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Internações por transtornos psiquiátricos em unidades de terapia intensiva: uma coorte multicêntrica em unidades privadas em Brasília - DF (2016-2024)

Sat, 04 Apr 2026 00:00:00 GMT

Título: Internações por transtornos psiquiátricos em unidades de terapia intensiva: uma coorte multicêntrica em unidades privadas em Brasília - DF (2016-2024) Autor(es): Lima, Gabryel Cordeiro de Primeiro Orientador: Fagundes Junior, Antônio Aurélio de Paiva Abstract: Background: Intensive care unit (ICU) admissions with a primary psychiatric diagnosis represent a distinct care subgroup and may be associated with acute medical complications. Objective: To describe the clinical-epidemiological profile, temporal trends, and outcomes of ICU admissions with a primary psychiatric diagnosis in three tertiary hospitals within the supplementary health sector in the Federal District, Brazil (2015–2024). Methods: Multicenter retrospective cohort including adults (≥18 years), identified using ICD-10 codes and extracted from the Epimed Monitor® registry. Phase-based temporal analyses used pre-pandemic, pandemic, and post-pandemic periods defined by national regulatory milestones. The primary outcome was prolonged ICU length of stay (LOS ≥7 days); ICU mortality was a descriptive secondary outcome. Results: Among 47,400 ICU admissions, 2,159 (4.55%) had a primary psychiatric diagnosis; 1,348 comprised the final cohort. Most patients were women (71.88%), and self-harm/attempted suicide predominated (63.43%), followed by mood disorders (12.54%) and psychotic disorders (9.72%). LOS ≥7 days occurred in 133 admissions (9.87%). ICU mortality was 0.59% (n=8). In the multivariable model for LOS ≥7 days, higher odds were observed for uncomplicated diabetes (OR 3.26; 95% CI 1.62–6.12), prior stroke without sequelae (OR 7.05; 95% CI 1.16–41.38), focal neurological deficit (OR 6.00; 95% CI 1.94–16.84), pneumonia (OR 16.90; 95% CI 4.75–67.01), and parenteral nutrition (OR 45.07; 95% CI 6.59–886.16). Conclusion: Primary psychiatric ICU admissions were infrequent and had low ICU mortality; prolonged LOS was mainly associated with acute medical complications, and intensive support needs rather than the psychiatric diagnostic category itself. Editor: Escola Superior de Ciências da Saúde, Universidade do Distrito Federal Tipo: Dissertação

Validação de vídeo instrucional sobre o dispositivo intrauterino comcobre e do conteúdo do protótipo do aplicativo DIU conecta

