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All Journal Belitung Nursing Journal
Sousa, Álvaro Francisco Lopes de
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Nursing

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Health literacy on Mpox among Brazilian men who have sex with men: Findings from a national cross-sectional study Santos, Guilherme Reis de Santana; Ribeiro, Caíque Jordan Nunes; Cepas, Lariane Angel; Bulcão, Carolina da Silva; Nascimento, Rita de Cassia Dias; Sousa, Anderson Reis de; Fronteira, Inês; Mendes, Isabel Amélia Costa; Fernandes, Ana Paula Morais; Sousa, Álvaro Francisco Lopes de
Belitung Nursing Journal Vol. 11 No. 6 (2025): November - December
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3974

Abstract

Background: In 2022, Mpox presented significant challenges globally, particularly in Brazil, where cases surged among men who have sex with men (MSM). Health literacy (HL) is essential for promoting health within this group. Objective: To analyze the HL of MSM in the context of Mpox transmission in Brazil. Methods: This was a national cross-sectional study conducted in a virtual setting. An electronic survey was carried out from September to December 2022. A translated and adapted version of the Health Literacy Scale (HLS-14) and a questionnaire containing sociodemographic information, sexual behaviors, and knowledge and beliefs about Mpox were administered. The distribution of predictor variables across health literacy (HL) levels was explored descriptively. Associations between predictors and HL were analyzed using Pearson’s Chi-square test (p < 0.20 for inclusion in multivariate analysis). A generalized linear Poisson model with robust variance was used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals. Model fit was assessed with the omnibus test and information criteria (AIC, deviance, log-likelihood). Significance was set at p <0.05. Results: The final sample included 1,449 MSM, with an overall prevalence of 53.83% (n = 780) for satisfactory HL. In the bivariate analysis, 15 of the 27 variables met the statistical criterion (p <0.20) for inclusion in the multivariate model, with six retained in the final model. Reporting non-adherence to treatment if diagnosed with Mpox (aPR: 1.73; 95% CI: 1.44–2.07), a prior Mpox diagnosis (aPR: 1.17; 95% CI: 1.04–1.32), having a basic education level (aPR: 1.15; 95% CI: 1.02–1.31), using apps to seek sex (aPR: 1.15; 95% CI: 1.04–1.27), and seeking sex at parties and clubs (aPR: 1.14; 95% CI: 1.04–1.26) were independently associated with a higher prevalence of satisfactory HL. Conclusion: HL levels among MSM during the Mpox public health emergency in Brazil were low, shaped by individual, economic, and social factors. The findings can guide nursing practice regarding how MSM deal with information and make decisions in contexts of episodic health events, as well as the HL strategies to be implemented in nursing therapy.
Risk factors and outcomes of healthcare-associated infections in a Brazilian intensive care unit: A cross-sectional study Sousa Moura, Andressa Maria de; Sousa, Álvaro Francisco Lopes de; Carvalho, Herica Emilia Félix de; Madeira, Maria Zélia de Araújo; Freitas, Daniela Reis Joaquim de; Lima, Ana Carolina de Macedo; Carneiro, Liliane Moretti; Valim, Marilia Duarte; Junior, Aires Garcia dos Santos; Batista, Odinéa Maria Amorim
Belitung Nursing Journal Vol. 12 No. 2 (2026): March - April
Publisher : Belitung Raya Publisher - Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.4399

Abstract

Background: Healthcare-associated infections (HAIs) in intensive care units (ICUs) are frequent and are associated with sepsis, antimicrobial resistance, and high mortality, reinforcing the need for early risk stratification at admission. Objective: To analyze risk factors and clinical outcomes associated with HAIs in ICU patients. Methods: This cross-sectional study was conducted in the ICU of a public hospital with 141 patients (182 HAI cases). Medical records covered ICU admissions from August 1, 2022, to August 31, 2024, and data collection occurred from November 2024 to February 2025. Data were extracted from medical records and the Hospital Infection Control Committee database. Risk factors were assessed at admission using the Rodríguez-Almeida-Cañon (RAC) Scale, which stratifies HAI risk using intrinsic and extrinsic factors and classifies patients as low, moderate, or high risk. Clinical outcomes monitored during hospitalization included hospital discharge, sepsis, septic shock, and death. Results: By RAC, 53.9% were moderate risk and 45.4% high risk; lower educational level was associated with higher risk (p = 0.016). Ventilator-associated pneumonia predominated (44.4%). Predominant pathogens were Pseudomonas (28.1%), Acinetobacter (19.1%), and Klebsiella (17.4%), with 34.3% showing carbapenem resistance. Sepsis occurred in 18.5% and septic shock in 30.2%; mortality was 62.9%. Compared with the reference group, odds of discharge were higher among patients aged 20–39 years (OR = 12.48; 95% CI: 4.89–102.90; p = 0.002) and 40–59 years (OR = 4.33; 95% CI: 3.89–35.78; p = 0.019). Conclusion: RAC screening revealed a high burden of predisposing factors at ICU admission, particularly among patients with lower educational levels, which was associated with worse outcomes. RAC-guided admission screening can support risk-proportional nursing surveillance and targeted prevention bundles, while institutional policies should reinforce microbiological surveillance and antimicrobial stewardship tailored to social vulnerability.
Co-Authors Batista, Odinea Maria Amorim Bulcão, Carolina da Silva Carneiro, Liliane Moretti Carvalho, Herica Emilia Félix de Cepas, Lariane Angel Fernandes, Ana Paula Morais Freitas, Daniela Reis Joaquim de Fronteira, Inês Junior, Aires Garcia dos Santos Lima, Ana Carolina de Macedo Madeira, Maria Zélia de Araújo Mendes, Isabel Amélia Costa Nascimento, Rita de Cassia Dias Ribeiro, Caíque Jordan Nunes Santos, Guilherme Reis de Santana Sousa Moura, Andressa Maria de Sousa, Anderson Reis de Valim, Marília Duarte