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- 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.
- Nursing knowledge on skin ulcer healing: a living scoping review protocolPublication . Gomes, João; Sousa, P.; Pereira, Filipe Miguel Soares; Queirós, Carmen; Neves, Hugo; Silva, Catarina; Silva, Abel; Parente, Paulo; Sousa, Paula Cristina; Brito, Alice; Silva, Maria Antónia; Morais, Ernesto; Cardoso, Alexandrina; Cruz, Inês; Machado, Natália; Oliveira, Manuel Fernando; Bastos, Fernanda; Prata, Ana Paula; Sequeira, CarlosObjective: This review aims to continuously map the nursing knowledge on skin ulcer healing in any context of care. Introduction: Chronic wounds are an increasing concern for society and health care providers. Pressure ulcers and venous ulcers, among others, have devastating effects on morbidity and quality of life and require a systematic approach. The nursing process is an important method that allows a better organization and overall care quality for a systematic and continuous professional approach to nursing management of skin ulcers. The integration of this nursing knowledge in informatics systems creates an opportunity to embed decision-support models in clinical activity, promoting evidence-based practice. Inclusion criteria: This scoping review will consider articles on nursing data, diagnosis, interventions, and outcomes focused on people with skin ulcers in all contexts of care. This review will include quantitative, qualitative, and mixed methods study designs as well as systematic reviews and dissertations. Methods: JBI’s scoping review guidance, as well as the Cochrane Collaboration’s guidance on living reviews, will be followed to meet the review’s objective. Screening of new literature will be performed regularly, with the review updated according to new findings. The search strategy will map published and unpublished studies. The databases to be searched include MEDLINE, CINAHL, Scopus, JBI Evidence Synthesis, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and PEDro. Searches for unpublished studies will include OpenGrey and Reposito´ rios Cientı´ficos de Acesso Aberto de Portugal. Studies published in English and Portuguese since 2010 will be considered for inclusion.
- Prevalence and predictive factors for fear of childbirth in pregnant Portuguese women: A cross-sectional studyPublication . do Souto, Sandra Patrícia Arantes; Prata, Ana Paula; de Albuquerque, Rosemeire Sartori; Almeida, SofiaObjective: To measure the prevalence of the fear of childbirth (FOC) and determine which factors predict severe FOC among pregnant Portuguese women. Methods: An online cross-sectional study among pregnant Portuguese women aged ≥ 20 years who were recorded using a convenience sampling. Self-administered questionnaires were used for data collection: sociodemographic and obstetric questionnaire and European Portuguese version of Wijma Delivery Expectancy Questionnaire-version A (WDEQ-A). Data of 669 participants were collected successfully from June 9 to October 30, 2019. Predictive factors for severe FOC were investigated using a multivariate logistic regression analysis. Odds ratios (OR) and 95% confidence intervals were calculated. Results: The prevalence of severe FOC (WDEQ-A ≥ 85) among pregnant Portuguese women was 10%. Severe FOC was significantly associated with lower educational level, single/divorced marital status, and negative previous childbirth experience. Multivariate logistic regression analysis indicated that being single or divorced and having a negative previous childbirth experience were predictive variables for severe FOC. Conclusion: Pregnant Portuguese women have FOC, although with varying severity. The data suggest that marital status and women’s perceptions of previous childbirth experience may be useful variables to predict severe FOC. Further research for extending the predictive factors of FOC should be refined. The results are clinically relevant for midwifery care, as they should be used in the sense of early identification of fearful pregnant women to provide adequate support strategies to reduce FOC.
- Tradução, adaptação e validação do chilbirth self-efficacy inventory (CBSEI) para o idioma e cultura portuguesaPublication . Reis Santos, Margarida; Prata, Ana Paula; Neves, Ana JoãoA autoe!cácia da mulher para lidar com o trabalho de parto in"uencia a forma como esta perceciona o trabalho de parto e o parto. Identi!car precocemente as grávidas com baixa autoe!cácia para lidar com o trabalho de parto, pode ajudar os enfermeiros de saúde materna e obstétrica a programar intervenções de enfermagem que deem uma resposta mais e!caz às necessidades de apoio que estas mulheres possam ter. O Childbirth Self-E#cacy Inventory (CBSEI) permite medir a con!ança da mulher nas suas capacidades para lidar com o trabalho de parto e pode constituir-se como uma ferramenta útil para a prática clínica, pelo que, este estudo teve como objetivo traduzir, adaptar culturalmente e validar para português este instrumento. A amostra de conveniência constituiu-se por 525 grávidas, com 28 ou mais semanas de gestação. Quanto à !abilidade da escala, os valores de alfa de Cronbach, superiores a 0.89, permitem concluir que esta é !ável para a população portuguesa. A análise de componentes principais suportou o facto de cada uma das subescalas ter duas dimensões, nomeadas autocontrolo/ relaxamento e distração. A forte correlação entre as subescalas nos dois estádios do trabalho de parto e valores de alfa de Cronbach superiores a 0.90 levam, também, a considerar a proposta de vários autores para reduzir de quatro para duas as subescalas do instrumento
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