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- From the concept of Independence to the questioning of its use in practice: scoping reviewPublication . Lima, Andreia; Martins, Maria Manuela Ferreira da Silva; Ferreira, Maria Salomé Martins; Fernandes, Carla Sílvia; Schoeller, Soraia Dornelles; Parola, Vítor Sérgio OliveiraAntecedentes: Independência é um conceito amplamente utilizado pelas áreas mais práticas do conhecimento em saúde, sendo essencial conhecer o seu real significado para posterior aplicação. Método: Scoping review baseada nos princípios recomendados pela Joanna Briggs Institute e pelo método de análise conceitual de Walker e Avant. Uma pesquisa cuidados foi realizada nas bases de dados: Scopus, CINAHL complete, and MEDLINE. Dois revisores independentes avaliaram a relevância dos artigos em estudo, a extração e síntese dos artigos. Resultados: Cento e dois artigos foram incluídos, após a aplicação dos critérios de inclusão. A maioria dos autores define independência como a capacidade física para o autocuidado e para a realização das atividades de vida diárias. Outros autores confundem independência com autonomia, referindo-se à independência como a capacidade cognitiva, capacidade financeira, capacidade de sociabilizar e capacidade de decisão.Conclusions: Independência inclui a capacidade para o autocuidado e para as atividades de vida diária.
- The Burnout of Nurses in Intensive Care Units and the Impact of the Pandemic of SARS-CoV-2: Protocol of a Scoping ReviewPublication . Lima, Andreia; Moreira, Maria Teresa; Fernandes, Carla Sílvia; Ferreira, Margarida; Teixeira, Joana; Parola, Vítor; Coelho, AdrianaAbstract: Background: The SARS-CoV-2 pandemic has brought multiple challenges for health institutions and their professionals. The requirement of this disease forced nurses to confront organizational and clinical challenges to maintain the quality standards of care they provide. These requirements may have contributed to increased burnout symptoms. This study aims to map the scientific evidence related to nurses’ burnout in intensive care units. Methods: A scoping review will be conducted according to the Joanna Briggs Institute methodology. Relevant databases will be used as well as grey literature, where the following words will be used: burnout, nurses, intensive care units and SARS-CoV-2. Results: This scoping review will include all types of studies—quantitative, qualitative and mixed—and all types of reviews that focus on the objective of this review. Conclusions: It is vital to determine the impact of the burnout caused by the pandemic of SARS-CoV-2 to assess amending measures of risk and protection factors. This will help in the implementation of guidelines according to the available evidence. Additionally, this will help to improve the skills of these professionals as well as to reduce their emotional and physical exhaustion. This protocol is registered with the Open Science Framework.
- Exergames to improve rehabilitation after knee arthroplasty: a systematic review and grade evidence synthesisPublication . Fernandes, Carla Sílvia; Magalhães, Bruno; Gomes, José Augusto; Lima, Andreia; Santos, CéliaObjective: We aimed to systematically review and synthesise the impact of rehabilitation with games in people after knee arthroplasty. Methods: We conducted a systematic review following the Preferred Reporting Items for the declaration of Systematic Reviews (PRISMA – Preferred Reporting Items for Systematic Reviews and Meta- Analysis). The summary of evidence was developed using the Grading of Recommendations, Assessment, Development, and Assessment (GRADE). The review included randomised controlled trials that used characteristics of games in rehabilitation. Results: Eight articles from a total of 1289 identified articles were included after duplicates were removed. In total, 239 participants participated. There were no statistically significant changes between the groups using the exergames and control groups. The level of evidence was rated using GRADE and was very low or moderate. The difference in grouped means was not significant for Knee Flexion, Knee extension, Range of Motion, WOMAC (Western Ontario and McMaster Universities Arthritis Index), AKSS (American Knee Society Score), Self-Efficacy, Five Times Sit-to-Stand Test time, Pain, or Proprioception. Conclusions: The results of the different studies did not find significant changes in the intervention groups with exergames in the physical domains, especially in studies with shorter interventions. Therefore, further investment in future studies on developing and evaluating games is suggested to enhance training during the recovery process.
