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- Improved professional competencies and leadership in PhD-prepared nurses and doctoral students after participating in the cross-national and web-based Nurse-Lead programPublication . van Dongen, Lisa; Suidman, Lisa; Henriques, Maria Adriana; Jónsdóttir, Helga; Leino-Kilpi, Helena; Luderer, Christiane; Suhonen, Riitta; Hafsteinsdóttir, Thóra B.Background: Doctor of Philosophy (PhD)-prepared nurses are expected to exercise leadership in their various roles. Therefore, European nurse scholars developed a cross-national web-based Nursing Leadership and Mentoring Educational (Nurse-Lead) program. Purpose: To evaluate changes in leadership practices, professional and research competencies as well as career development of PhD-prepared nurses and doctoral nursing students after participation in the Nurse-Lead program. Methods: A pre-post-test evaluation was conducted. Surveys addressed leadership, professional and research competencies, and career development. Quantitative data were analyzed with descriptive statistics and paired sample t-tests. Content analysis was used for qualitative data. Discussion: The 30 participants showed significant improvements in all leadership practices, professional competencies, and most research competencies. Participants reported increased confidence in decision-making, taking on new responsibilities, and becoming more visible within research teams. Conclusion: Web-based, international leadership and mentoring programs are promising tools for the leadership and professional development of PhD-prepared nurses and doctoral nursing students.
- The needs of women in the postpartum period: A scoping reviewPublication . Vaz Sendas, Mónica; Freitas, Maria JoãoBackground: The postpartum period is critical and challenging for women, implying emotional, physical, social and spiritual changes. For a positive postpartum experience, it is important to receive consistent information and support from health professionals. However, this is not always the case, as care is more focused on the newborn, forgetting the needs of the puerperal woman. Aim: The review aimed to map the published scientific knowledge about women's needs in the postpartum period. Methods: A Scoping Review was carried out, according to the method proposed by The Joanna Briggs Institute, in the MEDLINE Complete, MedicLatina and CINAHL Complete databases, and were selected articles since 2017 that answered the research question "What is the available evidence on women's needs in the postpartum period?". For the selection of articles, the eligibility criteria were defined. Results: A total of 6,647 articles were identified. After the exclusion of duplicate articles and the application of the eligibility criteria, at the end of the process, 27 articles were included in the review. The extracted data were grouped into four categories, which summarize the needs of women in the postpartum period: support, sharing, care and preparation for the postpartum period. Conclusion: In the articles analysed, women reveal that they do not feel prepared for the postpartum period and identify several unmet needs, so health education and parenting skills training during pregnancy are essential to improve the postpartum experience and the transition to parenthood.
- A qualitative study of older adults: The difficulties and needs of returning home after hip fracturesPublication . Rocha, Paula; Baixinho, Cristina Lavareda; Henriques, Maria AdrianaBackground: Falls and consequent fractures are an increasing problem among older adults, with low rates of return to previous functional condition and a substantial risk of subsequent falls. This scenario points to the need for an improved response to this population's needs. Objective: To define the difficulties and needs felt by older adults with hip fractures when returning home. Methods: This was a descriptive and exploratory qualitative study. Semi-structured interviews were conducted with hip fracture patients who had been submitted to surgery and who were treated at a hospital in the central region of Portugal. Bardin's content analysis was used to analyze the data. Content analysis was carried out with the support of MAXQDA® Analytic pro 2022 software. Results: The analysis of the results of the 15 interviews yielded three categories related to the difficulties perceived by hip fracture patients on returning home: functional limitations; pain; and emotional management. Regarding the needs felt, the following categories emerged: resources/help with activities of daily living; capacity-building for the return home; and information. Conclusions: The needs and difficulties of older adults with hip fractures on returning home are multiple and variable. Knowledge of these aspects can significantly enhance the standardized actions of nurses in this area of intervention, contributing to the improvement of continuity of care and ensuring a safe transition.
- 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.
