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- Midwifery theories: A scoping reviewPublication . Paz, Sara D.C.; Soares Goncalves, Andreia; Moreira Freitas, Conceição; Sampaio, Filipa; Prata, Ana PaulaProblem: The identification of midwifery theories will contribute to the identification of a midwifery model of care for women experiencing low-risk pregnancies, and to support its implementation in Portugal. Background: Previous research has explored the concept of woman-centredness as the core principle underpinning midwifery practice, mapped existing midwifery models of care, synthesized multiple theories and the scope of midwifery to achieve conceptual integration, and identified the aspects of midwifery care that most significantly contribute to the quality of care for women and their babies. However, to the best of the authors' knowledge, no other review has mapped the theories that underpin midwifery practice. Aim: This study aims to map and summarise the theories that underpin midwifery practice. Methods: The JBI methodology for scoping reviews was used to conduct this review. Findings: A total of 16 documents were included in this review. Sixteen theories were identified and the differences between them vary in both underpinning philosophical ideas and the methodology used to develop them. Discussion: The four concepts of the nursing-midwifery metaparadigm were identified in all documents and a fifth concept, midwife's self-knowledge, should be included in the characterisation of a midwifery theory, once it has a strong presence in all four concepts, underpinning them. Conclusion: This scoping review identified the theories underpinning midwifery practice. The compilation of these theories can be used to strengthen the scientific area and profession: development of theoretical knowledge as professional autonomy and power, internal control for the profession, guidance to professional practice, practice standardization, inter and intra-professional communication, and outcomes assessment and improvement.
- Maternal self-efficacy in newborn care: influence of maternal variablesPublication . Silva, Catarina Sousa; Brandão, Sónia; Azevedo, Ana Rita; Prata, Ana PaulaAim: To analyze the influence of sociodemographic, obstetric, childbirth, and breastfeeding variables on maternal self-efficacy in newborn care. Design: Descriptive cross-sectional study. Methods: The study was conducted in three hospital units in the Northern region of Portugal, with a non-probabilistic sample composed of 340 women recruited at postnatal wards on the day of hospital discharge. A questionnaire including the mother’s sociodemographic, obstetric, childbirth, and breastfeeding data was used. For the analysis of maternal self-efficacy in newborn care, the Scale of Perceived Parental Self-Efficacy in Child Care was used. The scale is a 20-item self-report instrument developed to identify women with low levels of self-efficacy in newborn care. Descriptive and inferential statistics were used for data analysis. Results: Significant differences concerning maternal self-efficacy in newborn care were found with regard to level of education and parity, with multiparous women and women with lower levels of education presenting higher levels of self-efficacy in newborn care. Conclusion: The analysis of these variables could be valuable in building new knowledge to support the development of an action model that would allow at-risk women to be highly confident in their parenting role.
- Effectiveness of perioperative family-centered educational interventions in the anxiety, pain and behaviors of children/adolescents and their parents: Systematic Review ProtocolPublication . Martins Esteves, Ines; Coelho, Márcia Silva; Cardoso, Daniela; Prata, Ana Paula; Pestana-Santos, Marcia; Reis Santos, MargaridaIntroduction: Every year, millions of children and adolescents undergo surgery, 50%-75% of them experience fear and anxiety. Children are particularly susceptible to stress and anxiety surrounding surgery as a result of their cognitive development, previous experiences, and knowledge about healthcare;this leads to additional interventions to prevent and reduce these symptoms.Objective: To evaluate the effectiveness of family-centered educational interventions in the children’s and adolescents’ anxiety, pain,and behaviors and their parents’ anxiety during the perioperative period. Methods: This review will follow the Joanna Briggs Institute guidelines for systematic reviews of effectiveness and will consider those studies (experimental and quasi-experimental) in which perioperative educational interventions have been applied to children and adolescents and their parents; these studies measuredchildren and adolescents’ pain, anxiety,and behaviors, as well astheirparent’s anxiety.An initial search of MEDLINE and CINAHLwill be followed by a second search for published and unpublished studies from January 2007 on, available in English, Spanish and Portuguese. After all full texts are retrieved, the methodological quality assessment and data extraction will be independently and critically evaluated by two reviewers, and the data will then be presented in a tabular format. An explanatorysynthesis will accompany the results. Wheneverpossible, a meta-analysis will be performed, and a Grading of Recommendations, Assessment, Development,and Evaluation Summary of Findings will be presented. Expected Results: This review will provideguidance on how family-centred educational interventions can be used as a resource to manage anxiety, pain, and behavior in children, adolescents and their relatives during the perioperative processes.
