The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

PARTO HUMANIZADO Y LA FUNCIÓN DE ENFERMERÍA EN LOS ESTABLECIMIENTOS DE SALUD PÚBLICA.

Introducción: la humanización del parto asegura el respeto de los derechos fundamentales, reproductivos y sexuales de la gestante y la familia, reduciendo complicaciones perinatales y morbi-mortalidad materno-infantil. Objetivo: Caracterizar el parto humanizado y las funciones de enfermería en los establecimientos de salud pública. Métodos: diseño documental con revisión bibliográfica sobre humanización del parto para lo cual se realizó una búsqueda en bases de datos como: PubMed, Taylor y Francis, LILACS, MEDLINE, BVS, SCIELO, LATINDEX, GOOGLE ACADÉMICO, en idioma español e inglés. Resultados: En base a revisión y análisis de 40 artículos se pudo conocer que el parto humanizado es reconocido mundialmente como una estrategia eficiente para reducir complicaciones perinatales y lograr una maternidad satisfactoria y que a nivel latinoamericano; Brasil, Perú, Argentina, Ecuador, Venezuela y México ya cuentan con iniciativas del sector público, privado y de organizaciones civiles para promocionar parto humanizado, y con ello reducir las tasas de cesáreas, parto instrumentado, morbi-mortalidad materno infantil y lograr una maternidad satisfactoria, segura basada en prácticas no invasivas ni farmacológicas para el alivio del dolor, educación y autorización sobre procedimientos, autonomía, buen trato y respeto por sentimientos y creencias. Conclusiones: En el pato humanizado, el rol de enfermería es esencial sobre todo en los establecimientos públicos en donde se asume maltrato, negligencia o falta de respeto por el parto, por lo que la enfermera está llamada a educar a la parturienta sobre el trabajo de parto y parto. Palabras clave: parto humanizado, atención perinatal, enfermería, recién nacido. ABSTRACT Introduction: the humanization of childbirth ensures respect for the fundamental, reproductive and sexual rights of the pregnant woman and the family, reducing perinatal complications and maternal and infant morbidity and mortality. Objective: To characterize humanized delivery and nursing functions in public health establishments. Methods: documentary design with bibliographic review on the humanization of childbirth for which a search was carried out in databases such as: PubMed, Taylor and Francis, LILACS, MEDLINE, BVS, SCIELO, LATINDEX, GOOGLE ACADEMICO, in Spanish and English. Results: Based on a review and analysis of 40 articles, it was possible to know that humanized delivery is recognized worldwide as an efficient strategy to reduce perinatal complications and achieve a satisfactory maternity and that at the Latin American level; Brazil, Peru, Argentina, Ecuador, Venezuela and Mexico already have initiatives from the public and private sectors and civil organizations to promote humanized delivery, and thereby reduce the rates of cesarean sections, instrumented delivery, maternal and infant morbidity and mortality and achieve motherhood, satisfactory, safe based on non-invasive or pharmacological practices for pain relief, education and authorization on procedures, autonomy, good treatment and respect for feelings and beliefs. Conclusions: In the humanized duck, the role of nursing is essential especially in public establishments where abuse, neglect or lack of respect for childbirth is assumed, so the nurse is called to educate the woman in labor about the labor of labor and delivery. Keywords: humanized delivery, perinatal care, nursing, newborn

PERCORRENDO CAMINHOS: ITINERÁRIO TERAPÊUTICO DE MULHERES USUÁRIAS DE ÁLCOOL E/OU OUTRAS DROGAS DURANTE CICLO GRAVÍDICO-PUERPERAL

Pregnancy, childbirth and postpartum care is provided in accordance with gestational risk factors, such as use of alcohol and/or other drugs by pregnant women. The objective of this study was to trace the therapeutic itinerary of pregnant women who use alcohol and/or other drugs in the health network of a city in the Mid-North of the state of Paraná. This is a qualitative, exploratory study conducted through individual interviews. Firstly, the therapeutic itineraries were built, then the speeches were analyzed in accordance with Bardin and discussed with the aid of current literature. Regarding the therapeutic itinerary, the interviewees accessed primary care, high-risk prenatal care, and hospital services. The results identified two categories: Considerations on the use of alcohol and drugs during pregnancy, and Strengths and weaknesses of the healthcare network’s points of attention. From the statements, probable biological and social implications of using psychoactive substances during pregnancy emerged, such as complications during gestation, fetal alterations, and loss of legal rights over children. As for the points of attention, the importance of multidisciplinarity and the role of nursing were highlighted. On the other hand, the network’s disarticulation and professionals’ inability, represented by inappropriate comments and lack of guidance, appear as weakness. It was concluded that it is necessary to provide comprehensive follow-up to pregnant and postpartum women who use alcohol and drugs, with the articulation of the healthcare network and professionals free from judgment to provide a care that meets their biopsychosocial demands.

