model. 3) Validation of content and appearance by judges, intentionally selected on the Lattes Platform. Validation was performed by two rounds of submission of the instrument to the judges, pilot test and lexical and grammatical correction. Twenty judges, nurses with a minimum degree of oncology nursing specialist, or with professional experience in breast oncology / breast cancer, of at least one year, and / or academic experience with at least one year of experience in oncology nursing were selected. . Likewise, the instrument was submitted to students of the last period of undergraduate nursing for evaluation and primary understanding of the instrument. Subjects who did not follow the Delphi Technological methodological process for content and form validation were excluded; 4) Adaptation of the instrument to free software available in three languages. This study was approved by the Research Ethics Committee of CAAE: 13927619.2.0000.5537 and Parecer: 3.382.745 and followed National Health Council Resolution No. 466/12. Data regarding content validation were analyzed using the content validity index, which assumed> 0.80, programmed in Microsoft Excel version 2010, for analysis of descriptive statistics with absolute and relative frequencies. Thus, we accept the hypothesis that the instrument has evidence of validity. It is expected that the use of a mobile application for nursing consultation for women with breast cancer, built on a theory and scientifically validated, can contribute to the nursing care practice for women with breast cancer.

This is a study about the development of a medium-range nursing theory, based on Callista Roy's adaptation model, about dryness eye. Its general objective was to develop a mid-range nursing theory of eye dryness based on Roy's adaptation model. This is a theoretical research, of descriptive-exploratory nature, with a qualitative approach. To reach the objectives, the strategies for the development of theories proposed by Walker and Avant (2019) were adopted, electing the concept analysis strategy to present the concepts, the establishment of relational statements from the statement synthesis and the strategy. From theory analysis to the realization of theoretical deduction. This study took place in five stages, namely: scoping review, concept analysis, statement synthesis, theoretical modeling and construction of elements for nursing taxonomies from the developed theory. In the first stage a Scoping Review was conducted guided by the steps recommended by the Joana Briggs Institute (2015). After identifying the research question, a search protocol was established and from the descriptors “dry eye syndromes” and “keratoconjuntivite cicca”, based on: Scopus, Web of Science, Science Direct, the identified synonyms were used as keywords in the electronic search engine in order to broaden the search. We obtained a sample of 193 studies that served as the basis for building the elements of the theory. The concept and statements were obtained from the primary studies included in this sample. When analyzed and synthesized, they were modeled from the theoretical deduction made by the analysis of Roy's adaptation model. From the analysis of the theory, it was found that this model starts from the metaparadigmatic understanding that the environment is an actor in human adaptive systems; health as a state in which the person seeks to stay through adaptation; nursing as a profession that promotes adaptation; and the person as an adaptive system that is controlled by stimuli, control and feedback. The central proposition of this medium range theory is that the event of eye dryness occurs as a result of activation of focal stimuli (intrinsic factors that lead to decreased tear production), contextual (environmental / extrinsic factors that promote instability and increased film evaporation lacrimal) and residual (combined), which can lead to adaptation or an adaptation problem. Nursing by identifying the unwanted human response provides conditions that act effectively and are able to reiterate human adaptive mechanisms promoting eye health. From the construction of the theory, propositions of taxonomic elements were elaborated that could serve as basis for the individual to recover the adaptive mechanisms and obtain eye health. It was built the proposition of the nursing result entitled: behavior for prevention of eye dryness and a proposition for the construction of the nursing intervention entitled: control of eye dryness. Based on the propositions, the theory will support the practice by proposing to describe, explain, predict and intervene in the phenomenon under study.

This is a methodological study, which aimed to validate an instrument for nursing consultation to people living with mental disorders within the scope of the Family Health Strategy. The instrument was developed based on the phases of the Nursing Process, in accordance with Federal Nursing Council Resolutions number 358/2009 and 429/2012, which deal with the use of its phases in health units, namely: data collection, diagnoses nursing, nursing actions and interventions, expected results and formal registration. Wanda Aguiar Horta's Theory of Basic Human Needs was used as a theoretical-analytical framework. The project was submitted to the Human Research Ethics Committee of the Federal University of Rio Grande do Norte, being approved with the Certificate of Presentation for Ethical Appreciation (CAAE) nº. 25688219.4.0000.5537 and opinion No. 3,736,262. The investigation was carried out in two stages: the first consisted of an integrative literature review to obtain aspects related to assistance to support the construction of an instrument for nursing consultation to people living with mental disorders within the scope of the Family Health Strategy. The following electronic databases were used: Latin American and Caribbean Literature in Health Sciences (Lilacs); Medical Literature Analysis and Retrieval System Online (MEDLINE / PUBMED); SCOPUS; Web of Sciense; Cumulative Index to Nursing, Allied Health Literature (CINAHL) and The Cochrane Library (Cochrane). The sample consisted of 14 articles. The second stage took place through the content validation of this instrument by specialists using the Delphi technique. These were selected through the Lattes Platform of the National Council for Scientific and Technological Development (CNPQ). The sample consisted of 42 specialists in Delphi 1 and 32 for Delphi 2, reaching the final version of the instrument for nursing consultation to people living with mental disorders within the scope of the Family Health Strategy. Statistical analysis was performed using: Content Validity Index (CVI), Relative Index (ARI) and alpha Cronbach. In the first stage, Delphi 1, the mean of Cronbach's alpha and ARI were greater than 0.80, and the CVI was 0.803. In the Delphi 2 phase, Cronbach's alpha reached 0.896, with a CVI of 0.998. A comparison was made between the Delphi 1 and 2 phases, and in both the reliability was quite satisfactory. Thus, the validity of the instrument in its content was achieved.

