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AIM: Investigate the incidence of the first diabetic foot ulcer. METHOD: This is a systematic review with meta-analysis of cohort studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and using RevMan software. A systematic search of Medline databases via PubMed, Embase, Lilacs, Scopus databases, and Web of Science was performed until July 2021. In addition to investigating the incidence of the first diabetic foot ulcer, the influence of the variables of the Human Development Index (HDI), glycated hemoglobin, and follow-up time of the participants on the incidence of the first diabetic foot ulcer (DFU) was analyzed through meta-regression. For the meta-analysis of cumulative incidence and possible variable associations, RevMan software was used in the Metaprop data package with 95% confidence interval (CI). RESULTS: A total of 9,772 articles were identified out of which 87 were selected and 12 studies ultimately included in the systematic review and meta-analysis. The meta-analysis of cumulative incidence was 5.65% (95% CI: 4.20; 7.57). By meta-regression, a significant inverse association was identified between DFU incidence and HDI (estimate - 2.38; 95% CI - 4.10--0.67; p = 0.01). CONCLUSION: The study presents the cumulative incidence for the first DFU, an inexistent datum in the national and international literature, and the HDI was inversely associated with the incidence of DFU.

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Objetivo: Avaliar a efetividade de um programa de educação de enfermagem em indivíduos com diabetes tipo 2, considerando a relação entre as atitudes psicológicas e as características sociodemográficas, assim como o controle glicêmico, atendidos pela Estratégia de Saúde da Família do município de Divinópolis, estado de Minas Gerais, Brasil. Material e Método: Ensaio clínico randomizado realizado com 278 pessoas com diabetes tipo 2 distribuídas em grupo intervenção e controle. As Equações de Estimação Generalizadas foram ajustadas para verificar se haveria mudanças das atitudes psicológicas ou hemoglobina glicada associadas às características sociodemográficas ou duração de diabetes. Resultados: Houve associação para atitudes psicológicas, educação e controle glicêmico. O grupo intervenção melhorou as atitudes psicológicas (p= 11,2; IC= 95%: 7,4-15,0). As pessoas que melhoraram as atitudes tiveram redução da hemoglobina glicada no grupo intervenção (7,9 ± 0,2 vs 7,4 ± 0,2; p< 0,001) e aumento no grupo controle. O grupo intervenção diminuiu a hemoglobina glicada ao final do programa (p= -0,9; IC= 95%: -1,4 -0,5). Conclusão: O grupo intervenção melhorou as atitudes psicológicas ao comparar com o grupo controle, exceto entre pessoas com menos de cinco anos de diagnóstico.

Objective: To evaluate the effectiveness of a nursing program in people with type 2 diabetes, considering the relationship between psychological attitudes and sociodemographic characteristics, as well as glycemic control in individuals with type 2 diabetes, assisted by the Family Health Strategy in the city of Divinópolis, State of Minas Gerais, Brazil. Material and Method: Randomized clinical trial carried out with 278 people with type 2 diabetes distributed in an intervention and a control group. The Generalized Estimating Equations were adjusted to control for changes in psychological attitudes or glycosylated hemoglobin associated with sociodemographic characteristics or duration of diabetes. Results: There was an association between psychological attitudes, education and glycemic control. The intervention group improved psychological attitudes (p = 11.21; CI = 95%: 7.4-15.0). People who improved attitudes had a reduction in glycosylated hemoglobin in the intervention group (7.9 ± 0.2 vs. 7.4 ± 0.2, p<0.001) and an increase in the control group. The intervention group decreased glycosylated hemoglobin at the end of the program (p = -0.9; 95% CI: -1.4; -0.5). Conclusion: The intervention group improved psychological attitudes when compared to the control group, except among people with less than five years of diagnosis.

Objetivo: Evaluar la efectividad de un programa de educación de enfermería en personas con diabetes tipo 2, considerando la relación entre las actitudes psicológicas y las características sociodemográficas y el control glicémico en individuos con diabetes tipo 2, atendidos en la Estrategia Salud de la Familia en la ciudad de Divinópolis, estado de Minas Gerais, Brasil. Material y Método: Ensayo clínico aleatorizado realizado con 278 personas con diabetes tipo 2 divididas en grupos de intervención y control. Las Ecuaciones de Estimación Generalizadas se ajustaron para comprobar si había cambios en las actitudes psicológicas o la hemoglobina glucosilada asociados con las características sociodemográficas o la duración de la diabetes. Resultados: Hubo una asociación para las actitudes psicológicas, la educación y el control glicémico. El grupo de intervención mejoró las actitudes psicológicas (p= 11,21; IC= 95%: 7,4-15,0). Las personas que mejoraron las actitudes tuvieron una reducción de la hemoglobina glucosilada en el grupo de intervención (7,9 ± 0,2 frente a 7,4 ± 0,2, p <0,001) y un aumento en el grupo de control. El grupo de intervención disminuyó la hemoglobina glucosilada al final del programa (p= -0,9; IC 95%: -1,4-0,5). Conclusión: El grupo de intervención mejoró las actitudes psicológicas en comparación con el grupo de control, excepto entre las personas con menos de cinco años de diagnóstico.

