Grazia Guerra - Academia.edu (original) (raw)
Papers by Grazia Guerra
European Heart Journal, Aug 1, 2016
Hypertension, 2015
Systemic arterial hypertension is a risk factor for cardiovascular diseases and has become a comm... more Systemic arterial hypertension is a risk factor for cardiovascular diseases and has become a common public health problem. Health education associated with educational technology may be used to encourage patients’ adherence to treatment and enable them to adequately understand how harmful hypertension can be to health, thereby promoting their quality of life. OBJECTIVE: To evaluate the influence of a strategy in an individual orientation program using educational technology associated with virtual learning environment (VLE) of hypertension care on the reduction in the white coat effect and the improvement in blood pressure control to be promoted by a nurse in a hypertension unit in a government state hospital in São Paulo. METHODS AND MATERIALS:This was a randomized clinical education study conducted with two groups, the VLE group (study group, 10 patients) and the control group (16 patients). Both groups were interviewed 6 times by nurses during the 120-day follow-up at 20-day inte...
Journal of Pharmacy and Pharmacology, 2018
The aim was to determine whether complaints about side effects made by stage III hypertensive pat... more The aim was to determine whether complaints about side effects made by stage III hypertensive patients undergoing antihypertensive therapy lead to adequate blood pressure control. Forty-eight patients were monitored by a nurse every 15 days over the course of 180 days. At baseline, both groups presented similar SBP (systolic blood pressure) (GA, 196 (5)) mm Hg and GB, 189 (6) mm Hg) and DBP (diastolic blood pressure) (GA, 122 (3) mm Hg and GB, 121 (4) mm Hg). On day 165, after a progressive decline in blood pressure levels, the two groups differed significantly from each other regarding SBP (GA,-16.9 (24) mm Hg and GB,-40.8 (31) mm Hg). At the final follow-up, the patients were allocated to two groups: without complaints (GA) and with (GB) complaints about side effects. Complaining about side effects was a decisive factor for immediate nursing intervention and improved control over BP.
American Journal of Hypertension, 1998
The acute hemodynamic effect of cyclosporine in man is controversial. A randomized, double blind,... more The acute hemodynamic effect of cyclosporine in man is controversial. A randomized, double blind, placebo-controlled, cross-over study was undertaken to evaluate the effect of a single oral dose of cyclosporine (20 mg/kg body weight) on mean blood pressure (MBP), heart rate (HR), forearm blood flow (FBF), and vascular resistance (FVR) in 16 healthy adult subjects. Subjects were studied twice, with an intervening period of 2 weeks, before and after the administration of either cyclosporine or the vehicle olive oil. Blood pressure was measured on brachial and digital arteries. After 30 min of rest, basal measurements were obtained and individuals were randomly assigned to receive either cyclosporine or the vehicle, and the same measurements were repeated 2 h later. Mean whole blood levels of cyclosporine were 1542 ؎ ؎ 387 ng/mL (range 1000 to 2550) 2 h after the administration of a single oral dose of cyclosporine. Cyclosporine did not cause any significant change in the hemodynamic parameters when compared with vehicle. Pre-and post-cyclosporine data were as follows (means ؎ ؎ SD): MBP (determined by Finapres on the digital artery), 92 ؎ ؎ 10 v 95 ؎ ؎ 11 mm Hg; HR, 66 ؎ ؎ 10 v 68 ؎ ؎ 11 beats/min; FBF, 3.9 ؎ ؎ 1.3 v 3.8 ؎ ؎ 1.8 mL/ 100 mL/min; and FVR, 28 ؎ ؎ 9 v 33 ؎ ؎ 18 units, respectively. For the vehicle the results were: MBP, 94 ؎ ؎ 9 v 94 ؎ ؎ 9; HR, 67 ؎ ؎ 9 v 67 ؎ ؎ 11; FBF, 3.3 ؎ ؎ 1.6 v 3.2 ؎ ؎ 2.0; FVR, 35 ؎ ؎ 14 v 37 ؎ ؎ 15, respectively. These figures did not differ from those obtained with the auscultatory method applied to the brachial artery among 10 selected subjects studied with Finapres. In conclusion, we found no evidence that at supratherapeutic doses cyclosporine causes acute increase in blood pressure or peripheral vasoconstriction in humans.