The objective was to investigate evidence of content validation and semantic validation of virtual booklet and sound media for blind people about the prevention of sexually transmitted infections (STIs), acquired immunodeficiency syndrome and viral hepatitis. Methodological development study, carried out with experts in special education and sexual and reproductive health and with blind people enrolled at the Support Center for the Visually Impaired (CADV), located in Mossoró/RN and at the Institute of Education and Rehabilitation of the Blind of Rio Grande do Norte (IERC/RN), located in Natal, from May 2018 to July 2020. The research was developed in four stages: (1) construction of content on prevention of STI/HIV/AIDS and Viral Hepatitis by conducting literature review on STI/AIDS prevention and blind people carried out in five databases (Virtual Health Library, Cochrane, PubMed, Scopus and Web of Science) and verification of the adequacy of blind people's knowledge about prevention and transmission of STI/AIDS carried out with blind people registered at CADV according to defined eligibility criteria; (2) construction of the virtual booklet considering the five phases proposed by Falkembach (2005) - analysis and planning, modeling, implementation and evaluation and maintenance and distribution; and, of the podcast considering the steps proposed by Silva (2019) - definition of the theme, choice of participants, definition of the necessary equipment, preparation of the agenda, recording of the episode, editing of the podcast and publication of the episode); (3) content validation of the assistive technologies developed, carried out by means of evaluation by judges in the areas of special education and sexual and reproductive health, chosen by searching the lattes platform and according to the criteria established by Joventino; and, (4) semantic validation of the podcast performed by blind people enrolled at IERC / RN and who met the inclusion criteria of the research. The content and semantics validation steps were guided by Pasquali and all the research was developed in the light of the Theory of Meaningful Learning proposed by David Ausubel. The collected data were compiled and analyzed in an electronic data spreadsheet and, to respond to the research objectives, absolute and relative frequencies of the adequacy of knowledge about STI/AIDS prevention and transmission and the content validation verification instruments were calculated. semantic validation. The Content Validity Index was also calculated in order to analyze the agreement index between the judges in relation to the analyzed items, having been considered validated the items that obtained agreement greater than or equal to 70%. Ethical recommendations for research involving human beings were followed in accordance with Resolution No. 466/2012, having been submitted to the Research Ethics Committee of the Federal University of Rio Grande do Norte, CAAE Nº 91753918.4.0000.5537. Inadequate knowledge of all participants on ways of transmitting some STIs / AIDS was identified and adequate control by most participants on HIV prevention and control methods. It was noticed that the manuscripts focused on the sexuality and sexual practices of people with visual impairments as risk factors for the development of STI/AIDS and the development, validation and testing of technologies as instruments for access of people with visual impairment to STI/information. AIDS. The virtual booklet was built following the international accessibility recommendations defined by the W3C and the podcast was recorded in a radio station studio, considering the transcribed agenda elaborated by the researcher. The content validation was performed by 29 judges in special education and 28 judges in sexual and reproductive health, in two rounds, and all items in the virtual booklet and the podcast had their content validated by these specialists. The items of the produced sound media were considered intelligible to all strata of the target population, conferring the podcast's appearance validation. It was concluded that the virtual booklet and podcast developed and validated in this research represent health education tools on STI / HIV / AIDS and Viral Hepatitis for blind people.

Adolescence is a life period marked by conflicts, modifications and discoveries, one of which is the first sexual intercourse, activity generally conducted precociously and usually without orientation and protection. This has resulted in increased vulnerability to sexually transmitted diseases and undesired pregnancy, cases that continue to be on the increase despite the existing health policies for adolescent health and the educational strategies on sexual health. In this study an active educational strategy on sexual health was implemented using a thematic game. The study was based on the need for educational strategies that link information to reflection, thus integrating knowledge to reality enabling the adolescent to be an active participant in the promotion of own sexual health, and in the permanent process of autonomy and learning, essential elements for decision making. The objectives were: 1) To analyze the perceptions of adolescents regarding their experience in a participative educational action about sexual health, and 2) To identify the adolescents´ knowledge regarding behaviors related to their sexual health as they participate in a participative educational strategy. Descriptive and exploratory qualitative study conducted in public high school located in Natal, RN. The population was composed of 122 enrolled adolescents, in average of 15 year of age. The educational activity was conducted in April and May 2018, in four sessions of 50 minutes duration. The sessions were used to identify the previous knowledge of sexual education, to implement round group discussions, and to apply the sexual health educational game. Data were collected by a semi-structured questionnaire, open discussions in the round group discussions, comments during the game sessions, and direct non-participative observations. Bardin´s thematic content analysis techniques were used to categorize the data. The thematic categories formed were: Interest in themes and methodology; Desire for continuation of activity; Activity as diversion, play; Activity as a participative class; Importance of the educational activity in health; Knowledge constructed and positive life results; Lack of dialogue in the. It is concluded that educational activities on sexual health with adolescents using active methodologies and educational games, incite interest and promote active participation of the students, also enable learning and reflection about health issues. This study seeks to contribute to strengthening of public health policy in adolescent health and for clinical thinking by nurses in the school context.

Accurate clinical indicators are important for nursing care and teaching. The identification of these components occurs through studies of diagnostic accuracy. Thus, the present study aims to analyze the accuracy of the clinical indicators of nursing diagnosis Fatigue in patients with heart failure. This is a cross-sectional, diagnostic accuracy study. The sample consisted of 96 patients in attendance at the University Hospital Onofre Lopes, selected for convenience, consecutively. The instrument of data collection was a form, containing questions related to sociodemographic, clinical aspects and diagnostic indicators. In addition, to support the data collection, a protocol was used with the conceptual and operational definitions of the clinical indicators. The research was approved by the ethics committee in research of the unit responsible, under number 2,517,527 and Certificate of Presentation for Ethical Appreciation: 80923217.7.0000.5537. The results showed that the majority of the clientele investigated were male, brown, with companion, from the interior of the state, practicing a religion, with incomplete elementary school and retired or benefited. The mean age was 57.78 years. The most prevalent clinical indicators were: Impaired ability to maintain habitual level of physical activity, Increased physical symptoms, Increased need for rest, Impaired ability to maintain habitual routines, Insufficient energy, Non-restorative sleep pattern, Introspection, and Tiredness. There was statistical association of the nursing diagnosis investigated with the variables gender and jugular engorgement. The most sensitive clinical indicators were: Increased physical symptoms and Tiredness. And the one of greater specificity was: Disinterest in the environment that surrounds it. The diagnostic study was present in 42.54% of patients with heart failure. Thus, it is concluded that the Fatigue diagnosis presents accurate clinical indicators in the clientele with heart failure. Furthermore, it is expected that, from the identification of these accurate clinical indicators, the diagnostic inference of the nurse will be facilitated in clinical practice.

