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- Effectiveness of a new thermal insulation blanket in the control of inadvertent perioperative hypothermia and comfort: a randomized controlled trialPublication . Carvalho, Isaura; Carvalho, Miguel; Abelha, Fernando; Martins, TeresaBackground Disturbances in the thermoregulatory system can precipitate inadvertent hypothermia in patients undergoing surgeries lasting over 60 min, causing serious complications in the recovery process. Cutaneous thermal protection is relevant for the control of temperature of patients in the perioperative setting. The standard thermal protection widely utilized is an electric forced warm air blanket. This study compared a new layered textile blanket with the standard protection. The hypothesis posited that the textile blanket could provide cutaneous thermal protection comparable to that of the standard protection (forced-air warming blanket), in terms of temperature variation and safety. Methods This randomized controlled trial was conducted at a Portuguese orthopedic hospital from October 2018 to January 2019, comprising 124 adult patients undergoing elective total knee arthroplasty. Participants were randomly allocated to either the intervention group, receiving the textile blanket, or to the control group, receiving standard measures. Tympanic temperature, shivering, and thermal comfort perception were evaluated at six time points. Comfort dimensions and ergonomic aspects were also assessed. Parametric statistics were performed, and independent samples t-tests and repeated measures were used to compare temperature variations and thermal comfort. Results No statistically significant differences were found between groups in mean temperature variation, visual perception of thermal comfort, and thermal and perioperative comfort scales. The intervention group (n = 65) scored significantly higher in ergonomic evaluations compared to the control group (n = 59) for: fit to body and general comfort (p = 0.004), touch (p = 0.005), and feeling of comfort with the inner layer texture and shape (p < 0.001). Conclusion The tested blanket had a comparable performance to the standard protection, suggesting it as a potential sustainable alternative to the recommended measures for thermal protection. However, further investigations across diverse contexts and populations are needed to validate these findings.
- Nurses’ perception of the nursing process and its relationship with leadershipPublication . Bär, Karen Ariane; Lima, Bianca dos Santos; Martelle, Gicelle Morais; Silva, Silvana Cruz da; Reis Santos, Margarida; Costenaro, Regina Gema SantiniObjectives: to describe Nurses’ perception of the Nursing Process and its relationship with leadership. Methods: action research conducted between September/2021 and April/2022 with nurses from a medium-sized hospital in southern Brazil. The data investigated, one of the stages of the method, was collected using the Focus Group technique and submitted to Strategic Focus Analysis. Results: three categories emerged from the organized and analyzed data, namely: Nursing Process: a tool that qualifies nursing care; Conditions that weaken the Nursing Process; and Strategies that enhance the Systematization of Nursing Care. Final Considerations: the perception of the Nursing Process and its relationship with leadership are not always understood as complementary themes. Although they recognize that the Nursing Process is sometimes imposed as normative, nurses do not perceive the importance of the role of the leader, who is considered a key player in conducting and boosting the Systematization of Nursing Care.
- Association between patient safety culture and professional quality of life among nursing professionalsPublication . Batalha, Edenise Maria Santos da Silva; Borges, Elisabete; Melleiro, Marta MariaObjective: To analyze the association between patient safety culture and professional quality of life in nursing professionals. Method: Correlational study carried out in a hospital in Salvador, Bahia, Brazil, with 180 participants. The data were collected through the Hospital Survey on Patient Safety Culture and Professional Quality of Life Scale and analyzed with correlation tests. Results: The use of the Quality of Professional Life model, which encompasses Compassion Satisfaction, Burnout and Traumatic Stress, showed that a better assessment of the safety culture was negatively associated with Burnout. Regarding the dimensions of culture, better evaluations of the general perception of safety, teamwork and staffing were negatively associated with Burnout and Traumatic Stress. Higher Burnout was negatively associated with better handoffs and greater Traumatic Stress was positively associated with error communication. Conclusion: Higher levels of Burnout were associated with worse perception of safety culture and worse teamwork evaluations; staffing and general perception of safety were associated to a higher level of Burnout and Traumatic Stress, which emphasizes the importance of investment in these areas.