Clinics, 2013
OBJECTIVES: We explored whether high blood pressure is associated with metabolic, inflammatory an... more OBJECTIVES: We explored whether high blood pressure is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome. METHODS: We evaluated 135 consecutive overweight/obese patients. From this group, we selected 75 patients who were not under the regular use of medications for metabolic syndrome as defined by the current Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults criteria. The patients were divided into metabolic syndrome with and without high blood pressure criteria ($130/$85 mmHg). RESULTS: Compared to the 45 metabolic syndrome patients without high blood pressure, the 30 patients with metabolic syndrome and high blood pressure had significantly higher glucose, insulin, homeostasis model assessment insulin resistance index, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, uric acid and creatinine values; in contrast, these patients had significantly lower high-density lipoprotein-cholesterol values. Metabolic syndrome patients with high blood pressure also had significantly higher levels of retinolbinding protein 4, plasminogen activator inhibitor 1, interleukin 6 and monocyte chemoattractant protein 1 and lower levels of adiponectin. Moreover, patients with metabolic syndrome and high blood pressure had increased surrogate markers of sympathetic activity and decreased baroreflex sensitivity. Logistic regression analysis showed that high-density lipoprotein, retinol-binding protein 4 and plasminogen activator inhibitor-1 levels were independently associated with metabolic syndrome patients with high blood pressure. There is a strong trend for an independent association between metabolic syndrome patients with high blood pressure and glucose levels. CONCLUSIONS: High blood pressure, which may be related to the autonomic dysfunction, is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome.
Hypertension (AH) is a risk factor for cardiovascular diseases and health education associated wi... more Hypertension (AH) is a risk factor for cardiovascular diseases and health education associated with educational technology can be used to improve adherence behavior. To evaluate the influence of educational strategy in an individual guidance program associating educational technology in the virtual learning environment (VLE) in the Distance Learning (DL) modality for hypertensive patients to be promoted by nurses and to verify the effect of the white coat and the quality of life in patients at a state in São Paulo. METHODS Randomized clinical study with AVA Group (study group, 10 patients) and Control Group (16 patients). Both groups participated in six consultations with the nurse during 120 days with intervals of 20 days. At the beginning of the study (randomization) and at the end, the following instruments were applied: Morisky test and WHOQOL and Ambulatory Blood Pressure Monitoring (ABPM) was performed. Only the study group had remote access to the VLE, consisting of six specific educational modules, with release at each meeting. RESULTS There was no statistical significance between the two groups regarding sociodemographic and hemodynamic variables. There was statistical significance at the end of the study between the groups in the Morisky Test (p = 0.001) and in the WHOQOL Social Domain 3 (p = 0.001) favorable to the AVA Group. As for the effect of the white coat, there was no reduction in the phenomenon at the end of the study.
Acta Paulista De Enfermagem, 2012
Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the ... more Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the content of this protocol.Methods: Study of quantitative and descriptive approach. The methodology followed three steps: development of the instrument; content validity and reliability verification of the protocol for the analysis of agreement between specialists with greater experience. The study included 48 specialists, including physicians and nurses experienced in patient care in use of balloon. Items considered valid achieved at least 75% of consensus before the analysis of agreement between evaluators. Results: We evaluated 36 items, of these, 20 were considered valid. The reliability was also verified, using consistency of the responses of more experienced evaluators. Among the items submitted to new statistical analysis by these evaluators, only two were considered valid. Conclusion: Based on the content validation, a protocol with 22 items concerning patient care without the use of intra-aortic balloon was developed.
