Cuidar da Saúde em um Clima em Transformação

Camila Takao Lopes (00:02.702)

Bienvenidos y bienvenidas al Nanda CAST. Soy la doctora Camila Tacaulopes, directora del Comité de Desarrollo Diagnóstico de Nanda Internacional y profesora de la Escuela Paulista de Enfermería de la Universidad Federal de São Paulo, Brasil. Es una alegria tenerlos con nosotros hoy. Hoy les presento a la doctora Rafaela Moreira. La doctora Rafaela es doctora en enfermería.

with postdoctoral at the University of Laguna, where researched climate and human She professor at the Institute of Health at the University of International of the Afro-Brazilian UNILAB, in Redenção, Ceará, here Brazil. She coordinates the postgraduate in the infirmary of her university.

is a of the Brazilian in process of Brazilian Nursing, member of Nanda International and presides over the task on climate change of Nanda International. Dr. Rafaela, it's pleasure to have you on this episode of Nanda Caste. Thank you for accepting our invitation to talk with us today.

Rafaella Pessoa Moreira (01:19.416)

Muchas gracias.

Camila Takao Lopes (01:21.888)

To comment, I would like you tell us how the interest of your group for the issue of climate and what motivated you to explore the relationship between this topic and the diagnosis of disease.

Rafaella Pessoa Moreira (01:37.678)

As professors and nurses of the research IJU, Unilab, we work with infirmary diagnoses, results and interventions of the infirmary, in the care of people with chronic In last six years, we work on the diseases sensitive to climate and its impact on human

from the alliances established with researchers from different areas and from various institutions of education and national and international We have research a interdisciplinary of researchers, engineers, hydrologists, climatologists, economists, among others. As a nurse, I always believe that

Rafaella Pessoa Moreira (02:38.05)

Oh, let's cut it.

Camila Takao Lopes (02:45.998)

John, you want to over, Rafa?

Rafaella Pessoa Moreira (02:47.342)

Como enfermeiras. It's because the story of Dja or Djeba, it's Ljeba, it's Djeba. Como enfermeiras, starts again with Como enfermeiras.

As nurses, there was always the need to take the results of these studies to infirmary. We started to approve projects...again, projects...

Camila Takao Lopes (03:18.382)

Do want to eating first? Okay. No problem, Rafa. Don't worry.

Rafaella Pessoa Moreira (03:19.15)

I'm starting again as a nurse. It's projectus, Because it's Y. Because it's Y, right? So it's projectus.

Camila Takao Lopes (03:27.77)

Oh, I think I'm everything wrong, I say projects. I invent.

Rafaella Pessoa Moreira (03:30.67)

Again, as nurse. As a nurse, I felt the need to... Oh, no. Again.

Camila Takao Lopes (03:45.846)

Não tem problema!

Rafaella Pessoa Moreira (03:46.991)

Yes, as a nurse, was always the need to take the results of these studies to the infirmary. We started to approve research projects with funding in the infirmary and interdisciplinary and publish scientific in high impact

As I before, nurses of the group have worked with the nursing process and the diagnosis of the nursing of Nandaí in the investigations and in the teaching. So, the idea of sending a letter to the editor for the Journal of Nurse Knowledge In the letter, we the need to update the classification of the nursing

considering climate change. A few days after the publication of the letter to the editor, Dr. Reda launched a call at the Nanda International inviting participants to compose a group of work on climate change in Nandaí. We expressed interest in participating.

I am the president of the work that has other members. The full of the work can be found on the Nenda International

Camila Takao Lopes (05:20.857)

Thank you, Dr. Rafaella. I to thank you for the work you have in this task which really started with this provocation, with this letter that was published on the need for Nanda to a review of her diagnoses regarding the content related to climate

We that your group has developed very relevant that shows how climate impacts health. And you have presented some results, even in our conference now in June 2025, which had many positive It is a great production. So you have produced results, for example, on the incidence of dengue in semi-arid

los efectos del calor en las hospitalizaciones cardiovasculares, y también cómo el acceso al agua puede reducir las enfermedades diarroicas. ¿Podría compartirnos sus principales resultados de estas investigaciones y qué significado tienen para la práctica de enfermería?

Rafaella Pessoa Moreira (06:39.886)

Yes, course, our group has been to understanding how climate change is already impacting the health of the populations. Our findings have direct for health and nursing. I will highlight three great results we found. About DEMB.

We the relationship between climate and dengue in semi-arid and also made projections for large urban What we is alarming. Historically, dengue has no seasonality. The mosquito needs ideal temperatures and humidity to hatch.

usually more present during or immediately after the Jubosa which occurs in the first months of the year in the state of Ceará, Brazil, for example. However, our projections using climate models indicate that, with climate we will have a substantial in dengue in the months that are currently low incidence. This changes everything for the nurse

in primary and also in emergencies. The surveillance of symptoms, the triage of suspicious cases and especially the actions of community will need to be maintained according to the reality of each region.