- Quality of life and family management of paediatric chronic condition amidst the COVID-19 pandemicPublication . Andrade, Luísa; Lemos, Sara Raquel Machado; Barbieri-Figueiredo, MC; Lima, LigiaPurpose: This study aimed to describe the perception of parents of children/adolescents with chronic conditions of their quality of life and family functioning during the COVID-19 pandemic and explore how the COVID-19 pandemic affected family management of children/adolescents' chronic conditions. Design and methods: A total of 237 parents of children/adolescents with chronic conditions participated in this cross-sectional study. Data were collected through an online questionnaire using the Paediatric Quality of Life Inventory™ Family Impact Module and an open-ended question about the impact of the pandemic on the family management of the paediatric chronic condition. Results: The Total Score of PedsQL™ FIM was slightly higher than the midpoint of the scale (M = 60.27; SD = 19.04), and the impact of the pandemic on the family's management of the chronic condition was perceived by 30% of parents as high or moderate. Statistically significant differences were found between parents who reported a high or moderate impact of the pandemic and those reporting little or no impact of the pandemic regarding parental quality of life and family functioning (t (233) = 8.13, p = .00, Cohen's d = 1.14). Two themes emerged from the analysis of the open-ended question: Impact on the child/adolescent and Impact on the family. Conclusions: Parents of children/adolescents with chronic conditions reported an average quality of life, and the COVID-19 pandemic significantly impacted the family management of chronic conditions. Practice implications: These results highlight the importance of developing interventions to support families in complex situations and contexts, targeting family functioning, family quality of life, and emotional management.
- Improving Accessibility with Gamification Strategies: Development of a Prototype AppPublication . Araújo, Tiago; Campos, Maria Joana; Ferreira, Marta; Fernandes, Carla SílviaObjective: The study aimed to demonstrate the development of a mobile app prototype, BarrierBeGone, a system that identifies potential barriers for individuals with mobility disabilities and promotes accessibility using gamification strategies. The main goal is to raise awareness about mobility and accessibility difficulties, especially for wheelchair users, and to promote more responsible behaviours. Method: The User-Centred Design methodology was employed, going through three phases: requirements gathering, design and development, and evaluation. Additionally, interviews with five individuals with mobility disabilities helped define the initial system requirements. The development of the barrier identification system was followed by usability tests with nine representative users. Results: The results of the usability tests of the "BarrierBeGone" barrier identification system were extremely positive. Stakeholders recognized the utility and simplicity of the platform, considering it a motivating factor for future use. Conclusion: The results support the effectiveness of the proposed educational tool in increasing awareness about accessibility and social inclusion in smart cities. This study makes a significant contribution to the field of urban planning and inclusive design.
- Exergames for rehabilitation in stroke survivors: Umbrella review of meta-analysesPublication . Fernandes, Carla Sílvia; Magalhães, Bruno; Gonçalves, Filipe; Lima, Andreia; Silva, Mafalda; Moreira, Maria Teresa; Santos, Célia; Ferreira, SaloméBackground: It is essential to explore alternative methods to motivate stroke survivors throughout their lengthy rehabilitation journey. Exergames have emerged as promising tools for rehabilitating this demographic. Objective: We aimed to synthesize the combined evidence from meta-analyses that assessed the effects of exergames in the rehabilitation of stroke survivors. Methods: The umbrella review was conducted utilizing several databases, including MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), the Psychology and Behavioral Sciences Collection, SPORTDiscus®, and Scopus®. It included studies published until December 2023 without any restrictions based on publication date. Results: The analysis included 11 meta-analyses involving approximately 9,615 patients, reflecting a growing adoption of exergames in post-stroke rehabilitation since 2015, focusing on using Nintendo Wii. The analyzed studies varied widely in intervention duration (from 1 to 16 weeks) and were applied across different phases of post-stroke rehabilitation, from the acute to the chronic phase. Significant improvements were observed in balance and upper limb functionality, although there was notable methodological heterogeneity and variability in the results. Conclusions: This study highlights the value of exergames in the rehabilitation of stroke survivors and recommends future research that adopts rigorous methodological designs with clearly specified intervention stages. It underscores the importance of additional qualitative studies to explore the perspectives of patients and healthcare professionals regarding exergames, aiming to refine rehabilitation strategies and enhance the clinical benefits achieved.
