ESEL - CIDNUR - Artigo cientifico
URI permanente para esta coleção:
Navegar
Entradas recentes
- Incidence and delirium risk factors in burn patients: A prospective cohort studyPublication . Silva, Márcia Pereira; Vala, Joana; Sousa, João; Teixeira, Joana Ferreira; Henriques, HelgaBackground Delirium is a neurocognitive syndrome caused by systemic disturbances, leading to impaired attention, awareness, and/or cognition. It poses a significant risk of comorbidities, mortality, prolonged hospitalization, and increased healthcare costs. The challenges in delirium management, follow-up, and rehabilitation, arising from complex chronic conditions and long-term complications after severe burns, highlight the urgent need for more research in this area. Thus, this study aims to investigate the incidence of delirium and the risk factors specific to this population. Methods This analytical observational prospective cohort study was conducted between August 2022 and January 2024. Adults (18 years and older) admitted to a single burn unit with a confirmed burn injury were included, regardless of burn severity. Sociodemographic and clinical variables included age, sex, extent of burn, and prior health status. Delirium assessment was made using the CAM-ICU scale at least twice a day. The primary outcome was the incidence of delirium and its risk factors, with secondary outcomes including the onset and duration of delirium episodes. Results/Discussion The sample consisted of 50 patients, with a delirium incidence of 52 %. Burn patients admitted to the burn unit developed delirium an average of 11.81 days (95 % CI=7.09–16.52) after hospitalization, with an average duration of 11.5 days (95 % CI = 7.28–15.72). Age was the only predisposing risk factor that emerged (p = 0.0141). Five variables emerged as precipitating risk factors in bivariate analyses: total surface burn area (TSBA) (p = 0.026), surgery (p = 0.0438), mechanical ventilation (p < 0.001), opioid infusion use (p < 0.001), and infection (p < 0.001). However, in multivariate Cox regression analyses, only mechanical ventilation remained statistically significant as a risk factor for delirium (HR=8.017; 95 % CI = 1.926 – 33.368; p = 0.004). Conclusion This study highlights mechanical ventilation as a critical risk factor contributing to the high incidence of delirium among burn patients. Early identification and management of risk factors—mainly mechanical ventilation, but also TSBA, surgery, opioid infusion use, and infection—can guide targeted interventions to improve patient outcomes and mitigate the impact of delirium on recovery.
- Targeted temperature management to minimise secondary brain injury after cardiac arrest: A systematic reviewPublication . Seixas, Joana Costa; Oliveira, Mariana; Monteiro, Mariana; Pinto, Maria do Rosário; Durão, Cândida; Teixeira, Gisela; Henriques, Helga Rafael; Teixeira, Joana FerreiraBackground: A patient recovering from an in-hospital or out-of-hospital cardiac arrest (CA) requires interventions for recovery, particularly for minimising secondary brain injury. Targeted temperature management (TTM) is the intervention with the greatest impact on neurological recovery. Aim: The aim of this systematic review was to describe current TTM in adult CA patients and its impact on functional outcomes. Methods: This systematic review was developed between March and May 2024 according to the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting. Eligibility criteria were established. We systematically reviewed studies enrolling adult CA patients who received TTM and reported functional outcomes. The search strategy was applied in the following databases: Medline and CINAHL Ultimate, the Cochrane Central Register of Controlled Trials, through EBSCO, and Scopus. The Rayyan software was used for the final extraction and selection. Results: The studies retrieved highlight the following interventions for neuroprotection: the use of a continuous temperature feedback system (continuous temperature monitoring with vesical, oesophageal, or parenthetic probes) for temperature induction; conducting a preinduction time between 390 min (6.5 h) and 12 h and an induction time greater than 440 min (7.3 h); setting the target temperature between 32 °C and 37.5 °C according to the patient's characteristics for a maintenance period between 24 and 48 h; the administration of sedatives, antipyretics, and neuromuscular blockers; and the assessment of neurological prognosis only after the rewarming phase, using scales such as the Cerebral Performance Category and the Modified Rankin Score. Conclusions: Continuous research and investment in this area of knowledge are highly encouraged, particularly in terms of refining accurate neurological prognostic tools and assessment scales.
