Percorrer por autor "Vareta, Diana"
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- Assessing the magnitude of burnout among emergency nurses in PortugalPublication . Fernandes, Júlio Belo; Antunes, Ricardo; Ivanel, Maria; Lucas, Mariana; Oliveira, Ricardo; Bico, Wilson; Simões, Aida; Vareta, Diana; Bernardes, Catarina; Vaz, Célia; Hall, Steven; Fernandes, Sónia; Castro, CidáliaBackground: Burnout is a health condition associated with chronic work-related stress. Nurses working in hospital emergency rooms are particularly susceptible to experiencing burnout. It is crucial to understand the phenomena of burnout among emergency room nurses, particularly in light of the COVID-19 pandemic that healthcare professionals have confronted. This study aims to evaluate burnout among nurses working in emergency rooms while examining the relationship between burnout and sociodemographic and occupational variables. Methods: This descriptive, observational, and cross-sectional study utilized a web-based survey administered to 112 nurses from eight hospital emergency rooms in the Lisbon metropolitan area between November 2022 and February 2023. Burnout was measured using the Portuguese version of the Maslach Burnout Inventory (MBI), which assessed three subscales: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). The relationship between burnout and sociodemographic and professional characteristics of nurses in emergency rooms was analyzed using Chi-square tests and one-way ANOVA. Results: The prevalence of burnout was 56.6%, with 27.4% experiencing severe burnout. The three subscales of the MBI showed high prevalence rates: 49.1% for EE, 44.6% for DP, and 38.4% for low PA. Severe burnout and high EE were associated with younger age, being single, not having children, having less professional experience, less graduate training, and having more precarious employment contracts. Conclusions: Three years after the onset of the COVID-19 pandemic, the results highlight the ongoing critical situation arising from the cumulative effects of the crisis on the Portuguese healthcare system, leading to high rates of burnout and EE among emergency room nurses.
- Can nursing strengthen one health initiatives?Publication . Fernandes, Júlio Belo; Vareta, DianaThe One Health framework emphasizes the interdependence of human, animal, and environmental health. Nurses, as the largest group of healthcare professionals and often the first point of contact with patients and communities, routinely engage in activities aligned with One Health objectives, including vaccination campaigns, community education, infection prevention, environmental monitoring, and the management of non-communicable diseases. Despite this, nursing contributions remain largely unrecognized, and One Health principles are seldom integrated into education, practice, or policy frameworks. This paper highlights the critical role of nursing in operationalizing One Health and identifies barriers to its recognition. It provides targeted recommendations to embed One Health into nursing curricula, promote experiential learning, support continuing education, foster research, formalize nursing roles, strengthen interdisciplinary collaboration, leverage digital technologies, and enhance professional advocacy and leadership. Recognizing and supporting nursing in One Health can significantly strengthen global health initiatives.
- Enablers, barriers and strategies to build resilience among cancer survivors : a qualitative study protocolPublication . Fernandes, Júlio Belo; Domingos, Josefa; Almeida, Ana Silva; Castro, Cidália; Simões, Aida; Fernandes, Sónia; Vareta, Diana; Bernardes, Catarina; Fonseca, Jorge; Vaz, Célia; Dias, Ana Rita; Fernandes, Tatiana; Godinho, CatarinaCancer is a life-threatening illness affecting all dimensions of a person’s health. Cancer survivors must build resilience to face this adversity and continue their life projects. The present study explores the enablers, barriers, and strategies to build resilience among cancer survivors. This qualitative, descriptive exploratory study will use purposive sampling to recruit cancer survivors and healthcare professionals from two hospital centers in Lisbon and Tagus Valley. Interviews will be conducted until data saturation occurs. Data analysis will be performed using an inductive content analysis process with the help of the QDA Miner Lite database. The findings from this study will generate knowledge that may help stakeholders to identify effective strategies to build resilience among cancer survivors. By implementing strategies to foster resilience, healthcare professionals can potentially promote positive adaptations to cancer by strengthening resilience enablers and reducing the impact of barriers.
- Exploring person-centredness in technology-based gait rehabilitation after stroke : a scoping review framework analysisPublication . Fernandes, Júlio Belo; Vareta, Diana; Fernandes, Sónia; Chalaça, Ana; Almeida, Ana Silva; Maia, Ana Catarina; Magsi, Faiza; Hall, Steven; McCormack, BrendanBackground: Technology-based gait rehabilitation after stroke is expanding, however the extent to which interventions embody person-centred care remains unclear. Aims: The objective of this review is to explore the extent to which technology-based interventions for gait rehabilitation in stroke survivors reflect the principles of person-centred practice. Methods: A scoping review was conducted following the Arksey and O’Malley methodological framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search was performed in MEDLINE Complete, CINAHL Complete, Nursing & Allied Health Collection: Comprehensive, and the Cochrane Central Register of Controlled Trials, with the last search update on September 1, 2025. Data charting was aligned with the domains of the PCPF, enabling the identification of person-centredness indicators both explicitly stated in the texts and inferred from their context. Results: The search identified 1,460 records; after screening, 21 randomised controlled trials were included. Extracted data were mapped to PCPF domains to identify explicit and implicit indicators of person-centredness. Representation was variable: Prerequisites, Practice Environment, Person-Centred Processes, and Outcomes appeared across studies, while Macro Context was absent. Alignment was evident via practitioner expertise and responsive parameter adjustments (Prerequisites), specialised, well-resourced settings (Practice Environment), and personalised goal setting, real-time feedback, and preference-sensitive features (Processes). Regarding outcomes, all studies reported performance-based measures (motor performance); one included biomarker outcomes and two used Patient-Reported Outcome Measures (quality of life). No Patient-Reported Experience Measures were reported. Conclusion: Technology-focused gait trials remain predominantly biomedical in framing and reporting. Future studies should embed and report explicit person-centred processes and broaden outcomes to include patient-reported experience measures.
