RESUMO
OBJECTIVE: Map the scientific evidence on the use of clinical decision support systems in diabetic foot care. METHOD: A scoping review based on the JBI Manual for Evidence Synthesis and registered on the Open Science Framework platform. Searches were carried out in primary and secondary sources on prototypes and computerized tools aimed at assisting patients with diabetic foot or at risk of having it, published in any language or period, in eleven databases and grey literature. RESULTS: A total of 710 studies were identified and, following the eligibility criteria, 23 were selected, which portrayed the use of decision support systems in diabetic foot screening, predicting the risk of ulcers and amputations, classifying the stage of severity, deciding on the treatment plan, and evaluating the effectiveness of interventions, by processing data relating to clinical and sociodemographic information. CONCLUSION: Expert systems stand out for their satisfactory results, with high precision and sensitivity when it comes to guiding and qualifying the decision-making process in diabetic foot prevention and care.
Assuntos
Sistemas de Apoio a Decisões Clínicas , Diabetes Mellitus , Pé Diabético , Humanos , Pé Diabético/terapiaRESUMO
OBJETIVO: Sintetizar evidências disponíveis sobre ações de enfermagem para melhorar a autogestão do diabetes durante a pandemia de COVID-19. MÉTODO: Revisão de escopo usando a metodologia Joanna Briggs Institute (JBI) e o Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Identificaram-se estudos acadêmicos e literatura cinzenta de sete bases de dados primárias e seis secundárias. Dois revisores avaliaram os estudos e os dados foram analisados ââdescritivamente. RESULTADOS: Foram identificados 1.322 títulos, dos quais 31 estudos foram incluídos. Os estudos foram publicados em 2020, principalmente em inglês. A teleconsulta foi uma estratégia relevante para ajudar os pacientes a controlar o diabetes e sua saúde. CONCLUSÃO: A revisão indica que ações de enfermagem realizadas durante a pandemia para melhorar a autogestão do diabetes não foram diferentes do que está consolidado, mas algumas adaptações foram realizadas. A necessidade de autocuidado, apoio social e uma abordagem centrada no paciente é reforçada.
OBJECTIVE: To synthesize the available evidence on nursing-based actions to improve diabetes self-management during the COVID-19 pandemic. METHOD: Scoping review using the Joanna Briggs Institute methodology (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The research covered academic studies and gray literature from seven primary and six secondary databases. Two independent reviewers assessed the studies, and the data were analyzed descriptively. RESULTS: A total of 1,322 titles were identified, of which 31 studies were included. All studies were published in 2020, mainly in English. Teleconsultation was a relevant strategy to help patients manage diabetes and their general health. CONCLUSION: The review indicates that the nursing-based actions carried out during the COVID-19 pandemic to improve diabetes self-management are not different from what has been consolidated, but some adaptations have been undertaken. The need for self-care, social support, and a collaborative and patient-centered approach is reinforced.
Assuntos
Humanos , Enfermagem , Diabetes Mellitus , Autogestão , COVID-19RESUMO
ABSTRACT Objective: Map the scientific evidence on the use of clinical decision support systems in diabetic foot care. Method: A scoping review based on the JBI Manual for Evidence Synthesis and registered on the Open Science Framework platform. Searches were carried out in primary and secondary sources on prototypes and computerized tools aimed at assisting patients with diabetic foot or at risk of having it, published in any language or period, in eleven databases and grey literature. Results: A total of 710 studies were identified and, following the eligibility criteria, 23 were selected, which portrayed the use of decision support systems in diabetic foot screening, predicting the risk of ulcers and amputations, classifying the stage of severity, deciding on the treatment plan, and evaluating the effectiveness of interventions, by processing data relating to clinical and sociodemographic information. Conclusion: Expert systems stand out for their satisfactory results, with high precision and sensitivity when it comes to guiding and qualifying the decision-making process in diabetic foot prevention and care.