- Unravelling Uncertainty Inception: When We Really Know That We Don't Know?Publication . Cunha, Lara Daniela Matos; Ventura, Filipa; Pestana‐Santos, Márcia; Lomba, Lurdes; Reis Santos, MargaridaThrough technical rationality, healthcare professionals address instrumental problems by applying the theory and technique arising from scientific knowledge. Nevertheless, the divergent situations of practice characterised by uncertainty, instability, and uniqueness place nurses in a positivist epistemological dilemma. Decision‐making under uncertainty is a challenge that nurses face in clinical practice daily. Nurses anticipate critical events based on the interaction between (un)known factors of clinical reasoning, putting uncertainty tolerance into perspective. With undeniable epistemological relevance, few nursing researchers have addressed this issue. Based on the insights garnered from the panel held at the 26th International Nursing Philosophy Conference, this discussion paper examines the inception of uncertainty within nursing reasoning, intertwining introspection, abstraction, and the rich discussions from the conference. Accordingly, the philosophical underpinnings of the perceived experience of uncertainty will be briefly addressed, while framing the decision‐making challenges faced by nurses. A compelling dimension of nursing care emerges when we delve into the inception of uncertainty, prompting a deeper examination of the interplay between its perception and consciousness in clinical practice, and the gravitation of uncertainty in the process of empirical reasoning. Navigating uncertainty involves varying individual responses, influenced by tolerance levels. Moral appropriateness is determined by their adaptability rather than solely their positivity or logical consistency, highlighting constancy as a quality demanding alignment with an understanding of challenges.
- Use of the Practical Approach to Care Kit Adult by nurses: a systematic reviewPublication . Celuppi, Ianka Cristina; Pires, Denise Elvira Pires de; Mendes, Mariana; Amadigi, Felipa Rafaela; Martins, Maria Manuela Ferreira Pereira da Silva; Lumini Landeiro, Maria José; Brehmer, Laura Cavalcanti de FariasObjective: To analyze scientific production about the Practical Approach to Care Kit Adult application in nurses’ work process in Primary Health Care. Methods: A systematic review carried out in the PubMed®, EMBASE, Scopus, Web of Science, MEDLINE® and CINAHL databases on July 17, 2023. Articles were included that demonstrate the Practical Approach to Care Kit Adult use in nurses’ work process in Primary Health Care, in countries where this technology has been implemented in the format of original studies, case reports, opinion articles and reviews. Articles that dealt with old versions of the Practical Approach to Care Kit or did not detail how the technology was used, were characterized as editorials, comments, news, conference abstracts, research protocols, theses and dissertations or were unavailable in full were excluded. The analysis of the risk of bias of studies was carried out in pairs, using the JBI checklists for qualitative studies, opinion and randomized clinical trials. Results: Six articles were selected that highlighted the Practical Approach to Care Kit use as a technology to support nurses’ clinical decision-making. Its application in permanent education actions of the teams in Primary Health Care services also stood out. Conclusion: This review contributes to public health nursing knowledge by highlighting the use of an innovative and low-cost technology in nurses’ care process.
- Pré-natal coletivo mediado por tecnologia educativa: percepção de gestantesPublication . Backes, Dirce Stein; Medeiros, Leandro da Silva de; Veiga, Andressa Caetano da; Colomé, Juliana Silveira; Backes, Marli Terezinha Stein; Reis Santos, Margarida; Zamberlan, ClaudiaThis article aims to explore the perception of pregnant women regarding collective prenatal care facilitated by educational technology, in the light of complexity thinking. Qualitative, exploratory and descriptive study conducted between August and November 2022. The participants were 19 pregnant women from a Family Health Strategy in the central region of the State of Rio Grande do Sul. Data were collected through individual interviews following prenatal meetings and analyzed using thematic analysis. The analysis of the data revealed three thematic axes: Prenatal care: the necessary reconnection of knowledge; Collective prenatal care: collaborative (re)construction of experiences and practices; and Educational technology: tool to foster self-reflection and self-knowledge. Collective prenatal care, facilitated by educational technology, can promote better practices in the pregnancy-postpartum journey by creating collaborative and shared environments for knowledge construction and enabling autonomous and informed decision-making
- Transition to family parenting in the face of the first child: a scoping reviewPublication . Araújo, Maria Isabel Ventura; Duarte, Alberto Carlos Marques; Figueiredo, Maria; Andrade, Carmen Maria da Silva MacielObjectives: to identify and summarize the elements that characterize the family transition process in relation to the first child. Methods: a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Results: ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/ responses used in the transition process. Final Considerations: elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.