Browsing by Author "Cunha, Lara Daniela Matos"
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- Nurses’ work conditions: The role of clinical reasoning uncertainty at the post-anesthesia recovery roomPublication . Cunha, Lara Daniela Matos; Santos, Márcia Noélia Pestana; Lomba, Maria de Lurdes Lopes de Freitas; Reis Santos, Margarida
- Qualidade e estilo de vida da pessoa hipertensaPublication . Cunha, Lara Daniela Matos; Ferreira, Paulo Alexandre Carvalho; Brito, Irma da SilvaEnquadramento: A apreciação da qualidade de vida é basilar na compreensão do impacto causado pela hipertensão arterial. Objetivos: Caraterizar o perfil da população hipertensa da consulta externa de um hospital central, investigar a influência do estilo de vida na qualidade de vida relacionada com a saúde. Metodologia: Estudo quantitativo, descritivo, analítico, de corte transversal, com amostra de 105 utentes. Os instrumentos de colheita de dados incluem o Mini Questionário da Qualidade de Vida (MINICHAL) e Estilo de Vida Fantástico (EVF). Resultados: Verificámos que a perceção da qualidade de vida na vertente somática, é influenciada por estilos de vida nas dimensões família e amigos, nutrição, sono e stress, comportamentos de saúde e sexuais, bem como pelo consumo de tabaco. Relativamente à dimensão estado mental, verificámos fatores preditores nomeadamente, família e amigos, sono e stress, introspeção, comportamentos de saúde e sexuais e consumo de álcool. Conclusão: Considera-se que este estudo fornece informação útil para aumentar a efetividade dos programas de prevenção e controlo dos fatores de risco cardiovasculares.
- Uncertainty in post-anaesthesia nursing clinical reasoning: An integrative review in the light of the model of uncertainty in complex health care settingsPublication . Cunha, Lara Daniela Matos; Pestana-Santos, Márcia; Lomba, Lurdes; Reis Santos, MargaridaProblem identification: Post-anaesthesia nursing plays an important role in the early detection and treatment of clinical deterioration after surgery and/or anaesthesia. Concomitantly, the effectiveness of post-operative care is highly dependent on the accurate analysis, synthesis of patient data and quality of diagnostic decisions through clinical reasoning. Given the dynamic processes required to come to a diagnosis, uncertainty is common in clinical reasoning and expected during practice. Nevertheless, uncertainty may permeate the foundations of clinical reasoning, which can jeopardise diagnostic accuracy and consequently the quality and safety of health care. Literature search: The objectives of this review are to identify available evidence related to uncertainty in post-anaesthesia nursing clinical reasoning and to analyse the results from the perspective of the Model of Uncertainty in Complex Healthcare Settings (MUCH-S). A comprehensive search strategy using CINAHL (EBSCO), Cochrane Library (EBSCO), Medline (PubMed), ProQuest and Google Scholar databases was used to find published and unpublished relevant studies. Studies published in English and Portuguese were included. There was no temporal restriction, nor geographical or cultural limitation for the studies included. Data evaluation synthesis: All papers were reviewed by the authors to extract key information about purpose, sample and setting, research design and method, key findings and limitations. The literature search identified a total of 248 studies, 22 of which were retrieved for full reading. A total of four articles were included in this review. Implications for practice: Three main themes were identified: nurses’ intuition to reason, feelings of uncertainty related to lack of nursing knowledge and clinical (in)experience to deal with uncertainty. These findings are encompassed within the MUCH-S taxonomy: personal, scientific and practical. This review offers post-anaesthesia nurses’ greater levels of understanding of this phenomenon and may support more informed and reflexive clinical reasoning.
- Unravelling Uncertainty Inception: When We Really Know That We Don't Know?Publication . Cunha, Lara Daniela Matos; Ventura, Filipa; Pestana‐Santos, Márcia; Lomba, Lurdes; Reis Santos, MargaridaThrough technical rationality, healthcare professionals address instrumental problems by applying the theory and technique arising from scientific knowledge. Nevertheless, the divergent situations of practice characterised by uncertainty, instability, and uniqueness place nurses in a positivist epistemological dilemma. Decision‐making under uncertainty is a challenge that nurses face in clinical practice daily. Nurses anticipate critical events based on the interaction between (un)known factors of clinical reasoning, putting uncertainty tolerance into perspective. With undeniable epistemological relevance, few nursing researchers have addressed this issue. Based on the insights garnered from the panel held at the 26th International Nursing Philosophy Conference, this discussion paper examines the inception of uncertainty within nursing reasoning, intertwining introspection, abstraction, and the rich discussions from the conference. Accordingly, the philosophical underpinnings of the perceived experience of uncertainty will be briefly addressed, while framing the decision‐making challenges faced by nurses. A compelling dimension of nursing care emerges when we delve into the inception of uncertainty, prompting a deeper examination of the interplay between its perception and consciousness in clinical practice, and the gravitation of uncertainty in the process of empirical reasoning. Navigating uncertainty involves varying individual responses, influenced by tolerance levels. Moral appropriateness is determined by their adaptability rather than solely their positivity or logical consistency, highlighting constancy as a quality demanding alignment with an understanding of challenges.