RESUMEN Objetivo: Mapeo de la evidencia científica sobre el uso de sistemas de apoyo a la toma de decisiones clínicas en el cuidado del pie diabético. Método: Revisión de alcance basada en el Manual de Síntesis de la Evidencia del JBI y registrada en la plataforma Open Science Framework. Se realizaron búsquedas en fuentes primarias y secundarias sobre prototipos y herramientas informatizadas dirigidas a la asistencia de pacientes con pie diabético o en riesgo de padecerlo, publicadas en cualquier idioma o periodo, en once bases de datos y literatura gris. Resultados: Se identificaron 710 estudios y, tras cumplir los criterios de elegibilidad, se seleccionaron 23, que retrataban el uso de sistemas de apoyo a la toma de decisiones en el diagnóstico del pie diabético, la predicción del riesgo de úlceras y amputaciones, la clasificación del estadio de gravedad, la decisión sobre el plan de tratamiento y la evaluación de la eficacia de las intervenciones, mediante el procesamiento de datos relativos a la información clínica y sociodemográfica. Conclusión: Los sistemas expertos destacan por sus resultados satisfactorios, con gran precisión y sensibilidad a la hora de orientar y cualificar el proceso de toma de decisiones en la prevención y el cuidado del pie diabético.
RESUMO Objetivo: Mapear as evidências científicas sobre uso de Sistemas de Apoio à Decisão Clínica no pé diabético. Método: Revisão de escopo fundamentada no JBI Manual for Evidence Synthesis e registrada na plataforma Open Science Framework. Realizaram-se buscas, em fontes primárias e secundárias, sobre protótipos e ferramentas informatizadas direcionadas à assistência ao paciente com pé diabético ou em risco de tê-lo, publicados em qualquer idioma ou período, em onze bases de dados e literatura cinza. Resultados: Foram identificados 710 estudos e, após critérios de elegibilidade, foram selecionados 23 que retratam o uso de sistemas de apoio à decisão no rastreio do pé diabético, predição do risco de úlceras e amputações, classificação do estágio de gravidade, decisão quanto ao plano de tratamento e avaliação da efetividade das intervenções, por meio do processamento de dados referentes a informações clínicas e sociodemográficas. Conclusão: Os sistemas especialistas destacam-se por resultados satisfatórios, com alta precisão e sensibilidade no que tange à orientação e qualificação do processo de tomada de decisão na prevenção e no cuidado ao pé diabético.
Assuntos
Humanos , Pé Diabético , Diabetes Mellitus , Revisão , Sistemas de Apoio a Decisões ClínicasRESUMO
OBJECTIVE: to analyze the effect of cutaneous foot thermometry in people with Diabetes Mellitus, compared with the standard prevention of foot ulcers adopted in these patients. METHOD: a systematic review with meta-analysis. Protocol registered with PROSPERO (CRD42020202686). The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. The search was performed in the following data sources: SCOPUS, Web of Science, MEDLINE via PubMed, MEDLINE via EBSCO, MEDLINE via Biblioteca Virtual em Saúde, Embase, CINAHL, Cochrane Library, LILACS via Biblioteca Virtual em Saúde, Google Scholar, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses & Dissertações-Capes, Open Grey and ProQuest Dissertations and Theses. The risk of bias was assessed by the Cochrane Collaboration Risk of Bias Tool (RoB 2), the meta-analysis was performed in the Review Manager 5.4 software and the Certainty of evidence in the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS: of the 670 records, five articles were eligible. The meta-analysis was calculated for the prevention of the incidence of diabetic foot ulcers outcome, with effect summarization (RR 0.53; 95%CI 0.29-0.96; p=0.02), with certainty of moderate evidence. CONCLUSION: thermometry showed a protective effect on the incidence of diabetic foot ulcers when compared to standard foot care.
Assuntos
Diabetes Mellitus , Pé Diabético , Termometria , Pé Diabético/prevenção & controle , Humanos , IncidênciaRESUMO
The COVID-19 pandemic caused tremendous disruption of health systems worldwide. Patients with diabetes are at a high risk of COVID-19 exposure because face-to-face consultations have been standard for diabetes management. This study describes the development and validation of a mobile application for nursing students on diabetes education during the COVID-19 pandemic. The application was developed by a certified diabetes educator nurse and by a freelance programmer and, in the next step, validated in terms of content and appearance by a group of expert nurses on diabetes (n = 29), nursing students (n = 40), and information technology experts (n = 11). Validity indexes of 0.99 for content and 0.92 for appearance were obtained, and usability values of 78.9 (±15.3) and 78.2 (±10.8) were obtained from nursing and information technology experts, respectively. The self-assessment and satisfaction items evaluated by nursing students had a total agreement of 96.3% and an intraclass correlation coefficient of 0.91. Both the content and the appearance of the application were considered adequate, and the usability scores indicate that the application is useful and easy to use.
