http://repositorio.ufc.br/handle/riufc/210 2026-08-13T11:15:11Z http://repositorio.ufc.br/handle/riufc/87321 Título: Adaptação e avaliação de cenário de simulação para a consulta de enfermagem à criança com disfunção respiratória Autor(es): Araújo, Moziane Mendonça de Abstract: Respiratory dysfunctions are common in pediatric patients and, when managed inadequately, may lead to unnecessary procedures and worsen respiratory infections. In this context, the nursing consultation plays a fundamental role in providing safe and high-quality care, requiring the training of well-prepared professionals. Clinical simulation has emerged as an important teaching-learning strategy to support this process. Therefore, this study aimed to adapt and evaluate a clinical simulation scenario focused on teaching nursing consultation for children with respiratory dysfunction to undergraduate nursing students. This methodological study involved the adaptation of a simulation scenario based on David Kolb’s Experiential Learning Theory and the methodological standards of the International Nursing Association for Clinical Simulation and Learning (INACSL). The evaluation was conducted by 17 experts and 27 undergraduate nursing students. The scenario adaptation phase took place during the first semester of 2025. The expert and student evaluations, as well as the pilot test, were carried out between September and December 2025. Data collection included the sociodemographic characterization of all participants. In addition, experts assessed the content and appearance of the scenario, while students evaluated its appearance, design, and debriefing process. Data analysis was performed using R software (version 4.x), applying the Content Validity Index (CVI), Cronbach’s alpha, and the Intraclass Correlation Coefficient (ICC). The study was approved by the Research Ethics Committee of the Federal University of Ceará. The experts’ evaluation of content and appearance yielded an overall CVI of 0.977. Of the total items analyzed, 24 achieved 100% agreement, with an observed proportion of 1.00. For these items, the binomial test indicated statistical significance (p < 0.05), with p-values ranging from 0.033 to 0.055. Only two items did not reach absolute agreement, presenting an agreement index of 94.1%. The results indicated adequacy regarding content, structure, language, and relevance. Concerning appearance assessment by the target audience, 11 of the 21 analyzed items achieved 100% agreement. Analyses using the Simulation Design Scale and the Debriefing Experience Scale demonstrated excellent internal consistency (α ≥ 0.91) and high agreement among respondents (ICC ≥ 0.89), in addition to Cronbach’s alpha and ICC values of 0.968, indicating a meaningful experience for learning consolidation and critical reflection. It is noteworthy that the suggestions provided by experts and students were incorporated into the final version of the scenario. The findings demonstrated that the clinical simulation scenario is valid according to both experts and the target audience for teaching nursing consultation to children with respiratory dysfunction and has the potential to be used as a teaching and learning tool in pediatric nursing education. Tipo: Tese 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86821 Título: Determinantes sociais de saúde e a qualidade de vida na intenção de amamentar Autor(es): Rodrigues, Icleia Parente Abstract: Social Determinants of Health (SDH) indicate the living and health conditions of a community, promoting comprehensiveness, equity, and highlighting pathways to reduce social inequities. Related to SDH, Quality of Life (QoL) is considered a predictor of health and well-being. The relationship between SDH and QoL regarding breastfeeding intention has been explored separately in the literature, making it difficult to understand the interrelationship between these constructs. Furthermore, the originality of this study lies in its focus on investigating breastfeeding intention rather than breastfeeding management. This study aimed to investigate the relationship between SDH and QoL in the breastfeeding intention of adolescent and young puerperal women. This was a cross-sectional, analytical, and correlational study conducted at a high-complexity maternity hospital within the Brazilian Unified Health System in Fortaleza, Ceará, Brazil. A total of 323 adolescents and young women aged 10 to 24 years admitted to a rooming-in care unit were included. The following instruments were applied: 1) sociodemographic, clinical, and obstetric questionnaire; 2) Social Determinants of Health in Schoolchildren Questionnaire (Q-DSSE); 3) Health-Related Quality of Life Scale for Children and Adolescents (KIDSCREEN-52); and 4) Infant Feeding Intentions