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      Educational handbook for healthcare professionals: Preventing complications and treating peristomal skin Translated title: Manual educativo para profissional da área da saúde: prevenindo complicação e tratando a pele periestoma

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          Abstract

          Abstract Objective To create and validate a handbook for the prevention of peristomal skin complications. Methods For the elaboration of the handbook, a literature review was conducted in the following databases: Cochrane Library, SciELO, LILACS, and MEDLINE. The handbook “Preventing and treating the complications of intestinal peristomal skin” was elaborated in nine steps. The first step addressed the concepts of ostomy, stoma type, and ostomy classification. In the second step, the following were described: definition of the collection equipment, type of collection equipment, and technique of changing one- and two-piece equipment. In the third step, the peristomal skin cleansing technique was described. In the fourth step, the types of complications of the peristomal skin were listed. In the fifth step, preventive approaches to avoid complications with the peristomal skin were described. In the sixth step, the therapeutic approaches in the treatment of aforementioned peristomal skin complications were addressed. In the seventh step, the handbook layout was created by an Information Technology professional. In the eighth step, the handbook was validated by 25 nurses. In the ninth step, the final version of the instrument was laid out. Results The final version of the “Preventing and treating the complications of intestinal peristomal skin” handbook has 37 pages. It was registered in the International Standard Book Number: 978-85-67647-46-3, standard format size (21 cm high by 15 cm wide), totaling 50 illustrations. In the first evaluation, the evaluators assessed the manual as partially adequate to completely adequate. In the first evaluation, the content validity index ranged between 0.88 to 1.0; no 100% agreement was observed among the evaluators' answers. In the second evaluation, as an agreement was observed in all items, the content validity index was 1.0. Conclusion The handbook “Preventing and treating the complications of intestinal peristomal skin” was elaborated based on scientific principles and had its content, language, and design validated by specialists in the field.

          Translated abstract

          Resumo Objetivo Construir e validar um manual para a prevenção das complicações da pele periestoma. Método Para a construção do manual, realizou-se uma revisão nas bases: Biblioteca Cochrane, SciELO, LILACS e MEDLINE. O manual “Prevenindo e tratando das complicações da pele periestoma intestinal” foi elaborado em nove etapas. A primeira etapa abordou os conceitos de estomia, tipo de estoma, classificação de estomia. Na segunda etapa, foram elaborados: definição de equipamento coletor, tipo de equipamentos coletores, técnica da troca do equipamento de uma e duas peças. Na terceira etapa, definiu-se a técnica de limpeza da pele periestoma. Na quarta etapa, foram descritos os tipos de complicações da pele periestoma. Na quinta etapa, enfocaram-se as condutas preventivas para evitar as complicações com a pele periestoma. Na sexta etapa, foram descritas as condutas terapêuticas no tratamento das complicações da pele periestoma citadas acima. Na sétima etapa, foi realizada a diagramação do manual por um profissional da área de Tecnologia da Informação. Na oitava etapa, validação do manual por 25 enfermeiros. A nona etapa correspondeu à diagramação da versão final do instrumento. Resultados A versão final do manual denominado “Prevenindo e tratando das complicações da pele periestoma intestinal” contém 37 páginas. Foi registrado no International Standard Book Number: 978-85-67647-46-3, tamanho padrão de formatação com 21 cm de altura por 15 cm de largura, totalizando 50 ilustrações. Na primeira avaliação, os juízes avaliaram o manual como parcialmente adequado a totalmente adequado. O Índice de validade de conteúdo na primeira avaliação foi entre 0,88 a 1,0; não tendo ocorrido 100% de concordância das respostas dos juízes; na segunda avaliação, tendo havido concordância dos juízes em todos os itens, o índice de validade de conteúdo foi 1,0. Conclusão O manual intitulado “Prevenindo e tratando das complicações da pele periestoma intestinal” foi construído com embasamento científico, validado quanto ao conteúdo, à linguagem e à aparência por especialistas na área.