Nursing (Säo Paulo), 2016
Revista Brasileira de Hipertensão, Dec 1, 2022
Avaliar a influência do uso da tecnologia educacional híbrida blended learning (ensino presencial... more Avaliar a influência do uso da tecnologia educacional híbrida blended learning (ensino presencial associado por meio do ambiente virtual de aprendizado "E-Care da Hipertensão") na melhoria do controle da pressão arterial. Métodos: Ensaio Clinico Randomizado Controlado, realizado no período de novembro de 2015 a março de 2016,dividido em dois grupos: a) Grupo Hibrido com 14 pacientes submetidos a orientação individual por meio da consulta de Enfermagem a cada 20 dias com a utilização do recurso tecnológico educacional digital "E-Care da Hipertensão" ; b) Grupo Controle com 16 pacientes em que se utilizou da consulta com orientação individual por meio da consulta de Enfermagem a cada 20 dias sem o uso da tecnologia educacional. Os grupos foram acompanhados por 120 dias, utilizando o Teste de Morisk-Green, e exame da MAPA e WHO-QOL-bref na randomização e aos 120 dias. Resultados: Para o Grupo Hibrido quando realizadas as comparações no início do estudo (momento da randomização) ao final 120 dias observou-se diferenças estatísticas em relação a diversas variáveis, a saber: a) circunferência abdominal, na randomização 99,61±10 vs. 96,69±8 (p=0,006); b) em relação a MAPA na pressão arterial sistólica PAS de vigília (PAS) 159,61±15mmHg vs. 143,30±19mmHg (p=< 0,001); c) pressão arterial diastólica na vigília (PAD) 106,61±12mmHg vs. 95,92±15mmHg (p= < 0,001); d) quanto a carga pressórica da MAPA na randomização para PAS na vigília obteve-se 93,28±7mmHg vs. 66,38±31mmHg (p=0,003); e) quanto aos valores da PAD 92,63±11mmHg vs. 70,96±28mmHg (p=0,002). Conclusão: Não foram observadas diferenças significativas nos resultados analisados em 120 dias com o uso da tecnologia educacional na modalidade hibrida quando comparada com o grupo controle que realizou apenas consulta individual pelo enfermeiro.
Revista Brasileira de Hipertensão, Jun 1, 2022
A Automedição da Pressão Arterial (AMPA) tem ganho interesse ultimamente e sua prática pode contr... more A Automedição da Pressão Arterial (AMPA) tem ganho interesse ultimamente e sua prática pode contribuir para o diagnóstico e seguimento da hipertensão arterial. Em nosso meio, devido a dificuldades de realização da Monitorização Residencial da Pressão Arterial (MRPA) e da indisponibilidade da Monitorização Ambulatorial da Pressão Arterial (MAPA) na maioria dos serviços, a AMPA, que difere dos métodos supracitados, tem uso disseminado em nosso país. Assim, nos parece importante discorrer sobre esse método, tão utilizado e tão pouco estudado. Neste trabalho vamos descrever os métodos de medida de pressão arterial, auscultatório e oscilométrico, além de listar vantagens e desvantagens da medida da pressão arterial no consultório, comparando-as com AMPA. Vamos também fazer um alerta sobre a necessidade de que o paciente receba orientações para a medida da pressão e, por fim, citar as Diretrizes Brasileiras e Europeias no que tange à menção que elas fazem a esse método.
O Mundo da saúde, Dec 30, 2013
Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetiv... more Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetivou realizar a adaptação transcultural do instrumento "Spiritual Assessment Scale" (SAS) para o Brasil. Foi desenvolvido um instrumento específico para a adaptação transcultural basedo nos estudos de Lynn (escala de Likert). A primeira etapa consistiu na aplicação do instrumento desenvolvido pelos autores para avaliação da SAS com 6 experts da área de Espiritualidade e Enfermagem e com 11 pacientes da unidade de clínica médica, para avaliação do instrumento SAS com 21 questões. Após a realização de testes estatísticos, as questões estavam adequadas para a aplicação na pesquisa, como demonstrado pelo coeficiente alfa de Cronbach, que indicou uma confiabilidade aceitável do instrumento. Pode-se afirmar que em ambos os grupos (expert e pacientes) a consistência interna foi elevada, mantendo as características da escala original, após as etapas de tradução e adaptação para o Brasil.
Acta Paulista De Enfermagem, Dec 1, 2012
Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the ... more Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the content of this protocol.Methods: Study of quantitative and descriptive approach. The methodology followed three steps: development of the instrument; content validity and reliability verification of the protocol for the analysis of agreement between specialists with greater experience. The study included 48 specialists, including physicians and nurses experienced in patient care in use of balloon. Items considered valid achieved at least 75% of consensus before the analysis of agreement between evaluators. Results: We evaluated 36 items, of these, 20 were considered valid. The reliability was also verified, using consistency of the responses of more experienced evaluators. Among the items submitted to new statistical analysis by these evaluators, only two were considered valid. Conclusion: Based on the content validation, a protocol with 22 items concerning patient care without the use of intra-aortic balloon was developed.