- The OPTIMUS International Consensus Guidance for Monitoring User‑Reported Outcomes of Opioid Maintenance Treatment: a Delphi StudyPublication . Wiessing, Lucas; Akartuna, Deniz; Antoine, Jérôme; Banka‑Cullen, Prakashini; Barbaglia, María Gabriela; Belackova, Vendula; Belbaisi, Saed A. S.; Bernardini, Claudia; Bitri, Sonila; Blanken, Peter; Carrieri, Patricia; Čelojević, Saša; Comiskey, Catherine; Dacosta‑Sánchez, Daniel; Dale, Laura; Dom, Geert; Fabricius, Venus; Faria, Hugo; Fischer, Gabriele; Fotopoulos, Dimos; Hijazi, Lina; Ičanović, Dario; Ignjatova, Liljana; Inić, Nemanja; Jacobsen, Britta; Jakavicius, Haris; Janíková, Barbara; Javakhishvili, Jana D.; Kamendi, Zuzana; Kapitány‑Fövény, Máté; Karczewska, Roksana; Kiss, Anna; Krasias, Andreas; Kyprianou, Evi; Lamy, Dominique; Landsmane, Inga; MacLeod, Katy; Marchand, Kirsten; Martinelli, Thomas; Millar, Tim; Mravcik, Viktor; Mustafa, Naser J. Y.; Nikolovski, Bojan; Partanen, Markus; Pedersen, Mads Uffe; Pericoli, Filippo Maria; Puhach, Olena; Putkonen, Hanna; Razmadze, Mariam; Reifenstein, Rebecca; Roux, Perrine; Schulte, Bernd; Schwarz, Tanja; Seabra, Paulo; Silva, María; Skocibusic, Sinisa; Sordo, Luis; Špringelová, Dana; Strada, Lisa; Stelmaszczyk, Beata; Subata, Emilis; Terykh, Kateryna; Thoma, Esmeralda; Torrens, Marta; Tubelewicz, Piotr; Vanaga‑Arāja, Diāna; Walley, Alexander Y.; Yiasemi, Ioanna; OPTIMUS study groupOpioid use disorder is a major cause of drug-related harm and mortality. These can be reduced by expanded access to evidence-based and highly effective opioid agonist maintenance treatment or therapy (OMT). There is a lack of consensus on how to assess opioid use disorder treatment outcomes, and key health outcomes are often omitted. We report the results of a Delphi study to produce service user- and public health–centred international consensus guidance for OMT outcomes monitoring. An international group of 110 substance use specialists in 32 countries, including service providers, researchers and people with lived experience of OMT, produced draft guidance over multiple meetings. The guidance includes a service user-reported OMT outcomes questionnaire, based on 26 core questions, plus optional questions, in six domains (treatment, physical health, mental health, social functioning, substance use, quality of life). A Delphi panel of 757 OMT professionals and service users (46%) from 29 countries, of which 40% were female, reviewed the questionnaire over two survey rounds, supporting and improving it (round 2 mean agreement score on a 1-6 Likert scale: 5.2; 95%CI 5.1–5.3). By focusing on service user– reported and public health–centred outcomes of OMT, the OPTIMUS consensus guidance aims to facilitate the communication between service providers and service users and improve the quality of care and the survival, health and quality of life of OMT service users.