Thu, 18 Dec 2025 00:00:00 GMT

Título: Validação de vídeo instrucional sobre o dispositivo intrauterino comcobre e do conteúdo do protótipo do aplicativo DIU conecta Autor(es): Leão, Débora Aparecida de Oliveira Primeiro Orientador: Barros, Angela Barros Abstract: Introduction: Among sexual and reproductive rights, reproductive planning stands out because it implies respect for people’s freedom and autonomy to decide, freely and responsibly, whether or not they want to have children, how many they wish to have, and at what moment in their lives. This is aligned with Sustainable Development Goal (SDG) No. 5 of the 2030 Agenda — to achieve gender equality and empower all women and girls — which highlights the need to ensure universal access to sexual and reproductive health. Unplanned pregnancy is associated with an increased risk of maternal and fetal complications. In this context, the Brazilian Unified Health System (SUS) adopts as a strategy the expansion of women’s access to qualified information on contraceptive methods, encouraging informed choices aligned with individual needs. Among the contraceptive methods available in the SUS, the copper intrauterine device (IUD) is widely used worldwide and stands out for its effectiveness and safety. However, its uptake in Brazil remains low, which is associated with misinformation. This scenario highlights the importance of developing strategies that promote access to clear, accessible, and reliable information about the copper IUD. Objective: To validate the instructional video on the copper IUD and the prototype of the DIU ConecTa application. Method: This is a methodological study aimed at validating instructional technology in video format and the content of a mobile application prototype. The adopted methodology comprised the stages of evaluation, maintenance, and distribution. The previous stages — development; conceptual modeling, navigation, and interface; and implementation — were carried out in a prior research project by another master’s student from the same graduate program. Developed products: Product 1: Original article – Validation of an instructional video on the copper intrauterine device. Objective: To validate the content, appearance, and semantics of the instructional video on the copper IUD. Method: Content validation was conducted by expert judges using a structured and validated instrument, considering objectives, structure/presentation, and relevance. The appearance of the video was evaluated by other judges with training in design, communication, and related fields, who assessed shapes, colors, images, text, quantity, and size of figures, elements that may enhance the efficiency of the technology. Data were analyzed based on the Content Validity Index (CVI) and the Appearance Validity Index (AVI), with items achieving a minimum index of 0.80 considered valid. Semantic validation with the target audience was carried out with 30 pregnant women receiving care at the Maternal and Child Hospital of Brasília between January and April 2025. After signing the informed consent form, the video was presented to the participants, who subsequently completed an instrument assessing clarity, comprehension, and linguistic adequacy of the video. Results: In the first stage of content validation, a panel of judges was formed, selected based on academic background, professional experience, and involvement in the thematic area. Content validation was conducted in two Delphi rounds. Sixteen judges participated in the first round and fifteen in the second. The majority were female in both rounds, accounting for 93.8% in the first round and 93.3% in the second. All judges were nurses, with academic training time ranging from 3 to 29 years, with a mean of 17 and 17.4 years in each stage, respectively. Judges’ ages ranged from 25 to 57 years, with a mean age of 40.2 years in the first round and 40.6 years in the second. Regarding academic qualifications, 80% held a master’s or doctoral degree. Concerning professional practice, most participants — 15 (93.8%) in the first validation stage and 14 (93.3%) in the second — reported working directly in women’s health care. Most judges in both evaluation rounds had training in IUD insertion, totaling 75% (12) and 80% (12), respectively. Regarding undergraduate or graduate teaching/preceptorship, 12 (75%) judges reported experience in the area, ranging from two to twenty years. In the first stage of content