Assuntos
COVID-19 , Diabetes Mellitus , Educação em Enfermagem , Aplicativos Móveis , Estudantes de Enfermagem , COVID-19/prevenção & controle , Diabetes Mellitus/terapia , Educação em Saúde , Humanos , Pandemias/prevenção & controleRESUMO
Resumo Objetivo: analisar o efeito da termometria podálica cutânea em pessoas com diabetes mellitus, comparado com prevenção padrão de úlceras podálicas adotada nesses pacientes. Método: revisão sistemática com metanálise. Protocolo registrado na PROSPERO (CRD42020202686). Foram seguidas as recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Busca realizada nas fontes de dados: SCOPUS, Web of Science, MEDLINE via PubMed, MEDLINE via EBSCO, MEDLINE via Biblioteca Virtual em Saúde, Embase, CINAHL, Cochrane Library, LILACS via Biblioteca Virtual em Saúde, Google Scholar, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses & Dissertações-Capes, Open Grey e ProQuest Dissertations and Theses. O risco de viés foi avaliado pela Cochrane Collaboration Risk of Bias Tool (RoB 2), a metanálise no software Review Manager 5.4 e a Certeza da evidência no sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: dos 670 registros, cinco artigos eram elegíveis. A metanálise foi calculada para o desfecho prevenção da incidência de úlceras de pé diabético, com sumarização de efeito (RR 0,53; IC95% 0,29, 0,96; p=0,02), com certeza da evidência moderada. Conclusão: a termometria mostrou efeito protetor na incidência de úlceras de pé diabético, se comparada ao cuidado podálico padrão.
Abstract Objective: to analyze the effect of cutaneous foot thermometry in people with Diabetes Mellitus, compared with the standard prevention of foot ulcers adopted in these patients. Method: a systematic review with meta-analysis. Protocol registered with PROSPERO (CRD42020202686). The recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. The search was performed in the following data sources: SCOPUS, Web of Science, MEDLINE via PubMed, MEDLINE via EBSCO, MEDLINE via Biblioteca Virtual em Saúde, Embase, CINAHL, Cochrane Library, LILACS via Biblioteca Virtual em Saúde, Google Scholar, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses & Dissertações-Capes, Open Grey and ProQuest Dissertations and Theses. The risk of bias was assessed by the Cochrane Collaboration Risk of Bias Tool (RoB 2), the meta-analysis was performed in the Review Manager 5.4 software and the Certainty of evidence in the Grading of Recommendations Assessment, Development and Evaluation system. Results: of the 670 records, five articles were eligible. The meta-analysis was calculated for the prevention of the incidence of diabetic foot ulcers outcome, with effect summarization (RR 0.53; 95%CI 0.29-0.96; p=0.02), with certainty of moderate evidence. Conclusion: thermometry showed a protective effect on the incidence of diabetic foot ulcers when compared to standard foot care.
Resumen Objetivo: analizar el efecto de la termometría cutánea del pie en personas con diabetes mellitus, en comparación con la prevención estándar de las úlceras del pie adoptada en estos pacientes. Método: revisión sistemática con metaanálisis. Protocolo registrado en PROSPERO (CRD42020202686). Se siguieron las recomendaciones de Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). La búsqueda se realizó en las fuentes de datos: SCOPUS, Web of Science, MEDLINE a través de PubMed, MEDLINE a través de EBSCO, MEDLINE a través de la Biblioteca Virtual en Salud, Embase, CINAHL, Cochrane Library, LILACS a través de la Biblioteca Virtual en Salud, Google Scholar, Biblioteca Digital Brasileña de Tesis y Disertaciones, Catálogo de Tesis y Disertaciones-Capes, Open Grey y ProQuest Dissertations and Theses. El riesgo de sesgo se evaluó mediante la Cochrane Collaboration Risk of Bias Tool (RoB 2), el metaanálisis se realizó con el software Review Manager 5.4 y la certeza de la evidencia se evaluó mediante el sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: de los 670 registros, cinco artículos fueron elegibles. El metaanálisis se calculó para el resultado prevención de la incidencia de úlceras del pie diabético, con sumarización del efecto (RR 0,53; IC95% 0,29, 0,96; p=0,02), con certeza de evidencia moderada. Conclusión: la termometría mostró un efecto protector sobre la incidencia de úlceras del pie diabético en comparación con el cuidado estándar del pie.
