ESEP - Artigos e Conference Proceedings
Permanent URI for this collection
Browse
Browsing ESEP - Artigos e Conference Proceedings by Field of Science and Technology (FOS) "Ciências Médicas::Ciências da Saúde"
Now showing 1 - 10 of 16
Results Per Page
Sort Options
- Administration, management, and leadership theoretical approaches in undergraduate nurse education: a scoping reviewPublication . Canedo, Estefania; Fernandes, Carla; Martins, Maria ManuelaIntrodução: Nas últimas décadas, a liderança estratégica tem sido identificada como um objetivo global; no entanto, a formação em enfermagem nem sempre fornece o conteúdo necessário em administração e gestão para preparar os enfermeiros aos desafios futuros de liderança. Objetivo: Explorar conceitos, teorias e programas de aprendizagem em administração, gestão e liderança na licenciatura em enfermagem. Métodos: A revisão foi realizada em abril de 2022, seguindo a metodologia JBI e as diretrizes PRISMA-ScR nas bases de dados MEDLINE, CINAHL, PsycInfo via EBSCO, e Scopus via Elsevier. Literatura cinzenta e estudos não publicados também foram incluídos através do RCAAP, Canadian Science Publishing e Google Scholar. Foram incluídos artigos em inglês, francês, espanhol e português, publicados e não publicados de 2012 a 2022. Resultados: Trinta e um artigos responderam aos critérios de elegibilidade da revisão. Foram identificados uma serie de conceitos-chave e estratégias pedagógicas para a aprendizagem de habilidades de liderança assim como um programa específico de aprendizagem na licenciatura de enfermagem. Conclusão: Foi confirmada a necessidade de introduzir todos os conceitos encontrados, apoiados por teorias adaptadas e lógicas ao nível de graduação. O programa de Liderança Clínica em Enfermagem parece apropriado e pode ser um modelo de implementação, mas é necessária mais investigação para desenvolver um currículo de liderança clínica com base em evidências.
- “A Certainty for you Does Not Mean That it is a Certainty for Science”: A Phenomenological Analysis of Experiences of Uncertainty in Clinical Reasoning of Nurses in the Postanesthesia Care UnitPublication . Cunha, Lara D. M.; Pestana-Santos, Márcia; Lomba, Lurdes; Reis Santos, MargaridaPurpose: To explore the experiences of uncertainty in the clinical reasoning of nurses in the postanesthesia care unit (PACU). Design: A phenomenological descriptive design, following Colaizzi’s analysis. Methods: Semistructured interviews were conducted with 14 nurses from a PACU on their experience of uncertainty in clinical reasoning. The interviews were digitally audio-recorded and transcribed verbatim. Two researchers conducted data analysis independently and followed seven phases: (re)reading the transcripts, extracting significant statements, formulating meanings from significant statements, aggregating formulated meanings into themes, developing a description of the phenomenon’s essential structure, generating of the fundamental structure of the phenomenon, validating of the findings through participant feedback. The process employed MAXQDA analytics Pro 2022 software. Consolidated Criteria for Reporting A Qualitative Research checklist was used for reporting. Findings: From uncertainty experiences in nurses’ clinical reasoning, 10 themes emerged: ambiguity and decision latitude, communication, work ethic, difficulty interpreting and predicting outcomes, cognitive performance impairment, incivility, core competence vagueness of postanesthesia nurses, high-tech care, (in)security and risk, and occupational stress. Conclusions: The experiences of uncertainty in clinical reasoning of nurses in postanesthesia care units are highly focused on patient safety. Exploring these experiences has made uncertainty more tangible and explicit, which will enable nurses in postanesthesia care units to prepare for adaptive responses to deal with uncertainty when it occurs in clinical practice.