- Exploring senior nursing students’ perspectives on humanizing care for patients in isolation : a qualitative studyPublication . Fernandes, Júlio Belo; Castro, Cidália; Simões, Aida; Vareta, Diana; Barros, Inês; Benatti, Luiza; Hall, Steven; Fernandes, SóniaBackground: Isolation units play a vital role in controlling disease transmission and ensuring the safety of both patients and healthcare professionals. However, the experience of isolation can lead to feelings of loneliness and anxiety that negatively affect patients’ wellbeing and recovery. Given this, making care more humanized in these settings should be a key priority in healthcare. This study explores nursing students’ perspectives on interventions that contribute to humanizing care for patients in isolation units. Methods: A theory-informed qualitative descriptive study was conducted with 19 senior nursing students completing clinical placements in isolation units across five hospitals. Interviews were transcribed and analyzed using Braun and Clarke’s six-step thematic analysis. Watson’s Theory of Human Caring was used as a sensitizing framework to support data interpretation. Results: The study identified several nursing interventions that enhance the humanization of patient care in isolation units. These interventions were classified into two main dimensions based on Watson’s theory. The instrumental dimension included interventions focused on symptom management, physical comfort, infection prevention and control, continuity of care, and discharge planning. The expressive dimension encompassed strategies directed at establishing a therapeutic relationship, individualized care planning, emotional and psychosocial support, relaxation and entertainment, patient empowerment, and family involvement. Conclusion: Categorizing these interventions within the framework of the Theory of Human Caring provides valuable insight into various approaches to humanizing care in isolation units. These findings can contribute to the development of patient-centered care models, encouraging healthcare professionals to deliver more comprehensive and compassionate care that addresses the holistic needs of isolated patients.
- Nursing interventions to ensure the safety of critically ill patients in intrahospital transportation : a scoping reviewPublication . Lemos, Ana Filipa; Vareta, DianaBackground: Intrahospital transportation of critically ill patients is a high-risk process, frequently linked to complications and increased vulnerability to adverse events. Ensuring safety requires nursing interventions that uphold the standards of care provided in critical care units. Objective: To identify nursing interventions that promote patient safety during intrahospital transportation. Methods: A scoping review was conducted following Arksey and O’Malley’s framework. The search was performed in 2024 across PubMed and EBSCOhost (CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, and Cochrane Central Register of Controlled Trials). Results: Seven publications met the criteria. All studies emphasized the need for strategies to prevent complications during transport. Four categories of interventions emerged: identification and management of adverse events, use of checklists, continuous nurse training, and effective communication. Conclusions: Nurses play a pivotal role in maintaining safety and quality of care. By applying evidence-based strategies, they minimize risks and ensure safer intrahospital transportation.
- Person-centered practice in the Portuguese healthcare system : a documentary studyPublication . Vareta, Diana; Santana, Elaine; Oliveira, Célia; Baixinho, Cristina; Ventura, FilipaBackground: Person-centered practice has increasingly become a key structural component of health systems, driving the progressive reformulation of public health policies internationally. Despite broad consensus regarding its importance, its integration into clinical practice continues to face significant challenges. The Person-Centred Practice Framework identifies the macro context as a critical domain for sustainable implementation, as it encompasses the structural and strategic factors that shape healthcare delivery. Objective: To characterize the person-centered practice framing within the macro context of the Portuguese healthcare system. Methodology: Qualitative, descriptive, and retrospective documentary study. A systematic literature search was conducted on the websites of entities responsible for defining, guiding, and regulating healthcare in Portugal. Using predefined eligibility criteria, 40 documents were selected. Textual analysis was performed using IRAMUTEQ® software and guided by the constructs of the macro context domain of the Person-Centred Practice Framework. Results: The lexicometric analysis identified five classes, grouped into two thematic fields: i) Structural and organizational determinants of person-centered practice, comprising the classes Systemic vision and integrated response, Organizational culture and participation, Digital transformation and information management, and Political vision and governance structures; and ii) Operationalization of person-centered practice, represented solely by the class Care approach, reflecting its thematic specificity. Factorial analysis revealed distinct and poorly connected discursive patterns associated with different action levels within the healthcare system. Similarity analysis highlighted a discourse centered on the health-care-person nucleus, showing relations with service organization, care integration, and person participation, albeit with word dispersion suggesting misalignment between organizational and practice levels. Conclusion: The macrocontextual framing of person-centered practice in the Portuguese healthcare system demonstrates significant political and strategic advances, as seen in the emphasis on humanized care, investment in health literacy and digitalization, and the introduction of Integrated Care Pathways. However, implementation remains limited due to the absence of clear formative guidelines, biomedical paradigm persistence, and lack of evaluation mechanisms sensitive to care experience.