In of and cardiovascular we conducted a broad of how the climate in arid affects people with cardiovascular and diabetes We that the heat and high temperatures with risk factors are critical to causing cardiovascular diseases, mainly acute myocardial and vascular

Rafaella Pessoa Moreira (08:50.574)

And the most affected are vulnerable such as elderly and people with preexisting overloads the cardiovascular I am professional who monitors this patient. In the consultation, for example, in the home visit or in hospital, need to actively the environmental

This means educating patients on hydration, how to prevent exposure to and, most importantly, recognize the first signs of thermal On drought and diarrhea, we have a study that brings a lesson of hope. We analyzed a historical of 11 years in the northeast of Brazil.

The logic would be extreme critical levels many eutrophic, therefore, more diaretic But what we found was the opposite. There was a significant in hospitalizations by diarrhea, almost 5 % per year. Why did this Because of health and water

that were implemented coincidentally in the same period. For example, an increase in the health of the family, community health and distribution of more than a million nurses implemented by the government. For the nursing sector, reinforces our role not only in care, but as defenders of public health

sanitation and access to safe It shows that the negative of the climate are not inevitable if we In addition to these lessons, one of the lessons we learned was to understand that in the case of climate change, the analysis of time series is important to understand the behavior of the disease in each region

Rafaella Pessoa Moreira (11:12.974)

and what climate factors influence more, identifying groups of greater vulnerability and verifying the need for prevention in health. With the results of our research, we have, for example, how a nurse can perform interventions in the health various diseases sensitive to climate.

Camila Takao Lopes (11:43.375)

Gracias por su respuesta, profesora Rafaela. Y cómo relaciona estas evidencias con la perspectiva de los diagnósticos de enfermería, especialmente en el cuidado a poblaciones más vulnerables. Rafa, voy a hacer de nuevo eso.

Gracias, profesora Rafaela, por su respuesta. ¿Cómo relaciona estas evidencias con la perspectiva de los diagnósticos de enfermería, especialmente en el cuidado a poblaciones más vulnerables?

Rafaella Pessoa Moreira (12:17.006)

This is exactly the central of our work group. I this evidence into the language of diagnosis of The diagnosis of the disease names the response to a problem. And our research shows how the climate is creating or intensifying these responses, especially the most vulnerable. For example,

An old man exposed to heat waves can have the diagnosis of an inefficient thermoregulation The fact related to the is the environmental exposure to heat, which changes our care With the dengue occurring all year round, diagnosis of disease, the of infection, example, ceases to be seasonal and becomes continuous.

and reducing permanent Vulnerability to droughts or floods generates diagnosis of disease as anxiety or anguish, and we are evaluating the emerging human responses to climate By integrating climate with the diagnosis of Nandaí, give the nurse the tool to name this problem.

And when we we can plan interventions and defend public policies to prevent and mitigate the impacts of climate change. You know, let's just stop there if it's good, if I'm saying lot of and I'll back and repeat. It's giving to understand.

Camila Takao Lopes (14:05.818)

I think you're getting it.

Rafaella Pessoa Moreira (14:07.566)

Because one word or another, after I read it, I I it wrong, I say, no, but let's with the naturalness, let's go, because otherwise will not stop.

Camila Takao Lopes (14:15.194)

What can I do after, Rafa? Let me see this question. How do relate and respond? What I can do is ask either Hortência or Miriam, who are native, for them to first, so they can see if we are talking the way we can understand.

Rafaella Pessoa Moreira (14:26.584)

Yes. Done.

Rafaella Pessoa Moreira (14:34.302)

If I that I can understand, well...

Camila Takao Lopes (14:38.106)

Okay. We can go to next

Rafaella Pessoa Moreira (14:41.347)

thing.

Camila Takao Lopes (14:44.218)

¿Podría contarnos cómo está haciendo el proceso de incorporar estos resultados a los diagnósticos de enfermería de Nanda?

Rafaella Pessoa Moreira (14:53.098)

Yes, course, studies already carried out allowed to this relationship between the impacts of climate change and environmental factors with some of the diagnosis of Nandai classification For example, the influence of exposure to high temperatures and air pollution was

in the increase of diagnosis of disease, risk of deterioration of the cardiovascular function. However, this relationship is clear in the current edition of Nandaí. Like this example, other phenomena do have this relationship either. So the researchers proposed suggestions for the inclusion of related factors

defining or risk so that the diagnosis of the disease contemplates this influence of change. It noted that this is initial effort and that must be deepened and better developed by all nurses in a theoretical and practical of their professional

Camila Takao Lopes (16:20.25)

and Professor Rafaela, in your opinion, why is important that our classification incorporates diagnostics related to climate change? What benefits can this to patients, to professionals in the field of and also to development of our discipline?

