https://repositorio.ufpb.br/jspui/handle/tede/4455 PPGENF 2026-09-05T15:14:20Z https://repositorio.ufpb.br/jspui/handle/123456789/38888 Título: Aplicativo móvel como ferramenta de apoio ao conhecimento e autocuidado de pessoas com insuficiência cardíaca: estudo quase-experimental Autor(es): Santos, Wallison Pereira dos Orientador: Oliveira, Simone Helena dos Santos Abstract: Introduction: Knowledge and adherence to self-care behaviors are essential for maintaining clinical stability in people with heart failure. Mobile health applications have been used as an adjuvant tool to support therapeutic and educational actions implemented by health professionals responsible for caring for these patients, in order to mitigate hospitalization and morbidity and mortality rates and improve quality of life. Objective: To analyze the influence of the use of the mobile application “Tum-Tum” on the knowledge and self-care of people with heart failure. Method: Quasi-experimental, single-group, before-and-after study, based on the Theory of Specific Situation of Self-Care in Heart Failure. The research was carried out at the cardiology outpatient clinic of a public hospital in João Pessoa, PB. The intervention consisted of the use, for 60 days, of the mobile application “Tum-Tum”, which has adequate evidence of content and usability. Questionnaires on knowledge of heart failure and the Self-Care of Heart Failure Index (SCHIF), v. 7.2, at baseline (T0) and after 60 days (T1), which have scores ≥ 70 points as adequate. To compare the scores at T0 and T1, descriptive and inferential statistics (proportionality test and Wilcoxon) were used, considering a significance level of 5%. The study was approved by the Research Ethics Committee under opinion no. 6,417,699 and registered in the International Clinical Trials Registration Platform RBR-5zx8rvc. Results: 57 people with heart failure participated, with a median age of 60 years and 6 years of education, with 54.4% male, 33.3% white, 68.4% residing in João Pessoa, 56.1% married or in a stable union, 47.4% retired, 78.9% with an income between one and two minimum wages; 70.2% had reduced left ventricular ejection fraction; 54.4% NYHA II; 56.2% had heart failure of ischemic etiology; and 75.4% were taking beta-blockers. Before exposure to the mobile application (T0), the median scores were: knowledge, 8.0; self-care maintenance, 63.0; self-care management, 59.0; self-care confidence, 85.0. After 60 days of using the application (T1), the median scores were: knowledge, 10.0; self-care maintenance, 66.0; self-care management, 62.0; self-care confidence, 95.0. There was a statistically significant increase in the level of knowledge and in the self-care maintenance and confidence subscales. However, the maintenance and management subscales remained <70 points. Conclusion: Modulations in scores were observed after the use of the “Tum-Tum” mobile application, evidencing an increase in knowledge and self-care reported by people with chronic heart failure followed in outpatient settings. Further studies with larger and randomized samples will be useful to compare the findings in different contexts, as well as to analyze the influence of external factors that may be associated with the success or failure of the application of this technological tool.; RESUMEN - Introducción: El conocimiento y la adherencia a conductas de autocuidado son esenciales para mantener la estabilidad clínica de las personas con insuficiencia cardíaca. Las aplicaciones móviles de salud se han utilizado como herramienta de apoyo a las acciones terapéuticas y educativas implementadas por los profesionales de la salud responsables del cuidado de estos pacientes, con el fin de mitigar la hospitalización y las tasas de morbimortalidad y mejorar la calidad de vida. Objetivo: Analizar la influencia del uso de la aplicación móvil “Tum-Tum” en el conocimiento y autocuidado de personas con insuficiencia cardíaca. Método: Estudio cuasiexperimental, unigrupo, antes y después, basado en la Teoría de la Situación Específica del Autocuidado en la Insuficiencia Cardíaca. La investigación se realizó en el ambulatorio de cardiología de un hospital público de João Pessoa, PB. La intervención consistió en el uso, durante 60 días, de la aplicación móvil “Tum-Tum”, la cual cuenta con evidencia adecuada de contenido y usabilidad. Cuestionarios sobre conocimientos sobre insuficiencia cardíaca y el Índice de Autocuidado de la Insuficiencia Cardíaca (SCHIF), v. 7.2, al inicio (T0) y después de 60 días (T1), que tengan puntuaciones ≥ 70 puntos como adecuadas. Para comparar los puntajes en T0 y T1 se utilizó estadística descriptiva e inferencial (prueba de proporcionalidad y prueba de Wilcoxon), considerando un nivel de significancia del 5%. El estudio fue aprobado por el Comité de Ética e Investigación bajo dictamen no 6.417.699 y registrado en la Plataforma Internacional de Registro de Ensayos Clínicos RBR-5zx8rvc. Resultados: participaron 57 personas con insuficiencia cardíaca, con mediana de edad de 60 años y 6 años de escolaridad, siendo 54,4% hombres, 33,3% blancos, 68,4% residentes en João Pessoa, 56,1% casados o en unión estable, 47,4 % jubilados, 78,9% con ingresos entre uno y dos salarios mínimos; el 70,2% tiene fracción