EDULEARN proceedings, Jul 1, 2023
Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetiv... more Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetivou realizar a adaptação transcultural do instrumento "Spiritual Assessment Scale" (SAS) para o Brasil. Foi desenvolvido um instrumento específico para a adaptação transcultural basedo nos estudos de Lynn (escala de Likert). A primeira etapa consistiu na aplicação do instrumento desenvolvido pelos autores para avaliação da SAS com 6 experts da área de Espiritualidade e Enfermagem e com 11 pacientes da unidade de clínica médica, para avaliação do instrumento SAS com 21 questões. Após a realização de testes estatísticos, as questões estavam adequadas para a aplicação na pesquisa, como demonstrado pelo coeficiente alfa de Cronbach, que indicou uma confiabilidade aceitável do instrumento. Pode-se afirmar que em ambos os grupos (expert e pacientes) a consistência interna foi elevada, mantendo as características da escala original, após as etapas de tradução e adaptação para o Brasil.
Journal of Clinical Densitometry, Dec 1, 2005
Background: It is a matter of controversy whether or not Colles' fracture is an osteoporotic frac... more Background: It is a matter of controversy whether or not Colles' fracture is an osteoporotic fracture. Indeed, the usefulness of quantitative ultrasound in distinguishing Colles' fracture from normal fractures is also unclear. Methods: A cross-sectional case-control study was done on 469 postmenopausal Spanish women, 121 with Colles' fracture and 348 controls. Assessment of risk factors for osteoporosis and measurement of calcaneus quantitative ultrasound were carried out using a Sahara \, Hologic \ device. Results: Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls, and no statistically significant differences were found. We estimated ROC curves for SOS and a score based on a linear combination of height and SOS (SH-Score). The areas under both curves were 0.56 and 0.61, respectively, which was statistically significant. To obtain 5% false-negative and 10% falsepositive figures, the T-score cutoff for SOS was À 2.45 and À0.045, respectively. Of these, only 9.2% were classified as high risk and 11% as low risk with 79.8% undetermined. Conclusions: Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls. Nevertheless, ROC curves calculated by a combination of height and SOS showed that quantitative calcaneus ultrasound may be a useful tool for identifying postmenopausal women with Colles' fracture. These results indicate that measuring bone mineral density with ultrasound only captures limited aspects of the pathophysiology of Colles' fractures.
European Heart Journal, Aug 1, 2016
Hypertension, 2015
Systemic arterial hypertension is a risk factor for cardiovascular diseases and has become a comm... more Systemic arterial hypertension is a risk factor for cardiovascular diseases and has become a common public health problem. Health education associated with educational technology may be used to encourage patients’ adherence to treatment and enable them to adequately understand how harmful hypertension can be to health, thereby promoting their quality of life. OBJECTIVE: To evaluate the influence of a strategy in an individual orientation program using educational technology associated with virtual learning environment (VLE) of hypertension care on the reduction in the white coat effect and the improvement in blood pressure control to be promoted by a nurse in a hypertension unit in a government state hospital in São Paulo. METHODS AND MATERIALS:This was a randomized clinical education study conducted with two groups, the VLE group (study group, 10 patients) and the control group (16 patients). Both groups were interviewed 6 times by nurses during the 120-day follow-up at 20-day inte...
Journal of Pharmacy and Pharmacology, 2018
The aim was to determine whether complaints about side effects made by stage III hypertensive pat... more The aim was to determine whether complaints about side effects made by stage III hypertensive patients undergoing antihypertensive therapy lead to adequate blood pressure control. Forty-eight patients were monitored by a nurse every 15 days over the course of 180 days. At baseline, both groups presented similar SBP (systolic blood pressure) (GA, 196 (5)) mm Hg and GB, 189 (6) mm Hg) and DBP (diastolic blood pressure) (GA, 122 (3) mm Hg and GB, 121 (4) mm Hg). On day 165, after a progressive decline in blood pressure levels, the two groups differed significantly from each other regarding SBP (GA,-16.9 (24) mm Hg and GB,-40.8 (31) mm Hg). At the final follow-up, the patients were allocated to two groups: without complaints (GA) and with (GB) complaints about side effects. Complaining about side effects was a decisive factor for immediate nursing intervention and improved control over BP.
