Introduction: Oral feeding in hospitalized older people is often compromised by environmental, care, and dietary choice factors, which are still overlooked in clinical practice. Recognizing these determinants is essential for supporting effective interventions. The nursing team is responsible for assessing food acceptance, assisting during meals, and communicating the identified needs and difficulties to the nutrition team. Objective: To identify environmental, care, and dietary choice factors that hinder oral feeding in hospitalized older people. Materials and Methods: An integrative literature review was conducted in compliance with the adapted PRISMA guidelines. Searches were performed during June 2024 in the MEDLINE, Virtual Health Library, Embase, CINAHL, Web of Science, and Scopus databases. Observational and intervention studies with hospitalized older people (≥ 60 years) were included, with no restrictions on language or date; case reports, letters, abstracts, theses, dissertations, monographs, and reviews were excluded. The studies were classified according to the hierarchical level of evidence established by the Oxford Centre for Evidence-Based Medicine. Results: A total of 640 studies were found, of which 32 were included in the final sample. The main factors that compromised nutrition were the lack of a dining room, reduced privacy, interruptions during meals, insufficient professional assistance, and inadequate meal schedules or food options, all of which are factors associated with lower caloric intake and an increased risk of malnutrition. Conclusion: The environmental, care, and dietary factors that interfere with oral feeding among hospitalized older people are multifactorial. Notable factors included inadequate infrastructure and inappropriate meal schedules, as well as a shortage of personnel to assist with feeding. These conditions compromise food intake, increasing the risk of food and nutritional insecurity in this population.
Introduction: Adolescence is characterized by intense biopsychosocial changes, in which the balance between a sense of belonging and autonomy is essential. Parenting practices, which range from overprotection to neglect, can directly influence adolescents’ mental health and emotional development. Objective: To understand the perspectives of nurses on adolescent parenting. Materials and Methods: This is a descriptive cross-sectional study with a qualitative approach, grounded in Jean Watson’s Transpersonal Human Care Theory, conducted in two municipalities in southern Minas Gerais, Brazil. Twenty-six primary care nurses participated in the study. Data were collected through on-site focus groups, including a pilot test, with a mean duration of 60 to 90 minutes. The transcripts were analyzed using Bardin’s content analysis method, with data categorization and interpretation in light of the Theory of Transpersonal Human Care. Discussion: Nurses identified adolescents who were often unprepared to face daily challenges, in contexts of inadequate or absent parental care. An analysis based on Watson’s Theory highlighted the importance of empathetic care, active listening, and the establishment of emotional bonds, which are essential for strengthening parenting and reducing emotional vulnerabilities. Conclusions: The study underscores that understanding the nursing perspective on adolescent parenting contributes to humanized practices, holistic health promotion, autonomy, and healthy family bonds.
Introduction: Ischemic stroke is a medical emergency that requires treatment to be initiated within the first 4.5 hours, which is the therapeutic window for alteplase to minimize the onset of severe and irreversible sequelae. Although studies on its management exist, gaps remain in the systematic analysis of the factors that explain delays in treatment. Thus, this review stands out by comprehensively mapping the barriers that compromise timely thrombolysis. Objective: To verify, based on the literature, the factors associated with delays in thrombolytic therapy for ischemic stroke. Materials and Methods: This is a qualitative, exploratory study, of the scoping review type, conducted in the Web of Science, Scopus, MEDLINE, Embase, and PubMed databases in 2025. The search and screening were conducted by two reviewers in a double-blind process using Rayyan.ai software. The process followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: Extension for Scoping Reviews, resulting in the inclusion of 30 articles. Results: Obstacles were identified and categorized as socioeconomic conditions, geographic factors, lack of knowledge, cultural habits, health care logistics, variations in the disease’s presentation, and medical history; collectively, these factors constitute barriers that hinder timely treatment and contribute to the morbidity and mortality associated with the disease. Conclusion: The findings highlight the importance of integrated strategies for public health education, professional training, and strengthening the logistics and infrastructure of health services. Identifying and addressing these gaps helps promote public policies that reduce morbidity and mortality and improve the population’s quality of life.
Introduction: Digital technologies, including mobile applications, serve an important role in the management of heart failure. However, their use to promote knowledge about the disease is limited. Objective: To evaluate the knowledge of people with heart failure about the disease before and after a pedagogical intervention mediated by the mobile application “Tum-Tum”. Materials and Methods: A one-group, quasi-experimental, before-and-after type study, conducted with 57 participants in outpatient follow-up in a public hospital in North-East Brazil, between November 2023 and January 2024, with an eight-week follow-up. Knowledge was evaluated through a questionnaire comprised of 14 items. The Wilcoxon test was used to compare the general knowledge before and after the intervention, and the McNemar test was used to compare the correct answers of each item. The adopted significance level was 0.05. Results: The average knowledge at the beginning of the intervention was 8.0 points, and after 60 days, it elevated to 10.0 points. The proportions of correct answers to the items related to the definition of the disease, the tracking of weight gain, the recognition of medicine’s adverse effects, the identification of failure, the indications for diuretic use, and the reduction of alcohol and sodium-rich foods significantly augmented after follow-up. Conclusion: The use of the application proved to be an effective strategy to increase knowledge about heart failure. Randomized controlled studies are recommended to evaluate the effect of the intervention and the impact of the knowledge acquired through the application on the necessary behaviors to maintain the clinical stability of the disease.
Introduction: Self-efficacy is a psychological construct developed by Bandura that is widely used in the health sciences; it refers to an individual’s belief in their ability to organize and perform the actions necessary to cope with future situations. In contrast, although inadequate self-efficacy is often described as a limited individual perception, it remains relatively undefined in the literature. Objective: To conduct a conceptual analysis of the term ‘inadequate health self-efficacy, focusing on its applicability in the nursing context. Materials and Methods: This is a conceptual analysis based on the eight steps proposed by Walker and Avant, complemented by an integrative literature review, following the guidelines of the PRISMA checklist. The search was conducted during June 2025 in the SciELO, PubMed, and EBSCO databases, using the keyword ‘inadequate health self-efficacy,’ with no language restrictions and a time frame limited to the last five years. Eligibility criteria included original articles, theoretical or methodological studies, and reviews that directly or indirectly addressed the concept of inadequate health self-efficacy, available in full. Results: Inadequate health self-efficacy is an individual’s limited belief in their ability to take the necessary actions to achieve therapeutic goals and maintain self-care behaviors, resulting in emotional, functional, and clinical impairments. Furthermore, precedents (chronic condition, lack of knowledge, and lack of social support) and consequents (poor treatment adherence, clinical deterioration, and psychoemotional distress) were identified. Conclusion: This conceptual evolution will contribute significantly to evidence-based nursing practices informed by clinical judgment, which will strengthen approaches aimed at promoting patient self-care and autonomy.