Scale (IFI). The Chisquare test was used to analyze associations between variables, and the strength of association was calculated using prevalence ratios (PR). Variables with p<0.20 in bivariate analyses were included in logistic regression. Simple linear regression was performed with transformed scale scores. A significance level of 5% was adopted for all analyses. The research project was approved by the Research Ethics Committee under opinion no. 6,800,591. The results showed a statistically significant reduction in the intention to exclusively breastfeed over time, with a progressive decline in mean scores between the 1st, 3rd, and 6th postpartum months (p<0.001). Correlation analysis revealed statistically significant positive associations, although of weak magnitude, between breastfeeding intention and maternal age (p=0.020), as well as neonatal clinical indicators. Higher Apgar scores at the 1st minute (p=0.002) and 5th minute of life (p<0.001) were associated with higher levels of maternal intention to exclusively breastfeed. Regarding QoL, puerperal women with more than one childbirth showed a higher proportion of low or regular QoL (39.3%) and (27.7%) (PR=1.69; p=0.031; 95%CI:1.05–2.74). Similarly, those with a previous childbirth presented worse scores (40.4%) (PR=0.55; p=0.017; 95%CI:0.34–0.90). Equivalent findings were observed among women with previous breastfeeding experience, who also showed a higher frequency of low or regular QoL (40.5%) (PR=0.55; p=0.017; 95%CI:0.34–0.90). It is concluded that, for adolescent and young puerperal women, breastfeeding intention appears to be less determined by structural social conditions and more sensitive to clinical and obstetric experiences, highlighting the importance of early interventions focused on perinatal care and individualized support in the immediate postpartum period. This study contributes to broadening the understanding of factors influencing breastfeeding and points to the need for comprehensive, longitudinal, and socially sensitive care strategies. Tipo: Tese 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86707 Título: Protocolo assistencial de enfermagem para prevenção dos cânceres de mama e colo de útero em pessoas transmasculinas: estudo metodológico Autor(es): Silva, Denise Montenegro da Abstract: The present study aimed to develop a nursing care protocol for the prevention of breast and cervical cancers among transmasculine individuals. This methodological study was conducted from June 2024 to January 2026, following the Iowa Model of Evidence-Based Practice to Promote Excellence in Health through eight stages: identifying a research question; securing organizational support by recognizing the topic as a priority; conducting a scoping review; designing and implementing a pilot for practice change, involving the team while considering preferences, resources, constraints, and approval processes; developing a protocol and implementation plan, collecting data, and evaluating processes; assessing whether the practice change was appropriate and ready for implementation; integrating the change directly into the current system while monitoring key indicators; and, finally, disseminating the results. The validation stage was conducted using a hybrid format (face-to-face and online). Content validation was performed by seven specialist nurses (online), five individuals from the target care population (hybrid format with members of the Associação Transmasculina do Ceará), and five primary healthcare nurses who evaluated the usability of the protocol (online). Only the penultimate stage was not fully completed. Data were analyzed and presented using descriptive statistics, including absolute and relative frequencies. In addition, item-level content validity indices and the specific calculation required by the evaluation tool were computed. Ethical principles were observed throughout all stages of the study, ensuring participant anonymity. The study results included: the production of a scoping review published in a highly relevant international journal; systematic meetings with the transmasculine population to understand perceptions and preferences regarding the topic; organization, analysis, and interpretation of the data culminating in the development of the protocol; and content validation, in which the overall protocol evaluation by specialists was 0.85, indicating good overall quality, with Domain 5 (Applicability) showing the lowest level of agreement (0.71). Among the transmasculine population, the overall evaluation was 0.95, with Domain 6 (Editorial Independence) presenting the lowest level of agreement (0.55). Following the validation stage, evaluators’ considerations were analyzed, and the relevant modifications were incorporated into the