This study aims to evaluate the accuracy of the nursing diagnosis of hypothermia in patients with heart disease. This is a methodological study with a quantitative approach, to be conducted in two stages: Concept analysis of hypothermia and analysis of the accuracy of clinical indicators of nursing diagnosis Hypothermia in patients with heart disease. The first step proposes to clarify the concept of hypothermia, its attributes, antecedents, consequent and empirical referentials, based on the model proposed by Walker & Avant (2011). In order to search the literature, an integrative literature review was carried out, which obtained a sample of 66 articles, identified from the following search engines and databases: Cochrane, Lilacs, Scielo, Web of Science, Scopus, Pubmed and Google Scholar, accessed by middle of the periodical directory of the Coordination of Improvement of Higher Level Personnel. In addition to the material selected through the databases, previous reading articles obtained from reverse search were used. The second step proposes to analyze the accuracy of the clinical indicators of the nursing diagnosis Hypothermia in patients with heart disease and verify the prevalence of this diagnosis in the presence of its clinical indicators based on the Latent Class Analysis method. Data were collected through an instrument containing sociodemographic, clinical information and clinical indicators of nursing diagnosis.
Hypothermia through physical examination and collection of information in the medical records of patients admitted to the cardiology unit. The study has a sample of 120 patients selected from the following eligibility criteria: being 18 years of age or older and hospitalized for pre-surgical or clinical treatment. The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, in compliance with Resolution no. 466/2012 of the National Health Council of the Ministry of Health and obtained a favorable opinion from the CEP under number 2,574,889 and CAAE 85607418.3.0000.5537. From the integrative review, the United States of America was the country with the highest production of articles (44.0%), a large part of the research was produced in the last five years (43.7%) and in the English language (97%). Regarding the concept analysis, the main attribute was the reduction of the central body temperature to less than 36 ° C. As antecedent are all the factors that influence in the reduction of the temperature as the metabolic ones and exposure to the cold. Among the consequences are: cardiac events, respiratory events, increased susceptibility to infections, tremors, hypoglycemia, increased metabolic rate, peripheral vasoconstriction, piloerection and cold skin on the touch. The sociodemographic characterization of the patients who participated in the second stage of this study identified: a majority male (62.5%), companion (74.2%), born and resident in the state of Rio Grande of the North (65% and 59.2%), retired (59.2%), practicing religion (87.5%). Most of them had incomplete elementary education (37.5%), with an approximate income of two or more minimum wages (50.8%) and a mean age of 59.7 years. Among the hospitalization reasons identified, congestive heart failure occurred with a higher prevalence (30%).

Stomy is the name given to any artificially created opening of the internal environment of the body structure to the external environment. The fact of becoming aesthetic entails a change to a new excreta elimination condition generating an adaptation to this situation. Attempts to access care may result in poor knowledge of the stomatomania about the care of the stomach, in view of this. Roy's Model of Adaptation as a guideline for nursing actions. It is aimed at analyzing the effectiveness of the telephone intervention without the adaptive process of the stomized person. This is a longitudinal, almost experimental, type-of-trial, randomized, and unicego study conducted with 2 groups of individuals with up to one year of oestrus, the only conventional treatment. , the monitoring by phone. The indicators indicated that they were not able to differentiate statistically between the control and intervention groups, because their sociodemographic, clinical and adaptation variables, a sample characterization, identified a predominance of people with a lower gender, with lesser or equal age to 60 years, pardos, retired, living with companion, elementary school, with income of 1 minimum wage, catholics. According to asics as well as non-orquality and uravities, have anti-therapy, have anti-therapy or radiotherapy, have had behavior of the stoma and peristomal, has not colostomy, with comestible temporary, Use the device collector of 1 piece, being the patient who makes an exchange of his bag, and feels adapted. Regarding the adaptive modes, an absence of significant statistical significance was identified between the control groups and their adaptation without pre-test. However, in the post-test it was pointed out that, since the means and medians of the control group were lower than those in the group that received an intervention in a statistically significant way. An adaptive score of the control group in the post-test was also lower when compared to the pre-test of the group, whereas an analysis of the intervention group evidenced an elevation of the adaptive levels of the group when comparing the pre- and post-east . It is noticed the effectiveness of a telephone intervention in the levels of adaptation of the person with health, emphasizing the importance of a complementary and regular accompaniment in the promotion of health actions that influence the self-esteem, self-care and the adaptation of the public.

This is a cross-sectional study with a quantitative approach that aimed to cross-map the nursing diagnosis titles of children with kidney disease prepared according to the International Classification for Nursing Practice (ICNP®) with NANDA International diagnoses, Inc (NANDA-I), as well as classifying diagnostic titles according to levels of basic human needs theory and cross-mapping product content validation. The present study was divided into methodological steps, namely: construction of the term bank for children with kidney disease, elaboration of diagnostic titles for children with kidney disease according to the term bank. Data were collected between May and October 2015. The diagnoses were made in two lists and tabulated in the Microsoft Excel program (Office 2013) and also classified according to the levels of the theory of basic human needs. The diagnoses were compared between these classification systems, and thus classified into constant and non-constant titles. Thus, non-constant titles were classified as: similar, broader, more restricted and there is no agreement. Then the mapping product was subjected to the content validation process by experts. Content Validity Index of 0.80 or greater was considered. The experts who participated in the cross-mapping validation process were from the ICNP® Development Center of Brazil. The project was approved by the Research Ethics Committee of Onofre Lopes University Hospital with Opinion No. 1,007,954 and presentation certificate for ethical appreciation No. 42666815.0.0000.5292. A total of 67 nursing diagnoses were identified, 48 from ICNP® and 19 from NANDA-I. After cross-mapping, 85.4% of ICNP® diagnoses were not constant in NANDA-I. Non-constants were classified into: similar (7.3%), narrower (7.3%), broader (12.1%), and 73.3% of the diagnoses were not found in NANDA-I. The constant or non-constant diagnostic titles were classified in ICNP® and NANDA-I, respectively: Psychobiological 68% and 32%; Psychosocial 82.4% and 17.6%. No psychospiritual needs were identified. In cross-mapping, seven NANDA-I and ICNP® diagnoses were validated by the specialists and 11 non-constant diagnoses, with CVI> 0.8. The study presented numerical differences during the identification of nursing diagnoses with the use of two classification systems; however, the contribution of these systems to the development of nursing promotes effective results in care delivery, since the identification of the nursing diagnosis incorporated into a nursing diagnosis. Standardized language contributes to support nursing interventions and the strengthening of the profession.

