Browsing by Author "Esteves, Inês Martins"
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- Efectiveness of family-centred educational interventions for anxiety, pain and behaviours of children and adolescents and anxiety of their parents during the perioperative journey: A systematic review and meta-analysisPublication . Esteves, Inês Martins; Coelho, Marcia Silva; Neves, Hugo; Pestana-Santos, Marcia; Reis Santos, MargaridaAim: To evaluate the e,ectiveness of family-centred educational interventions on the anxiety, pain and behaviours of children and adolescents (three to 19 years old) and their parents’ anxiety during the perioperative journey. Design: Systematic review of e,ectiveness and meta-analysis. Data sources: MEDLINE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, SciELO and Sources of unpublished studies OpenGrey, Open Access Theses and Dissertations, and RCAAP – Portugal were systematically searched from January 2007 to April 2021 for available articles in English, Spanish and Portuguese. Review methods: This review followed the methodology for systematic reviews of e,ectiveness from Joanna Briggs Institute (JBI). Included studies were critically appraised using JBI Critical Appraisal Checklist for Randomised Controlled Trials and JBI Critical Appraisal Checklist for Quasi-Experimental Studies. Data was synthesised through meta-analysis, using a random-e,ects model in the Stata Statistical SoZtware 16.0, and narrative synthesis. Two independent reviewers performed the selection process, critical analysis, and data extraction. Results: Twenty-eight studies (26 randomised controlled trials (RCTs) and two quasi-randomised controlled trials) were included with a total of 2516 families. In a meta-analysis of ten RCTs with 761 participants, pre-operative anxiety management was more e,ective in children and adolescents who received educational interventions (SMD = -1.02; SE = 0.36; 95% CI [-1.73; -0.32]). At the induction of anaesthesia, children and adolescents were significantly less anxious (SMD = -1.54; SE = 0.62; 95% CI [-2.72; -0.36]) and demonstrated better compliance than controls (SMD = -1.40; SE = 0.67; 95% CI [-2.72; -0.09]). Post-operative pain (SMD = -0.43; SE = 0.33; 95% CI [-1.05; 0.19]) and pre-operative parental anxiety (SMD = -0.94; SE = 1.00; 95% CI [-2.87; 0.99]) were reduced in favour of the educational interventions. Conclusion: Family-centred educational interventions probably lead to a considerable reduction of paediatric and parental anxiety and improve paediatric behaviours at induction of anaesthesia. The evidence is very uncertain regarding the e,ectiveness of these interventions on post-operative paediatric maladaptive behaviours and pain intensity or parental anxiety levels at the induction of anaesthesia.
- Intervenções educativas para crianças, adolescentes e pais no período perioperatório: Revisão sistemática da literaturaPublication . Esteves, Inês Martins; Reis Santos, MargaridaIntrodução: A cirurgia pediátrica é um evento potencialmente stressante e traumático para a criança e sua família. As intervenções educativas, através de uma abordagem centrada na família, podem servir de recurso aos enfermeiros na gestão da ansiedade perioperatória, dor e ajudar a melhorar as atitudes e comportamentos de pais, crianças e adolescentes submetidos a cirurgia. Objetivo: Avaliar a efetividade das intervenções educativas na dor, ansiedade e comportamentos de crianças/adolescentes (3-19 anos) e na ansiedade dos seus pais, no período perioperatório. Métodos: O estudo seguiu a metodologia do Instituto Joanna Briggs para revisões sistemáticas de efetividade. O protocolo foi elaborado e registado na PROSPERO. Consideraram-se estudos em que foram realizadas intervenções educativas a crianças e adolescentes dos três aos 19 anos, submetidos a cirurgia eletiva, e aos seus pais e cujos resultados se focassem na dor, ansiedade e comportamentos em crianças e adolescentes e ansiedade nos pais. Foram incluídos estudos, publicados e não publicados, entre janeiro de 2007 e abril de 2021, disponíveis em inglês, espanhol e português, pesquisados nas bases de dados MEDLINE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials e SciELO; para estudos não publicados OpenGrey, Open Access Theses and Dissertations e RCAAP – Portugal. Os estudos foram avaliados de forma independente por dois revisores. Resultados: Foram incluídos 28 estudos (dois quasi-experimentais e 26 estudos randomizados controlados) de um total de 4500 registos identificados. As intervenções educativas centradas na família incidiram em explicações sobre os cuidados perioperatórios, estratégias para facilitar o contacto da criança com o ambiente cirúrgico e fornecer aos pais informação sobre equipamentos e procedimentos, e utilizaram DVDs, vídeos, jogos, panfletos, livros, visitas guiadas e o brincar terapêutico. Os dados da meta-análise revelaram que as crianças e adolescentes beneficiam das intervenções educativas na gestão da ansiedade perioperatória (SMDpré-operatória=−1,02; SE=0,36; 95% CI [−1,73;−0,32]), demonstraram melhor compliance durante a indução anestésica (SMD=−1,40; SE=0,67; 95% CI [−2,72;−0,09]) e níveis de dor pós-operatória mais reduzidos (SMD=−0,43; SE=0,33; 95% CI [−1,05;−0,19]). Não foi encontrada evidência relativamente à efetividade das intervenções educativas nos comportamentos negativos pós-operatórios, como distúrbios do sono, da alimentação ou emocionais (SMD=0,12; SE=0,15; 95% CI [−0,84; 1,09]). As intervenções educativas também foram efetivas na redução da ansiedade pré-operatória dos pais (SMD=−0,94; SE=1,00; 95% CI [−2,87;−0,99]). Conclusões: As intervenções educativas centradas na família devem ser consideradas na gestão da ansiedade e dor das crianças e adolescentes e na ansiedade dos pais durante o período perioperatório.
- Promotion of adjustment to the exercise of parental role in adolescencePublication . Esteves, Inês Martins; Carvalho, Maria Isabel; Cruz, Sara Filipa; Figueiredo, MariaINTRODUCTION. Parental exercise itself constitutes a very demanding challenge – however, when pregnancy occurs in adolescence, often unplanned, it converges tasks of di'erent stages of development, irreversibly modifying an identity, roles and functions, not only of the young woman, but also of her family. OBJECTIVES. Applying the Dynamic Model of Family Assessment and Intervention (MDAIF), by Figueiredo (2012), and assessing the impact of nursing care in the promotion of skills for a transition to the parental role’s exercise in the teenager and her family. METHODS. Qualitative study, conducted based on MDAIF, as a theoretical and operational reference, in clinical and community context in Primary Health Care, based on the process of family intervention who experienced an adolescent pregnancy. Seven nursing consultations to family were carried out, as a unit, from April to May 2016. RESULTS AND DISCUSSION. Extended family, with several subsystems and strict limits. Middle-class family. Although unplanned, and the antagonistic relationship with her parents, the instrumental and emotional support provided by them became critical in adapting to motherhood and the newborn’s development. CONCLUSIONS. With MDAIF’s use, nurses have developed their skills for a personalized approach to the family, centered on the adaptation and holistic transition to the parental process. It also made it possible to respond to the identi+ed family needs, not only through the restructuring of a parental and personal identity, based on values, personal and professional goals and priorities (the teenager pursued her academic training), but also promoting a family environment based on trust and harmony