de eyección del ventrículo izquierdo reducida; 54,4% NYHA II; El 56,2% tenía insuficiencia cardíaca de etiología isquémica y el 75,4% utilizaba medicamentos betabloqueantes. Antes de la exposición al uso de la aplicación móvil (T0), las puntuaciones medianas fueron: conocimiento, 8,0; mantenimiento de autocuidado, 63,0; gestión del autocuidado, 59,0; confianza en el autocuidado, 85,0. Después de 60 días de uso de la aplicación (T1), las puntuaciones medianas fueron: conocimiento, 10,0; mantenimiento de autocuidado, 66,0; gestión del autocuidado, 62,0; confianza en el autocuidado, 95,0. Hubo un aumento estadísticamente significativo en el nivel de conocimiento y en las subescalas de mantenimiento del autocuidado y confianza. Sin embargo, las subescalas de mantenimiento y gestión se mantuvieron <70 puntos. Conclusión: Se observaron modulaciones en los puntajes después del uso de la aplicación móvil “Tum-Tum”, mostrando un aumento en el conocimiento y el autocuidado informado de las personas con insuficiencia cardíaca crónica seguidas de forma ambulatoria. Futuros estudios, con muestras más amplias y aleatorias, serán útiles para comparar hallazgos en diferentes contextos, así como analizar la influencia de factores externos que puedan estar asociados con el éxito o fracaso en la aplicación de esta herramienta tecnológica. Editor: Universidade Federal da Paraíba Tipo: Tese 2024-08-22T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38797 Título: Construção e validação de um checklist de orientações para o autocuidado de pessoas submetidos a amputação com pé diabético Autor(es): Santos, Suenny Alves dos Orientador: Costa, Marta Miriam Lopes Abstract: Introduction: Diabetic foot is one of the most significant complications affecting individuals with diabetes mellitus, contributing to high rates of lower limb amputations, a condition that has a major physical, emotional, familial, and social impact. Nursing plays a key role in self- care education. This study aimed to develop and validate a checklist of self-care guidelines for individuals discharged after amputation due to diabetic foot. Method: This is a methodological study with a quantitative approach, conducted through the following steps: scoping review, checklist development, and content validation by 22 specialists in diabetes and amputation care, selected by convenience sampling. The evaluation was performed using a 0 to 2 rating scale and the Content Validity Ratio (CVR) to analyze expert agreement. Data were collected in loco and analyzed using IBM® SPSS® Statistics 25.0 software. Items with a CVR ≥ 0.455 were considered valid. Results: A protocol and two articles were produced: a scoping review and a content validation article. The reviewed studies indicate a high prevalence of modifiable risk factors, including lifestyle and diet, in patients with people amputees due to diabetic foot, highlighting growing concerns about skin and foot care. Additionally, the lack of comprehensive foot assessments prevents the immediate recognition of potential risks and an accurate diagnosis of ulcerative conditions. Furthermore, the checklist validation demonstrated its relevance as a nursing support tool, presenting structured, consistent, and relevant content for professional practice. Conclusion: Several interventions have proven effective in altering the disease course and preventing the need for amputation. Finally, nursing plays a crucial role in supporting the self-care of individuals with diabetes.; RESUMEN Introducción: El pie diabético es una de las complicaciones más importantes que afectan a las personas con diabetes mellitus, estando relacionado con altos índices de amputaciones de miembros inferiores, una condición que genera un gran impacto físico, emocional, familiar y social. La enfermería desempeña un papel clave en la educación para el autocuidado. Este estudio tuvo como objetivo desarrollar y validar una lista de verificación de orientaciones para el autocuidado después del alta de personas sometidas a amputación por pie diabético. Método: Se trata de un estudio metodológico con enfoque cuantitativo, desarrollado a través de las siguientes etapas: revisión de alcance, construcción de la lista de verificación y validación de contenido, realizada por 22 especialistas en la asistencia a personas con diabetes y amputación, seleccionados por criterio de conveniencia. La evaluación se realizó utilizando una escala de 0 a 2 y la Razón de Validez de Contenido (RVC) para analizar la concordancia entre los jueces. Los datos fueron recolectados in situ y analizados con el software IBM® SPSS® Statistics 25.0. Los ítems con RVC ≥ 0,455 fueron considerados válidos. Resultados: Se produjeron un protocolo y dos artículos: una revisión de alcance y un artículo de validación de contenido. Los estudios revisados indican una alta prevalencia de factores de riesgo modificables, entre ellos el estilo de vida y la alimentación, en pacientes con personas amputadas por pie diabético, reflejando una creciente preocupación por el cuidado de la piel y los pies. Además, la ausencia de evaluaciones integrales de los pies impide el reconocimiento inmediato de los riesgos potenciales y el diagnóstico preciso de las condiciones ulcerativas. Asimismo, la validación