Introduction: The gestational period during the deprivation of liberty in the prison system, as well as lactation, are delicate, complex and marginalized processes, attacking the best experience of motherhood. The experience of the gestational process in the prison environment enables interactions that rework the senses and symbolic world of these women. Objective: To analyze the social representations of motherhood among pregnant and lactating women who experienced pregnancy deprived of liberty in the prison system. Method: This is a qualitative study, anchored in the assumptions of the Theoretical Paradigm of Social Representations in the structural aspect, conducted with 42 pregnant women, lactating women who experienced pregnancy deprived of freedom in the prison system of the state of Rio Grande do Norte. From May to September 2019. For data collection, we used a sociodemographic questionnaire, thematic drawing-story and the free word evocation technique associated with the substitution and decontextualization model (mute zone), with the term inductor. “Being a mother in prison”. Data were analyzed by prototypic processing (four-box table) for each matrix, for which intermediate frequencies (± 8.37 matrix 1 and ± 8.10 matrix 2) and mean evocation orders (matrix) were automatically calculated. 1: ± 3.08; matrix 2: ± 3.01) according to requirements. Thus, it composed the central nuclei, the peripheries and the contrast zones. The words composition and co-occurrence test (similarity analysis) was also performed. The analytical processing was carried out using the Software interface for Multidimensional Analysis of Textes and Questionnaires (IRAMUTEQ), version 7 alpha 2. The research was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under CAAE. : 08005219.7.0000.5537. Results: Most participants were between 18 and 28 years old (n = 20; 47.62%); were single (n = 20; 47.62%). They had two or more pregnancies (n = 38; 90.47%) and reported one or more miscarriages (n = 21; 50%). In the prototypic analysis, it was found that the term inductor resulted in 420 evocations and 133 distinct words. After categorization and lemmatization, the number of different words evoked by women were 84 between matrix 1 and 2. Excluding the evocations with frequency less than three, resulted in a use of 31.15%. In matrix 1, the possible representation of being a mother in prison crystallized, principally and semantically, by the terms: separation (f = 27; OME: 2.9), sadness (f = 18; OME: 2.3), horrible (f = 16; OME: 2.1), pain (f = 12; OME: 2.8). In the substitution and decontextualization zone (matrix 2), the representations were objectified by the terms separation (f = 18; OME: 3), sadness (f = 13; OME: 2.5), fear (f = 11; OME: 2.2), horrible (f = 10; OME: 1.5). Thus, the only representational difference between the two cores was the change of the word pain for fear in matrix 2, maintaining the crystallization between the two frames with respect to the first square of the frame. In the similarity analysis, the central nucleus, composed by the term “separation”, had a strong co-occurrence with the words: “suffering (11), distant (4), abandoned (3), horrible (9), adoption (4) and sadness (8)”. Final considerations: Experiencing motherhood in the prison system, whether pregnant or lactating, represents for women a set of meanings and meanings, which are attributed from institutional norms and prison laws that weaken the mother-child dyad and potentiate the mother. female imprisonment, meaning for these women, essentially, suffering for the dichotomy of the bond with the child.

      As a refined methodology for health education, peer education has been delineated as a significant form of prevention and health promotion in adolescents, an age group that has gained prominence in the face of the global epidemic of the human immunodeficiency virus. Aim: To evaluate the scientific evidence on peer education in the prevention of immunodeficiency virus in adolescents. Method: This is a systematic review with the PICO strategy research question: Can peer education produce health-related behavioral changes when used as a prevention method for human immunodeficiency virus in adolescents? The search was performed on the Elsevier, PubMed Central, PubMed, DART-Europe, Web of Science, Capes Thesis and Dissertation Catalog, RCAAP, LILACS, Scopus, Scielo, Open Access Thesis and Dissertations (OATD), Cyberthesis, DART- Europe, Ethos, New Zealand theses by crossing the indexed descriptors 1.peer influence, 2.peer group, 3.health educativon, 4.peer education (1 OR 2 OR 3 OR 4) 4.adolescent, 5.adolescence, 6.youth (4 OR 5 OR 6) 7.acquired immunodeficiency syndrome, 8.HIV (8 AND 9) 9.primary prevention, 10.school-based prevention (9 OR 10). The method design was developed based on the guidelines defined by the Cochrane Handbook (2011) and the instrument The PRISMA Statement (PRISMA). All comparative study designs will be included in the review, including clinical trials, pretest / posttest, cohort, case-control and cross-sectional studies. Of the 6,142 studies found, after the first selection of reading titles and abstracts, excluding duplicates, the sample consisted of 11 articles. Studies were evaluated from 2000 onwards. ROBIS: A Risk of Bias Assessment Tool for Systematic Reviews was used for risk assessment of bias. This review was submitted to registration in the PROSPERO database under the identifier 150530. Results: Data from 11 studies were analyzed for behavioral and non-behavioral outcomes. Concerning the former, peer education had a positive impact on reducing risk attitudes (63%), self-efficacy against condom use (18.1%), intention to refuse unprotected sex (9%), intention to use condoms (90%) and condom use (90%). Non-behavioral aspects include effective results for elements such as knowledge related to sexual health (81.8%), conversation and sharing of knowledge with friends / colleagues about the use of preventive methods. Behavioral changes were also found to be more pronounced soon after the intervention than at follow-up months. Conclusion: Peer education represents a new genre of promotion and prevention that promotes individual and community health behavior changes that can maintain long-term modified habits.

       The advent of new Communication and Information Technologies establishes the emergence of educational strategies consistent with the current transformations, presenting impacts on the world of work, a productive scenario for the realization of educational practices. The distance education offered by Virtual Learning Environments is a relevant educational strategy for the Permanent Education of the nursing team, as it allows for time flexibility, the transposition of geographical barriers and the opportunity for digital inclusion. Thus, the proposal of building an educational technology on bladder catheterization for the qualification of the nursing team, based on the gap identified in a public health service, emerged. The study aims to describe the construction of a distance course on bladder catheterization for nursing. This is a methodological study for the construction of a technology-mediated educational instrument, developed according to the methodological framework of Pasquali Psychometry. The study is in line with the ethical precepts established by the National Health Council and was approved by the opinion of the Research Ethics Committee, nº 3.187.303, CAAE: 08005519.6.0000.5537. The construction of the distance learning course proved to be a challenging experience, since it was sought to develop it with high methodological rigor, considering the constructivist perspectives of education, such as problematization and meaningful learning. Given the use of educational technologies in continuing education, it is concluded that the study may contribute to improve nursing care, aiming at patient safety. The validation of educational technology is suggested later.

