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Percorrer por autor "Lopes, Joana"

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  • Assessment of nutritional status of oncology patients at hospital admission : a Portuguese real-world study
    Publication . Trabulo, Carolina; Lopes, Joana; Dias, David da Silva; Gramaça, João; Fernandes, Isabel; Gameiro, Rita; Pina, Idília; Mäkitie, Antti; Ottery, Faith; Ravasco, Paula
    Background: Nutritional status in patients with cancer has a determining role in the evolution of the disease and tolerance to treatments. Severity of undernutrition impacts morbidity and mortality in cancer patients and can limit patient response to the optimal therapies if nutritional issues are not appropriately addressed and managed. Despite the importance of malnutrition for the clinical evolution of oncology patients, there is not yet a universally accepted standard method for evaluating malnutrition in such patients. The aim of this study was to stratify the nutritional status of inpatients at an Oncology Department. Methods: This is an observational study with 561 cancer patients, assessed at admission to a Medical Oncology Department from November 2016 to February 2020. All patients were considered eligible. Non-compliant and/or comatose patients were excluded. Nutritional status was assessed using the PG-SGA, BMI classified with the WHO criteria, and calculation of the percentage of weight loss in the previous 3–6 months. Results: A total of 561 patients (303 F: 258 M; mean age 65 ± 13 years) were included. One-third of the patients, n=191/561 (34%), lost 6% of their weight in the month prior to admission and 297/561 (53%) patients lost 10.2% of weight in the previous 6 months. Mean BMI was 24.1 ± 5.8 kg/m2; N = 280/561 (50%) patients had regular BMI according to the WHO criteria. N = 331/561 (59%) patients reported eating less in the month prior to admission. N = 303/561 (54%) had moderate/severe deficits of muscle and adipose compartments. The PG-SGA identified 499/561 (89%) patients as moderately/severely malnourished, of which 466/561 (83%) patients scored ≥9 points, meeting criteria for a critical need for nutritional support. Fifteen percent of patients scored >4 points, indicating a need for directed therapy for symptom control and only 1% scored <2 points (maintenance nutritional counseling). Conclusion: In this oncological setting, a higher proportion of patients were nutritionally-at-risk or with moderate/severe malnutrition. The large majority of patients in this study presented with a critical need for nutritional intervention. These findings highlight the need for an integrated assessment of nutritional status at patient referral. This will allow early and timely nutrition care, which is recommended to prevent or reverse further deterioration of the condition and to optimize treatment administration.
    2022-09Contributo em revista Acesso aberto Ver mais
  • Avaliação do familiar cuidador de pessoas com ostomia de eliminação intestinal : construção de um instrumento para avaliar capacidades e habilidades
    Publication . Lopes, Joana
    A presença de uma ostomia de eliminação intestinal provoca alterações na autoimagem e autoestima do doente. Assim como o doente se ajusta à notícia do seu diagnóstico, também a família é afetada por alterações emocionais. Um número significativo de doentes tem dificuldades em desenvolver competências para o autocuidado à ostomia, pelo que é necessário preparar um familiar cuidador. O enfermeiro deve perceber qual é a pessoa que irá ter um papel mais ativo nos cuidados e a sua disponibilidade, para que este seja capaz de desenvolver habilidades e adquirir conhecimentos para prestar os cuidados necessários à ostomia de eliminação intestinal e ao doente. O objetivo deste estudo foi a construção de um instrumento que permita proceder à avaliação inicial do familiar cuidador, orientando o enfermeiro para as necessidades destes parceiros informais, que irão assumir um papel importante no cuidado aos doentes com ostomias de eliminação intestinal. Trata-se de um estudo metodológico desenvolvido em duas fases. Na primeira fase, baseada na metodologia qualitativa, recorreu-se ao grupo focal para a construção do instrumento. Os peritos definiram um conjunto de domínios para avaliar o familiar cuidador. Revelaram que seria importante conhecer os dados sociodemográficos, a sua destreza manual e perceção, os conhecimentos e vivências anteriores, a repulsa e aversão à ostomia, a disponibilidade, envolvimento e motivação que demonstravam, a consciencialização da situação, as crenças que tinham, a sua capacidade de autoeficácia, de tomada de decisão e assertividade. Na segunda fase, conduzida pela metodologia quantitativa, procedeu-se à validação facial e estudo de consistência interna do instrumento aplicando-o a uma amostra de 51 familiares cuidadores. Pelos resultados obtidos percebemos que o instrumento é de preenchimento amigável, apropriado ao fim a que se destina e com consistência interna aceitável. Os domínios definidos mostraram-se adequados para efetuar a avaliação inicial do cuidador. Com a utilização deste instrumento os enfermeiros são capazes de avaliar o familiar cuidador quanto a capacidades, conhecimentos e habilidades, identificando áreas que terão que ser trabalhadas para um melhor desempenho de cuidados à ostomia.