American Journal of Hypertension, 1998
The acute hemodynamic effect of cyclosporine in man is controversial. A randomized, double blind,... more The acute hemodynamic effect of cyclosporine in man is controversial. A randomized, double blind, placebo-controlled, cross-over study was undertaken to evaluate the effect of a single oral dose of cyclosporine (20 mg/kg body weight) on mean blood pressure (MBP), heart rate (HR), forearm blood flow (FBF), and vascular resistance (FVR) in 16 healthy adult subjects. Subjects were studied twice, with an intervening period of 2 weeks, before and after the administration of either cyclosporine or the vehicle olive oil. Blood pressure was measured on brachial and digital arteries. After 30 min of rest, basal measurements were obtained and individuals were randomly assigned to receive either cyclosporine or the vehicle, and the same measurements were repeated 2 h later. Mean whole blood levels of cyclosporine were 1542 ؎ ؎ 387 ng/mL (range 1000 to 2550) 2 h after the administration of a single oral dose of cyclosporine. Cyclosporine did not cause any significant change in the hemodynamic parameters when compared with vehicle. Pre-and post-cyclosporine data were as follows (means ؎ ؎ SD): MBP (determined by Finapres on the digital artery), 92 ؎ ؎ 10 v 95 ؎ ؎ 11 mm Hg; HR, 66 ؎ ؎ 10 v 68 ؎ ؎ 11 beats/min; FBF, 3.9 ؎ ؎ 1.3 v 3.8 ؎ ؎ 1.8 mL/ 100 mL/min; and FVR, 28 ؎ ؎ 9 v 33 ؎ ؎ 18 units, respectively. For the vehicle the results were: MBP, 94 ؎ ؎ 9 v 94 ؎ ؎ 9; HR, 67 ؎ ؎ 9 v 67 ؎ ؎ 11; FBF, 3.3 ؎ ؎ 1.6 v 3.2 ؎ ؎ 2.0; FVR, 35 ؎ ؎ 14 v 37 ؎ ؎ 15, respectively. These figures did not differ from those obtained with the auscultatory method applied to the brachial artery among 10 selected subjects studied with Finapres. In conclusion, we found no evidence that at supratherapeutic doses cyclosporine causes acute increase in blood pressure or peripheral vasoconstriction in humans.
Clinics, 2013
OBJECTIVES: We explored whether high blood pressure is associated with metabolic, inflammatory an... more OBJECTIVES: We explored whether high blood pressure is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome. METHODS: We evaluated 135 consecutive overweight/obese patients. From this group, we selected 75 patients who were not under the regular use of medications for metabolic syndrome as defined by the current Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults criteria. The patients were divided into metabolic syndrome with and without high blood pressure criteria ($130/$85 mmHg). RESULTS: Compared to the 45 metabolic syndrome patients without high blood pressure, the 30 patients with metabolic syndrome and high blood pressure had significantly higher glucose, insulin, homeostasis model assessment insulin resistance index, total cholesterol, low-density lipoprotein-cholesterol, triglycerides, uric acid and creatinine values; in contrast, these patients had significantly lower high-density lipoprotein-cholesterol values. Metabolic syndrome patients with high blood pressure also had significantly higher levels of retinolbinding protein 4, plasminogen activator inhibitor 1, interleukin 6 and monocyte chemoattractant protein 1 and lower levels of adiponectin. Moreover, patients with metabolic syndrome and high blood pressure had increased surrogate markers of sympathetic activity and decreased baroreflex sensitivity. Logistic regression analysis showed that high-density lipoprotein, retinol-binding protein 4 and plasminogen activator inhibitor-1 levels were independently associated with metabolic syndrome patients with high blood pressure. There is a strong trend for an independent association between metabolic syndrome patients with high blood pressure and glucose levels. CONCLUSIONS: High blood pressure, which may be related to the autonomic dysfunction, is associated with metabolic, inflammatory and prothrombotic dysregulation in patients with metabolic syndrome.
Hypertension (AH) is a risk factor for cardiovascular diseases and health education associated wi... more Hypertension (AH) is a risk factor for cardiovascular diseases and health education associated with educational technology can be used to improve adherence behavior. To evaluate the influence of educational strategy in an individual guidance program associating educational technology in the virtual learning environment (VLE) in the Distance Learning (DL) modality for hypertensive patients to be promoted by nurses and to verify the effect of the white coat and the quality of life in patients at a state in São Paulo. METHODS Randomized clinical study with AVA Group (study group, 10 patients) and Control Group (16 patients). Both groups participated in six consultations with the nurse during 120 days with intervals of 20 days. At the beginning of the study (randomization) and at the end, the following instruments were applied: Morisky test and WHOQOL and Ambulatory Blood Pressure Monitoring (ABPM) was performed. Only the study group had remote access to the VLE, consisting of six specific educational modules, with release at each meeting. RESULTS There was no statistical significance between the two groups regarding sociodemographic and hemodynamic variables. There was statistical significance at the end of the study between the groups in the Morisky Test (p = 0.001) and in the WHOQOL Social Domain 3 (p = 0.001) favorable to the AVA Group. As for the effect of the white coat, there was no reduction in the phenomenon at the end of the study.