- Desenvolvimento de competências de enfermagem avançadas na manutenção da normotermia da pessoa no perioperatório – scoping reviewPublication . Costa, Ana; Teixeira, Carla; Barroso, Cristina; Segadães, FátimaIntrodução: A monitorização da temperatura, manutenção da normotermia, prevenção e tratamento da hipotermia perioperatória são considerados, atualmente, standard of care. É necessária a existência de protocolos que visem a monitorização, avaliação, prevenção e controlo da hipotermia na fase intraoperatória. Esta associação, evita complicações, garante a segurança e conforto do doente cirúrgico, levando à qualidade de todo o processo cirúrgico. Objetivo: Mapear as intervenções de enfermagem para a manutenção da normotermia no perioperatório. Métodos: Scoping Review com base nos princípios preconizados pelo Joanna Briggs Institute. Realizada pesquisa nas bases: SCOPUS, Web of Science e EBSCOhost Web da Escola Superior de Enfermagem do Porto e as bases de dados consultadas foram a CINAHL Complete, MedcLatina e a MEDLINE Complete. Para pesquisa de literatura cinzenta foi utilizado o Repositório Científico de Acesso Aberto de Portugal – RCAAP. Foram incluídos estudos publicados com livre acesso online, em texto integral, em português, espanhol ou inglês, com limite temporal entre 2013 a 2023. Resultados: Para conseguir a normotermia perioperatória, os enfermeiros devem adotar métodos de aquecimento do doente. Os estudos apontam para a utilização de mantas térmicas, cobertores aquecidos e ar forçado, e monitorizar a temperatura do doente de forma regular e estruturada. Conclusão: A manutenção da normotermia perioperatória pode ser conseguida através da adoção do aquecimento do doente e é essencial para garantir a segurança, melhorar o resultado do procedimento cirúrgico, garantir o conforto e a satisfação do doente com a experiência cirúrgica.
- Development and Psychometric Properties of the Therapeutic Relationship Assessment Scale–Patient (TRAS‐Patient)Publication . Coelho, Joana Catarina Ferreira; Ribeiro, Joana Isabel Ferreira; Ribeiro, Ana Rita Martins; Trindade, Ana Carolina Gonçalves; Sequeira, Carlos; Roldán Merino, Juan Francisco; Moreno Poyato, Antonio Rafael; Sampaio, FranciscoThe therapeutic relationship plays a crucial role in nursing care for people with mental illness. Adopting a systemic and person‐centred approach that considers the individual experiences and needs of the person is paramount. However, no instruments were found in the literature designed to evaluate the nurse–patient therapeutic relationship from the perspective of a person with mental illness. This study aimed to develop and evaluate the psychometric properties of an instrument for assessing the quality of the nurse–patient therapeutic relationship from the patient's perspective. An e‐Delphi study was conducted to develop the assessment tool, and a psychometric study was carried out to examine its psychometric properties. The sample comprised 240 adults with mental illness. Internal consistency was assessed using Cronbach's alpha and the Omega coefficient. The final structure of the assessment instrument included 24 items distributed across two factors, explaining 64.2% of the variance. Cronbach's alpha was 0.94, and the Omega coefficient was 0.96. The intraclass correlation coefficient was 0.84 (95% CI: 0.66–0.92). The therapeutic relationship assessment scale (TRAS‐Patient) shows good psychometric properties. This is a relevant tool for assessing the quality of the nurse–patient therapeutic relationship from the patient's perspective, thus promoting a patient‐centred approach and responding to the patient's needs. Mental health nurses can access a tool for evaluating the nurse–patient therapeutic relationship centred on disciplinary knowledge. This enables patient involvement in care, enhanced care and person‐centred practice.
- The effect of exergame rehabilitation on the quality of life of cancer patients undergoing abdominal surgery: a randomized controlled trialPublication . Alves, Isabel; Moreira, Ana Paula; Sousa, Teresa; Teles, Paulo; Magalhães, Bruno Miguel; Gonçalves, Filipe; Fernandes, Carla SílviaPurpose Exergames, which combine digital games and physical exercise, have become increasingly popular for rehabilitation in the health domain. This study aimed to assess the effectiveness of exergame rehabilitation on the quality of life of cancer patients undergoing abdominal surgery. Methods This randomized controlled trial evaluated the effectiveness of exergame rehabilitation on the quality of life of cancer patients who had undergone abdominal surgery. Seventy postoperative patients were included, and data collection took place between January 2023 and May 2023. The patients were randomly assigned to either an exergame rehabilitation program (n = 35) or a traditional rehabilitation program (n = 35). The assessed outcome was the quality of life, and data collection occurred at three different time points: upon admission, 48 h postoperatively, and on the 7th day after surgery. Results Quality of life was evaluated using the WHOQOL-BREF Scale. At the third assessment, a statistically significant difference was observed between the two groups (p = 0.016), indicating that the intervention group had a higher quality of life than the control group. Conclusions The study showed a positive effect of exergames on the population under investigation. By the 7th day after surgery, the intervention group demonstrated an improvement in their quality of life compared to the control group. Clinical trial registration Center of Open Science OSF https:// osf. io/ 286zb/, registered in July, 2023