de la lista de verificación demostró su relevancia como herramienta de apoyo para la enfermería, presentando un contenido estructurado, consistente y relevante para la práctica profesional. Conclusión: Diversas acciones han demostrado ser eficaces para cambiar el curso de la enfermedad y prevenir la necesidad de amputación. Finalmente, la enfermería desempeña un papel esencial en el apoyo al autocuidado de las personas con diabetes. Editor: Universidade Federal da Paraíba Tipo: Dissertação 2025-02-21T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38272 Título: Qualidade de vida relacionada à saúde, autoestima e funcionalidade de pessoas em pós-alta de hanseníase Autor(es): Fortunato, Cibelly Nunes Orientador: Freire, Maria Eliane Moreira Abstract: Objective: To assess quality of life related to health, self-esteem and functionality of people post-discharge from leprosy treatment. Method: The study was developed in two stages. In the first stage, a scoping review was built to map evidence in the scientific literature on health impairment after leprosy discharge and related factors, guided by the methodological guidelines proposed by the Joanna Briggs Institute, systematized by a PRISMA-ScR flowchart and recorded in the Open Science Framework (osf.io/vmdc6). In the second stage, an original, descriptive, cross- sectional study was developed with a quantitative approach, carried out in a referral hospital in Paraíba, Brazil, between May and August 2021. A non-probabilistic sample was adopted, with older individuals 18 years old, both sexes, who completed the leprosy treatment regimen. To obtain the data, a sociodemographic and clinical instrument, the Whoqol-bref, the Rosenberg self-esteem scale and the Screening of Activity Limitation and Safety Awareness (SALSA) were used. The research was approved by the Research Ethics Committee, under Opinion No. 4,663,032. Results: The scope review consisted of ten articles, of which nine showed some impairment in the degree of physical disability, demonstrating as related factors, weaknesses in post-discharge follow-up, shortage of trained professionals, lack of health education, difficulty in accessing to health services, delay in the treatment of reactional episodes and biopsychosocial rehabilitation, and absence of protocols and instruments for systematization and surveillance of care. For the field study, the sample consisted of 131 participants, most of them male, married, aged between 41 and 60 years. There was a negative impact on health-related quality of life, especially in the physical domain, with a better level of self-esteem and impairment of functionality in people post-discharge from leprosy. When comparing health-related quality of life and self- esteem, there was significance in all domains (p≤0.001). And, when compared with functionality, there was a significant difference in the Physical (p<0.001), Environmental (p=0.001) and Psychological (p=0.004) domains, since they obtained the p-value <0.05. Conclusion: The data obtained point to a worsening in health- related quality of life, improvement in self-esteem and impairment of functionality in the interviewees. It shows a positive association when comparing quality of life and better self-esteem, as well as, the greater the impairment of functionality, the worse the impact on health-related quality of life.; RESUMEN Objetivo: Evaluar la calidad de vida relacionada con la salud, la autoestima y la funcionalidad de las personas después del alta del tratamiento de la lepra. Método: El estudio se desarrolló en dos etapas. En la primera etapa, se construyó una revisión de alcance para mapear la evidencia en la literatura científica sobre el deterioro de la salud después del alta de la lepra y los factores relacionados, guiado por las pautas metodológicas propuestas por el Instituto Joanna Briggs, sistematizado por un diagrama de flujo PRISMA-ScR y registrado en el Marco de ciencia abierta (osf.io/vmdc6). En la segunda etapa, se desarrolló un estudio original, descriptivo, transversal, con enfoque cuantitativo, realizado en un hospital de referencia de Paraíba, Brasil, entre mayo y agosto de 2021. Se adoptó una muestra no probabilística, con personas mayores de 18 años, de ambos sexos, que completaron el régimen de tratamiento de la lepra. Para la obtención de los datos se utilizó un instrumento sociodemográfico y clínico, el Whoqol-bref, la escala de autoestima de Rosenberg y el Screening of Activity Limitation and Safety Awareness (SALSA). La investigación fue aprobada por el Comité de Ética en Investigación, bajo el Dictamen no 4.663.032. Resultados: La revisión de alcance constó de diez artículos, de los cuales nueve evidenciaron alguna afectación en el grado de discapacidad física, demostrando como factores relacionados, debilidades en el seguimiento posterior al alta, escasez de profesionales capacitados, falta de educación en salud, dificultad de acceso a la salud servicios, retraso en el tratamiento de episodios reaccionarios y rehabilitación biopsicosocial, y ausencia de protocolos e instrumentos de sistematización y vigilancia de la atención. Para el estudio de campo, la muestra estuvo conformada por 131 participantes, en su mayoría del sexo masculino, casados, con edades entre 41 y 