          BACKGROUND: The human aging process is a worldwide phenomenon and also exists among indigenous people, however, in Brazil, information about the health conditions and self-care culture of indigenous elderly people is still scarce and fragmented. Researching about the human responses and the self-care culture in this population is needed as it enables a qualified, systematized and culturally congruent nursing care. OBJECTIVE: To analyze human responses in nursing and the self-care culture of indigenous elderly. METHOD: This is an exploratory and descriptive study with a mixed method approach, of convergent parallel type. Quantitative and qualitative data were collected concurrently, with equal weighting for both data. Data integration was performed, in which the results of quantitative and qualitative data were mixed and produced mutually supported information. Finally, Leininger's Theory of Culture Care Diversity and Universality was used, which is the theoretical perspective that conducted this research. The study population consisted of indigenous people of Potyguara ethnicity, living in the indigenous community of Amarelão, João Câmara, Rio Grande do Norte. In the quantitative approach, a Nursing Consultation with 51 participants was held, and in the qualitative approach phase, a semi-structured interview with 17 indigenous elderly was performed in August 2019. Data obtained from the Nursing Consultation were analyzed following two steps: phase I - data analysis and synthesis; phase II - establishment of nursing diagnoses using the North American Nursing Diagnosis Association Internacional (2018-2020). Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) program. Absolute and relative frequencies were used and Fisher's Q-Square and Exact Test were applied. Qualitative data were analyzed from thematic content analysis. The research was submitted to the Ethics and Research Committee of the Federal University of Rio Grande do Norte and the National Research Ethics Committee under the CAAE: 07990219.7.0000.5537, being approved by the opinion nº. 3,475,904. RESULTS: Regarding nursing diagnoses, 38 were identified, being the prevalent ones: Impaired dentition (98.0%), Risk of impaired skin integrity (66.7%), Chronic pain (64.7%), Risk of deficient fluid volume (54.9%), Impaired Swallowing (45.1%), Impaired Ambulation (45.1%), Sleep Pattern Disorder (43.1%), Stress Urinary Incontinence (41.2%), Discus falls (35.3%) and sexual dysfunction (33.3%). Concerning the qualitative data, three thematic categories were identified: 1) Meaning of health in the conception of indigenous elderly; 2) Indigenous experience of becoming ill and 3) Indigenous self-care practices. CONCLUSION: Based on the convergences and combinations of qualitative and quantitative results, the human responses most present in the indigenous elderly are those resulting from factors leads to decrease in their functionality and independence, corroborated by the participants' statements. Regarding self-rated health, reported problems relate to limiting conditions that also interfere with the performance of daily activities. Regarding self-care practices, the use of medicinal plants for disease prevention and treatment was evidenced, as well as the performance of domestic activities, manual labor and autonomy in problem solving, as ways of obtaining health, which is, an active aging. However, the medicalization is still present in this unique ethnic health-disease process, shown in the statements of the elderly, when citing the dependence on the use of drugs, including psychotropic drugs. This finding is also evidenced by quantitative data, which points to necessary reflections on the abusive use, self-medication and indiscriminate prescription of drugs for this population. The quantitative data also revealed a low presence of preventive practices adopted by the group, which makes evident the influence of the medical-curative model absorbed in the self-care practices of this population, as a result of contact with non-indigenous society through health services.

This study aimed to construct and validate the nursing diagnosis Ocular dryness in adult patients hospitalized in an intensive care unit (ICU). This is a methodological research of validation of nursing diagnosis developed in three interrelated stages, namely: STAGE 1: Construction of the nursing diagnosis Ocular dryness in adult patients hospitalized in an ICU and construction of the definitions, based on the concept analysis framework and operationalized through Scoping Review. STAGE 2: Analysis of diagnostic content, in which the evaluators judged the adequacy of previously created concepts, through focus group. STAGE 3: Clinical validation of nursing diagnosis Ocular dryness in adult patients hospitalized in an ICU, performed by means of a study of the accuracy of clinical indicators of nursing diagnosis Ocular dryness, with a cross-sectional design and quantitative approach, performed with 206 patients hospitalized in an ICU of adults of a university hospital located in the Brazilian northeast. The data collected was organized and stored in a database built in Microsoft Office Excel 2016 and analyzed by a specific statistical program. The study obtained a favorable opinion from the Research Ethics Committee under number 918.510 and CAAE 36079814.6.0000.5537. The recommendations of Resolution nº 466/12, approved by the National Health Council of the Ministry of Health, on December 12, 2012, were obeyed. In the first stage, 169 articles were selected and two attributes, 32 antecedents and 12 consequent ones were identified. In the second stage, after discussion in the focus group, the judges obtained a consensus regarding the adequacy of each component and definition of the diagnosis. We defined 14 defining characteristics, nine related factors, two populations at risk and 22 associated conditions. In the third stage, was verified using the latent class model the prevalence of nursing diagnosis Ocular dryness in 76.22% of the sample. The clinical indicators decreased lacrimal volume and excess mucoid secretion presented high values of specificity. In addition, dilated blood vessels on the ocular surface, excess mucoid secretion, mucoid filament and chemosis presented higher values for sensitivity. It is concluded that the data obtained can contribute to a better understanding of the manifestation of the diagnosis in adults hospitalized in an ICU, as well as the most important signs for inference of Ocular dryness. Thus, the nursing diagnosis Ocular dryness is valid in adult patients admitted to the ICU.

This study aims to build and validate a Virtual Learning Object to support teaching on prison health. It is a methodological study, with a quantitative approach, developed from June / 2017 to March / 2019, whose stages followed the model proposed by Pasquali: theoretical, empirical and analytical procedures. Theoretical procedures included the identification of the contents that comprised the Virtual Learning Object, based on interviews with the health professionals of the Prison Basic Attention Teams and a scoping review. For the construction of hypermedia was considered the Pasquali reference for content elaboration, the organization followed the principles of Significant Learning Theory and the concepts of Instructional Design (ADDIE model). In the empirical procedures the content validation stages were carried out, in which the frame proposed by Pasquali, using the Delphi technique, was also adopted. This stage was carried out with experts through electronic form (Google forms), for the selection of the judges the criteria of eligibility proposed by Fehring were adopted. In the analytical procedures the analyzes were carried out regarding the agreement and the Content Validity Coefficient. The usability assessment was performed with nursing students, using the System Usability Scale and, in a complementary way, the Suitability Assessment of Materials, to measure the adequacy of educational material to the target audience. The ethical determinations present in Resolution 466/2012 of the National Health Council were respected, so a study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte under CAAE 62825716.8.000.5537. From the interviews with the health professionals and the results of the scope review, the work process developed and the assistance practices carried out by the prison staff and the health condition of the persons deprived of their liberty are revealed. This information resulted in the structuring of the Virtual Object of Learning in seven screens, namely: presentation, concepts, legal apparatus, penitentiary system, work process, publications and final provisions / credits. The screens presented information regarding its theme, interactive text, reading suggestion for deepening and exercise. After the construction, content validation followed, in which 11 and 8 judges participated in the first and second rounds, respectively. After the first round of Delphi, the Virtual Object was reformulated and submitted to Delphi 2, where the agreement was 97.6% and Content Validity Coefficient equal to 1. In this study, the usability evaluation with the System Usability Scale obtained an average of 82.9 and Suitability Assessment of Materials of 88.36%. The Virtual Learning Object - Penitentiary Health had its content validated and the usability assessment satisfactory. In this sense, the future availability of educational material can foster and contribute to the teaching of prison health among health students.