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          Implementation of Patient-Centered Education for Chronic-Disease Management in Uganda: An Effectiveness Study

          Background The majority of non-communicable disease related deaths occur in low- and middle-income countries. Patient-centered care is an essential component of chronic disease management in high income settings. Objective To examine feasibility of implementation of a validated patient-centered education tool among patients with heart failure in Uganda. Design Mixed-methods, prospective cohort. Settings A private and public cardiology clinic in Mulago National Referral and Teaching Hospital, Kampala, Uganda. Participants Adults with a primary diagnosis of heart failure. Interventions PocketDoktor Educational Booklets with patient-centered health education. Main Measures The primary outcomes were the change in Patient Activation Measure (PAM-13), as well as the acceptability of the PocketDoktor intervention, and feasibility of implementing patient-centered education in outpatient clinical settings. Secondary outcomes included the change in satisfaction with overall clinical care and doctor-patient communication. Key Results A total of 105 participants were enrolled at two different clinics: the Mulago Outpatient Department (public) and the Uganda Heart Institute (private). 93 participants completed follow up at 3 months and were included in analysis. The primary analysis showed improved patient activation measure scores regarding disease-specific knowledge, treatment options and prevention of exacerbations among both groups (mean change 0.94 [SD = 1.01], 1.02 [SD = 1.15], and 0.92 [SD = 0.89] among private paying patients and 1.98 [SD = 0.98], 1.93 [SD = 1.02], and 1.45 [SD = 1.02] among public paying patients, p<0.001 for all values) after exposure to the intervention; this effect was significantly larger among indigent patients. Participants reported that materials were easy to read, that they had improved knowledge of disease, and stated improved communication with physicians. Conclusions Patient-centered medical education can improve confidence in self-management as well as satisfaction with doctor-patient communication and overall care in Uganda. Our results show that printed booklets are locally appropriate, highly acceptable and feasible to implement in an LMIC outpatient setting across socioeconomic groups.
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            Association of sociodemographic and clinical factors with the self-image and self-esteem of individuals with intestinal stoma

            Objective: To evaluate the clinical and sociodemographic factors and correlate them to the self-image and self-esteem. Methods: A study conducted at Ostomy Pole of PousoAlegre. The data were collected between December 2012 and May 2013. This was a non-probabilistic, by convenience, sample. For data collection, the Rosenberg Self-Esteem Scale/UNIFESP-EPM and Body Investment Scale were used. For statistical analysis, chi-squared test, Kruskal-Wallis test and Spearman correlation were used. Levels of significance of 5% (p ≤ 0.05) were considered. Results: Participants had a mean score of 10.81 in the Rosenberg Self-Esteem Scale/UNIFESP. Regarding Body Investment Scale results, the mean total score was 38.79; the mean in the domain of body image was 7.74, and for personal touch, 21.31. When comparing data related to the stoma and sociodemographic profiles with the Rosenberg Self-Esteem Scale/UNIFESP and Body Investment Scale, we realize that all patients demonstrated a decrease in self-esteem and self-image. Individuals were over 60 years old, male, retired, married and were not participants in support group/association. With regard to the characteristics of the stoma, those permanent colostomized had as causes of stoma implementation inflammatory disease and neoplasia; stomata measured between 20 and 40 mm; these people used two-piece devices. People who have not been notified that would be subjected to the stoma and in whom no demarcation was done showed worsening in self-esteem and self-image in relation to other features related to injury and sociodemographic data. Conclusion: Patients who participated in this study had low self-image and self-esteem in all characteristics of the stoma and in sociodemographic data, meaning that these individuals had negative feelings about their own bodies.
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              Health education and its theoretical perspectives: a few reflections

              The purpose of this study was to reflect theoretically on the theme of health education and how it interfaces with health promotion. It consists of a theoretical-reflexive study aimed at comparing these practices to the concepts elaborated in the Letter of Ottawa, the pedagogy of liberation of Paulo Freire, empowerment and culture, here comprehended as key elements guiding the activity of the nurse in health education in actions performed by health services. In order to take this reflexive path, the authors analyzed the interrelationships of these theoretical interfaces and their approaches to health promotion practices. From this presented theoretical framework, it is possible to reflect on the possibilities of extending care, based on the premise that all moments comprising interaction with patients of health services must be considered an opportunity to develop health education actions, considering the knowledge of nurses characterized as social actors who are responsible for the events that take place in the health scenario.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                jcol
                Journal of Coloproctology (Rio de Janeiro)
                J. Coloproctol. (Rio J.)
                Sociedade Brasileira de Coloproctologia (Rio de Janeiro, RJ, Brazil )
                2237-9363
                2317-6423
                December 2019
                : 39
                : 4
                : 332-338
                Affiliations
                [1] Pouso Alegre Minas Gerais orgnameUniversidade do Vale do Sapucaí Brazil
                Article
                S2237-93632019000400332 S2237-9363(19)03900400332
                10.1016/j.jcol.2019.07.005
                56013273-f85c-4fde-b2f5-6d3678422a9e

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 28 July 2019
                : 22 June 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 7
                Product

                SciELO Brazil

                Categories
                Original Articles

                Estomia,Cuidados de enfermagem,Dermatitis,Ostomy,Handbook,Nursing care,Manual,Dermatite

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