- Person-centered workplace culture : insights from an inpatient department for older adults with chronic illnessesPublication . Vareta, Diana; Oliveira, Célia; Ventura, FilipaIntroduction: An aging population and the increasing prevalence of chronic conditions challenge healthcare systems in developed countries. In response, there is a growing emphasis on person-centered care, as advocated by the World Health Organization and integrated into national health strategies in countries such as the UK and Sweden. However, transitioning to person-centered care is a complex, long-term process shaped by organizational culture and care environments. These contextual factors play crucial roles in the development and sustainability of person-centered practice, significantly transforming the experiences of both older adults and staff.Objective: To describe how workplace culture within an inpatient hospital department shapes person-centered care practices for older adults with chronic illnesses. Methods: A qualitative, descriptive, exploratory-observational study was performed. Data were collected through participant observation guided by the Workplace Culture Critical Analysis Tool®. In a deductive thematic content analysis, data patterns of meaning were identified. The themes were generated underpinned by the Person-Centered Practice Framework dimensions of prerequisites, the practice environment, and person-centered processes and their respective constructs. Results: Themes related to all person-centered practice dimensions were identified. Task demands during shifts create tension between routine-oriented work and the holistic, individualized approach required for person-centeredness. The absence of systematic multiprofessional team meetings further exacerbates this issue, limiting collaborative decision-making and personalized care planning. The contrasts in some subthemes may be related to discrepancies in the care provided by different professionals. Conclusion: This study highlights the tension between routine-driven care and individualized approaches. Addressing identified challenges, such as formalizing multiprofessional meetings and enhancing reflective practices, is crucial for advancing person-centered care in this setting.
- Perspectives of older adults with chronic illness on person-centered practice at an inpatient hospital department : a descriptive studyPublication . Vareta, Diana; Ventura, Filipa; Família, Carlos; Oliveira, CéliaBackground: The growing aging trend associated with a higher prevalence of chronic illnesses is increasing the demand for the development of person-centered practice in specific care settings. Knowing the person’s perception of the care and the care experience is essential to improving inpatient care toward person-centeredness. This study aims to characterize the perceptions of person-centered practice of hospitalized older adults with chronic illness at a Portuguese inpatient hospital department. Methods: A quantitative, descriptive, cross-sectional approach was followed. Data were collected using a sociodemographic and health history questionnaire and the Person-Centered Practice Inventory - Care (PCPI-C). The effect of the different variables on each PCPI-C construct was determined using analysis of variance (ANOVA). Results: The results show that person-centered practice was positively perceived in the five constructs of the person-centered processes domain (M = 3.92; SD = 0.47). The highest-scored construct was working with the person’s beliefs and values (M = 4.12; SD = 0.51), and the lowest was working holistically (M = 3.68; SD = 0.70). No significant effect of the independent variables was found to influence the perceptions of any of the constructs in the person-centered processes domain. Conclusions: These results might indicate that person-centered processes are perceived uniquely by each person through individualized therapeutic relationships rather than a pattern of care shared by hospitalized older adults.
- Portuguese translation, cultural adaptation, and validation of the Person-Centered Practice Inventory – CarePublication . Vareta, Diana; Oliveira, Célia; McCormack, Brendan; Slater, Paul; Tyagi, Vaibhav; Ventura, FilipaBackground: In person-centered practice implementation and development, it is essential to incorporate standardized measurements that consider the perspectives of those involved in the therapeutic relationship. This work aims to translate, culturally adapt, and validate the Person-Centered Practice Inventory – Care (PCPI-C) for the Portuguese healthcare context. The PCPI-C is derived from the middle-range theory of the Person-Centered Practice Framework and is an 18-item self-reported inventory. Methods: This methodological study followed a two-stage research design entailing the translation and cultural adaptation of the PCPI-C from English to European Portuguese and the Portuguese healthcare context in phase I, followed by a psychometric evaluation (N = 312) conducted using principal component and confirmatory factor analysis in SPSS version 27.0 and SPSS AMOS version 21.0 in phase II. The model was continuously and iteratively refined until it was considered acceptable per gold standard estimators. Results: In phase I, the results revealed linguistic and contextual cultural differences compared to the original version. The cognitive debriefing showed that the respondents considered the items understandable and adequate for the purpose. In phase II, among the two adjusted PCPI-C models fit, i.e., first-order, and single-factor, the best fit to the empirical data was revealed by the single-factor structure, reflecting a good fit (x2/df = 2.408, CFI = .93, RMSEA = .07, SRMR = .05). Conclusions: The PCPI-C is a valid and reliable instrument for assessing the perceptions of Portuguese service users regarding person-centered practice. It is necessary to consider the purpose for which the instrument is used to select the most appropriate measurement model, i.e., process evaluation as an outcome or as an inventory measure for continuous improvement.