Methodological study, with the aim to evaluate the efficacy of virtual clinical simulation, grounded on problem based learning, as an educational strategy for the Nursing diagnosis reasoning in adult health. The study was developed in four stages, namely: construction of the scenarios for virtual clinical simulation on diagnostic reasoning; content analysis of scenarios by specialists; development of the virtual learning object for clinical simulation; and application of virtual clinical simulation with undergraduate students in Nursing. The creation of the simulated scenarios was based on the literature, through diagnostic validation studies. The scenarios were analyzed by 22 experts in diagnostic reasoning and / or clinical simulation. The third stage allowed to allocate the scenarios in the virtual clinical simulation. After the final engineering, the virtual object was submitted to the test of its usability next to a team composed by eight students of Nursing and nurses. In the last step, the virtual clinical simulation strategy was tested by an experimental study with undergraduate students of the Nursing undergraduate course at a public university in Northeast Brazil. The students were randomized into the intervention and control groups. The intervention group was submitted to virtual clinical simulation and evaluated the quality of the virtual learning object. Data were analyzed using descriptive and inferential statistics. The project was approved by the research ethics committee, with favorable opinion nº 2.171.393. The results show that the simulated clinical scenarios were created by the responsible researcher, who were later judged by the specialists as relevant (CVI equal to or greater than 0.85). All the proposed diagnoses presented a high degree of accuracy, with an acceptable measurement for CVI and Kappa index. As a third step, the virtual learning object was developed. It presented good usability (final score of 87.81). In the experimental stage, the comparison of the intervention and control groups for diagnostic inference showed a significant increase in the number of correct answers for diagnostic inference (p = 0.008) and identification of related factors (p = 0.031) at the post-test stage of the intervention group. The prioritization of the diagnoses showed a statistically significant difference when the pre- and post-test moments (p = 0.08) were compared in the intervention group, as well as when the intervention and control groups were compared (p = 0.014). There was a greater difference in performance between the pre- and post-test in the scores of the students who participated in the intervention (p = 0.003). In addition, the virtual object obtained a high average quality score (4,66). Thus, it is concluded that the virtual clinical simulation grounded on problem-based learning was presented as an effective educational strategy for the nursing diagnosis reasoning in adult health. Moreover, the educational technology developed was attractive and favored the active and meaningful learning of the student.

The objective of this study was to evaluate safe nursing care in neonatal intensive care units. Evaluative research with quantitative approach, conducted in six hospitals in the metropolitan region of Natal / RN / Brazil. The study was subdivided into three methodological steps: 1) identification and mapping of Patient Safety in the Neonatal Intensive Care Unit, based on a scoping review; 2) elaboration of a safe care evaluation instrument, with subsequent validation of content and appearance; 3) evaluation of safe nursing care through a quasi-experimental, before-after study, with intervention. In step 1, a scoping review was performed in order to list the essential elements for safe nursing care. The construction of the assessment instrument (graphic protocol) of safe care (step 2) was based on the triad structure-process-result, with adaptations for neonatal care, supported by scoping review data. To validate the content and appearance of the graphic protocol, nurse judges were enrolled from a Lattes Platform search according to previously established inclusion criteria. The Delphi technique was used, divided into two steps (Delphi 1 and 2) and the validation process took place through an electronic form in Google forms. The relevance of the items was judged by the result of the Content Validation Coefficient. In step 3, for the measurement of safe care, a previously validated pre- and post-test instrument was used, interspersed with an intervention in the neonatal units. Data collection of this stage occurred from January to July 2019 through the non-participant observation of two trained evaluators and without interaction between them. The results were analyzed by descriptive statistics, thus the care classification was performed from the score listed in the graphic protocol. The Kappa coefficient was measured to assess interobserver agreement. All ethical precepts were respected and the project received approval from the Research Ethics Committee of the Federal University of Rio Grande do Norte, issued CAEE No. 64879717.4.0000.5537.Scoping review resulted in a total of 87 scientific productions, whose themes were subdivided into : Adverse Event Investigation (49; 56.3%) and Safe Practice Assessment / implementation (38; 43.7%). The construction of the protocol was based on these results. A structured checklist script was elaborated, consisting of ten items and 111 sub-items about the elements "structure, process and result". The protocol was considered valid for content, with Content Validity Coefficient of 0.97 in the second Delphi round. The overall estimate of the instrument for appearance validation was 0.99 at Delphi II. In addition, 100% of the judges recommended the use of the protocol after inclusion of suggested changes. In step 3, the process element presented the best compliance percentage, above 50% for all neonatal units. The process element varied so that those services that did not have the active patient safety center had their items considered inadequate (below 50% of compliance) in three services, in the first evaluation. The result element had the highest number of inadequacies (below 50% compliance in three intensive care units). In the metropolitan region of Natal, partially safe care prevailed, evidenced by 83.3% of NICUs with a protocol score between 7 and 13. It is concluded that, in the investigated services, nursing care is partially safe. Moreover, the evaluation, through the graphic protocol, was essential to identify problems that impact the safety of newborns. Similarly, the intervention played an important role in achieving improvements. However, it is necessary that these actions occur continuously to subsidize the practice of nursing professionals in the face of harm reduction.

        This is a cross-sectional study conducted with 100 homeless people in the city of João Pessoa, Paraíba, with the objective of analyzing the health and disease conditions of homeless people. Data were collected between February and May 2018. For this purpose, a structured interview script, Self-Reporting Questionnaire Scale, Beck Anxiety Scale, Beck Depression Scale, Beck Desperation Scale, Resilience, Hamilton Depression Scale and HIV / AIDS Vulnerability Questionnaire. In addition, rapid tests for HIV, virus, hepatitis B and C were performed. One research was approved by the Ethics Committee on Research on Human Beings of the Federal University of Paraíba, according to opinion number 2456847. Initially, the questionnaire on vulnerability to HIV was validated. HIV, Tuberculosis, and other Sexually Transmitted Infections through Item Response Theory. To verify the influence of variables on the diagnosis of HIV and tuberculosis, perform the Weight of Evidence by measuring the Information Value. The latent class model and confirmatory factor analysis are also used to verify an association of variables with psychological, sociodemographic and behavioral factors. These procedures were performed with the aid of the software SPSS 19.0, Software R and MPLUS. It was found that 79% of respondents have common mental disorders, 37% mild, 29% desperate, 48% low resilience, 69% depression; 74% use drugs, 29% are HIV positive, 5% HIV, 1% hepatitis B, 75% do not use condoms in all sexual relations, 52% have sex with casual partners, 54% have sex with drug users, 71% suffered physical violence. An analysis using the Item Response Theory validated as reliable for measuring vulnerability to HIV, the following items: early diagnosis of STI (F = 0.473), partner with STI symptom (F = 0.518), drug use (F = 0.509), sex for money (F = 0.552), STI symptoms (F = 0.448), amount of sexual partner (F = 0.616), sharpening (F = 0.398) and being a victim of sexual violence (F = 0.347). Factors considered by the Weight of Evidence that influence HIV were: hopelessness, anxiety, time spent living on the street, age, oral sex. For tuberculosis found: hopelessness, resilience, dwelling time on the street, anal and oral sex. We highlight the Latent Class Model for three classes with Akaike Information Criterion of 1828.24, Bayesian Information Criterion of 1989.76, relative entropy of 95.89%, being interpreted as ≤ 30 years, men, single, low resilience, depression, 85% mental disorder, oral, anal and vaginal sex, anxiety symptoms and mild depression. A confirmatory factor analysis found a presence of factors that influence or harm homeless people, such as: sociodemographic, psychic and behavioral, with a Comparative Adjustment Index of 0.986; Tucker-Lewis Index of 0.982; Mean Square Root of Approximation Error Squares 0.022; Mean Square Index 0.075. Conclusion: The study allowed identifying factors that predispose to postponement and that can be inserted in the care provided as homeless people in order to find early factors that favor the postponement, minimizing them and providing the necessary assistance.