    2013-01Dissertação de mestrado Acesso aberto Ver mais
  • 2021Capítulo de livro Acesso aberto Ver mais
  • Modelo continuum de supervisão de Anderson: Estudo de caso
    Publication . Lopes, Joana; Guimarães, Isabel; Tavares, Maria Dulce
    2012-12Dissertação de mestrado Acesso aberto Ver mais
  • Periodontitis impact in interleukin-6 serum levels in solid organ transplanted patients: a systematic review and meta-analysis
    Publication . Machado, Vanessa; Botelho, João; Lopes, Joana; Patrão, Mariana; Alves, Ricardo; Chambrone, Leandro; Alcoforado, Gil; Mendes, José João
    This systematic review aimed to investigate the influence of periodontitis on post-transplant IL-6 serum levels of solid organ transplanted patients as compared to healthy subjects. Four databases (PubMed, Scholar, EMBASE, and CENTRAL) were searched up to February 2020 (PROSPERO CRD42018107817). Case-control and cohort studies on the association of IL-6 serum levels with a periodontal status of patients after solid organ transplantation were included. The risk of bias of observational studies was assessed through the Newcastle-Ottawa Scale (NOS). Random effects meta-analyses were thoroughly conducted. GRADE assessment provided quality evidence. Four case-control studies fulfilled the inclusion criteria (274 transplant recipients and 146 healthy controls), all of low risk of bias. Meta-analyses revealed significantly higher IL-6 levels in transplanted patients than healthy individuals with low-quality evidence (Mean Difference (MD): 2.55 (95% confidence interval (CI): 2.07, 3.03)). Transplanted patients with periodontitis have higher serum IL-6 levels than transplanted patients without periodontitis with moderate quality evidence (MD: 2.20 (95% CI: 1.00, 3.39)). We found low-quality evidence of higher IL-6 levels than healthy patients in patients with heart and kidney transplant. In these transplanted patients, there was moderate quality evidence that periodontitis is associated with higher IL-6 serum levels. Future research should consider the impact of such a difference in organ failure and systemic complications.
    2020-04Contributo em revista Acesso aberto Ver mais
  • Physical Exercise Program on Fall Prevention Using Technological Interface: Pretest Study
    Publication . Nilza Caldevilla, Maria; Silva, Joana; Nogueira, Isabel; Pacheco, Maria Neto; Lopes, Joana; Araújo, F.
    Background: Prevention of falls among older adults has boosted the development of technological solutions, requiring testing in clinical contexts and robust studies that need prior validation of procedures and data collection tools. Objective: The objectives of our study were to test the data collection procedure, train the team, and test the usability of the FallSensing Games app by older adults in a community setting. Methods: This study was conducted as a pretest of a future pilot study. Older adults were recruited in a day care center, and several tests were applied. Physical exercise sessions were held using the interactive FallSensing Games app. Nurse training strategies was completed. Results: A total of 11 older adults participated. The mean age was 75.08 (SD 3.80) years, mostly female (10/11, 91%) and with low (3-6 years) schooling (10/11, 91%). Clinically, the results show a group of older adults with comorbidities. Cognitive evaluation of the participants through the Mini Mental State Examination showed results with an average score of 25.64 (SD 3.5). Functional capacity assessed using the Lawton Instrumental Activities of Daily Living Scale (overall score from 0-23, with lower scores reflecting worse capacity to perform activities) showed impairment in different instrumental activities of daily living (average score 14.27). The data collection tool proved to enable easy interpretation; however, its structure needed small adjustments to facilitate the data collection process. Despite the length of the questionnaire, its implementation took an average of 21 minutes. For the assessment of the prevalence of fear of falling, the need to add a question was identified. The performance of functional tests under the guidance and presence of rehabilitation nurses ensured the safety of the participants. The interactive games were well accepted by the participants, and the physical exercises allowed data collection on the functionality of the older adults, such as the number of repetitions in the tests, range of movement (angle), duration of the movements, and execution of each cycle. Concerning the training of the nurses, it was crucial that they had experience with the platform, specifically the position of the chair facing the platform, the position of the feet, the posture of participants, and the use of sensors. Conclusions: In the future pilot study, the researchers point out the need to design a study with mixed methods (quantitative and qualitative), thus enriching the study results.
    2022Artigo científico Acesso aberto Ver mais
  • Self-care competence of patients with an intestinal stoma in the preoperative fase
    Publication . Silva, Carla; Santos, Célia; Brito, Alice; Cardoso, Teresa; Lopes, Joana
    Background: Patients undergoing intestinal stoma formation need to develop their stoma self-care competence. This competence should start being developed during the preoperative phase. Objective: To identify patients’ stoma self-care competence in the preoperative phase, particularly on the day before ostomy surgery. Methodology: Quantitative, descriptive, and cross-sectional study. Non-probability sampling technique with 50 participants. Data were collected using the assessment form of the Self-Care Competence of the Person with an Intestinal Stoma (CAO-EI: ESEP). Results: The level of knowledge represents the self-care competence of patients with an intestinal stoma in the preoperative phase of an ostomy surgery. Conclusion: The multidimensional nature of the self-care competence of patients with intestinal stoma justifies exploring other domains of this competence besides knowledge in the preoperative phase given the identified benefits on the process of adaptation after surgery
    2018Artigo científico Acesso aberto Ver mais