Assuntos
Humanos , Pé Diabético/prevenção & controle , Diabetes Mellitus , Termometria/métodos , Úlcera do Pé/prevenção & controleRESUMO
OBJECTIVE: To map evidence on the use of digital technologies in the care of people with diabetes during the COVID-19 pandemic. METHOD: This is a scoping review, based on the JBI manual, which included scientific articles and gray literature from nine primary and seven secondary databases. Articles were independently assessed by two reviewers. Rayyan® was used to select the studies. The description of study characterization is presented in a table and tables, ending in a narrative synthesis. RESULTS: A total of 1,964 studies were identified and, after selection, 23 publications remained for analysis. It turned out that telemedicine was used in all studies and remote consultation support technologies included continuous glucose monitoring devices, glucose data analysis software, insulin delivery systems, applications, audio and/or voice communication devices, which facilitated remote diabetes mellitus monitoring and management. CONCLUSION: Telehealth, monitoring technologies, insulin delivery systems and communication devices were tools used to monitor patients with diabetes during the pandemic.
Assuntos
COVID-19 , Diabetes Mellitus , Telemedicina , Glicemia , Automonitorização da Glicemia , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Tecnologia Digital , Humanos , Pandemias , SARS-CoV-2RESUMO
Abstract Objective: To map evidence on the use of digital technologies in the care of people with diabetes during the COVID-19 pandemic. Method: This is a scoping review, based on the JBI manual, which included scientific articles and gray literature from nine primary and seven secondary databases. Articles were independently assessed by two reviewers. Rayyan® was used to select the studies. The description of study characterization is presented in a table and tables, ending in a narrative synthesis. Results: A total of 1,964 studies were identified and, after selection, 23 publications remained for analysis. It turned out that telemedicine was used in all studies and remote consultation support technologies included continuous glucose monitoring devices, glucose data analysis software, insulin delivery systems, applications, audio and/or voice communication devices, which facilitated remote diabetes mellitus monitoring and management. Conclusion: Telehealth, monitoring technologies, insulin delivery systems and communication devices were tools used to monitor patients with diabetes during the pandemic.
RESUMEN Objetivo: Mapear la evidencia sobre el uso de tecnologías digitales en la atención de personas con diabetes durante la pandemia de COVID-19. Método: Revisión del alcance, basada en el manual del JBI, que incluyó artículos científicos y literatura gris de nueve bases de datos primarias y siete secundarias. Los artículos fueron evaluados de forma independiente por dos revisores. Se utilizó Rayyan® para la selección de estudios. La descripción de la caracterización de los estudios se presenta en tabla y tablas, finalizando en una síntesis narrativa. Resultados: Se identificaron 1.964 estudios y, tras la selección, quedaron 23 publicaciones para análisis. Resultó que la telemedicina se utilizó en todos los estudios y las tecnologías de apoyo a la consulta remota incluyeron dispositivos de monitoreo continuo de glucosa, software de análisis de datos de glucosa, sistemas de administración de insulina, aplicaciones, dispositivos de comunicación de audio y/o voz, que facilitaron el control y el manejo remotos de la diabetes mellitus. Conclusión: La telesalud, las tecnologías de monitoreo, los sistemas de administración de insulina y los dispositivos de comunicación fueron herramientas utilizadas para monitorear a los pacientes con diabetes durante la pandemia.
RESUMO Objetivo: Mapear as evidências sobre a utilização de tecnologias digitais no cuidado a pessoas com diabetes durante a pandemia de COVID-19. Método: Revisão de escopo, fundamentada no manual do JBI, que incluiu artigos científicos e literatura cinza oriunda de nove bancos de dados primários e sete secundários. Os artigos foram avaliados de forma independente por dois revisores. Utilizou-se o Rayyan® para seleção dos estudos. A descrição da caracterização dos estudos se encontra apresentada em tabela e quadros, findando em síntese narrativa. Resultados: Identificaram-se 1.964 estudos e, após seleção, restaram 23 publicações para análise. Revelou-se que a telemedicina foi utilizada em todos os estudos e as tecnologias de apoio à consulta remotas incluíam dispositivos de monitoramento de glicose contínuo, software de análise de dados de glicose, sistemas de aplicação de insulina, aplicativos, aparelhos de comunicação áudio e/ou voz, que facilitaram o acompanhamento e o gerenciamento remoto do diabetes mellitus. Conclusão: Telessaúde, tecnologias de monitoramento, sistemas de aplicação de insulina e aparelhos de comunicação foram ferramentas utilizadas para o acompanhamento dos pacientes com diabetes durante a pandemia.
