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Representações sociais sobre espiritualidade e religiosidade no cuidado de crianças em fim de vida

2026-01-31T03:00:06Z

Title: Representações sociais sobre espiritualidade e religiosidade no cuidado de crianças em fim de vida Author(s)/Inventor(s): Azevedo, Thamires Goulart Lambranho de Advisor: Ferreira, Márcia de Assunção Abstract: Introduction: Although death is a natural and inevitable process, it remains a topic rarely addressed in the education of health professionals, particularly when it involves children, leading to significant emotional impacts on healthcare teams. The predominance of the biomedical model limits the inclusion of subjective aspects such as spirituality and religiosity, which are important in end-of-life care. Despite recognition of their relevance, these themes are seldom integrated into training curricula. Objectives: To analyze the social representations of spirituality and religiosity and their expressions in the care provided by health professionals to pediatric patients at the end of life; to describe the social representations of spirituality and religiosity among professionals who care for pediatric patients at the end of life; to describe actions and/or practices considered by professionals as enabling the expression of spirituality and/or religiosity in the care of pediatric patients at the end of life; to analyze the expressions of spirituality and religiosity in the actions and/or care provided by professionals to pediatric patients at the end of life; and to propose strategies aimed at addressing spirituality in care, based on the social representations of professionals who work in this context. Method: This is a qualitative, descriptive study conducted with 30 health professionals working in a pediatric hospital in Rio de Janeiro between April and July 2024. Data collection was carried out through semi-structured interviews to explore participants' social representations on the investigated topic. The empirical material was analyzed using a lexical approach with the Alceste-2012 software, and descriptive statistics were used to characterize the participants' profiles. Results: Most participants were women, with over 20 years of professional experience and postgraduate education. A large portion of the professionals identified as spiritual and believers in deities, with affiliations mainly to Kardecist Spiritism, Catholicism, and Evangelical Christianity. Although participants acknowledged the importance of spirituality and religiosity as sources of comfort and coping at the end of life, gaps were observed in their conceptual understanding and practical application in professionais settings. The most cited expressions included prayer, meditation, and contact with nature. However, significant obstacles to integrating these dimensions into care were also reported, such as the lack of specific training, institutional limitations, and insufficient infrastructure in healthcare services. Conclusion: The social representations of religiosity and spirituality among health professionals reveal their potential as coping resources both for pediatric patients at the end of life and for the professionals themselves. Despite their acknowledged importance, persistent gaps in training and institutional structures hinder their effective integration into care. Ethical dilemmas and uncertainties regarding the practical application of spirituality and religiosity were also identified, requiring sensitive and respectful preparation. Therefore, it is recommended that these topics be included in professional training, along with the development of institutional guidelines and welcoming spaces, to ensure more ethical, humanized, and holistic care. Publisher: Universidade Federal do Rio de Janeiro Type: Dissertação

Construção e validação de conteúdo de um instrumento clínico para apoiar enfermeiros na assistência a pessoas com feridas infectadas de difícil cicatrização

2026-01-30T03:00:11Z

Title: Construção e validação de conteúdo de um instrumento clínico para apoiar enfermeiros na assistência a pessoas com feridas infectadas de difícil cicatrização Author(s)/Inventor(s): Lima, Daniella Cristina Julio Advisor: Paes, Graciele Oroski Abstract: Introduction: Managing people with wounds is a challenge for nurses, as several factors influence the healing process and increase the risk of infection. A targeted assessment of signs and symptoms of infection is essential for early identification, enabling effective and timely interventions. Objective: To develop a clinical instrument to assist people with infected wounds and to analyze the evidence of content validity. Methodology: A clinimetric study divided into two main stages: development of a clinical instrument, consisting of an algorithm and its guidance manual, and content validation. The instrument’s content was developed from an integrative and a scoping review, while the content validation process was carried out by a panel of judges composed of nurses who work directly with people with wounds. Data collection was carried out through an online form, and the snowball technique was used to increase participant recruitment. The content was analyzed for overall clarity and comprehensibility of items, organization, logical sequence, comprehensiveness, relevance, and pertinence of the tool’s information. Data analysis was performed using the Content Validity Ratio (CVR), with a critical CVR value of 0.28, calculated based on the number of experts on the panel and a pre-established significance level (p < 0.05). Results: The findings demonstrated a high level of content validity for the instrument, both for the algorithm and its manual, with CVR values above the critical threshold for all items. Discussion: The analysis of the instrument development process and the judges' opinions during the validation stage allowed for the systematization and grouping of suggestions into categories that supported the refinement of the clinical instrument. Conclusion: The instrument showed satisfactory content validity results but requires further evidence to ensure safe use in clinical practice. Publisher: Universidade Federal do Rio de Janeiro Type: Dissertação