- Conversational agents for pharmaceutical use: insights from the eCCo databasePublication . Guerreiro, Mara Pereira; Henriques, Helga Rafael; Mugellini, Elena; Angelini, LeonardoConversational agents are computer programmes designed to replicate bidirectional human conversation through spoken or written language, potentially supplemented with nonverbal features. The eCCo database is a searchable repository of primary studies on conversational agents in health and well-being. It catalogs 657 papers currently, published between 1991 and 2022; 51 address the use of medicines. Most of these papers focus on usability rather than rigorous effectiveness or implementation research, underscoring a need for more robust evaluation. The largest category of conversational agents for pharmaceutical use consists of non-embodied agents (n = 24), followed by virtual embodiment only (n = 19), most using virtual humans (n = 16). This database facilitates the comparison and appraisal of existing research in this field, while contributing to a more nuanced understanding of this technology through multidimensional attributes. We aim to enhance the database accuracy and expand its completeness beyond 2022 with the support of the global research community.
- The documentation used by the nurses during the transition from the hospital to the community setting: A scoping reviewPublication . Ferreira, Rafael Paulino Cruz Matos; Narciso, Beatriz Ferreira; Ramos, Afonso; Mendes, Sara; Palma, Sara; Ferreira, Óscar Manuel Ramos; Baixinho, Cristina LavaredaAim: This study aimed to identify the content of documentation used between hospital and community care and describe the communication mechanisms that allow the continuity of care. Design: We conducted a scoping review following the JBI recommendations. Methods: The sources of the information used were obtained from the MEDLINE and CINAHL databases (via EBSCO), Web of Science, SCOPUS, Joanna Briggs Institute and Cochrane Database of Systematic Reviews. Additionally, grey literature was included. The databases searched from 2018 to 2023 for articles written in English and Portuguese. Two researchers independently screened articles based on inclusion and exclusion criteria, and a third researcher adjudicated disagreements. Results: We retrieved 3217 articles, of which 5 were included. Six themes were summarised from these articles: Communication and information between clinical practice environments; Discharge letter content; The use of technologies in healthcare communication; Client empowerment in information communication; Factors hindering the safe transition of information between hospital and community; and Benefits of secure information transition between hospital and community. Implications for the profession and/or patient care: The results allow systematisation of the information that should accompany the person at the time of discharge to ensure the continuity of transitional care, including the patient/family's own perception of their difficulties and needs. Reporting method: PRISMA 2020.
- Mental health of portuguese nurses in 2024 : what has changed since 2017? a cross-sectional observational comparative studyPublication . Seabra, Paulo; Lopes, Joaquim Oliveira; Pessoa, Ezequiel; Capelas, Manuel LuisBackground: Nurses’ mental health has become an increasingly pressing concern worldwide because of its impact on health systems, patient health outcomes, job satisfaction, and workforce attrition. Aim: This study updates and compares findings from a national survey initially conducted in 2017 to assess the mental health of Portuguese nurses and examine associations with socio-professional variables. Methods: This cross-sectional observational study was expanded to include 1894 nurses working in hospitals, primary care, and other settings. The General Health Questionnaire-24 was used to assess mental health perception. Results: Results indicate a substantial decline in mental health perceptions across all indicators compared with 2017. Participants reported more negative assessments of overall mental health, with notable increases in somatic symptoms, anxiety and insomnia (the most affected domain), social dysfunction, and severe depression. Moreover, participants reported increased use of psychotropic drugs. Protective factors identified include specialised training, increased time off (particularly weekends), and engagement in sports or hobbies. Conclusions: Being the largest group in Portugal’s healthcare workforce, and reflected globally, nurses play a pivotal role in the health system. Their mental well-being directly impacts patient care quality and safety. These findings support the implementation of targeted strategies to safeguard nurses’ mental health and enhance healthcare delivery.
