Episode Summary

This conversation explores the significant impact of climate change on health, particularly focusing on the role of nurses in addressing these challenges. It emphasizes the necessity for healthcare professionals to adapt their practices to mitigate the effects of climate change on patient care, especially for vulnerable populations like the elderly during extreme weather conditions.

Esta conversa explora o impacto significativo das mudanças climáticas na saúde, com foco especial no papel dos enfermeiros em enfrentar esses desafios. Ela enfatiza a necessidade de que os profissionais de saúde adaptem suas práticas para mitigar os efeitos das mudanças climáticas no cuidado aos pacientes, especialmente entre as populações vulneráveis, como os idosos, durante condições climáticas extremas.

Takeaways:

• We are all impacted by the effects of climate change.
• Nurses need to have knowledge about climate change.
• It's fundamental to consider climate changes in diagnosis.
• Interventions should be introduced in daily work.
• Climate change affects human health daily.
• Adaptation is necessary in healthcare practices.
• Primary healthcare must account for environmental factors.

• Todos nós somos impactados pelos efeitos das mudanças climáticas.
• Os enfermeiros precisam ter conhecimento sobre as mudanças climáticas.
• É fundamental considerar as mudanças climáticas no diagnóstico.
• As intervenções devem ser incorporadas ao trabalho diário.
• As mudanças climáticas afetam a saúde humana diariamente.
• A adaptação é necessária nas práticas de saúde.
• A atenção primária à saúde deve levar em conta os fatores ambientais.

About Our Guest: 

Dra. Rafaella Pessoa Moreira

Doutora em Enfermagem, com pós-doutorado na Universidad de La Laguna,

onde desenvolveu pesquisa sobre clima e saúde humana. É professora do

Instituto de Ciências da Saúde da Universidade da Integração Internacional da

Lusofonia Afro-Brasileira (UNILAB), em Redenção – Ceará – Brasil. Coordena

o Programa de Pós-Graduação em Enfermagem da UNILAB, é membro da

RePPE, da NANDA International e preside a Task Force Climate Change da

NANDA-I.

Dra. Vanessa Emille Carvalho de Sousa Freire

Doutora em Enfermagem. Atualmente é pesquisadora visitante na Universidade

da Integração Internacional da Lusofonia Afro-Brasileira (UNILAB), em

Redenção – Ceará – Brasil, e desenvolve pesquisas sobre a interface entre

meio ambiente, saúde e enfermagem.

Dra. Huana Carolina Cândido Morais

Doutora em Enfermagem e professora do Instituto de Ciências da Saúde da

Universidade da Integração Internacional da Lusofonia Afro-Brasileira

(UNILAB), em Redenção – Ceará – Brasil, onde atua nos Programas de Pós-

Graduação em Enfermagem e em Saúde da Família. É membro da RePPE.

Dra. Andressa Suelly Saturnino de Oliveira

Enfermeira e professora dos cursos de Enfermagem e Medicina da

Universidade da Integração Internacional da Lusofonia Afro-Brasileira

(UNILAB), em Redenção – Ceará – Brasil. Atua nos Programas de Pós-Graduação em Enfermagem e em Saúde da Família.

About NANDA:

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Join us as we explore the power of words, the strength of knowledge, and the future of nursing. Let’s define the profession together—one diagnosis at a time.

Welcome to NandaCast. I Dr. Camila Takao Lopes, Director of the Diagnostic of Nanda International and Professor of São Paulo It pleasure to you here with us and today I present you Dr. Rafaela Moreira, Vanessa Carvalho, Ruana Moraes and Andressa Oliveira.

Dr. Rafaela is a doctor in infirmary with post-doctorate at Universidade da Laguna, on climate and human She is professor at the of Health of Unilab, in Redenção, in Ceará, here in Brazil, and coordinates the post-graduate in infirmary at Unilab. She is also member of the research in the of Brazilian infirmary, of Nanda International, and presides over the task force on climate also of Nanda International.

Dr. Vanessa is also a doctor and nurse and is a visiting at Unilab and has collaborated in research on the environment, health and disease Dr. Ruana is a doctor and nurse, professor at the Unilab and the family disease She is also a member of the Brazilian disease research Dr. Andressa is a nurse.

Professor of the and Medicine at Unilab and the post-graduation at Unilab in Family Welcome and welcome to NandaCast. Thank you much for accepting to participate with us today. I'm going record again because I last part wrong. Welcome, welcome. Welcome to NandaCast. Thank you for accepting to talk to us today.

To start, could tell us how each of you with the theme of climate and what motivated you to explore this theme with disease

Good afternoon. I and the professors and nurses from the Unilab work with infirmary diagnoses, results and interventions in care for people with chronic In last six years, we work on the diseases sensitive to the climate and its impact on human health.

from partnerships established with researchers from different areas and from various educational and international We the research an interdisciplinary of researchers, engineers, hydrologists, climatologists, economists, among others. As nurses, was always the concern of need to bring the results of these studies to the areas of infirmary.