- The effectiveness of a digital shared decision-making tool in hormonal contraception during clinical assessment: study protocol of a randomized controlled trial in SpainPublication . de Molina-Férnandez, Maria Inmaculada; Raigal-Aran, Laia; de la Flor-Lopez, Miriam; Prata, Ana Paula; Font-Jimenez, Isabel; Valls-Fonayet, Francesc; March-Jardi, Gemma; Escuriet-Peiro, Ramon; Rubio-Rico, LourdesDecision-making tools represent a paradigm shift in the relationship between the clinician and the user/patient. Some of their advantages include patient commitment, the promotion of preferences and values, and increased treatment adherence. This study protocol aims to assess the effectiveness of a decision-making tool in contraception (SHARECONTRACEPT) concerning: a) Improvement in counselling on hormonal contraception at the medical consultation, measured in terms of decreasing decisional conflict and improving knowledge of available contraceptive options; b) Improvement in adherence to treatment measured in terms of: persistence in the chosen treatment, compliance with dose or procedure of use, and ability to deal with incidents related to the use of the contraceptive method; and decreasing unwanted pregnancies and voluntary interruption of pregnancy. The SHARECONTRACEPT tool, developed by previous phases of this project, is available at: http://decisionscompartides.gencat.cat/en/decidir-sobre/anticoncepcio_hormonal/ METHODS/DESIGN: A longitudinal, prospective-type, randomized, controlled community clinical trial, carried out in the clinical contraceptive counselling units of 6 autonomous regions in Spain, with an experimental group and a control group. Description of the intervention: The health professionals participating will be randomly assigned to one of the two groups. Clinicians assigned to the experimental group will perform contraceptive counselling assisted by SHARECONTRACEPT, and those of the control group will follow the conventional contraceptive counselling provided in their clinical unit. It is planned to study 1708 users (control group n = 854 and intervention group n = 854), recruited from women who attend the consultations of the health professionals. The selected users will be followed up for one year. The data will be collected through ad-hoc questionnaires, and validated instruments for measuring decisional conflict and adherence to treatment.
- Building trust to childbirth: assessment of a nursing intervention programmePublication . Prata, Ana Paula; Santos, Célia; Reis Santos, MargaridaEnquadramento: A autoeficácia da mulher durante o trabalho de parto influencia a forma como este é percebido e afeta a sua satisfação com a experiência de parto. Vários estudos demonstraram ser necessário que a preparação para o parto incorpore e reforce este conceito. Objetivo: Avaliar a eficácia do programa Construir a Confiança para o Parto na perceção de autoeficácia das grávidas para lidarem com o trabalho de parto. Metodologia: Estudo longitudinal, quasi-experimental, pré e pós-teste, com medidas repetidas. Realizado numa instituição do Norte de Portugal. Amostra de 66 grávidas no grupo experimental e 55 no grupo controlo. Utilizado o Questionário de Autoeficácia no Trabalho de Parto. Resultados: As expetativas de autoeficácia aumentaram de forma extremamente significativa ao longo do tempo no grupo experimental (F(1,81; 118) = 37,26; p = 0,000). Não se encontraram diferenças com significado estatístico entre os grupos (F(1; 119) = 3,39; p = 0,068). Conclusão: O programa promoveu um aumento significativo da autoeficácia da grávida para lidar com o trabalho de parto, embora sem diferenças significativas com o grupo controlo.
- Supervisão clínica em enfermagem: contributo para o desenvolvimento de competências para a mobilidadePublication . Koch, Maria Cândida; Prata, Ana Paula; Frade, Josefina; Reis Santos, MargaridaA crescente mobilidade dos enfermeiros no espaço europeu implica uma maior preocupação com a excelência dos cuidados que se pretende prestar aos cidadãos. Torna-se fundamental identificar as competências necessárias para a mobilidade, bem como os fatores que a podem influenciar. Inserido no projeto Training Requirement and Nursing Skills for Mobility (TRaNSforM), patrocinado pela União Europeia, desenvolveu-se este trabalho com o objectivo de Identificar habilidades e competências necessárias à mobilidade dos enfermeiros para outros países. Tendo por base o Inquérito Apreciativo e com recurso à técnica de Focus Group, os dados foram recolhidos em duas entrevistas semiestruturadas efetuadas a dois grupos, num total de 14 enfermeiros. Para além das competências nucleares como o trabalho de equipa, a comunicação e o respeito, os participantes consideraram que um conhecimento básico acerca da cultura e da sociedade do país, a criatividade/inovação, o conhecimento linguístico, a flexibilidade, a mente aberta, a capacidade de transcender as questões culturais, a empatia, a competência ética e a capacidade para estabelecer uma relação de confiança seriam competências essenciais à mobilidade. A supervisão Clínica em Enfermagem pode ser um importante processo no suporte para o exercício e desenvolvimento destes profissionais