- Effects of physical exercise in reducing caregivers burden: a systematic reviewPublication . Cardoso, Carla; Lumini Landeiro, Maria José; Martins, TeresaBackground and aim: Caring for someone can be physically and psychologically demanding, predisposing caregivers to muscle injuries, fatigue, exhaustion, depression, anxiety, and burnout. The literature suggests several approaches to reducing caregiver burden, one of which is physical exercise. The aim of this systematic review was to analyze the eectiveness of exercise-based programs or muscle relaxation in reducing caregiver burden and stress among family caregivers. Method: A systematic literature review was conducted following the PRISMA guidelines. The search was performed in the Web of Science, Cochrane Library and Scopus databases and through the EBSCOhost aggregator (CINAHL Plus, MEDLINE, and SportDiscus). Studies were selected based on the PICODacronym. Results: Eleven randomized controlled trials (RCTs) and two other experimental studies were included. The reviewed programs encompassed aerobics, strengthening, and muscle relaxation exercises, delivered by various professionals in diverse settings, such as caregivers’ homes, gyms, and hospital environments. Although the programs varied in type, duration, and structure, the majority of the studies demonstrated positive eects on caregivers’ physical and psychological well-being, along with reductions in burden and stress. Conclusion: The results suggest that physical exercise interventions are eective in reducing caregiver burden and stress, while also enhancing overall well- being. Future strategies should emphasize the importance of raising awareness among caregivers about adopting healthy lifestyles, with a particular focus on regular physical activity, as a means of relaxation and self-care. To maximize the eectiveness of these interventions, incorporating flexible, home-based components and engaging multidisciplinary teams could enhance accessibility, adherence, and impact.
- Exergame-based rehabilitation for cancer patients undergoing abdominal surgery: Effects on pain, anxiety, depression, and fatigue - A pilot studyPublication . Alves, Isabel; Moreira, Ana Paula; Sousa, Teresa; Teles, Paulo; Fernandes, Carla Sílvia; Goncalves. Filipe; Magalhães, BrunoPurpose: This study aimed to determine the efficacy of an exergame rehabilitation program on pain, anxiety or depression, and fatigue in oncology patients undergoing abdominal surgery. Methods: The randomized controlled trial evaluated the efficacy of exergame rehabilitation on Pain, Anxiety, Depression, and Fatigue in oncology patients undergoing abdominal surgery. Patients were recruited from October 2022–March 2023 and were randomly assigned to the intervention group (postoperative traditional rehabilitation plus an exergame rehabilitation program) or control group (postoperative traditional rehabilitation). Data were collected at three different times: on admission, in the first 48 h, and on the 7th day after surgery. Primary outcomes were evaluated and monitored with different validated instruments: numeric rating scale (NRS) for pain, Hospital Anxiety and Depression Scale (HADS) to assess the level of anxiety and depression, and the Fatigue Assessment Scale (FAS) to assess physical and psychological fatigue. The length of stay and program completion were secondary outcomes. Results: A total of 128 postoperative patients were recruited. Of these, 58 patients were excluded from the study due to clinical complications related to the surgical procedure (n = 53) or healthcare staff-related reasons (n = 5). Both the control and intervention groups were the same size (n = 35). Lower pain scores were observed on the 7th postoperative day in the group subject to the “exergame rehabilitation program” (p = 0.006). No statistically significant differences were observed for anxiety and depression between the 2 groups. Regarding fatigue, statistically significant differences were observed on admission (p = 0.03), which disappeared 48 h after surgery (p = 0.143). Differences between the groups were observed again on the 7th day after surgery (p = 0.005). Conclusions: The intervention using exergames was effective in reducing the postoperative pain of the patient undergoing major abdominal surgery and in restoring the levels of fatigue before surgical intervention. However, no differences were observed for anxiety or depression. Future studies with larger samples should be carried out.
- Family Nursing Care during the Transition to Parenthood: A Scoping ReviewPublication . César-Santos, Bruna; Bastos, Fernanda; Dias, António; Campos, Maria JoanaBackground: Family-centered care places the family at the core of care, with family nurses playing a pivotal role in supporting and guiding members through pregnancy and the transition to parenthood and acknowledging the significant adjustments during these phases. Aim: To map the evidence concerning family nurses’ care for families during the transition to parenthood. Method: The scoping review followed the Joanna Briggs Institute (JBI) methodology, focusing on family-centered care during pregnancy adaptation and the initial months of parenthood. Using a PCC (population, concept, and context) strategy, the research covered various databases: Scopus; Web of Science; and CINAHL Complete, MedLine Complete, and MedicLatina by EBSCOhost. Results: A Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) flow diagram was used to present the results. Eighteen articles were included, mainly from the Middle East and Europe, including cross-sectional studies and reviews. Key findings addressed the transitioning process to parenthood, the impact of family characteristics, and the role of family nurses in enhancing these processes. Conclusion: Home care is considered vital during this transition. Family nursing should concentrate on both individuals and the parental subsystem, addressing social determinants equitably. Through these efforts, they empower families to establish an optimal environment for children’s development.