FACTORS RELATED TO INCREASING THE NUMBER OF CASES OF MEASURES AND THE ROLE OF NURSING

The aim of the present study was to analyze the factors related to the increase in the number of measles cases and the role of nursing in this context. This work was developed by a literature search with a descriptive approach, which will be based on a systematic literature review. Available in the Scientific Eletronic Library Online (SciELO), Virtual Health Library (VHL) and Latin American and Caribbean Literature in Health Sciences (Lilacs) databases. Published between 2010 and 2020, in English and Portuguese. With the following keywords, National Program for Immunization, Nursing, Measles and Anti-vaccine Movement. Measles is a viral, acute infectious disease, potentially serious, transmissible and extremely contagious. Being the only form of prevention through vaccines. Transmission occurs directly, through nasopharyngeal secretions excreted when coughing, talking, sneezing or breathing by infected people. Brazil received the certificate of elimination of the circulation of the measles virus by the WHO, declaring the region of the Americas free of measles. In 2019 new cases arose in Brazil. There are several factors related to this increase in the number of cases ranging from anti-vaccine movements, false news about vaccination and poor vaccination coverage. Therefore, the objective is to relate these factors, highlighting the performance of nursing, showing some control strategies and seeking a solution to the problem.

Munchausen Syndrome by Proxy as a Cause of Child Abuse

Munchausen syndrome by proxy (MSBP) is a rare form of mental disorder and is known as a particular type of child abuse. MSBP has been described since 1977 as a severe form of abuse with illness falsification or the intentional harming by guardians, mostly mothers. The perpetrator of MSBP may inflict damage to the child directly or indirectly through medical procedures. The perpetrator’s alleged motive is to satisfy her psychological needs, and she has a history of mental illness, mostly, factitious disorder, personality disorder, and somatic disorder. The pathology is not well known; as such, it is difficult for medical personnel to detect it early. In addition, it is hard to be handled effectively by the police and child welfare agencies because of the scarcity of evidence. Therefore, the authors attempt to examine the essential information from early detection and child abuse prevention by analyzing its clinical characteristics and the perpetrator’s characteristics, including alerting signs of MSBP. For this purpose, we focus on the role of nursing staff to detect this unusual cause of child abuse.

Analysis of integrative and complementary therapies applied by health teams in Primary Care

Introduction: Integrative and complementary therapies are being increasingly sought after in the field of health by the general population almost all over the world and, in Brazil, it is no different. Therefore, this research aimed to identify the integrative and complementary therapies used by health teams in Primary Care, after the publication of the National Policy on Integrative and Complementary Practices, and to verify the role of Nursing in the use of therapies. Materials and Methods: Exploratory-descriptive research, with a qualitative character. This is a bibliographical review with scientific articles published from 2008 to 2018, by consulting the Lilacs, Scielo and Capes databases. It was found 11 articles related to the topic. Results and Discussion: It was possible to perceive the constant search for comprehensive care by health professionals to identify and meet the real needs of users who seek the service, using integrative and complementary therapies. Conclusion: This research identified the need to strengthen the work process in health teams so that it has attended to seek a re-evaluation to keep the actions taken under discussion so that its essence is not lost, including the necessary steps to take advantage of therapies in its entirety.

The Concerns of Pakeha Men Living on Home Haemodialysis: a Critical Interpretive Study

<p>This nursing study seeks to understand the experience of one group of people with chronic renal failure using renal replacement therapy, Pakeha men living on home haemodialysis. It is based on the assumptions that people living on dialysis have distinctive experiences that are characterized by common concerns reflecting their shared position as subjects of renal illness and therapy, but that these are not easy to discern because they are obscured by the professional viewpoint that is dominant in the renal setting. In order to understand the experience of people living on dialysis this study develops a critical interpretive approach, seeking the participant's own interpretation of their individual experiences, but then reinterpreting them from a critical standpoint, recognizing that they can only be adequately understood by contextualizing them, in order to discern the common perspective underlying them in contrast to the dominant professional viewpoint in the renal setting. Using some ideas derived from the thought of Michel Foucault this study develops a critical nursing view of the renal setting, as a specialized healthcare context that is constituted by several interrelated discourses, primarily the dominant professional discourse, but also by several other discourses, in particular a client discourse that is a response to the dominant discourse. The different discourses reflect contrasting perspectives based on the different positions of various groups within the renal context. The study presents accounts, derived from interviews, of the experience of six Pakeha men living on home haemodialysis. Reflecting on these accounts as a set, by contextualizing them in terms of the critical nursing view of the renal setting, I outline four concerns of Pakeha men living on home haemodialysis. Together these make up the renal client discourse that models the distinctive perspective from their position within the renal context, underlying each of their individual accounts of their experience of illness and therapy. These concerns include symptoms from chronic renal failure and dialysis, limitations resulting from the negotiation of the therapeutic regime into their lifestyle, their sense of ongoingness and uncertainty of living on dialysis, and the altered interrelationship between autonomy and dependence inherent in living on dialysis. The study suggests that the individual accounts can be understood as resulting from the interaction of the various dimensions of their own personal social locations, including their gender and ethnicity, with the concerns of client discourse, reflecting their common position as people living on dialysis. One important implication of this understanding is that the role of nursing in the renal setting can be articulated as a response to the experience of the person living on dialysis. The nurse can support the renal client in seeking to integrate the requirements of the therapeutic regime, reflecting the dominant discourse, into their personal situation, reflecting the interaction of their own personal location with their position as a person living on dialysis, outlined in the client discourse.</p>