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BACKGROUND: Medical devices can cause pressure injuries. PURPOSE: This study was conducted to determine the prevalence of and factors associated with medical device-related pressure injury (MDRPI) in an intensive care unit (ICU). METHODS: A cross-sectional study was performed among adult patients (at least 18 years of age) admitted to an ICU in a referral hospital in Brazil between December 2019 and February 2020. The skin of patients who consented to participate was assessed for the presence of an MDRPI, and the use of all medical devices was noted. Other independent variables (sociodemographic variables, medical history, pressure injury risk factors, medications, and length of hospitalization) were abstracted from the medical records. Bivariate data analysis included Pearson's chi-square test or Fisher's exact test; odds ratio and a confidence interval of 95% also were established. Correlation among independent variables and MDRPI was determined using the ρ Spearman correlation test, and a hierarchical binary logistic regression analysis was performed using statistically significant variables from the bivariate analysis. P < .05 was considered statistically significant. RESULTS: The 125 study participants ranged in age from 15 to 97 years (mean, 63.02 ± 19.2), 76 (60.8%) were men, and 76 (60.8%) were White. Of the 125 participants, 43 (34%) experienced MDRPI; the total number of MDRPIs was 58 (3 patients had 3 injuries, and 7 patients had 2 injuries). Of those 58 MDRPIs, 46 were stage 1, and 12 were stage 2. Polypharmacy (> 4 medications) was a significant risk factor for MDRPI. Use of a nasal catheter, cord for orotracheal tube fixation, oximeter, intra-abdominal pressure equipment, and indwelling urinary catheter was significantly associated with the presence of MDRPI. Renal and respiratory diseases and the presence of infection were positively related to the presence of MDRPI. CONCLUSION: Medical device-related pressure injury was prevalent in this patient population. Most of these injuries were stage 1, which suggests that frequent monitoring and device repositioning (when possible) may help prevent more serious injuries. Additional research involving other hospitals in Brazil is needed to increase the understanding of the prevalence and risk factors of MDRPIs in patients in the ICU.

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RESUMO Objetivo Avaliar a adesão ao tratamento medicamentoso e não-medicamentoso de usuários de um serviço de atenção primária diagnosticados com hipertensão arterial sistémica antes e após a implementação da consulta de enfermagem sistematizada. Métodos Ensaio clínico não-controlado realizado em uma Estratégia Saúde da Família de Minas Gerais, onde 14 participantes foram acompanhados por meio da assistência sistematizada de enfermagem entre os meses de outubro de 2016 e setembro de 2017. Resultados Verificou-se uma diferença estatisticamente significativa na adesão ao tratamento da hipertensão arterial sistêmica após as intervenções de enfermagem (p=0,102), que foram realizadas individualmente e coletivamente. "Disposição para controle aumentada do regime terapêutico" e "Estilo de vida sedentário" foram os Diagnósticos de Enfermagem mais prevalentes. Conclusão A assistência sistematizada de enfermagem pode beneficiar pessoas diagnosticadas com hipertensão arterial sistêmica na atenção primária em saúde. Faz-se necessário o fortalecimento da utilização do processo de enfermagem e da identidade do enfermeiro no cuidado das condições crónicas.(AU)

ABSTRACT Objective To assess adherence to both drug and non-drug therapy by users of primary care services diagnosed with systemic arterial hypertension before and after the implementation of systematic nursing appointments. Material and Methods Open clinical trial held in a Family Health Strategy center of the state of Minas Gerais, in which 14 participants were followed up through systematic nursing care from October 2016 to September 2017. Results Data showed a statistically significant difference in adherence to systemic arterial hypertension therapy after conducting nursing interventions (p=0,102), both individually and in group. The most prevalent nursing diagnoses were "Readiness for enhanced health literacy" and "Sedentary lifestyle". Conclusion Systematic nursing care may benefit people diagnosed with systemic arterial hypertension treated by primary care services. It is necessary to consolidate the use of nursing processes as well as the nurse identity in the context of chronic care.(AU)

RESUMEN Objetivo Evaluar el cumplimiento de la medicación y el tratamiento no farmacológico de los usuarios de un servicio de atención primaria diagnosticado con hipertensión arterial sistémica antes y después de la implementación de la consulta de enfermería sistematizada. Métodos Ensayo clínico no controlado realizado en una Estrategia de salud familiar de Minas Gerais, donde 14 participantes fueron seguidos a través de cuidados sistemáticos de enfermería entre los meses de octubre de 2016 y septiembre de 2017. Resultados Hubo una diferencia estadísticamente significativa en el cumplimiento del tratamiento de la hipertensión arterial sistémica después de las intervenciones de enfermería (p=0,102), que se realizaron individual y colectivamente. La "disposición para un mayor control del régimen terapéutico" y el "estilo de vida sedentario" fueron los diagnósticos de enfermería más frecuentes. Conclusión La atención de enfermería sistematizada puede beneficiar a las personas diagnosticadas con hipertensión arterial sistémica en la atención primaria de salud. Es necesario fortalecer el uso del proceso de enfermería y la identidad de la enfermera en el cuidado de afecciones crónicas.(AU)

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OBJECTIVE: To assess adherence to both drug and non-drug therapy by users of primary care services diagnosed with systemic arterial hypertension before and after the implementation of systematic nursing appointments. MATERIAL AND METHODS: Open clinical trial held in a Family Health Strategy center of the state of Minas Gerais, in which 14 participants were followed up through systematic nursing care from October 2016 to September 2017. RESULTS: Data showed a statistically significant difference in adherence to systemic arterial hypertension therapy after conducting nursing interventions (p=0,102), both individually and in group. The most prevalent nursing diagnoses were "Readiness for enhanced health literacy" and "Sedentary lifestyle". CONCLUSION: Systematic nursing care may benefit people diagnosed with systemic arterial hypertension treated by primary care services. It is necessary to consolidate the use of nursing processes as well as the nurse identity in the context of chronic care.

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