The objective of this study was to analyze the approach of nurses (a) children and adolescents in situations of violence in the three levels of health care based on the line of care for children and adolescents in situations of violence. Analytical study with qualitative approach, conducted in the city of Campina Grande, Paraíba, in primary, secondary and tertiary health care services that assist children and adolescents in situations of violence. Approved by CEP/UFRN, Parecer: 2.456.493, CAEE: 80006417.2.0000.5537. The sample consisted of 76 nurses distributed: in primary care, working in the Family Health Strategy; in secondary care, in a municipal hospital for child and adolescent care in the reception, red room and pediatric ward sectors; in tertiary care, the nurses of the reception, red room, pediatric observation, pediatric ward and pediatric intensive care unit of a referral trauma hospital. Data were collected through sociodemographic form and recorded and transcribed semi-structured individual interviews. The collected data were analyzed by IRAMUTEQ software through Descending Hierarchical Classification, Similitude Analysis and Word Cloud. In Primary Care we obtained, from the lexicographic analysis classes, five categories named: Category I (Class 1) - Living and identification by the nurse of situations of violence with children and adolescents; Category II (Class 4) -Family context and violence; Category 3 (Class 5) - Health promotion actions by nurses; Category IV (Class 3) - Multidisciplinary team and services of the care network as support for the approach of the nurse; Category V (Class 2) -Capacitation and performance of the nurse facing the victim of violence. In Secondary Care emerged five categories defined as: Category I (Class 1) - Conducts directed to children and adolescents victims of violence in the service of medium complexity; Category II (Class 4) -Scope of medium complexity and actions of the nurse; Category III (Class 5) -Capacitation and the nurse's way of dealing with victims of violence; Category IV (Class 3) -Nurse's perception of the family context and the victim; Category V (Class 2) -Identification of violence against children and adolescents by nurses through nursing consultation; and for Tertiary Care the data produced six categories named: Category I (Class 1) - Reception, notification and follow-up of cases of violence; Category II (Class 5) -Nursing consultation: signs of identification of violence; Category III (Class 6) -Relation of the nurse with the relative; Category IV (Class 4) -Nurse training to approach children and adolescents victims of violence; Category V (Class 2) -Specificities of the service sectors in the highly complex service; Category IV (Class 3) -High complexity health service as a reference for situations of violence. The analysis of the three levels of health care identified weaknesses in the approach of nurses to children and adolescents in situations of violence regarding scientific and technical knowledge in undergraduate or training, in the identification of cases of violence, in relationships with victims and family, in articulation. multidisciplinary and intersectoral approach and in defining the internal flows of each It is concluded that the approach of nurses to children and adolescents in situations of violence needs qualification through specific professional training, definition of flows and protocols, articulation with the Forensic Nursing protection and advancement network for an advanced practice of nurses at victims of violence.

Introduction: Rehabilitation nursing has not been widely established in Brazil. Many nurses are unaware of their role and importance as members of the rehabilitation team. It is believed that there is a conceptual gap in the area of nursing in rehabilitation in this country, which may be contributing to this problem. Objective: To develop the concept of Rehabilitation Nursing for the Brazilian context, based on the hybrid concept development model. Method: The Hybrid Concept Development Model was implemented in three phases: Theoretical, Field and Final Analytic. In the Theoretical Phase, 120 studies that described the practice of nurses focusing on rehabilitation were analyzed. The Field Phase was conducted at a University Hospital and a Specialized Rehabilitation Center (CER), both located in a northeastern capital of Brazil, through participant observations and semi-structured interviews with nurses, health team members, patients. and companions. Field Phase data were analyzed using Theoretical Phase results as the theoretical axis and Thematic Analysis as the methodological framework. In the final analytical phase, the results of the theoretical and field phases were compared, analyzed and integrated in the light of the Nursing Theoretical Model based on Life Activities, which allowed a definition of the concept. The research project was approved by the Research Ethics Committee (CEP) of the Federal University of Rio Grande do Norte (UFRN) with CAAE 03986518.0.0000.5537. Results: The facts show that Rehabilitation Nursing in Brazil can be defined as an educational and care process, developed by the nursing team, based on a systematized care that involves the patient, the family and the multidisciplinary team and aims at prevention. complications, promoting independence and autonomy in life activities, quality of life, adapting to a new life situation, social and family reintegration and / or well-being. Conclusion: It is believed that the hybrid approach allowed to expand and clarify essential aspects of definition and measurement of the concept under study, which favored the development of a concept that could be applicable in different contexts of professional practice in the Unified Health System (SUS).

