Introdução: Apesar dos avanços nas técnicas cirúrgicas de confecção e nos cuidados às pessoas com estomas, as dermatites periestomais de estomas intestinais são frequentes. Nesse contexto, a enfermagem assume papel fundamental para a prevenção dessas complicações. Objetivo: Realizar uma revisão sistemática para identificar intervenções de enfermagem utilizadas como medidas de prevenção de dermatite periestomal em estomias intestinais. Método: Realizou-se uma revisão sistemática nas bases de dados Scopus, PubMed (MEDLINE), Cochrane Library, Web of Science e CINAHL. Foram selecionados ensaios controlados randomizados que investigassem a eficácia das intervenções de enfermagem na prevenção de dermatite periestomal, publicados nos idiomas inglês, português e espanhol, até dezembro de 2020. Resultados: Inicialmente, 2.976 estudos foram identificados, no entanto apenas três desses foram incluídos na amostra final, os quais foram publicados entre 2011 e 2017. As ações de prevenção encontradas nos ensaios clínicos versaram sobre medidas educativas, uso de barreira cutânea moldável e padronização da técnica de limpeza e uso de pó de hidrocoloide como prevenção. Conclusão: As evidências sobre as intervenções de enfermagem no cuidado preventivo de lesões periestomais ainda são escassas e com riscos de viés consideráveis. Dessa maneira, encoraja-se a comunidade científica a realizar estudos primários de alto rigor metodológico, a fim de subsidiar a prática da estomaterapia e promover uma assistência de qualidade e baseada nas melhores evidências científicas.
Objective: to carry out an integrative review about the augmentative and alternative communication strategies used with adults and the elderly in the hospital environment and their impact on communication. Methods: this research study used the integrative review methodology with descriptors in English and Portuguese: 'communication', 'hospitals', 'communication aids for the disabled', in the following databases: LILACS, PubMed, Cinahl, Cochrane Library, SciELO, Scopus, Web of Science. Several articles in English and Portuguese, from the last 14 years, which addressed alternative communication strategies used with hospitalized adults and the elderly, were included. Studies on children, as well as duplicates, reviews, and those that addressed other methods of communication were excluded. Results: 13 articles characterized the alternative communication strategies used with adults and the elderly. There was a prevalence of intubated or tracheostomized patients, and health professionals, nurses being the ones with the highest citation, and researches on a qualitative approach. Six studies have used high and low technologies; however, most have shown a greater use of low-tech tools. Conclusion: a variety of high and low-tech strategies were identified, a reduction in communication difficulties being noted, as well as improvements in the quality of life and communication with professionals. The most used tool was the communication board, due to its hospitals' availability and its simple use. The evaluation and the effectiveness of communication tools in distinct clinical settings and profiles should be studied.
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