validation, a mean CVI of 0.91 was observed. Five judges participated in the appearance validation, with a mean age of 35.4 years and an average of 13.2 years of professional training. At this stage, an AVI of 0.90 was identified. Suggestions from the judges in the first stage of content validation and in the appearance validation led to modifications in the video, resulting in a second version with a duration of five minutes and twenty-four seconds. In the second stage of content validation, a CVI of 0.97 was observed, demonstrating improved agreement among judges after the implemented changes. In the semantic validation, 30 women participated, and a CVI of 0.92 was identified. A one-sided binomial test was used for analysis, and results showed that eight out of ten items presented statistically significant agreement proportions (p < 0.05), particularly those related to language, clarity, and comprehension. This approach ensures the technical quality and pedagogical relevance of the developed material, guaranteeing alignment with the profile and needs of the target audience. Result: Version 2 of the video is available on the YouTube platform on the channel of the Graduate Program in Health Sciences at the following link: https://youtu.be/XawwBtBrmGo?si=G32RRc8MC82_rVWk. The video “Copper IUD – An effective choice to prevent pregnancy” was registered and holds a copyright certificate issued by the Brazilian Book Chamber as an intellectual work. Conclusion: The video presented satisfactory results in all stages of validation. Product 2: Content validation of the “DIU ConecTa” application prototype. Objective: To validate the content of the DIU ConecTa application prototype. Method: This is a methodological study focused on content validation of a mobile application prototype on the copper IUD named “DIU ConecTa.” A panel of judges was formed, selected based on predefined criteria related to academic background, professional experience, and involvement with the technology’s thematic area. Expert selection followed the snowball sampling method. Judges evaluated the technology items using a structured and validated instrument, considering three domains: objectives, structure/presentation, and relevance. Results: Data were analyzed based on the CVI, with items achieving a minimum index of 0.80 considered valid. The analysis demonstrated high agreement among participants, with CVI values ranging from 0.90 to 0.96 and a mean of 0.93, indicating a satisfactory degree of relevance, clarity, and adequacy. Suggestions were incorporated into the prototype content, resulting in a second version of the product. Conclusion: The DIU ConecTa application prototype also demonstrated satisfactory evidence of content validity. These materials are believed to contribute to expanding access to qualified information about the copper IUD, strengthening women’s empowerment in reproductive decision-making, and consequently promoting respect for their autonomy. The adopted methodology proved appropriate to ensure rigor, clarity, and relevance in the developed products and may help reduce informational gaps. This perspective directly aligns with Sustainable Development Goal No. 5, target 5.6, which emphasizes the importance of universal access to information and sexual and reproductive health services as an essential component of gender equality and women’s empowerment. The proposal is innovative in integrating accessible and easy-to-understand digital resources, contributing to expanded access to information on effective contraceptive methods and strengthening women’s autonomy in decision-making. Furthermore, the developed products demonstrate potential for practical application across different levels of health care, and may be incorporated into educational actions, training processes, and public policies related to reproductive planning. This initiative is relevant to Nursing and to the SUS, with real potential for positive impact on care practices and user experience. It is expected that the produced results may engage both the scientific community and public health managers, contributing to improved reproductive health actions and reaffirming Nursing’s role as a social transformation agent committed to rights, equity, and the promotion of autonomy. This project aligns with the research line Quality of Care in Women’s, Children’s, and adolescents’ Health. Editor: Escola de Saúde Pública do Distrito Federal Tipo: Dissertação