Acta Paulista De Enfermagem, 2012
Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the ... more Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the content of this protocol.Methods: Study of quantitative and descriptive approach. The methodology followed three steps: development of the instrument; content validity and reliability verification of the protocol for the analysis of agreement between specialists with greater experience. The study included 48 specialists, including physicians and nurses experienced in patient care in use of balloon. Items considered valid achieved at least 75% of consensus before the analysis of agreement between evaluators. Results: We evaluated 36 items, of these, 20 were considered valid. The reliability was also verified, using consistency of the responses of more experienced evaluators. Among the items submitted to new statistical analysis by these evaluators, only two were considered valid. Conclusion: Based on the content validation, a protocol with 22 items concerning patient care without the use of intra-aortic balloon was developed.
Nursing (Säo Paulo), 2016
Revista Brasileira de Hipertensão, Dec 1, 2022
Avaliar a influência do uso da tecnologia educacional híbrida blended learning (ensino presencial... more Avaliar a influência do uso da tecnologia educacional híbrida blended learning (ensino presencial associado por meio do ambiente virtual de aprendizado "E-Care da Hipertensão") na melhoria do controle da pressão arterial. Métodos: Ensaio Clinico Randomizado Controlado, realizado no período de novembro de 2015 a março de 2016,dividido em dois grupos: a) Grupo Hibrido com 14 pacientes submetidos a orientação individual por meio da consulta de Enfermagem a cada 20 dias com a utilização do recurso tecnológico educacional digital "E-Care da Hipertensão" ; b) Grupo Controle com 16 pacientes em que se utilizou da consulta com orientação individual por meio da consulta de Enfermagem a cada 20 dias sem o uso da tecnologia educacional. Os grupos foram acompanhados por 120 dias, utilizando o Teste de Morisk-Green, e exame da MAPA e WHO-QOL-bref na randomização e aos 120 dias. Resultados: Para o Grupo Hibrido quando realizadas as comparações no início do estudo (momento da randomização) ao final 120 dias observou-se diferenças estatísticas em relação a diversas variáveis, a saber: a) circunferência abdominal, na randomização 99,61±10 vs. 96,69±8 (p=0,006); b) em relação a MAPA na pressão arterial sistólica PAS de vigília (PAS) 159,61±15mmHg vs. 143,30±19mmHg (p=< 0,001); c) pressão arterial diastólica na vigília (PAD) 106,61±12mmHg vs. 95,92±15mmHg (p= < 0,001); d) quanto a carga pressórica da MAPA na randomização para PAS na vigília obteve-se 93,28±7mmHg vs. 66,38±31mmHg (p=0,003); e) quanto aos valores da PAD 92,63±11mmHg vs. 70,96±28mmHg (p=0,002). Conclusão: Não foram observadas diferenças significativas nos resultados analisados em 120 dias com o uso da tecnologia educacional na modalidade hibrida quando comparada com o grupo controle que realizou apenas consulta individual pelo enfermeiro.
Revista Brasileira de Hipertensão, Jun 1, 2022
A Automedição da Pressão Arterial (AMPA) tem ganho interesse ultimamente e sua prática pode contr... more A Automedição da Pressão Arterial (AMPA) tem ganho interesse ultimamente e sua prática pode contribuir para o diagnóstico e seguimento da hipertensão arterial. Em nosso meio, devido a dificuldades de realização da Monitorização Residencial da Pressão Arterial (MRPA) e da indisponibilidade da Monitorização Ambulatorial da Pressão Arterial (MAPA) na maioria dos serviços, a AMPA, que difere dos métodos supracitados, tem uso disseminado em nosso país. Assim, nos parece importante discorrer sobre esse método, tão utilizado e tão pouco estudado. Neste trabalho vamos descrever os métodos de medida de pressão arterial, auscultatório e oscilométrico, além de listar vantagens e desvantagens da medida da pressão arterial no consultório, comparando-as com AMPA. Vamos também fazer um alerta sobre a necessidade de que o paciente receba orientações para a medida da pressão e, por fim, citar as Diretrizes Brasileiras e Europeias no que tange à menção que elas fazem a esse método.