Microteoria da ocorrência do trauma vascular periférico na administração intravascular de meios de contraste

2026-01-29T03:00:11Z

Title: Microteoria da ocorrência do trauma vascular periférico na administração intravascular de meios de contraste Author(s)/Inventor(s): Lemos, Romanda da Costa Pereira Barboza Advisor: Brandão, Marcos Antônio Gomes Abstract: Introduction: Nursing has made a significant contribution to Diagnostic Imaging Units, improving the quality of services provided. Among its various responsibilities, peripheral venipuncture is the most frequently performed procedure for the intravascular administration of contrast media. Although it is considered a routine and relatively simple nursing intervention, local complications may occur, known as vascular trauma. Extravasation is the most widely addressed type of trauma, as contrast media are classified as irritant substances. However, the literature describes other types of vascular trauma that should also be considered in this context. Nursing is a constantly evolving field that generates its own body of knowledge; however, a gap between theory and practice still persists, partly due to the difficulty of applying existing models and nursing grand theories in clinical settings. Bridging the gap between theory, research, and practice is essential to advance nursing knowledge, foster scientific development, and generate evidence-based outcomes through the construction of microtheories. Objective: To develop a descriptive and explanatory microtheory regarding the occurrence of vascular trauma in adults during peripheral venipuncture and intravascular administration of contrast media during Computed Tomography and Magnetic Resonance Imaging. Method: Theoretical research based on the General Method for Theory Construction in Applied Disciplines, supported by an integrative review guided by the approach of Whittemore and Knafl. Results: Ten studies were included in the integrative review, providing information on the types of vascular trauma, associated clinical signs and symptoms, and potential risk factors for their occurrence. The concept of peripheral vascular trauma was defined as a nursing phenomenon, characterized as a human response manifested by types such as extravasation and phlebitis, and clinically diagnosed through signs and symptoms including edema, erythema, and induration. Several elements were identified as potential risk factors as conditions that precede the trauma. Grouping by similarity enabled the identification of three categories of risk factors: those related to contrast media and imaging exam dynamics, those related to patient characteristics, and those related to the peripheral venipuncture procedure. The mechanisms of trauma occurrence refer to the processes triggered when risk factors act independently or synergistically, activating the trauma process. Despite differing origins, all mechanisms converge on a local inflammatory response, leading to increased vascular permeability and decreased vascular compliance, thereby compromising the integrity of the punctured vein. These mechanisms explain how the human response to the trauma phenomenon occurs and can be diagnosed by nurses. Final Considerations: The developed microtheory offers relevant insights for clinical nursing practice and contributes to the advancement of nursing education. Its well-defined scope and level of abstraction, appropriate for a microtheory, allow for the exploration of a specific phenomenon (peripheral vascular trauma) in a specific population (adults undergoing contrast-enhanced imaging examinations), supporting critical reflection on nursing practice in this context. Its specificity and applicability are expected to improve nursing care outcomes. Publisher: Universidade Federal do Rio de Janeiro Type: Tese

National Survey Children with Special Health Care Needs® - NSCSHCN ® versão brasileira: atualização e adaptação