- Narrative Inquiry as a nursing research methodology: reflection on ethical considerationsPublication . Frade, Inês; Pinto, Vanda Marques; D'Espiney, LuisaIntroduction: There is an emerging propensity to use narrative inquiry as a nursing research methodology. The narrative inquiry aims to understand experiences and reveal the meaning of individual experiences providing crucial knowledge. The relationship between the nurse researcher and the participant is especially relevant in narrative inquiry. Purpose: To discuss ethical conduct in narrative inquiry and examine specific ethical issues at different stages of the narrative inquiry process in nursing research. Methods: Critical reflection supported by scientific evidence. Results: The relational component and the greater proximity with the participants in narrative research means that additional ethical issues have to be considered and respected in research planning, data collection, text composition, analysis, data interpretation and presentation of results. Conclusion: The relational properties of this methodology involve scrupulous ethical conduct with increased responsibilities in the relationship with participants and in the use of their narratives, respecting scientific rigor.
- Transitional care for older persons with need of geriatric rehabilitation nursing interventionsPublication . Ferreira, Rogério; Pedrosa, Ana Rita; Reis, Neuza; Sousa, Luís; Nicolau, Célia; Ferreira, Bruno; Rocha, Belmiro; Baixinho, Cristina LavaredaBackground: The literature review notes that people in need of care from Rehabilitation Programs do not always see their continuity ensured. Objective: This study aim to analyze the perspective of Specialists Nurse in Rehabilitation Nursing in relation to the organization and specialized intervention of transitional care for older people in need of rehabilitation programs. Methods: This is a qualitative study within the interpretivist paradigm. A focus group with 8 nurses and 13 interviews with Portuguese nurses were carried out between April 2022 and February 2023. Content analysis was carried out. Results: The triangulation of the data made it possible to identify 3 categories: Coordination of a transitional care program; Empowering the person to self-manage the transitional care process and Empowering the Informal Caregiver. Conclusions: It is imperative to promote the coordination of transitional care, increase the functional capacity of the person and empower the informal caregiver.
- Perceptions and educational needs of social and healthcare professionals in the prevention of domestic violence - A focus group studyPublication . Sakellari, Evanthia; Berglund, Mari; Lagiou, Areti; Pinto, Maria Luisa Sotto-Mayor De Carvalho; Santos, Maria Anabela Ferreira dos; Lahti, Mari; Murto, TiinaObjective: To explore and describe social and healthcare professionals' perceptions and educational needs in relation to domestic violence and its prevention. Methods: A qualitative research was conducted in three European countries. Two multidisciplinary focus group interviews were conducted (in each country) among professionals and higher education teachers in the field of social and health care. Total number of participants were 32 (Finland n=12, Greece n=12, Portugal n=8). The transcribed data were analyzed by thematic analysis. Results: Participants' perceptions of domestic violence and its prevention included: multidimensional phenomenon, consequences, and addressing concern. Domestic violence was seen as a multidimensional phenomenon, which has various consequences for several aspects of life. Professionals have difficulties addressing their concern due to lack of knowledge and tools. Solutions to prevent domestic violence that the participants shared were: education, intervention, and strategies. Education was seen as the key aspect for the prevention of domestic violence. Also, professionals' communication and situation management skills, as well as national and international strategies, were seen as valuable solutions. Educational needs for prevention of domestic violence were expressed based on content, methods, and practices, such as services system and legislation. Conclusion: The findings of the current study highlight the social- and healthcare professionals' need for education about domestic violence. It is essential that these professionals receive appropriate training to effectively identify and address domestic violence. The current study provides useful information for the development of relevant training/education for this group of professionals.
- Literacia em saúde mental: Caminhos interdisciplinares para um futuro mais conscientePublication . Valentim, OlgaA literacia em saúde mental tem-se tornado uma prioridade crescente nas agendas de saúde pública e nas discussões globais sobre bem-estar e qualidade de vida. Mais do que um conhecimento técnico sobre perturbações mentais, envolve a capacidade de reconhecer sinais de alerta, procurar ajuda de forma eficaz e contribuir para a construção de uma sociedade mais empática e inclusiva. Num contexto em que a saúde mental ainda é envolta em estigma e desinformação, a literacia emerge como um dos instrumentos mais poderosos para o empoderamento individual e coletivo.