- Efficacy of the Use of Wii Games in the Physical and Functional Training of the Elderly: Protocol of a Systematic ReviewPublication . Lima, Andreia; Moreira, Maria Teresa; Ferreira, Maria Salomé; Parola, Vítor; Mendes, Dárcio Tadeu; Nóbrega, Maria do Perpétuo; Fernandes, Carla SílviaAbstract: Background: Scientific and technological development has constituted a reality in the lives of populations, making it unimaginable to live without specific incentives that development has allowed. That said, given the increase in the longevity of people, it will be helpful to implement these resources in promoting health and disease prevention in the elderly. The objective of this study is to identify, in the scientific evidence, the effects ofWii games on the physical training of the elderly. Methods: A systematic review will be carried out according to the methodology recommended by the Joanna Briggs Institute. Relevant databases will be used for the research, where the words will be used: rehabilitation, exercise, physical activity, rehabilitation exercise; movement; therapeutic exercise; engine activity; rehabilitation, geriatric, gerontologic care, and aged. Results: This systematic review will include experimental and quasi-experimental studies, including randomised studies with and without a control group, pre- and post-assessment. Conclusions: To promote the autonomy of the elderly and consequently healthy and prosperous ageing, it is crucial to implement all available measures and resources. For this purpose, exergames have been shown to be effective, and it is necessary to know which ones are suitable for the physical training of the elderly. This one protocol is registered with the Open Science Framework.
- Efficacy of the Use of Exergames in Promoting the Mental Health of the Elderly: Protocol of a Systematic ReviewPublication . Lima, Andreia; Moreira, Maria Teresa; Ferreira, Maria Salomé; Parola, Vítor; Sampaio, Francisco; Nóbrega, Maria do Perpétuo; Fernandes, Carla SílviaBackground: Scientific and technological advancements have significantly impacted our daily lives, and it is not easy to imagine living without their benefits. However, elderly individuals may experience limited access to these resources, impeding their autonomy. To address this, the use of exergames has been proposed to promote the mental health and socialization of older people. This study aims to systematically review the effectiveness of exergames in promoting older people’s mental health and socialization. Methods: The Joanna Briggs Institute’s recommended methodology will be used for a systematic review. Databases relevant to the research topic, such as those regarding gerontologic care, aged rehabilitation, geriatric games, video games, play and playthings, mental health, anxiety, depression, stress, and physiological factors, will be searched for experimental and quasi-experimental studies, as well as randomized studies with and without control groups. Results: The systematic literature review will synthesize findings on the effectiveness of exergames in promoting mental health and socialization in the elderly population. Conclusions: Exergames may have the potential to effectively improve the mental health and socialization of the elderly population. Identifying which exergames are most effective for these purposes is important to inform the provision of healthcare to this population.
- The Burnout of Nurses in Intensive Care Units and the Impact of the SARS-CoV-2 Pandemic: A Scoping ReviewPublication . Lima, Andreia; Moreira, Maria Teresa; Fernandes, Carla Sílvia; Ferreira, Maria Salomé; Ferreira, Margarida; Teixeira, Joana; Silva, Mafalda; Parola, Vítor; Coelho, AdrianaBackground: The world’s population changed with the emergence of the SARS-CoV-2 pandemic. Burnout arises due to overwork, prolonged work periods, a lack of human and material resources, etc. Several studies have reported the incidence of burnout syndrome in nurses that work in intensive care units (ICUs). The aim was to map the scientific evidence related to nurses’ burnout in the ICU, namely the repercussions of SARS-CoV-2 in terms of burnout among nurses. Methods: A scoping review followed the Joanna Briggs Institute methodology guidelines to search for and synthesise studies published between 2019 and 2022. The databases searched were MEDLINE, CINAHL, LILACS, SCOPUS, PsycINFO and OPEN GREY. A total of fourteen articles were eligible to be included. Results: A content analysis of the selected articles was carried out, and three categories emerged that corresponded to the dimensions of burnout according to Maslach and Leiter: emotional exhaustion, depersonalisation dimension and a lack of personal accomplishment. It was evident that nurses who worked in the ICU during the pandemic showed high levels of burnout. Conclusions: It is recommended that hospital administrations hire health professionals, namely nurses, as a strategic and operational management strategy to reduce the risk of increased burnout during pandemic outbreaks.