We to approve research with funding in field infirmary and interdisciplinary, and publish scientific and periodic both at national and international As I said before, the group's always worked with the infirmary and the infirmary of Nanda AI in research and teaching.

So we decided to a letter to the editor for the newspaper Journal of Nursing Knowledge. In the letter, we the need to the hospital considering the climate changes. A few days after the letter Dr. Redder launched a call on the Ananda International inviting participants to compose a task on the changes of Ananda I.

Immediately, we interested in participating. I am presiding over the task which has other members, such as the professors who are here present. They are also part of the task and the complete of the task can be checked on the Nenda International

Thank much, Professor Rafaela. And really, as soon as the article came out, we read the article, we saw the call and was a consensus within the directory of Nanda that would be of interest to a task force to work with these elements. You have published a lot about this and certainly contributed lot to Nanda and to your classification in relation to these possible new diagnostic elements related to climate

You have developed very important showing, for example, climate affects health, as in case of dengue in semi-arid as in case of effects of heat on hospitalizations for cardiovascular and also the relationship between access to water and reduction of diarrhea Could share the main results of these studies and the relevance of these results for practice of infirmary?

Yes,

group discovered a very alarming so historically is known that Dengue has a seasonality.

The mosquito needs the ideal of temperature, for the closure. And normally this happens right after the rainy season or immediately, Or right after the rainy season here in the state of Ceará. So what we discovered with our projections using some climate was that with climate we will have a substantial in case of dengue in the months that are now low incidence.

So, this changes everything for the nurse who acts in primary and also in emergencies. The surveillance of symptoms, the triage of suspected cases, the community will need to maintained throughout the year and also respecting the regionality of each region of country. About the heat and cardiovascular we did a broad review on how the climate in arid affects people with cardiovascular

muscular and geometric.

And we confirm that the heat and temperatures are critical for worsening cardiovascular diseases, mainly acute myocardial and stroke. And most affected are the vulnerable so the elderly, people with preexisting which makes us worry about this population and the nurse needs to be aware that extreme

the cardiovascular So the nurse, as a professional responsible for monitoring this patient in the consultation, whether it is in the domicile area or hospital, will need to be aware of this, will need to be able to assess the environmental and also educate patients, obviously, about hydration, how to refresh, avoid exposure to

and how to the main symptoms of thermal And the third result that we would to share is about drought and diarrhea. We have a study that brings a lesson of hope. It was a historical series that corresponded to a period of 11 years of drought in the Northeast of Brazil. And the logic would be extreme reservoirs at critical levels, therefore more diarrhea diseases. But what we was the opposite.

there was a significant in hospitalizations by JARREA, corresponding to approximately 5 % per year.

And why this happen? Because of public health water which were implemented coincidentally in same period. For example, was an increase in family health health care and distribution of more than 1 million cisterns, which was implemented by the government during this period.

So, for the disease, this reinforces our role not only in direct but as defenders of public policies, sanitation and access to water. This shows that the negative of the climate are not inevitable if we as long as are taken in the right

In addition to the lessons she brought us with the results of the research, another learning we had was to that when we talk about climate change, this analysis of the time series, which was what we in some of these studies, is important to understand how each of these diseases behaves in the regions and what are the climate factors

that more influence the occurrence of these diseases. So, when we can identify the groups with the highest vulnerability, we can also the need for planning actions, especially those prevention and health. And then the results of these researches that we developed allowed us to be able to suggest, a nurse can perform these interventions of infirmary for these various diseases that are sensitive to the climate.

Thank much, Professor Vanessa and Professor Andressa, for your answer. The teachers presented a little of their during the Nanda our last conference in June, now in 2025. And after the presentation, the was very impressed because it really is a production not only big in terms of quantity, volume, but also great, that has applicability, that is impactful, not only for...

for the nurse as a professional, but for the nurse as a citizen, as a person who cares about future of humanity. So it's really an impressive, interesting that is worth it for all listeners who are interested and really access it because it's really worth I would to know from you how the group relates these evidence produced

the of the diagnosis of especially in the care of populations in situations of greater vulnerability.

Bye.

I will answer this question. This is exactly the central of our task Translate these evidences into the language of the disease The disease diagnosis names the human to a problem. So our research shows how the climate is creating or intensifying these responses, especially in the most vulnerable. For example, an elderly exposed to heat waves can have the disease diagnosis in inefficient

The factor related now is the environmental to heat, which changes our care With dengue occurring all round, example, the diagnosis of disease and risk of would cease to be seasonal and would become continuous, requiring permanent surveillance. And vulnerability to droughts or floods generates diagnosis of disease such as anxiety, anxiety, and we are also some emerging

with a climate anxiety. So, by integrating the climate with the diagnosis of Nanda, we give the nurse the tool to name this problem. And when we it, we can plan interventions and defend public policies to prevent or mitigate the impacts of climate change.

Thank you for your answer, Professor Vanessa. Could you tell us a little bit about how this process of incorporating these findings and research in the diagnosis of our classification

Certainly. The studies have been carried out, they have to integrate this relationship between the impacts of climate and environmental with some of diagnoses of the disease already present in Nandai So, for example, the influence of exposure to high temperatures and air in the increase of diagnosis at of cardiovascular function.