Protocolo institucional padrão como tecnologia em saúde para o uso do brinquedo terapêutico no cuidado a criança submetida à punção venosa periférica

Wed, 06 May 2026 00:00:00 GMT

Título: Protocolo institucional padrão como tecnologia em saúde para o uso do brinquedo terapêutico no cuidado a criança submetida à punção venosa periférica Autor(es): Oliveira, Ana Christiane Soares de Primeiro Orientador: Melo, Manuela Costa Abstract: Introduction: Hospitalization is an experience that drastically changes children's daily lives. During this experience, routine interventions are performed, with peripheral venipuncture being one of them. This intervention is carried out through the insertion of a needled catheter in a number appropriate to age and body mass. Because it is invasive, the child has difficulty understanding the treatment necessary for their recovery. To support healthcare professionals, during peripheral venipuncture, a therapeutic toy can be used. This is a health education tool that can be mediated by objects that become therapeutic. For its effective application, it is necessary to use the protocol associated with the use of therapeutic toys, which will contribute to patient safety, standardizing care practices, promoting the humanization of care and valuing interventions during the hospitalization process. Objectives: Improve existing standard institutional protocol to support nursing care for children undergoing peripheral venipuncture; and its specific objectives are: to map national and international studies on assistance to children with peripheral venipuncture; update care protocol in nursing care for children with peripheral venipuncture; evaluate the care protocol in nursing care for children with peripheral venipuncture; validate the content and appearance of the protocol based on contributions from healthcare professionals; propose recommendations for implementing the protocol, in health services, with a view to qualifying assistance and humanizing pediatric care; highlight the importance of continuous training of health professionals to implement humanizing strategies in the care of hospitalized children. Method: This is Methodological Research that aims to investigate methods for collecting and organizing data for the application of the Standard Institutional Protocol, which favors the conduct of investigations with greater rigor. Developed in four phases: literature review; adjustment to the protocol drawn up in 2021, validation of the content and appearance of the protocol; and evaluation with target audience. The project was submitted and approved to the Research Ethics Committee of the State Department of Health of the Federal District – CEP – SES/DF through final opinion 5.192.420 and CAAE 53246921.4.0000.5553. Results: The developed and validated protocol may contribute to improving the quality of care provided to hospitalized children using peripheral venipuncture, promoting patient safety and health updates for nursing professionals. Developed products: Product 1: Review manuscript entitled “Therapeutic toy in supporting nurses during peripheral venous puncture in children.” The review showed positive results regarding the professionals' willingness to use the therapeutic toy, as well as proposing a model for implementing the use of therapeutic toys in pediatric units, especially in the intensive care unit. Product 2: Process of developing the therapeutic toy to support nursing care for children undergoing peripheral venous puncture. The therapeutic toy is considered a low-cost simulator, and therefore this simulator was produced and is made of 100% polyester silicone fiber (stuffing foam) and nonwoven fabric; it is fully disinfectable with 70% alcohol, with disinfection recommended after each use. Product 3: Developed protocol called “Standard Institutional Protocol for Preparing the Child Undergoing Peripheral Venous Puncture Through Therapeutic Play”. The protocol content was outlined with the help of institutional manuals: ebook “Therapeutic Play in Nursing Care for Children,” published by the Brazilian Society of Pediatric Nurses; Technical Note No. 4/2022 from Anvisa, on safe practices for preventing incidents involving peripheral intravenous catheters in healthcare services; Resolution No. 546/2017 from the Federal Nursing Council, and Ordinance 529/2013 from the Ministry of Health on the Patient Safety Policy. Thus, Version-1 was adjusted after content and appearance validations, resulting in Versions 2 and 3. After completing the phases, the protocol, Version-4, is concluded, presented through o link: https://docs.google.com/document/d/1gTrFEPLDTcIR0fQSjW1SuqCJMkemH8YN/edit?usp=sharing&ouid=103496046691393723283&rtpof=true&sd=true. Este protocolo foi registrado na Câmara Brasileira do Livro sob o ID de Copyright DA-2025-10399, em 7 de novembro de 2025. Product 4: Manuscript submitted to the Brazilian Journal of Nursing entitled 'Study on the Validation of an Institutional Protocol for Venipuncture in Children Mediated by Therapeutic Toys,' aiming to propose a standard institutional protocol to support nursing care for children undergoing peripheral venipuncture, developed through a methodological study carried out in three phases: phase 1, adjustments to the previously prepared protocol; phase 2, content validation, in which seven judges participated, obtaining an index of 0.86; phase 3, face validation, with the participation of nine nurses, index 0.98. Therefore, the protocol was considered relevant, concluding that the validated protocol can guide, organize, and facilitate care planning, with the aim of promoting quality in the care provided to hospitalized children. Product 5: Refers to the Technical Report presented to the Permanent Protocol Committee of the State Health Department of the Federal District with the proposal of recommendations for the implementation of the protocol in health services, aiming at improving care quality and humanizing pediatric care, and highlighting the importance of continuous training of health professionals for the implementation of this humanizing strategy. Submitted in SEI 00060-00111928/2026-42.Conclusions: The use of instructional therapeutic toys stands out as an innovative strategy that qualifies assistance, promotes patient safety, contributing to minimizing the emotional impacts of child hospitalization. Associating the therapeutic toy tool with the elaborated and validated protocol highlights an advance in pediatric care, and reinforces that the use of the instructional therapeutic toy, with the use of the doll as a mediator, may not just be a common toy in the hospital environment, but an essential therapeutic tool that can humanize care and minimize the trauma of hospitalization for children, in line with professional practice and the guidelines of the Federal Nursing Council and the National Patient Safety Policy. Furthermore, the findings provide solid evidence to support discussions and improve public health policies focused on the well-being of hospitalized children, promoting the integration of the standard institutional protocol with instructional therapeutic toys as an essential part of pediatric care. Editor: Escola de Saúde Pública do Distrito Federal Tipo: Dissertação

Reposicionamento no leito e prevenção da lesão por pressão: revisão sistemática e produção de tecnologia educacional em vídeo