Assuntos
Tecnologia , Infecções por Coronavirus , Aplicativos Móveis , Tecnologia Educacional , Síndrome Respiratória Aguda Grave , Diabetes MellitusRESUMO
OBJECTIVE: To report the use of auriculotherapy to optimize emergency workers' health during the COVID-19 pandemic. METHODS: Experience report of auriculotherapy application in 48 workers of a mobile emergency care service center located in a city in the Northeast of Brazil. RESULTS: Six auriculotherapy sessions were held, each lasting eight minutes, based on specific protocols in the area and Chinese energy physiology. The aim of the practice was to contribute to the improvement of physical (pain) and emotional (anxiety, stress) symptoms, and the promotion of greater health and willingness to work. In addition, the experimentation of this practice was thought of as a pilot for the creation of a care service for workers. FINAL CONSIDERATIONS: In the report of auriculotherapy, the description of its application and its positive and negative points in relation to professionals working in the pandemic scenario were considered and its continuity was requested.
Assuntos
Acupuntura Auricular/métodos , Ansiedade/prevenção & controle , COVID-19/epidemiologia , Doenças Profissionais/prevenção & controle , SARS-CoV-2 , Estresse Psicológico/prevenção & controle , Acupuntura Auricular/instrumentação , Acupuntura Auricular/psicologia , Brasil/epidemiologia , COVID-19/psicologia , COVID-19/terapia , Serviços Médicos de Emergência , Pessoal de Saúde , Humanos , PandemiasRESUMO
Objetivo: Investigar a adesão ao tratamento medicamentoso e a qualidade de vida dos hipertensos atendidos na Estratégia Saúde da Família. Metodologia: Estudo descritivo e transversal, realizado com 105 hipertensos de uma Unidade Básica de Saúde, por meio de um formulário, composto por itens que avaliaram os dados socioeconômicos, adesão medicamentosa, adesão/vínculo, e qualidade de vida. A análise se deu por testes ANOVA-One e de Tukey. Adotou-se o nível de significância nas análises de 5% e intervalo de confiança de 95%. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa, Universidade Federal do Piauí, parecer nº 2.244.618. Resultados: Observou-se que 70,5% dos participantes eram do sexo feminino. Em relação à adesão medicamentosa 46,7% dos hipertensos apresentavam baixa adesão, quanto adesão e vínculo, 88,6% relataram adesão satisfatória. Acerca da qualidade de vida, observou-se maior comprometimento dos domínios psicológico e meio ambiente. Conclusão: O estudo contribui com a identificação de que a não adesão medicamentosa interfere diretamente na qualidade de vida dos hipertensos. Nesse contexto, os profissionais da saúde precisam estar qualificados, para tornar as medidas preventivas mais eficazes e rotineiras na atenção primária, com promoção da assistência de qualidade que estimule o autocuidado das pessoas com hipertensão quanto ao tratamento.
Objective: To investigate adherence to drug treatment and the quality of life of hypertensive patients treated in the Family Health Strategy. Methodology: It is a descriptive and cross-sectional study, carried out with 105 hypertensive patients from a Basic Health Unit, using a form, consisting of items that assessed socioeconomic data, medication adherence, adherence / bond, and quality of life. The analysis was performed by ANOVA-One and Tukey tests. The level of significance was adopted in the analyzes of 5% and 95% confidence interval. The research was approved by the Research Ethics Committee, Federal University of Piauí, opinion number 2,244,618. Results: It was observed that 70.5% of the participants were female. Regarding medication adherence, 46.7% of hypertensive patients had low adherence, in relation to adherence and bond, 88.6% reported satisfactory adherence. Regarding quality of life, there was a greater impairment in the psychological and environmental domains. Conclusion: The study contributes to the identification that non-adherence to medication directly interferes with the quality of life of hypertensive patients. In this context, health professionals need to be qualified to make preventive measures more effective and routine in primary care, with the promotion of quality care that encourages self-care for people with hypertension regarding treatment.