- 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
- Nursing interventions to promote dyspnea self-management of complex chronic patients: An integrated reviewPublication . Henriques, Helga Rafael; Correia, Andreia; Santos, Tatiana; Faria, José; Sousa, Diana; Portela, Joana; Teixeira, JoanaObjectives: Chronic dyspnea, a distressing symptom in patients with complex chronic conditions, is linked to higher risks of mortality. This study aimed to identify nursing interventions that could improve self-management for complex chronic patients, thereby enhancing control over chronic dyspnea. The findings intend to guide nursing care strategies that promote self-management among this population. Methods: We searched the databases Medline, Scopus, Web of Science, CINAHL, Cochrane Database of Systematic Reviews (CDSR), and Joanna Briggs Institute (JBI) databases were searched in December 2023. We included adult patients with complex chronic conditions with chronic dyspnoea. The team screened articles collaboratively, using Rayyan software. A qualitative appraisal was performed according to JBI Critical Appraisal Checklist tools. The review protocol is registered under the number CRD42023456021. Results: Our review included 18 studies that explored a variety of interventions for chronic dyspnea. We identified pharmacological interventions (such as oxygen therapy and inhalation treatments) and nonpharmacological approaches (including educational programs, breathing exercises, fluid intake management, body awareness techniques, peer support, emotional intelligence training, and the use of web applications). Those interventions empower patients, improve their ability to fulfill life roles, mitigate emotional distress, and improve overall quality of life. Nursing care can be crucial in enabling individuals to achieve independence and autonomy in self-care. Conclusions: Promoting self-management for chronic dyspnea in complex chronic patients requires a holistic approach, encompassing multidisciplinary interventions, individualized self-care education, peer engagement, and technological support. Current research on self-management inadequately addresses interventions targeting patient behaviour change. It highlights the need to delve deeper into the selfmanagement process. Further research is needed to expand the evidence base and refine these interventions.
- 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.
- Promoting knowledge translation: An ecosystem approach to evidence in healthPublication . Silva, Marcelle Miranda; Baixinho, Cristina Lavareda; Marques, Maria de Fátima Mendes; Oliveira, Claudia Sousa; Bubadué, Renata de Moura; Souza, Samhira Vieira Franco; Cabral, Ivone EvangelistaThe dissemination and implementation of evidence in health contexts have been a concern of several international organizations responsible for recommending actions to health policymakers. World Health Organization has been advocating for an ecosystem of evidence to improve clinical practice and health professional education. Thus, in this article, we address the challenges to developing the evidence ecosystem from the point of view of health professional education, considering the contexts of practice and teaching, focused on knowledge translation. There are three pivotal challenges: producing qualified knowledge; adequate communication of the synthesized evidence; and institutional policy to sustain the implemented evidence in continuous and updated flow. The evidence ecosystem helps to understand these flows between the production and implementation of knowledge, based on the capacity and resources of different health systems. It needs to be developed in the field of health professional education, feedback in the contexts of practice and teaching, to contribute to third-generation knowledge being used by different users of health services.
- Safety-promoting interventions for the older person with hip fracture on returning home: A systematic reviewPublication . Rocha, Paula; Lavareda Baixinho, Cristina; Marques, Andrea; Pereira Henriques, Maria AdrianaBackground: Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre-fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge. Objective: To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge. Method: A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were evaluated for risk of bias. Results: Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting interventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutritional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care education, and support and counseling. Conclusions: In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more interventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.
- Impact of social prescribing intervention on people with type 2 diabetes mellitus in a primary healthcare context: a systematic literature review of effectivenessPublication . Oliveira, Dulce; Nogueira, Paulo; Costa, Andreia; Henriques , AdrianaAim To identify social prescribing intervention for people with type 2 diabetes mellitus (T2DM) in the context of primary healthcare and evaluate their impact on improving health, behavior, and economic outcomes. Subject and Methods Following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, a literature search was conducted in SCOPUS database (MEDLINE) and via EBSCO Host (CINHAL, MEDLINE, and Psychology, and Behavioral Sciences Collection). Review studies were included and excluded on the basis of defined criteria. A comprehensive quality appraisal was conducted by analyzing the risk of bias according to each study design. Narrative synthesis was performed by analyzing the social prescribing intervention, with the outcomes sorted into categories. Results Eleven papers were selected with 19,202 participants describing nine social prescribing intervention domains with a positive contribution to health-related outcomes (improvement in quality of life, psychological and mental well-being, physical activity, and modestly reduced HbA1c), less evidence for health-related behavior outcomes (self-care management slow growth) and less evidence for health-related economic evaluation (small decline in care costs and primary care visits). Social prescribing intervention delivery in a face-to-face mode, performed for longer periods and involving fewer professionals in the referral and accompaniment of the person, demonstrated greater effectiveness. Quality methodology evaluation revealed concerns about the low quality of some studies and a high risk of bias. Conclusion The analyzed studies suggest that social prescribing interventions can play an important role in producing related health, behavioral, and economic outcomes for people