2026-01-16T03:00:12Z

Title: National Survey Children with Special Health Care Needs® - NSCSHCN ® versão brasileira: atualização e adaptação Author(s)/Inventor(s): Pimentel, Thaís Guilherme Pereira Pinheiro Advisor: Cabral, Ivone Evangelista Abstract: Background: The doctoral thesis aimed to identify which questions from the National Survey of Children’s Health (NS-CH) tool, related to children with special health care needs, are compatible with the Brazilian version of the NS-CSHCN® 2019, to develop a new version for use in Brazil. The overall goal of the thesis was to update and culturally adapt the Brazilian version of the NS-CSHCN® 2019 based on selected questions from the United States’ NS-CH® instrument. The specific objectives were: a) to contrast the questions from the 2019 Brazilian version of NS-CSHCN® with the questions related to children with special health care needs (CSHCN) in the NS-CH® version; b) to select CSHCN questions from the NS-CH for the purposes of translation and cross-cultural adaptation; c) to update the Brazilian version of NSCSHCN ® with the new questions incorporated from the NS-CH; d) to propose a new expression in Brazilian Portuguese for CSHCN (children with special health care needs); e) to develop a manual for the application of the new Brazilian version of NS-CSHCN®. Method: This is a methodological study conducted in four phases. The initial stage involved analyzing documents as a supplementary method to assist in translating and culturally adapting an instrument. This phase enabled a systematic comparison of the original, translated, and adapted versions, focusing on maintaining conceptual integrity while adjusting them to fit the Brazilian sociocultural context. The following stages included translation, back-translation, review by a focus group, and an analysis of semantic, idiomatic, cultural, and conceptual equivalences. Results: Following the processes of translation, adaptation, and updating facilitated the development of the Brazilian version of the instrument (NS-CH® – 2025 version), which consists of 123 questions organized into eight sections. It is intended for use with children and adolescents within the Brazilian Unified Health System (SUS). This thesis produced three principal deliverables: an adapted instrument, a comprehensive application manual, and a proposal for a new conceptual framework concerning children with special health care needs, aligned with Brazil's sociocultural and epidemiological context. Conclusions: The data collection instrument – the Brazilian version of NS CSHCN® 2025 - features content and methodology appropriate to the reality of children and the Brazilian health care system, with the potential to support the development of studies estimating the prevalence of children with special health care needs in different regions and contexts of the country. Its implementation is recommended as a pilot project to assess its psychometric specificity and sensitivity in relation to the Brazilian context.; Introducción: La tesis doctoral tuvo como objetivo responder a la siguiente pregunta de investigación: ¿qué preguntas del instrumento National Survey of Children’s Health (NS-CH), relacionadas con niños con necesidades especiales de salud, son compatibles con la versión brasileña del NS-CSHCN® 2019, con el fin de proponer una nueva versión para su aplicación en Brasil? El objetivo general de la investigación fue: actualizar y adaptar culturalmente la versión brasileña del NS-CSHCN® 2019, basada en preguntas seleccionadas del instrumento NS-CH® de los Estados Unidos de América. Los objetivos específicos fueron: a) contrastar las preguntas de la versión brasileña del NS-CSHCN® 2019 con las preguntas sobre NANEAS en la versión NS-CH®; b) seleccionar preguntas relacionadas con niños y adolescentes con necesidades de atención especiales en salud (NANEAS/CSHCN) del NS-CH para su traducción y adaptación transcultural; c) actualizar la versión brasileña del NS-CSHCN® incorporando las nuevas preguntas del NS-CH; d) proponer una nueva expresión en portugués brasileño para CSHCN (niños con necesidades especiales de atención en salud); y e) elaborar un manual de aplicación de la nueva versión brasileña del NS-CSHCN®. Método: Este estudio de carácter metodológico se llevó a cabo en diversas fases. La etapa inicial consistió en el análisis de documentos, utilizado como una estrategia complementaria para la traducción y adaptación transcultural de un instrumento. Esta fase posibilitó una comparación sistemática entre las versiones original, traducida y adaptada, con el fin de mantener la fidelidad conceptual y adaptarlas al contexto sociocultural brasileño. Las etapas siguientes incluyeron la traducción, la retrotraducción, la revisión por un grupo focal y el análisis de las equivalencias semánticas, idiomáticas, culturales y conceptuales. Resultados: Tras el proceso de traducción, adaptación y actualización, se desarrolló la versión brasileña del instrumento (NS-CH® – versión 2025), conformada por 123 preguntas organizadas en ocho secciones, destinadas a su aplicación en niños y adolescentes en el contexto del Sistema Único de Salud (SUS). La investigación generó tres productos principales: el instrumento adaptado, un manual detallado para su aplicación y la propuesta de un nuevo concepto de niños con necesidades especiales de atención en salud, alineado con el contexto sociocultural y epidemiológico brasileño. Conclusiones: El instrumento de recolección de datos —versión brasileña del NS-CSHCN® 2025— presenta contenido y metodología adecuados a la realidad de las niñas, los niños y el sistema de salud brasileño, teniendo potencial para respaldar el desarrollo de estudios que estimen la prevalencia de niñas, niños y adolescentes con necessidades atención en salud especiales (NANEAS) en distintas regiones y contextos del país. Se recomienda su aplicación como proyecto piloto para evaluar su especificidad y sensibilidad psicométrica en relación con la realidad brasileña. Publisher: Universidade Federal do Rio de Janeiro Type: Tese