- Fast Healthcare Interoperability Resources–Based Support System for Predicting Delivery Type: Model Development and Evaluation StudyPublication . Coutinho-Almeida, João; Cardoso, Alexandrina; Cruz-Correia, Ricardo; Pereira-Rodrigues, Pedro; Cardoso, AlexandrinaBackground: The escalating prevalence of cesarean delivery globally poses significant health impacts on mothers and newborns. Despite this trend, the underlying reasons for increased cesarean delivery rates, which have risen to 36.3% in Portugal as of 2020, remain unclear. This study delves into these issues within the Portuguese health care context, where national efforts are underway to reduce cesarean delivery occurrences. Objective: This paper aims to introduce a machine learning, algorithm-based support system designed to assist clinical teams in identifying potentially unnecessary cesarean deliveries. Key objectives include developing clinical decision support systems for cesarean deliveries using interoperability standards, identifying predictive factors influencing delivery type, assessing the economic impact of implementing this tool, and comparing system outputs with clinicians’ decisions. Methods: This study used retrospective data collected from 9 public Portuguese hospitals, encompassing maternal and fetal data and delivery methods from 2019 to 2020. We used various machine learning algorithms for model development, with light gradient-boosting machine (LightGBM) selected for deployment due to its efficiency. The model’s performance was compared with clinician assessments through questionnaires. Additionally, an economic simulation was conducted to evaluate the financial impact on Portuguese public hospitals. Results: The deployed model, based on LightGBM, achieved an area under the receiver operating characteristic curve of 88%. In the trial deployment phase at a single hospital, 3.8% (123/3231) of cases triggered alarms for potentially unnecessary cesarean deliveries. Financial simulation results indicated potential benefits for 30% (15/48) of Portuguese public hospitals with the implementation of our tool. However, this study acknowledges biases in the model, such as combining different vaginal delivery types and focusing on potentially unwarranted cesarean deliveries. Conclusions: This study presents a promising system capable of identifying potentially incorrect cesarean delivery decisions, with potentially positive implications for medical practice and health care economics. However, it also highlights the challenges and considerations necessary for real-world application, including further evaluation of clinical decision-making impacts and understanding the diverse reasons behind delivery type choices. This study underscores the need for careful implementation and further robust analysis to realize the full potential and real-world applicability of such clinical support systems.
- Literacia dos profissionais de saúde sobre segurança do doentePublication . Amaral, Catarina; Sequeira, Carlos; Albacar-Riobóo, Núria; Pinho, Lara; Férre-Grau, CarmeIntrodução: A segurança do doente é uma questão séria de saúde pública global, focada num sistema de prestação de cuidados que previne erros e é construído sobre uma cultura de segurança que envolve todos os profissionais de saúde, organizações e doentes. Objetivo: Avaliar o nível de literacia dos profissionais de saúde em relação à segurança do doente num centro hospitalar na região central de Portugal. Métodos: Foi realizado um estudo quantitativo, descritivo-correlacional e transversal para avaliar o nível de literacia dos profissionais de saúde em relação à segurança do doente. Uma amostra de 300 profissionais de um Centro Hospitalar na região central de Portugal respondeu ao "Questionário para Avaliar a Implementação do Guia Multiprofissional" da Organização Mundial de Saúde. A maioria dos profissionais de saúde incluídos no estudo são do sexo feminino (76,3%), encontram-se na faixa etária (dos 36-50 anos) 50,3% e são maioritariamente enfermeiros (90%). Resultados: 44,0% dos inquiridos demonstraram baixa literacia na dimensão "Erro e segurança do doente". De forma semelhante, 44,7% apresentaram baixa literacia na dimensão "Segurança do Sistema de Saúde". Quanto à dimensão "Influência Pessoal na Segurança", mais de metade da amostra (52,7%) é altamente letrada. Por último, a maioria dos inquiridos mostrou baixa literacia (54,7%) na dimensão "Atitudes Pessoais em relação à Segurança do Doente". Conclusão: Os resultados apontam existir lacunas por parte dos profissionais de saúde sobre literacia na segurança do doente, com predominância na dimensão "Atitudes Pessoais em Relação à Segurança do Doente". Assim, é essencial que os profissionais de saúde recebam mais formação em segurança do doente para garantir a confiança dos cidadãos nas suas práticas profissionais e na confiança no sistema de saúde.