However, this relationship is clear in current Anandai As in this example, other phenomena do not also present this relationship. So we, researchers at the Tarefa propose suggestions for inclusion of factors related to defining or populations at risk, so that the diagnosis of disease contemplates this influence of change. It that this is initial effort.

that should be deepened and better developed by all nurses in a theoretical and practical of their professional

Thank much, Ruana, your answer. And in your what is the importance of including the diagnoses in Nanda's that are related to climate change, what benefits could this bring to patients, to professionals in the field of to the scientific of disease?

Camila, this question is very interesting because not long ago, issues related to climate change were studied mainly by engineering and also by meteorologists, are even professionals who are involved in these researches that we have developing, of interdisciplinary But it something that we need to attention to in current And then it very clear to us that these changes

has greatly the health of the populations, in view of the results of the research we have developed. So is necessary that nurses can really plan, offer quality for people in this scenario, considering the climate changes. And then when we think about the care that is offered in the day-to-day, when we include these diagnosis of the disease.

related to climate change, the nurse starts to identify these risks also implement these prevention for these vulnerable that Ruana talked about, that Vanessa talked about. And then these children, these elderly, these people with chronic diseases, gives these people the opportunity to these seasonal of aging.

And then this also us to act on our health, on risk In addition, is important for us to be to promote sustainable Because the nurse, is important to remember that he is an educator. And then one thing that we can also put in relation to the interdisciplinary is that there is very big for the nurse to recognize this interface.

between the environment, the environment general, the climate and human And then this allows theories example, medium range. This can contribute to the enrichment of science as a scope of the nurse's So we recognize the importance of the nurse as a leader, about the impacts of the climate, the health of the populations.

And this also allows for structured of the disease. What knowledge would it The theories, classification example, of the practices of the disease. And then this will help in the continued of nurses, in the training of the professionals of the disease. So when the nurse has this broad view, attentive to these conditions of risk, of environmental climatic he will be to plan and perform a care of the disease that is safer.

and also more juridical.

Thank much for the answer, Professor Vanessa. It's very complex that I'm seeing here in your force, in this trajectory of incorporating this new or this way of thinking, this way of thinking for nurses, with this complexity of climate changes, to incorporate this into the diagnosis of disease.

What you consider today to be the biggest challenges, both conceptual and methodological, and the practical you have had at Forza Tarefa?

There just a little microphone from Professor Ruana that we are not being able hear.

We cross over.

microphone.

Sorry, I didn't Let's resume.

Now photo.

To fully these relations between climate and health, is necessary to integrate specific and methodologies from different areas of knowledge. As we said, there is in the task force these areas that are representative of physics, hydrology, recently of transports beyond health. And this represents a challenge.

However, the proposal of this interdisciplinary which is employed in the task allows us these challenges. So this partnership allows us the interlocution between these different concepts with the climate-sensitive and with determinants, which indicates that to mitigate this problem, all areas should be involved in this purpose.

But emphasize that the biggest challenge is to raise among nurses about their individual or within the health the of climate because there is this difficulty of understanding that the disease has an active to mitigate or mitigate the effects of the global on health of the population.

Thank much, Professor Ruana, for your answer. And now, unfortunately, due to time, we will have to close, but to close, I would like to know what message you could leave to students, to nurses who are in clinical to educators, to infirmary to managers, about the importance of integrating the issue of climate change to use of infirmary

Before answering your question, would to finish by emphasizing that climate change is a current and worldwide We are all impacted by the effects of climate change on a daily basis and consequently in human There is more place for us to So is necessary that we adapt and introduce the theme in various ways in our daily lives.

And then, answering the question, in our case, we, nurses, clinicians, need to have knowledge about the introduce interventions in daily work to prevent or minimize the effects of climate change. For this, the difference in diagnosis of disease, whose components take account the climate changes, is extremely fundamental.

For example, in primary nurses who have suffered from risk of cardiovascular for an elderly person exposed to a heat wave, should guide them not to develop outdoor increase hydration and use of saline. The nurse in hospital should understand and consider that a person who is admitted and has a risk of thrombosis diagnosis may have been exposed to a heat wave or even to extreme

For the nurse to be to develop this clinical he needs training and that's the managers should be attentive. The teachers should introduce the content of the disciplines in a transversal way, in the curricular of graduation and post-graduation, the theme for the development of professional to prepare them for the clinic. Therefore, we hope that the work of the members

of the Tarefa Nandai, can contribute to the update of disease diagnostics, with the introduction of components related to climate change to the present and that initiate the investigation for the development of new diagnostics. We would like to thank you opportunity to share our experience of the Tarefa with you. Thank you

We thank Professor Rafaela for opportunity to part of the group of Força Tarefa that I know and for using your donating your time to us, Nanda, to our listeners. I thank for joining us here at NandaCast. I hope you enjoyed my conversation with the Força Tarefa on climate from Nandaí.

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