Browsing by resource type "Artigo científico"
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- Air quality self-management in asthmatic patients with COPD: An integrative review for developing nursing interventions to prevent exacerbationsPublication . Sebastião, Bruna F.; Hortelão, Raquel M.; Granadas, Sara S.; Faria, José M.; Pinto, Joana R.; Rafael Henriques, Helga Marília da SilvaObjectives: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) patients experience a lower quality of life, frequent exacerbations, and worse pulmonary function. Environmental management is essential in a complex chronic condition, as pollutant exposure can worsen symptoms and increase morbidity and mortality. We aimed to identify evidence that informs nursing interventions in promoting self-management of air quality in asthmatic people with COPD. Methods: We conducted an integrative review in March of 2023. We searched the databases CINAHL, MEDLINE, Academic Search Complete, Cochrane Database of Systematic Reviews (CDSR), Scopus, Web of Science, Joanna Briggs Institute (JBI) Evidence-Based Practice Database, and Google Scholar. We included articles whose participants were adults with asthma, COPD, or both; the intervention was air quality management and the outcome of any exacerbations. We excluded editorials, letters, commentaries, opinion papers, position papers, study protocols, conference abstracts, and reviews. Data extraction and synthesis were performed, categorizing interventions according to nursing actions. Methodological quality assessment was conducted using the JBI Critical Appraisal Checklist tools. The review protocol was registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/5Y4KW). Results: We included five articles from different countries. The interventions promoting air quality self-management for individuals with asthma and COPD included vigilance interventions (health professional regular visits, assessment of symptoms), monitoring interventions (measurement of indoor and outdoor trigger factors), and educational interventions (air quality alerts, allergen avoidance). Policy interventions such as smoke-free policies and comprehensive strategies to improve air quality were also identified. These areas of focus represent critical components of nurses' interventions and can integrate the fundamental patterns of knowing in nursing. Although the studies reveal heterogeneous interventions and the methodological quality is variable, these interventions showed potential for preventing exacerbations, reducing emergency department visits, and minimizing hospitalizations. Conclusions: The study emphasizes the need for a comprehensive approach involving nurses in multidisciplinary teams to air quality self-management. They can use these results to inform their interventions and ways of knowing, benefiting individuals with asthma and COPD. Further research is needed to expand the evidence base and refine these interventions.
- Analyzing innovative policies and practices for palliative care in Portugal: a qualitative studyPublication . Silva, Marcelle Miranda da; Telles, Audrei Castro; Baixinho, Cristina Lavareda; Sá, Eunice; Costa, Andreia; Henriques, Maria Adriana PereiraBackground Countries with formal policies for palliative care, and advanced and integrated practices in this field, such as Portugal, face challenges in achieving excellence in care, particularly in home-based assistance. Issues include care coordination among providers, confusion regarding the roles of each health care professional in the network, and a lack of monitoring and evaluation of actions. Our objective was to analyze the implementation of palliative care in primary health care in Portugal. Methods We conducted a qualitative, descriptive, and exploratory study in Portugal involving health care professionals with experience in palliative care. The data were collected through semistructured interviews and focus groups between March and October 2023. Eighteen health care professionals participated. We used the Alceste software for lexicographic analysis. The research was authorized by an Ethics Committee. Results Four classes were identified; classes 1 and 2, comprising 77% of the corpus, addressed the study objectives. Participants highlighted inequitable access, strategic development plans with unattainable short-term goals; and low literacy. They emphasized the importance of legislation, professional training initiatives for generalist palliative care at home, and early referral. Home-based challenges included professionals’ lack of exclusive dedication, absence of 24/7 coverage, and unavailability of capable family caregivers. The networks’ response to hospital admissions and patient transitions from hospital to home, with access to the specialized team, was also inadequate. Conclusions Health care professionals aim to increase patients’ time spent at home, reduce emergency department visits, and minimize hospitalizations by leveraging the resources of the national palliative care network. In addition to investments to sustain network implementation and legally guaranteed palliative care rights, the country must focus on measurable indicators for evaluating and monitoring actions, providing better guidance in the short, medium, and long term.