Fibrinolytic Therapy (TF) is the pharmacological treatment for myocardial reperfusion in patients with a diagnosis of ST-segment elevation myocardial infarction (STEMI) in accordance with the criteria of indication and contraindication. Its pre-hospital administration is associated with a significant reduction in mortality rates. This study aimed to describe the effectiveness of the use of TF in prehospital care for the treatment of patients with STEMI. Epidemiological research, with a quantitative approach, of the descriptive, analytical, observational, individuated type, performed through a sectional design. It was carried out in two stages in which the first occurred with the Mobile Emergency Service (SAMU) and Emergency Care Units (UPA) in the city of Natal/RN and the second in the services referenced as entrance doors of those units. Data were collected from secondary sources from March to October 2017. For this study, the effectiveness was related to the outcome of the patients, considered as clinical improvement, refractory AMI, reinfarction, worsening of the clinical picture or death. The data were organized in a spreadsheet using the Microsoft Excel^® 2010 program, submitted to statistical analysis through the Statistic Package for Social Sciences - SPSS^® version 20.0. Frequencies and measures of central tendency were used and association measures were applied (chi-square test). The level of significance was set at 0.05 (p <0.05). The Research Protocol of this study was approved in its ethical and methodological aspects by the Research Ethics Committee of the Federal University of Rio Grande do Norte under opinion n^o. 1.762.797 and CAAE n^o. 59963416.5.0000.5537. Of the 53 patients' charts of the final study sample, there was a predominance of care by the UPA with 88.68%, when 41.51% were discharged with clinical improvement still in the prehospital care, 37.73% were transferred to other services and 13.21% died. The main signs and symptoms at admission were precordialgia (84.62%), sweating (36.54%), dyspnea (26.92%), hypertension (19.23%), nausea (17.31%), malaise (17.31%) and emesis (13.46%). The main characteristic of chest discomfort was precordialgia (70.45%). The TF drug administered in all patients was tenecteplase. The median time to symptom-port was 180 minutes, symptom-reperfusion 300 minutes and needle-holder 160 minutes. As outcome, 74.47% had clinical improvement, 19.15% died, 4.25% refractory AMI and 2.13 reinfarction. The main characteristic of the clinical improvement was the reversal of precordialgia (68.57%), characterized as myocardial reperfusion criterion. Early administration of TF could still optimize the outcome of clinical improvement (100%) when performed within 3 hours. In 60.78% of the cases, there was no record of occurrences that could be related to the use of TF and among the occurrences after its use, 21.56% presented some bleeding. As a limitation, it was observed the insufficiency of important records. The present study presented scientific evidence of the effectiveness of TF with improvement of the clinical outcomes of patients who used it and the shorter times related to chest discomfort and the administration of TF were responsible for increasing the outcomes of clinical improvement and reducing the outcome of death.

Introduction: Among the precarious working conditions, many nursing professionals who work in the emergency and emergency hospital network are subjected to high levels of stress, putting at risk physical and mental health. Objective: To analyze the prevalence and factors associated with suicidal ideation, predisposition to depression, and job satisfaction with sociodemographic, occupational and suicide risk factors among nursing professionals from the emergency and emergency (EU) sectors of regional hospitals in Rio Grande From north. Method: A cross-sectional study involving 56 nurses and 91 nursing technicians (n = 147) from the Public Hospitals of the Network of Emergency and Emergency Care of the II, IV and VII URSAP / RN. Data collection took place from January to November 2017, using four instruments: Socio-demographic, Occupational Characterization and Risk Factors for Suicide, Beck Depression Inventory, Beck Suicidal Ideation Scale, Satisfaction Scale in the Work by Martins. Data were entered in a Microsoft Excel® v.2016 worksheet and checked by double entry. Descriptive analysis (absolute and relative frequencies, measures of central tendency and dispersion), univariate analysis (Pearson's Chi-square test or Fisher's exact test, Likelihood ratio, Student's t test, Mann-Whitney U test or Kruskal Walliss, depending on the presence of normality of the variables) and multivariate analysis (the prevalence ratio and confidence intervals -IC95% were calculated using Poisson regression with robust variance). The software SPSS v.20 and Package R v.2.7.1 were used. The level of significance was 5%. The research project was approved by CEP / UFRN under Opinion No. 1,877,910 of December 21, 2016 and CAAE: 62824216.6.0000.5537. Results: Suicidal Ideation (IS) was identified in 4.8% (n = 7) of the participants, and depressive states - minimum: 86.4% (n = 124), mild: 12.2% (= 18), moderate: 1.4% (n = 2). Mean overall satisfaction at work: 85.7% (n = 126) indifferent, 10.9% (n = 16) satisfied, 2% (n = 3) dissatisfied and 14% (n = 2) very dissatisfied. There was a statistically significant relationship between: IS and the variables sexual orientation (p = 0.006), low self-esteem (p-value = 0.010) and depressive states (p = 0.012). Depressive states and last training on emergency situations (p = 0.041), evaluation of family relationship (p = 0.012), self report of low self-esteem (p = <0001) and hopelessness (p = 0.001); Average overall job satisfaction with average length of service in the EU area (p = 0.016), living with the family (p = 0.015) and having a family member who attempted suicide (p = 0.024). The adjusted models showed that heterosexuals were 0.60 less likely to develop IS when compared to homosexuals (95% CI -0.44-0.83). Those with low self-esteem had 1.17 higher odds of developing IS (95% CI -1.02 - 1.34). Individuals with a poor family relationship (95% CI -3.87-12.30) and low self-esteem (CI 95% -2.07-10.57) were more likely to present mild / moderate depressive status, 1.35 and 4, 76 respectively. Conclusion: It is evidenced that the nursing professionals of this study presented processes of mental illness in the context of the hospital emergency and emergency service. Specifically, suicidal ideation and depressive states have been associated with personal and collective factors of the work environment. It is suggested the development of analytical studies that can mainly evaluate the issues of self-esteem and social support, in order to reach new evidences.

This is a concept analysis, according to the Walker and Avant method, operationalized through integrative review, aiming to analyze the concept of nursing diagnosis ineffective control of health in people living with AIDS. To do so, we searched the databases: Scopus, Cinahl, PubMed, Web of Science, Science Direct, Cochrane and Lilacs, using the descriptors: Cooperation and Adherence to Treatment; adherence to medication and acquired immunodeficiency syndrome. Data collection was performed between January and March 2018, by a pair of researchers. The initial sample was 7693 articles, 1,029 in Scopus, 427 in CINAHL, 3,673 in PubMed, 1,280 in the Web of Science, 646 in Science Direct, 354 in Cochrane and 284 in LILACS. Next, the inclusion criteria were applied to refine the search, ie: articles available in the selected databases in Portuguese, English or Spanish; studies that respond to the proposed guiding questions. The following exclusion criteria were applied: prior notice, protocols, ongoing research, reviews, editorials and letters to the editor. After the application of the established criteria, a final sample of 46 articles was obtained, 14 in Scopus, 3 in Cinahl, 8 in PubMed, 6 in Web of Science, 5 Science in Direct, 7 in Cochrane and 3 in Lilacs. Five attributes, 34 antecedents and 17 consequent ones were identified. The concept was defined as: a dynamic and multifactorial process that involves physical, psychological, behavioral, socio-cultural, environmental and economic aspects related to the difficulty of following the therapeutic plan agreed between the person / caregiver and the health professional, negatively affecting their condition clinical and quality of life; and bringing personal, social and economic consequences to people living with AIDS. The definition of NANDA International for the diagnosis Ineffective control of health and its components need a complementation, aiming at a better targeting of care to people living with AIDS. It is necessary to carry out other studies on this subject and future research is intended to validate content and clinical validation of the concept of ineffective health control in people living with AIDS. Finally, this study may represent an advance for the literature on the subject by synthesizing, defining and analyzing the phenomenon of ineffective health control in people living with AIDS.