- Preparing for childbirth: women's lookPublication . Prata, Ana Paula; Koch, Maria Cândida; Santos, Célia; Reis Santos, MargaridaINTRODUCTION. Childbirth preparation is a form of health intervention education performed by specialist nurses in maternal health and obstetrics aimed at promoting self-e'cacy during labour. In planning an e'cient childbirth education intervention, it is essential that nurses know the pregnant women’s/couple’s expectations on this speci+c issue. OBJECTIVES. To understand the pregnant women’s expectations related to preparation for childbirth. MATERIAL AND METHODS. This was an exploratory, transversal study of qualitative nature where data was collected through interviews, after an informed consent was signed. The Bardin technique was applied to data analysis. A non-probability sample of 224 pregnant women was made, all over 20 years of age, with 28 weeks or more of gestation. The majority of participants possessed an advanced degree, were married or living in a marital situation, and were experiencing their +rst pregnancy. RESULTS. From an analysis of the interviews, three categories emerged: knowledge, ability, and self-e'cacy to deal with labour, and seven subcategories. These results corroborate +ndings of other researchers who have concluded that couples wish to be informed regarding how to prepare for labour, and that this preparation is relevant when the acquired knowledge helps the pregnant woman or couple make decisions and exercise control over their labour experience. CONCLUSION. The results enabled nurse-midwives to increase their knowledge and understanding of pregnant women’s labour preparation expectations and preferences. Knowledge of this variety can assist these professionals in planning e9ective, quality interventions, which in turn can clearly contribute to gains in health
- Construção e validação de um objeto de aprendizagem para enfermeirosPublication . Reis Santos, Margarida; Koch, Maria Cândida; Prata, Ana PaulaIn today’s societies, health care is increasingly culturally diverse due to the increasing migratory processes of the population and nurses. Therefore, it is necessary to train nurses to provide culturally competent care. Learning objects are didactic, multimedia, interactive and challenging materials that constitute relevant resources for the teaching-learning processes that go beyond the classroom. In many countries, in nursing education, they are still an innovative way of learning. The study was developed as part of the international project Developing Multimedia Learning for Cross-Cultural Collaboration and Competence in Nursing - TransCoCon, (ERASMUS + Program, contract: 2017-1-UK01-KA203-36612) and aimed to build and validate a learning object that supports the learning of transcultural competences, necessary in nursing care. The learning object developed is subordinated to the theme of admission of a client in a hospital. For its development, the following steps were followed: choice of content; analyze; conceptual map; navigational architecture; storyboard; Implementation; documentation of use; use, evaluation and maintenance. As a result of the work developed, we obtained the learning object “Admission to hospital” and its Portuguese version “Acolhimento do Cliente num Hospital”. Both versions include a set of written supportive material for cross-cultural nursing care in hospital and illustrative videos of cross-cultural communication skills. The adopted methodology proved to be effective for the construction of an attractive, interactive and meaningful learning object for nursing students, nurses and nursing teachers.
- Sexual dysfunction and quality of life in prostate cancer.Publication . Teixeira, Joana; Couto, Germano; Prata, Ana Paula; Almeida, Ana MariaProstate cancer causes changes, such as erectile dysfunction, with a significant impact on the perception of quality of life (QoL). The aim of this study is to identify changes in perception of QoL related to erectile dysfunction over time. A descriptive, analytical and longitudinal study was conducted with the participation of oncological patients from the ambulatory urology department of an oncology hospital unit of the North of Portugal. The sample, obtained through convenience non-probabilistic sampling between October 2015 and July 2016, included 60 patients. The instrument used for data collection was IIEF-5 (International Index of Erectile Function-5) that evaluates the severity degree of erectile dysfunction (ED). Sexual function did not present clinical or statistical differences along the studied period. Cultural issues related to privacy preservation may justify our sexual function scores. Early identification of QoL changes may guide nurses to patient-centered care.
- Urinary incontinence: the impact on the quality of lifePublication . Teixeira, Joana; Couto, Germano; Prata, Ana PaulaQuality of life (QoL) assessment represents an emerging focus in the health area since it use can complement clinical practice and optimize resources. Urinary incontinence is a common consequence in the oncologic pathology of the prostate that severely affects QoL.A descriptive, analytical and longitudinal study was conducted with the participation of oncological patients from the ambulatory urology department of an oncology hospital unit of the North of Portugal. The sample, obtained through convenience non-probabilistic sampling between October 2015 and July 2016, included 60 patients. The ICIQ-SF was used. The impact on QOL was classified as: zero (0), no impact; from 1 to 3, slight impact; 4 to 6, moderate; from 7 to 9, severe; and, of 10 or more, very serious. Urinary incontinence had a moderate impact on the perception of QoL of patients in M0 and M1. It was observed that as the symptoms decreased, the patients’ perception of QoL increased and M3 and M6 had a slight impact.
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