60 años. Hubo un impacto negativo en la calidad de vida relacionada con la salud, especialmente en el dominio físico, con un mejor nivel de autoestima y deterioro de la funcionalidad en las personas después del alta por lepra. Al comparar la calidad de vida relacionada con la salud y la autoestima, hubo significación en todos los dominios (p≤0,001). Y, cuando se comparó con la funcionalidad, hubo diferencia significativa en los dominios Físico (p<0,001), Ambiental (p=0,001) y Psicológico (p=0,004), ya que obtuvieron el p-valor <0,05. Conclusión: Los datos obtenidos apuntan a un empeoramiento de la calidad de vida relacionada con la salud, mejora de la autoestima y deterioro de la funcionalidad en los entrevistados. Muestra una asociación positiva al comparar calidad de vida y mejor autoestima, así como, cuanto mayor es el deterioro de la funcionalidad, peor es el impacto en la calidad de vida relacionada con la salud. Editor: Universidade Federal da Paraíba Tipo: Dissertação 2022-02-18T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38086 Título: Construção e validação de um protocolo de intervenções de enfermagem para promoção do conforto de pessoas idosas hospitalizadas Autor(es): Oliveira, Sanni Moraes de Orientador: Fernandes, Maria das Graças Melo Abstract: Introduction: Longevity leads to multidimensional changes in the aging population and brings with it greater susceptibility to the occurrence of chronic health conditions, with risks of frailty and organic dysfunction and consequently a greater occurrence of prolonged and recurrent hospitalizations. Hospitalization, although necessary to restore health, can generate anxiety, fear and discomfort and constitute an unpleasant experience for elderly people. Although Nursing plays a preponderant role in caring for people in the context of hospitalization, through actions to promote well-being and comfort, it appears that these actions, in general, do not follow standardization, which implies the implementation of fragmented and inefficient care. Thus, in order to support nursing practice with a view to promoting the comfort of hospitalized elderly people, we propose an intervention protocol supported by Kolcaba's Comfort Theory, scientific evidence, as well as nursing interventions and activities proposed by the NIC. Objective: Build a protocol of nursing interventions to promote the comfort of hospitalized elderly people in light of Kolcaba's Theory. Method: This is a methodological study, initially starting from an integrative review of the literature to search for scientific evidence in the Database regarding interventions, activities and nursing care aimed at promoting comfort in people in the hospital environment. At the same time, the NIC Standardized Language System was used to identify the proposed Interventions for the “Impaired Comfort” Nursing Diagnosis of NANDA-I version 2021- 2023. Next, Cross Mapping of interventions and activities validated by experts in the area of knowledge was carried out. Finally, the construction and final validation was guided by the Appraisal of Guidelines for Research & Evaluation II instrument. To meet the requirements of the Guidelines and Standards for Research on Human Beings, all regulatory procedures and standards recommended by Resolution 466/2012 and 580/2018 of the CNS/MS/BRAZIL were respected, with approval from the Research Ethics Committee under CAAE no: 56816022.7.0000.5183. Results: 21 NIC interventions and information extracted from 15 studies were analyzed and validated by experts in light of theory in the physical, environmental, sociocultural and psychospiritual dimensions. A total of 604 nursing activities proposed in the NIC 7th edition were obtained, of which 176 were mapped with 137 interventions, activities and care evidenced in the literature, 13 activities did not show similarity with the proposed interventions, among which the majority were related to the psychospiritual context, with inclusion in other NANDA-I NDs, confirmed by the absence of this class of comfort in the aforementioned taxonomy. In validating the guideline, the domains 'scope and purpose', 'involvement of the parties' and 'clarity of presentation' were evaluated with maximum points, resulting in 100% suitability in the experts' assessment. In the domains ‘rigor of development’ and ‘editorial independence’, a percentage of 94% agreement was reached. In the ‘applicability’ domain, the maximum score corresponded to 93%, this being the domain that required small adjustments requested by the judges and for subsequent clinical validation. Final considerations: The relevance of the Comfort Theory supported the successful development of the nursing intervention protocol aimed at the comfort of hospitalized elderly people, demonstrating the predominance of the psycho-spiritual context as the main focus of intervention for this population. The study made it possible to identify the main evidence-based interventions in nursing and correlate them in the Standardized Nursing Language System. Continuing this study is essential to validate its practical applicability, ensuring its improvement and meeting the real needs of hospitalized elderly people. Editor: Universidade Federal da Paraíba Tipo: Tese 2024-07-23T00:00:00Z