Thu, 18 Dec 2025 00:00:00 GMT

Título: Reposicionamento no leito e prevenção da lesão por pressão: revisão sistemática e produção de tecnologia educacional em vídeo Autor(es): Ribeiro, Flávia de Carvalho Antunes Vieira Primeiro Orientador: Figueiredo, Ana Claudia Morais Godoy Abstract: Introduction: Pressure Ulcer (PU) remain one of the most significant and costly challenges in both hospital and home healthcare settings. They are defined as localized damage to the skin and/or underlying tissues—typically occurring over bony prominences—resulting from prolonged pressure or a combination of pressure and shear (PAHO, 2018; Sardo et al., 2023). Prevention is recognized as a more efficient and less costly strategy than treatment, with an estimated 95% of PIs considered preventable (Araujo et al., 2019). Objective: To review the literature for original studies evaluating whether bed repositioning contributes to the prevention and treatment of pressure ulcer in bedridden individuals, and to develop guidance material for formal and informal caregivers on an appropriate strategy for positioning bedridden adults without the need for assistance. Methods: This project consisted of a rigorous systematic review and the development of a technical–technological product (TTP). The first stage was a systematic review (SR), designed as an evidence synthesis aimed at answering a research question structured using the PICO framework. The review protocol was registered in PROSPERO (Centre for Reviews and Dissemination, 2019). A comprehensive search was conducted with no language or date restrictions across eight databases, including grey literature sources. The strategy used MeSH and Emtree terms based on PICO and was refined using the PRESS tool. Eligibility criteria included bedridden adults in any care setting, focusing exclusively on original longitudinal studies. Title and abstract screening was conducted independently by two reviewers using the Rayyan application, with disagreements resolved by a third reviewer. Risk of bias was assessed using the Robvis tool (applying ROBINS-I, RoB 2.0, or RoB 2 CR, depending on study design). The certainty of the evidence was evaluated using the GRADE approach. Data analysis was performed using STATA® version 19, employing random-effects meta-analysis and assessment of publication bias. Product 2 consisted of a short instructional video developed as didactic material to guide formal and informal caregivers of bedridden adults on proper positioning techniques. The central aim of the TTP was to teach methods that could be performed independently, using only the basic features of a hospital bed. The script, written in plain language and grounded in the evidence identified, included an introduction, development, and conclusion, with full subtitles and narration by the researcher. Recordings were conducted in the Nursing Laboratory of FEPECS with support from a professional videographer to ensure high audio and video quality. A large male model, acting as a non-cooperative adult patient, was used to demonstrate the technique’s effectiveness regardless of patient size. Following production, the video underwent content validation by expert judges—nurses with at least five years of experience and a master’s or doctoral degree— selected through snowball sampling. Validation used the Content Validity Coefficient (CVC) proposed by Hernández-Nieto (2002), assessing clarity of language, practical relevance, and theoretical relevance on a 5-point Likert scale. The material will be disseminated through institutional channels and public platforms, including YouTube, and social media profiles of SES/DF, FEPECS, ESP/DF, and Cofen Play, as well as via QR Code access. Results: Product 1 – Systematic Review: Prevention of pressure injury and repositioning in bed: a systematic review. Results indicated that the intervention increased the probability of preventing pressure ulcer by 7% compared with the control group. When considering repositioning intervals of 3 or 4 hours versus 2 hours, the probability of prevention increased to 12%, based on clinical trial data. Despite statistical significance, findings should be interpreted cautiously due to high heterogeneity and very low certainty of evidence according to GRADE. Product 2 – Instructional Video: A didactic and accessible instructional video demonstrating how formal and informal caregivers can position a bedridden adult without the help of a second person, using the resources of a hospital bed. The technique is also adaptable for use on a standard bed. The results demonstrated high overall validity (total CVC = 0.88), with emphasis on the organization and sequencing of the material (0.91), indicating strong agreement regarding clarity, technical accuracy, and suitability for the target audience. The video proved to be a robust educational technology, grounded in best practices and capable of supporting caregivers in performing a critical intervention for patient safety. For initial product promotion, the official YouTube channel of the graduate program hosts the video link. In addition to this strategy, the program is being promoted via QR code at each bedside in the inpatient unit where the researcher works, with the aim of disseminating the information to other units within the network. The project is aligned with the research line Quality in Adult and Elderly Healthcare. Conclusion: Repositioning bedridden adults is a validated intervention for the prevention of pressure ulcer and serves as an adjunct treatment when performed correctly and according to established criteria. Evidence indicates that effective repositioning does not require strict adherence to a fixed two-hour schedule; instead, repositioning intervals should be individualized. The developed technical product demonstrates potential applicability for influencing care practices and contributing to scientific and social advancement in the field of nursing at a national level. It represents a high-complexity innovation that adapts existing knowledge and returns meaningful benefits to both the general public and the scientific community. Editor: Escola de Saúde Pública do Distrito Federal Tipo: Dissertação