- Assessment of rehabilitation nurses' knowledge and results of nurse educational programme (C2F) regarding osteoporosis and fragility fracturesPublication . Pimentel, Georgina; Cruz, Arménio; Baixinho, Cristina Lavareda; Loureiro, Maria; Fernandes, Silvia; Ferreira, Ricardo J.O.; Marques, AndréaBackground: Providing adequate care for the person with a fragility fracture is essential to prevent recurrences. A key strategy involves training by improving nursing care in the fields of osteoporosis and fragility fractures. However, in Portugal, there is no report on the level of knowledge of nurses, nor experimental studies on how to improve it. Objective: The study aimed to assess the knowledge of Rehabilitation Nurses in Portugal on osteoporosis and fragility fractures. Additionally, it sought to evaluate the impact of a specific educational programme on nurses' knowledge. Methods: In Phase I, a cross-sectional study involved 452 participants, utilizing a 26-question knowledge test. In Phase II, a quasi-experimental study included 42 nurses from 28 hospitals, subjected to a 30-h hybrid educational programme. The program comprised 9 online (2 h 30 min each) and 2 live sessions, covering assessment, pharmacological and non-pharmacological treatment, monitoring, project planning, consultations, and outcome indicators measurement. A before-and-after programme knowledge test was administered. Results: Phase I revealed an average knowledge score of 69.6%. In Phase II, there was a significant improvement with programme (70.4% vs. 85.8%, p < 0.01). Specialized nurses performed better than non-specialized nurses (80% vs. 75%, p = 0.011), and those from orthopaedic services showed the greatest improvement (92% vs. 83%, p = 0.014). Conclusions: Rehabilitation Nurses in Portugal have room to improve their knowledge of osteoporosis and fragility fractures. The hybrid educational programme proved effective in improving nurses' knowledge, especially among specialist and orthopaedic service nurses. We hope that this knowledge can be translated into continuous improvement in healthcare provision.
- Autogestão do diabetes na adolescência: experiência de jovens adultos e pais portugueses adolescênciaPublication . Malheiro, Maria Isabel Dias da Costa; Vinagre, Maria da Graça; Colaço, Sónia Isabel; Flora, Marília Costa; Paixão, Maria José Góis; Figueiredo, Inês Carnall; Dingle, MarinaObjective To identify the factors that facilitate or hinder the construction of autonomy in adolescence through the experience of young adults with type-1 diabetes and their parents. Methods This was a qualitative, descriptive, and exploratory study. Two focus group interviews were conducted: one with nine young adults who were experts in managing their illness and the other with seven parents. Thematic and categorical content analysis was used for data analysis, with particularities of a focus group interview and the use of the NVIVO 12 software. Results Two major categories and ten subcategories related to factors that facilitated (support systems, knowledge, diet, insulin pump, early responsibility for managing therapy, and characteristics of young people) and hindered (therapeutic regimen, stigma, attitude of health professionals, characteristics of young people, and knowledge) the development of autonomy in disease management emerged. Conclusion Autonomy in the management of diabetes involves several challenges for adolescents, which requires adaptation of attitudes and interventions by professionals. In addition to the traditional management of the health condition, addressing issues related to the socialization of adolescents is essential, looking for innovative strategies that promote coping and quality of life. The results of this study make it possible to reflect on the therapeutic relationship with adolescents, emphasizing the importance of individualizing care and innovative responses to their specific needs. type1 type 1 type- parents qualitative descriptive conducted software support systems knowledge diet pump therapy people regimen stigma professionals emerged condition essential life needs
- Comment on Yu et al. (2024) ‘Effects of interventions to promote resilience in nurses: A systematic reviewPublication . Costa, Paulo Santos; Almeida, Inês F.; Bernardes, Rafael A.Letter
- Considering Participant Observation Methods for Nursing Qualitative ResearchPublication . Costa, Ana Inês Lourenço da; Rosa, Maria da Luz Jansénio Monteiro de Almeida Fonseca; Diogo, Paula Manuela JorgeObservation is used as a research technique and the selection of the appropriate type depends on the research question and the paradigm underlying each study. The degree of participation and involvement of a nurse researcher varies according to the nature of the setting and the research question. The objective is to reflect on the experience in applying observational techniques in nursing qualitative research. We report on the experience of using 14 observations of interactions between nurse-childparents in a nursing appointment in a healthcare center. This data collection allowed identification of advantages and limitations in the nurse-child-parent interaction processes, in a healthcare center. We argue that advantages of observation can include overcoming the divergence between what participants say and what they do; capturing the emotional dimension cultivated within the natural environment; f lexibility and non-intrusiveness if the researcher gives time to develop a relationship with the participants. Doing observations requires significant time in the natural context, through sustained presence, building trust, and becoming integrated into the context before the research begins. In interpretive and naturalistic qualitative research observational techniques continue to offer a method that can be used alone or conjugated with other data collection techniques.
