ESEP - Artigos e Conference Proceedings
Permanent URI for this collection
Browse
Recent Submissions
- “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.
- 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.
- Variables related to perceived stress and resilience among international migrants: a multicenter study (AFFAIR Project)Publication . Barreto, Mayckel da Silva; Barbieri-Figueiredo, Maria do Céu; Garcia-Padilla, Francisca Maria; Saenz Mendia, Raquel; Silva, Renan Alves; Sá, Florinda Laura Ferreira Rodrigues Galinha De; Almeida, Camila Aparecida Pinheiro Landim; Campos, Maria Joana; Lise, Fernanda; Marcon, Sonia SilvaABSTRACT Objective: To identify variables related to perceived stress and resilience of international migrants. Method: Multicenter, observational, cross-sectional study carried out with 403 migrants residing in Brazil, Spain, or Portugal. The following instruments were used to collect data: Perceived Stress Scale and Resilience Scale. Student's t-test and analysis of variance were applied in the analysis. Results: Perceived stress was related to: living in Brazil or Portugal; shorter stay in the host country; being black or brown; and having no religion. Greater resilience was related to: not being divorced; having less education and lower family income; being from developing countries; living in Spain; and having a religion. Conclusion: Aspects such as host and origin country, skin color, income, marital status, education, length of stay in the host country, and religion are related to the level of stress and/or resilience of migrants. Knowing this profile is useful for developing public integration policies and interventions that seek to reduce stress and improve resilience.
- Nurses’ perspectives on the use of mobile applications for self-care in chronic illnessesPublication . Carvalho, Simone Mendes; Sousa, Maria RuiABSTRACT Objective: to analyze the nurses’ perspective on the possibility of incorporating the use of mobile applications into their care practice as a strategy for promoting self-care in people with chronic diseases. Method: an exploratory-descriptive study with a qualitative approach. Data were collected between the months of February and March 2023 with 10 nurses who were Master’s degree students in Community Nursing in the Family Health Nursing area from a higher education institution in Nursing in Portugal. The data were analyzed using the content analysis technique proposed by Bardin. The MAXQDA software program was used to facilitate and accelerate qualitative data analysis through coding and categorization. Results: the results were organized into two main categories: challenges for managing the therapeutic regimen and self-care; and strategies for promoting self-care in chronic diseases from the perspective of nurses. The challenges during the Covid-19 pandemic generated elements which hinder and facilitate management of the therapeutic regimen and self-care in people with chronic diseases. From the nurses’ perspective, the use of mobile applications can facilitate promoting self-care in people with chronic illnesses. Conclusion: chronic disease control heavily depends on people’s behaviors and self-management of the disease. The nurses in this study considered that the use of mobile applications can help both healthcare professionals and people with chronic illnesses in promoting health and in the self-care process.
- 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.
- 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.
- 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.
- Perspectives of adult patients with mental health disorders on the relationship with nurses: a focus group studyPublication . Coelho, Joana; Moreno Poyato, Antonio; Roldán Merino, Juan; Sequeira, Carlos; Sampaio, FranciscoBackground The relationship between the nurse and the patient with mental health disorder is crucial to the recovery process. Thus, patients with mental health disorders should be active subjects in this relationship by having autonomy and self-determination. Methods This study aimed to explore the perspectives of adult patients with mental health disorders on the relationship with nurses. A qualitative, descriptive, and exploratory study was conducted in March 2023, using focus group meetings in an association to support patients with severe mental health disorders in the Northern region of Portugal. The study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). A total of 8 patients participated in the study. Two focus group meetings were conducted. The inductive method was used, and content analysis of the transcripts was performed. The QDA Miner Lite 4.0 and Microsoft Excel were used for content analysis. Results Participants considered the relationship with nurses important for their recovery and expected nurses to provide support and help, being able to identify their needs, thus personalising their care. Attitudinal and communication aspects were also considered crucial for establishing a solid, trusting, and meaningful relationship. Conclusion According to the findings nursing care is expected to focus on the patient, his/her preferences, expectations, and the uniqueness of each individual. The results of this study may be useful for the reflection and improvement of nurses in their relational and communication skills and the driving force for nursing students’ awareness of the perspective of the relationship with patients with mental health disorder and its relevance.
- Posttraumatic growth in women after a childbirth experience: The influence of individual characteristics and intrusive and deliberate rumination.Publication . Brandão, Tânia; Brandão, Sónia; Prata, Ana Paula; Silva, Rosa; Abreu, Wilson; Riklikiene, Olga; Jarasiunaite-Fedosejeva, Gabija; González-Mesa, Ernesto; İsbir, Gözde Gökçe; Inci, Figen; Akik, Burcu Kömürcü; Uriko, Kristiina; Thomson, GillObjective: This study targeted women who had a self-defined traumatic birth to a) explore the differences between sociodemographic, obstetric, and childbirth trauma related variables in relation to women’s rumination style following a traumatic birth, b) determine differences between intrusive and deliberate rumination in relation to post-traumatic growth dimensions, and c) test whether deliberate rumination explains the relationship between intrusive rumination and post-traumatic growth dimensions. Method: A cross-sectional study design was employed using a web-based survey method for data collection. In total, 202 women who identified their childbirth experience as traumatic participated in this study. Results: Intrusive rumination and deliberate rumination were positively associated with all dimensions of post-traumatic growth in women following the traumatic childbirth event. Deliberate rumination fully explained the relationship between intrusive rumination and post-traumatic growth aspects of relating to others, new opportunities, and personal strength, and partially explained the relationship between intrusive rumination and posttraumatic growth aspects of spiritual changes and appreciation of life. Conclusions: The results suggest that deliberate rumination can contribute to explaining the occurrence of post-traumatic growth. These findings could help develop psychosocial interventions to maximise opportunities for deliberate rumination for women with traumatic childbirth experiences.
- 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.