- Game4NurseSupervisor: Development of a board game for nursing mentoringPublication . Almeida, Inês Santos; Pinto, Cristina; Lima, Andreia; Moreira, Teresa; Fernandes, Carla SílviaAim: To describe the stages of developing a board game prototype to promote knowledge about nursing mentorship. Background: Clinical supervision in nursing is a vital strategy for the quality of care. The use of gamification through a board game can enhance knowledge about mentoring in nursing. Design: We present a pilot study describing the development phases of the board game "Game4NurseSupervisor®." Methods: The study comprised three phases. The first phase involved a modified e-Delphi study with experts to collect and validate the content to be integrated into the board game. The second phase focused on constructing the prototype of the board game. Finally, the third phase involved testing the prototype in sessions held in two healthcare units, followed by an evaluation through a questionnaire. Results: The e-Delphi study, involving a panel composed of 59 experts, progressed through two rounds, resulting in 61 cards divided into four categories. The second phase involved constructing the board game, incorporating interactive elements such as "Game4NurseSupervisor®." In the third phase, 25 nurses, consisting of clinical practice nurses, participated in the testing phase and expressed satisfaction with the game. Highlighted benefits included reflective, playful, dynamic, interactive and educational aspects. Conclusions: The conclusions suggest that "Game4NurseSupervisor®" could be a valuable tool for promoting knowledge about nursing mentorship, providing an innovative and interactive approach to skill development. This study makes a valuable contribution by addressing a previously unexplored aspect of nurse mentor training: the potential of board games.
- Impact of Exergames on the Mental Health of Older Adults: A Systematic Review and GRADE Evidence SynthesisPublication . Fernandes, Carla Sílvia; Magalhães, Bruno; Lima, Andreia; Nóbrega, Perpétua; Silva, Mafalda; Santos, CéliaExergames, which combine digital games and physical exercise, have become a popular alternative to traditional exercise programs and are increasingly used in the health domains. This study aimed to provide a systematic review to synthesize existing studies on the use of exergames for the mental wellbeing of healthy older adults, aggregating the collected data to identify effect size. We performed a Systematic Review and Grading of Recommendations, Assessment, Development, and Assessment (GRADE) evidence synthesis. We performed the search in the following databases: MEDLINE®, CINAHL®, SPORTDiscus, SCOPUS, SciELO, Psychology and Behavioral Sciences Collection, and Cochrane® Central Register of Controlled Trials from the first record until October 2021. Randomized controlled trials using exergames as an intervention were included. A total of 10 articles published between 2009 and 2021 were selected. Most studies used the Nintendo Wii® as the exergame in the intervention program. Interventions ranged from 6 to 12 weeks, with 8-week programs being most frequent. It was possible to observe a positive effect on mood, the reduction of apathy, anxiety and depression, self-esteem, and affection.
- Exergames for rehabilitation in stroke survivors: Umbrella review of meta-analysesPublication . Fernandes, Carla Sílvia; Magalhães, Bruno; Gonçalves, Filipe; Lima, Andreia; Silva, Mafalda; Moreira, Maria Teresa; Santos, Célia; Ferreira, SaloméBackground: It is essential to explore alternative methods to motivate stroke survivors throughout their lengthy rehabilitation journey. Exergames have emerged as promising tools for rehabilitating this demographic. Objective: We aimed to synthesize the combined evidence from meta-analyses that assessed the effects of exergames in the rehabilitation of stroke survivors. Methods: The umbrella review was conducted utilizing several databases, including MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), the Psychology and Behavioral Sciences Collection, SPORTDiscus®, and Scopus®. It included studies published until December 2023 without any restrictions based on publication date. Results: The analysis included 11 meta-analyses involving approximately 9,615 patients, reflecting a growing adoption of exergames in post-stroke rehabilitation since 2015, focusing on using Nintendo Wii. The analyzed studies varied widely in intervention duration (from 1 to 16 weeks) and were applied across different phases of post-stroke rehabilitation, from the acute to the chronic phase. Significant improvements were observed in balance and upper limb functionality, although there was notable methodological heterogeneity and variability in the results. Conclusions: This study highlights the value of exergames in the rehabilitation of stroke survivors and recommends future research that adopts rigorous methodological designs with clearly specified intervention stages. It underscores the importance of additional qualitative studies to explore the perspectives of patients and healthcare professionals regarding exergames, aiming to refine rehabilitation strategies and enhance the clinical benefits achieved.