- Development and Validation of the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE-PT)Publication . Teixeira, Gisela; Gaspar, Filomena; Lucas, PedroIntroduction. This study introduces the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE-PT), a pioneering instrument designed to assess leadership behaviours in multicultural nursing work environments, addressing gaps in current leadership assessment tools. Aim. This study aimed to develop and validate the Portuguese Transcultural Nursing Leadership Questionnaire (QLTE-PT). Methods. It was conducted as a sequential exploratory mixed-method study, integrating DeVellis’s steps for instrument development. Items were formulated based on a literature review and a focus group study, and the content validity was evaluated by a panel of experts. A methodological approach involving nurses registered in the Portuguese Order of Nurses with leadership experience in multicultural nursing work environments was employed to further conduct an exploratory and a confirmatory factor analysis to assess the instrument’s structure and psychometric properties. Results. One hundred forty-five items were initially generated, of which 39 were included in the QLTE-PT following content validity assessment by a panel of experts. EFA revealed a factor structure of 25 items loading on six factors, explaining 64% of the total variance. The overall Cronbach’s α coefficient of the questionnaire was 0.90. This six-factor structure was tested by CFA, revealing a final model of 23 items and six factors, with a good quality of adjustment (CFI = 0.980, TLI = 0.976, SRMR = 0.078, and RMSEA = 0.070). Both convergent and discriminant validity were confirmed. Conclusions. The QLTE-PT demonstrates good psychometric properties and is suitable for assessing transcultural leadership behaviours of nurse managers and leaders in multicultural nursing work environments. Implications for Nursing Management. The QLTE-PT can assist nurse managers to improve their leadership behaviours, promote supportive working environments for their multicultural nursing staff, and improve the quality of care provided to patients from different cultural backgrounds.
- The effectiveness of nursing interventions in adherence to self-care for preventing venous ulcer recurrence: A systematic literature reviewPublication . Gomes, Filipe José Paulo; Pereira Henriques, Maria Adriana; Baixinho, Cristina LavaredaVenous ulcers affect up to 3% of the global population, with a high impact on economies and quality of life. This is exacerbated by its recurrence rates, which reach 70% at 12 months after healing. The perpetuation of these cycles of healing and recurrence is not interrupted or even attenuated by the self-care activities recommended and directed toward their prevention. In this context, we sought to identify the effectiveness of interventions that promote adherence to self-care to prevent venous ulcer recurrence. In August 2022, we conducted a literature search via EBSCO in the following databases: CINAHL Complete, MEDLINE Complete, Cochrane Database of Systematic Reviews, Scopus, and Web of Science. The inclusion criteria were researched in the form of randomised controlled trials or systematic literature reviews, and 99 studies were identified. During the different times of selection, four studies met the defined inclusion criteria and were included. As the main conclusions, the emphasis goes to the importance of the use of compression and the greater effectiveness of higher compression classes for the prevention of recurrence. Different educational methodologies seem to be important to increase knowledge about prevention, specifically regarding the aetiology of recurrence and the implementation of prevention measures.