O Mundo da saúde, Dec 30, 2013
Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetiv... more Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetivou realizar a adaptação transcultural do instrumento "Spiritual Assessment Scale" (SAS) para o Brasil. Foi desenvolvido um instrumento específico para a adaptação transcultural basedo nos estudos de Lynn (escala de Likert). A primeira etapa consistiu na aplicação do instrumento desenvolvido pelos autores para avaliação da SAS com 6 experts da área de Espiritualidade e Enfermagem e com 11 pacientes da unidade de clínica médica, para avaliação do instrumento SAS com 21 questões. Após a realização de testes estatísticos, as questões estavam adequadas para a aplicação na pesquisa, como demonstrado pelo coeficiente alfa de Cronbach, que indicou uma confiabilidade aceitável do instrumento. Pode-se afirmar que em ambos os grupos (expert e pacientes) a consistência interna foi elevada, mantendo as características da escala original, após as etapas de tradução e adaptação para o Brasil.
Acta Paulista De Enfermagem, Dec 1, 2012
Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the ... more Objective: To develop a protocol of care for patients with Intra-Aortic Balloon and validate the content of this protocol.Methods: Study of quantitative and descriptive approach. The methodology followed three steps: development of the instrument; content validity and reliability verification of the protocol for the analysis of agreement between specialists with greater experience. The study included 48 specialists, including physicians and nurses experienced in patient care in use of balloon. Items considered valid achieved at least 75% of consensus before the analysis of agreement between evaluators. Results: We evaluated 36 items, of these, 20 were considered valid. The reliability was also verified, using consistency of the responses of more experienced evaluators. Among the items submitted to new statistical analysis by these evaluators, only two were considered valid. Conclusion: Based on the content validation, a protocol with 22 items concerning patient care without the use of intra-aortic balloon was developed.
EDULEARN proceedings, Jul 1, 2023
Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetiv... more Considera-se a espiritualidade parte integrante da assistência de enfermagem. Este estudo objetivou realizar a adaptação transcultural do instrumento "Spiritual Assessment Scale" (SAS) para o Brasil. Foi desenvolvido um instrumento específico para a adaptação transcultural basedo nos estudos de Lynn (escala de Likert). A primeira etapa consistiu na aplicação do instrumento desenvolvido pelos autores para avaliação da SAS com 6 experts da área de Espiritualidade e Enfermagem e com 11 pacientes da unidade de clínica médica, para avaliação do instrumento SAS com 21 questões. Após a realização de testes estatísticos, as questões estavam adequadas para a aplicação na pesquisa, como demonstrado pelo coeficiente alfa de Cronbach, que indicou uma confiabilidade aceitável do instrumento. Pode-se afirmar que em ambos os grupos (expert e pacientes) a consistência interna foi elevada, mantendo as características da escala original, após as etapas de tradução e adaptação para o Brasil.
Journal of Clinical Densitometry, Dec 1, 2005
Background: It is a matter of controversy whether or not Colles' fracture is an osteoporotic frac... more Background: It is a matter of controversy whether or not Colles' fracture is an osteoporotic fracture. Indeed, the usefulness of quantitative ultrasound in distinguishing Colles' fracture from normal fractures is also unclear. Methods: A cross-sectional case-control study was done on 469 postmenopausal Spanish women, 121 with Colles' fracture and 348 controls. Assessment of risk factors for osteoporosis and measurement of calcaneus quantitative ultrasound were carried out using a Sahara \, Hologic \ device. Results: Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls, and no statistically significant differences were found. We estimated ROC curves for SOS and a score based on a linear combination of height and SOS (SH-Score). The areas under both curves were 0.56 and 0.61, respectively, which was statistically significant. To obtain 5% false-negative and 10% falsepositive figures, the T-score cutoff for SOS was À 2.45 and À0.045, respectively. Of these, only 9.2% were classified as high risk and 11% as low risk with 79.8% undetermined. Conclusions: Patients with Colles' fracture had BUA, SOS, and QUI values that were similar to those of controls. Nevertheless, ROC curves calculated by a combination of height and SOS showed that quantitative calcaneus ultrasound may be a useful tool for identifying postmenopausal women with Colles' fracture. These results indicate that measuring bone mineral density with ultrasound only captures limited aspects of the pathophysiology of Colles' fractures.