instrument. Regarding usability, the protocol was recognized as a practical and easily implementable tool. In conclusion, the protocol demonstrated valid content and usability within the context of primary healthcare, enabling nurses to guide preventive care practices through evidence-based actions delivered in a more inclusive manner to transmasculine populations. Tipo: Tese 2026-01-01T00:00:00Z http://repositorio.ufc.br/handle/riufc/86555 Título: Eficácia e segurança da auriculoterapia na melhora da qualidade do sono de pessoas vivendo com HIV: Ensaio clínico randomizado Autor(es): Ramalho, Ane Kelly Lima Abstract: People living with HIV (PLHIV) have more difficulty sleeping, which may be associated with the virus itself, stigma, and antiretroviral therapy (ART). As a non-pharmacological alternative, there is auriculotherapy, which is included in the National Policy on Integrative and Complementary Practices. The overall objective was to evaluate the effectiveness and safety of auriculotherapy in improving sleep quality in PLHIV and sleep disorders. This is a randomized, controlled clinical trial with a sample of 200 PLHIV, with 100 in the Auriculotherapy group and 100 in the Control group. Inclusion criteria: PLHIV over 18 years of age, on ART for at least three months, and a score higher than 10 on the Pittsburgh Sleep Quality Index (PSQI-BR). Exclusion criteria: mental illness, pregnant women, and ear injury/allergy. Discontinuation criteria: loss to follow-up, initiation of antiretroviral with sleep interference, adverse events, and inability to make telephone contact. PLHIV were recruited from three healthcare institutions in Fortaleza, Ceará, Brazil, and interviewed using the Sociodemographic, Epidemiological, and Clinical Form for PLHIV, the PSQI-BR, and the Insomnia Severity Index (ISI). After randomization, the intervention group received auriculotherapy with mustard seeds on 6 points: Neurasthenia, Neurasthenia area, Anxiety, Heart, Shen Men, and Occipital, with instructions to press them 3 times a day for 30 seconds. The Control group received microporous tape in the 6 points, but without seeds and without applying pressure to the sites. For both groups, after the first session, two more in-person sessions took place on days 7 and 14, with reapplication of the PSQI-BR and ISI. On day 21, a phone call was made and the PSQIBR and ISI were reapplied, with instructions to remove the microporous tapes and mustard seeds. On the 28th day, the PSQI-BR and ISI were reapplied by telephone to analyze the residual effect of auriculotherapy. In the analyses, the normality of distribution of the variables was verified, descriptive statistics were performed, and the area under the curve was calculated. A two-factor analysis of variance model with repeated measures was used. A p-value < 0.05 was considered statistically significant. GraphPad Prism v. 8.0 and IBM SPSS Statistics v. 23.0 software were used for analysis. The study was approved by Ethics Committee and the participants signed the informed consent form. The research was registered in the Brazilian Registry of Clinical Trials and followed the Consolidated Standards of Reporting Trials. Of the 402 PLHIV recruited, 277 were randomized to the Auriculotherapy (N=134) or Control (N=143) groups, with loss to follow-up of 25.5% and 30.0%, respectively. Differences were observed between the groups on days 7, 14, 21, and 28, with a reduction in the total PSQI-BR score in the Auriculotherapy group from day 7 onwards compared to day 0, in addition to differences compared to day 0 within the Auriculotherapy group. Seven days after the removal of materials from the ears, the effect of auriculotherapy lasted until the 28th day. The proportion of responsive patients in the Auriculotherapy group was higher than in the Control group, with a probability of clinical improvement 18.5 times greater in those who underwent auriculotherapy. The relative risk indicated a 72 times greater probability of remission in those undergoing auriculotherapy. In the overall assessment of sleep quality, the area under the curve was smaller in the Auriculotherapy group, due to the reduction in PSQI-BR scores. There were differences between the groups at D7, D14, D21, and D28, with a significant reduction in the total ISI score in the Auriculotherapy group from D7 onwards compared to D0. The proportion of patients without insomnia was higher in the Auriculotherapy group. Adverse events included pain, itching, and increased temperature at the ear points, as well as dizziness, all of which were considered mild. It was concluded that auriculotherapy was effective and safe in improving sleep quality in PLHIV and sleep disorders. Project funded (CNPq, Brazil, No 402380/2023-1). Tipo: Tese 2026-01-01T00:00:00Z