- Efficacy and safety of pharmacological treatment of psoriatic arthritis: a systematic literature research informing the 2023 update of the EULAR recommendations for the management of psoriatic arthritisPublication . Kerschbaumer, Andreas; Smolen, Josef S; Ferreira, Ricardo J O; Bertheussen, Heidi; Baraliakos, Xenofon; Aletaha, Daniel; McGoagle, Dennis G; van der Heijde, Désirée; McInnes, Iain B; Esbensen, Bente Appel; Winthrop, Kevin L; Boehncke, Wolf-Henning; Schoones, Jan W; Gossec, LaureObjectives: To obtain an overview of recent evidence on efficacy and safety of pharmacological treatments in psoriatic arthritis (PsA). Methods: This systematic literature research (SLR) investigated the efficacy and safety of conventional synthetic (cs), biological (b) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) in patients with PsA. A systematic database search using Medline, EMBASE, Cochrane CENTRAL was conducted to identify relevant articles published since the previous update in 2019 until 28 December 2022. Efficacy was assessed in trials while for safety observational data were also considered. Adverse events of special interest were infections (including herpes zoster, influenza and tuberculosis), malignancies, major adverse cardiovascular events, venous thromboembolisms, liver disease, laboratory changes and psychiatric adverse events. No meta-analyses were performed. Results: For efficacy, of 3946 articles screened, 38 articles (30 trials) were analysed. The compounds investigated included csDMARDs (leflunomide, methotrexate), bDMARDs inhibiting IL17 (bimekizumab, brodalumab, ixekizumab, izokibep, secukinumab,), IL-23 (guselkumab, risankizumab, tildrakizumab), IL-12/23 (ustekinumab) as well as TNF (adalimumab, certolizumab-pegol, etanercept, infliximab, golimumab) and Janus Kinase inhibitors (JAKi) (brepocitinib, deucravacitinib, tofacitinib, upadacitinib). The compounds investigated were efficacious in improving signs and symptoms of PsA, improving physical functioning and quality of life. For safety, 2055 abstracts were screened, and 24 articles analysed: 15 observational studies and 9 long-term follow-ups of trials, assessing glucocorticoids, TNFi, IL-17i, JAKi, IL-12/23i and PDE4i (apremilast). Safety indicators were generally coherent with the previous SLR in 2019. Conclusion: The results of this SLR informed the task force responsible for the 2023 update of the European Alliance of Associations for Rheumatology recommendations for pharmacological management of PsA.
- EULAR points to consider for patient education in physical activity and self-management of pain during transitional carePublication . Courel-Ibáñez, Javier; Prieto-Moreno, Rafael; Briones-Vozmediano, Erica; Ariza-Vega, Patrocinio; Angevare, Saskya; Anton, Jordi; Bini, Ilaria; Clemente, Daniel; Correia, Matilde; Costello, Wendy; De Cock, Diederik; Domján, Andrea; Leon, Leticia; Marques, Andréa; Minden, Kirsten; Mourão, Ana Filipa; Najm, Aurélie; Ozen, Seza; Pimentel, Georgina; Saleem, Zainab; Vetrovsky, Tomas; Wulffraat, Nico M.; Crovato, Andrea Zacarias; Prior, Yeliz; Carmona, Loreto; Estévez-López, FernandoObjectives A EULAR task force was convened to develop points to consider (PtC) for patient education in physical activity and self-management of pain in young people with juvenile-onset rheumatic and musculoskeletal diseases during transitional care. Methods A task force of 26 people from 10 European countries followed the EULAR Standardised Operating Procedures to establish overarching principles (OAPs) and PtC based on a literature review and expert consensus. Level of evidence (LoE), grade of recommendation (GoR) and level of agreement (LoA) were determined. Results Two OAPs and seven PtC were formulated. The OAPs highlight the importance of personalised transitional care in rheumatology, ideally based on shared decision-making and incorporate interactive education to empower young individuals in managing their physical activity and pain. The PtC emphasise the clinical importance of patient education in these areas to improve readiness to transfer from paediatric to adult care. For two PtC, the GoR was moderate (grade B), based on individual cohort study (LoE 2b). For the remaining five PtC, the GoR was weak (grade D), based on expert opinion (LoE 5). The LoA among the task force was high, ranging from 9.4 to 9.8, except for one PtC that was 8.7. Conclusion These EULAR PtC establish guidance on best practices for delivering patient education in physical activity and self-management of pain during transitional care in rheumatology. The adoption of these PtC in clinical settings is recommended to standardise and optimise transitional care across European healthcare systems. Additionally, the task force expects that these PtC will drive future research and potentially shape policies across Europe.