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      Work environment of hospital nurses during the COVID‐19 pandemic in Brazil

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          Abstract

          Aim

          To investigate the nurses' work environment in university hospitals during the COVID‐19 pandemic in Brazil.

          Background

          The COVID‐19 pandemic brought challenging times for nurses worldwide. In Brazil, as well as in several countries, nurses are working hard in hospital settings caring for patients infected with the virus, sometimes with unfavourable work environment conditions.

          Methods

          This study was a convergent embedded mixed methods research. The sample comprised 104 nurses from three Brazilian university hospitals. Data were collected in April–June 2020 from an online questionnaire with a self‐reporting Likert scale survey designed to measure the nurses' perceptions of their work environment. Qualitative data in the form of written comments were also collected through an open question. Data were analysed using descriptive statistics and content analysis.

          Results

          The quantitative results showed that the responses to ‘I received training on the correct use of personal protective equipment’ and ‘I am afraid of being infected’ items had the best and worst evaluations, respectively. The qualitative findings revealed five themes: feeling of insecurity, lack of personal protective equipment, lack of diagnostic tests, changes in the care flow and fear of the unknown.

          Conclusion

          The study has highlighted the challenges faced by hospital nurses while caring for patients with COVID‐19.

          Implications for Nursing and Nursing Policy

          The gaps identified will assist the policymakers and hospital managers in developing policies to enhance the support offered to nurses and improve the care provided to patients with COVID‐19 in university hospitals. The results also indicate the need for attention to the mental health of the professionals due to the increasing workload and treatment of an illness hitherto unknown.

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          Most cited references41

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          Is Open Access

          A new coronavirus associated with human respiratory disease in China

          Emerging infectious diseases, such as severe acute respiratory syndrome (SARS) and Zika virus disease, present a major threat to public health 1–3 . Despite intense research efforts, how, when and where new diseases appear are still a source of considerable uncertainty. A severe respiratory disease was recently reported in Wuhan, Hubei province, China. As of 25 January 2020, at least 1,975 cases had been reported since the first patient was hospitalized on 12 December 2019. Epidemiological investigations have suggested that the outbreak was associated with a seafood market in Wuhan. Here we study a single patient who was a worker at the market and who was admitted to the Central Hospital of Wuhan on 26 December 2019 while experiencing a severe respiratory syndrome that included fever, dizziness and a cough. Metagenomic RNA sequencing 4 of a sample of bronchoalveolar lavage fluid from the patient identified a new RNA virus strain from the family Coronaviridae, which is designated here ‘WH-Human 1’ coronavirus (and has also been referred to as ‘2019-nCoV’). Phylogenetic analysis of the complete viral genome (29,903 nucleotides) revealed that the virus was most closely related (89.1% nucleotide similarity) to a group of SARS-like coronaviruses (genus Betacoronavirus, subgenus Sarbecovirus) that had previously been found in bats in China 5 . This outbreak highlights the ongoing ability of viral spill-over from animals to cause severe disease in humans.
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            Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness.

            Qualitative content analysis as described in published literature shows conflicting opinions and unsolved issues regarding meaning and use of concepts, procedures and interpretation. This paper provides an overview of important concepts (manifest and latent content, unit of analysis, meaning unit, condensation, abstraction, content area, code, category and theme) related to qualitative content analysis; illustrates the use of concepts related to the research procedure; and proposes measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure. Interpretation in qualitative content analysis is discussed in light of Watzlawick et al.'s [Pragmatics of Human Communication. A Study of Interactional Patterns, Pathologies and Paradoxes. W.W. Norton & Company, New York, London] theory of communication.
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              • Article: not found

              Diagnostic Testing for Severe Acute Respiratory Syndrome–Related Coronavirus-2

              Diagnostic testing to identify persons infected with severe acute respiratory syndrome–related coronavirus-2 (SARS–CoV-2) infection is central to control the global pandemic of COVID-19 that began in late 2019. In a few countries, the use of diagnostic testing on a massive scale has been a cornerstone of successful containment strategies. In contrast, the United States, hampered by limited testing capacity, has prioritized testing for specific groups of persons. Real-time reverse transcriptase polymerase chain reaction–based assays performed in a laboratory on respiratory specimens are the reference standard for COVID-19 diagnostics. However, point-of-care technologies and serologic immunoassays are rapidly emerging. Although excellent tools exist for the diagnosis of symptomatic patients in well-equipped laboratories, important gaps remain in screening asymptomatic persons in the incubation phase, as well as in the accurate determination of live viral shedding during convalescence to inform decisions to end isolation. Many affluent countries have encountered challenges in test delivery and specimen collection that have inhibited rapid increases in testing capacity. These challenges may be even greater in low-resource settings. Urgent clinical and public health needs currently drive an unprecedented global effort to increase testing capacity for SARS–CoV-2 infection. Here, the authors review the current array of tests for SARS–CoV-2, highlight gaps in current diagnostic capacity, and propose potential solutions.
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                Author and article information

                Contributors
                Role: Assistant Professorsantosjlg29@gmail.com
                Role: Assistant Professor
                Role: Assistant Professor
                Role: PhD Student
                Role: Chief Nursing
                Role: Assistant Professor
                Role: MSc Student
                Role: Professor
                Role: Associate Professor
                Journal
                Int Nurs Rev
                Int Nurs Rev
                10.1111/(ISSN)1466-7657
                INR
                International Nursing Review
                John Wiley and Sons Inc. (Hoboken )
                0020-8132
                1466-7657
                15 February 2021
                : 10.1111/inr.12662
                Affiliations
                [ 1 ] Nursing Department Federal University of Santa Catarina Florianopolis Brazil
                [ 2 ] Nursing Graduate Program Federal University of Santa Catarina Florianopolis Brazil
                [ 3 ] Paulista School of Nursing Federal University of São Paulo São Paulo Brazil
                [ 4 ] Nursing Department Federal University of Santa Maria Santa Maria Brazil
                [ 5 ] Nursing Graduate Program Federal University of Santa Maria Santa Maria Brazil
                [ 6 ] São Paulo Hospital Federal University of São Paulo São Paulo Brazil
                Author notes
                [*] [* ] Correspondence address: José Luís Guedes dos Santos R. Eng. Agronômico Andrei Cristian Ferreira, s/n ‐ Trindade, Florianópolis ‐ SC 88040‐900, Brazil. E‐mail: santosjlg29@ 123456gmail.com

                Author information
                https://orcid.org/0000-0003-3186-8286
                https://orcid.org/0000-0003-3757-1061
                https://orcid.org/0000-0002-8589-2524
                https://orcid.org/0000-0002-8840-4653
                https://orcid.org/0000-0002-3718-8241
                https://orcid.org/0000-0003-1788-866X
                https://orcid.org/0000-0003-3454-3698
                https://orcid.org/0000-0003-4845-8515
                https://orcid.org/0000-0001-9342-3683
                Article
                INR12662
                10.1111/inr.12662
                8014554
                33586794
                3068bdcb-08cf-4446-bc7f-483eb8e501d4
                © 2021 International Council of Nurses

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                History
                : 10 December 2020
                : 18 August 2020
                : 31 December 2020
                Page count
                Figures: 1, Tables: 2, Pages: 10, Words: 13048
                Funding
                Funded by: Conselho Nacional de Desenvolvimento Científico e Tecnológico , open-funder-registry 10.13039/501100003593;
                Award ID: 402392/2020‐5
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.1 mode:remove_FC converted:01.04.2021

                Nursing
                coronavirus infections,hospitals,university,nurse's role,organization and administration,pandemics,work environment

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