Rafaella Pessoa Moreira (16:41.998)

Professor Camila, long ago, the issues related to climate change were studied mainly by engineering and meteorology However, considering the current scenario, is clear that these changes have affected the health of populations this way, is necessary that nurses manage to plan and offer

Caring for people with this scenario. Practically, by including diagnosis of disease related to climate change, the nurse can, for example, identify early the risks and implement prevention for vulnerable such children, elderly, people with chronic recognize seasonal of disease,

act in health and management, as well as promoting sustainable because the nurse is also an Another benefit that nurses recognize the interface between environment, climate and human is the possibility of formulating medium-range

which will contribute to enrichment of science and the scope of the nurse's We the importance of the nurse as a leader in the impacts of climate change on the health of the populations and with the knowledge of structured theories and the classification of nursing

will help in the continuous of nurses and in professional in nursing. The nurse with a broad and attentive of the risk and vulnerability conditions, environmental and climatic, will be to plan and execute a safer and more direct

Camila Takao Lopes (18:52.396)

Thank you, Professor Rafaela. I imagine that this journey has not been easy. And on this journey, what have been the main challenges, whether conceptual, methodological or practical, when trying to such new and complex as climate change in the diagnosis of infirmary?

Rafaella Pessoa Moreira (18:52.952)

you

Rafaella Pessoa Moreira (19:14.474)

Yes, it is easy. To fully these relations between climate and health, is necessary to specific and methodologies of different areas of knowledge, as hydrology, transport, health, among others, which represents a challenge. However, the proposal of an interdisciplinary work, used in the research group,

allows us to these challenges. This alliance allows us understand the interlocution between these different concepts with the clinical of diseases sensitive to climate and with the determinants of health, which indicates that to mitigate this problem, all areas must be involved in this purpose. In addition, the biggest challenge is to consider land.

It's the macho. Let's stop, too

In biggest challenge is to raise awareness among nurses about their actions in of climate change, as there is a difficulty in understanding that the infirmary has an active to mitigate or mitigate the effects of global climate crises on the health of the population.

Camila Takao Lopes (20:44.474)

And to close, Professor Rafaela, what message would like leave to students, clinical teachers and managers on the importance of integrating the issue of climate change into use of of disease?

Rafaella Pessoa Moreira (21:02.446)

Very well. To finish, I like to start by little about the fact that climate change is a current and global We are all impacted by the effects of climate change and, consequently, health. We need to adapt ourselves and introduce the theme in various ways in our daily

So, the question, clinical need to knowledge about the topic and introduce interventions in their daily to prevent or minimize the effects of change. For them, the reference of diagnosis of disease whose components take into account climate change is fundamental.

For example, in primary nurses who put the diagnosis of cardiovascular health the elderly exposed to a wave of should guide them not to develop outdoor increase hydration and use protection.

The nurse in the hospital must understand and that a person who is admitted and who is diagnosed with a disease of the risk of thrombosis may have exposure to a heat or extreme For the nurse to able to develop this clinical rationing, needs training and the managers must be aware of this.

Also, teachers must introduce the content of their assignments in a transversal in the plan of studies, in grade or post-grade. It is theme for me, the development of rationing of professionals in clinical Therefore, hope that work of the members of the Climate Change Tax Force of Nandayi

Rafaella Pessoa Moreira (23:13.838)

can contribute to the update of Nandaí's with the introduction of components related to climate change to the diagnosis of disease present and the concern for the development of new diagnoses. We would like to thank all the members of the...

Rafaella Pessoa Moreira (23:42.734)

In Spanish, that's I said it a difficult way. That was the task. Climate change tax force is the best. Let's again, just a thank you. So, we, all members of the change tax force, would like to thank you opportunity to be with you. Camila, it's great satisfaction.

Camila Takao Lopes (23:44.986)

Here it says, Torea

Rafaella Pessoa Moreira (24:12.354)

por este momento. Muchas gracias.

Camila Takao Lopes (24:16.954)

I thank you Raffaella for all your work and also for the time you have given us being here today with us in Nanda Kest. To our OINTES, I thank you for joining us here in Nanda Kest. I you have enjoyed my conversation with Dr. Raffaella from the International Nanda

No se olviden de suscribirse a nuestro boletín en www.nanda.org y seguirnos en LinkedIn, Instagram y Facebook. También pueden encontrar enlaces para comprar el libro Diagnósticos de Enfermería de Nanda Internacional en nuestro sitio web. Hasta la próxima, sigamos definiendo el conocimiento de la enfermería, un concepto a la vez.