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- Self‐care nursing interventions: A qualitative study into electronic health records’ contentsPublication . Queirós, Carmen; Silva, Maria Antónia; Gomes, João; Neves, Hugo; Cruz, Inês; Brito, Alice; Cardoso, Alexandrina; Pereira, Filipe Miguel SoaresAims:This study aims to (1) analyse all self-care–related interventions Portuguesenurses documented, (2) determine potential issues that may impair semantic interoper-ability and (3) propose a new set of interventions representing nursing actions regardingself-care that may integrate any HER application.Background:As populations age and chronic diseases increase, self-care concerns rise.Individuals who seek healthcare, regardless of context, need prompt access to accuratehealth information. Healthcare professionals need to understand the information in allplaces where care is provided, creating the need for semantic interoperability withinelectronic health records.Methods:A qualitative descriptive and exploratory study was conducted in two phases:(1) a content analysis of nursing interventions e-documentation and (2) a focusgroup with fifteen registered nurses exploring latent criteria or insights gleaned fromthe findings of content analysis. The COREQ statement was used to guide researchreporting.Results:We extracted 1529 nursing intervention sentences from the electronic healthrecords and created 209 intervention categories. We identified the main issues withsemantic interoperability in nursing intervention identification.Conclusion:According to the findings, nurses cooperate with clients, offering phys-ical aid and encouraging them to overcome functional limitations to self-care taskshampered by their conditions.Implications for nursing policy and health policy:This article provides evidence towarn policy makers against decisions to use locally customised electronic health records,as well as evidence on the importance of policy promoting the adoption of a nursingontologyforelectronichealthrecords.And,asaresult,theharmonisationandeffec-tive provision of high-quality nursing care and the reduction of healthcare costs acrossnations.
- Healthy Lifestyle Beliefs Scale: Psychometric properties in Portuguese pregnant womenPublication . Nunes, Maria A.; Almeida, Sofia; Cardoso, Alexandrina; Vieira, Margarida; Melnyk, Bernadette M.Healthy lifestyle during pregnancy influences the pregnant woman's and child's physical and mental health, impacting perinatal outcomes. Healthy lifestyle beliefs are predictors of lifestyle behaviors, requiring a valid and reliable instrument to assess them during prenatal care. The 16-item Healthy Lifestyle Belief Scale (HLBS) measures a person's beliefs about their ability to live a healthy lifestyle. This study aimed to examine the psychometric properties of a Portuguese version of the HLBS among pregnant women. A methodological study was developed in two phases: cross-cultural adaptation and evaluation of the psychometric properties of the Portuguese version in a nonprobability sample of 192 Portuguese pregnant women. The exploratory factor analysis suggested three subscales, which explained 53.8% of the total variance. Cronbach's α was 0.83 for the overall scale and for the subscales ranged between 0.71 and 0.81. The HLBS is a reliable and valid instrument to assist health professionals in assessing the ability of Portuguese pregnant women to adopt a healthy lifestyle. Assessing healthy lifestyle beliefs potentially contributes to the development of health behavior interventions in pregnant women and consequently improves perinatal outcomes through evidence-based practices.
- Factors associated with puerperal women's perception of the support received from their companions during labor and deliveryPublication . Sena, Marcela Matias; Barros, Maria Aline Rodrigues; Holanda, Sâmia Monteiro; Aquino, Priscila de Souza; Cardoso, AlexandrinaObjective The aim of the current study was to associate sociodemographic characteristics and satisfaction with the support received from companions during labor and delivery. Method An analytical cross-sectional study was performed in a maternity hospital in Fortaleza, Brazil, from March to August 2019, with 320 postpartum women. A form containing sociodemographic and obstetric questions, companion-related information, type of support provided, and the Birth Companion Support Questionnaire (BCSQ) were used to assess the frequency of social support behaviors. χ2 and Fisher exact tests were used for statistical analyses. Results Nonpharmacological methods were associated with an unsatisfactory perception of support, but the emotional support provided by companions was positively associated with women's satisfaction. Conclusion The findings of the current study concerning women's perceptions of the support received from their companions may allow improvements in the delivery of care to women in labor toward the humanization of obstetric practices.
- Fast Healthcare Interoperability Resources–Based Support System for Predicting Delivery Type: Model Development and Evaluation StudyPublication . Coutinho-Almeida, João; Cardoso, Alexandrina; Cruz-Correia, Ricardo; Pereira-Rodrigues, Pedro; Cardoso, AlexandrinaBackground: The escalating prevalence of cesarean delivery globally poses significant health impacts on mothers and newborns. Despite this trend, the underlying reasons for increased cesarean delivery rates, which have risen to 36.3% in Portugal as of 2020, remain unclear. This study delves into these issues within the Portuguese health care context, where national efforts are underway to reduce cesarean delivery occurrences. Objective: This paper aims to introduce a machine learning, algorithm-based support system designed to assist clinical teams in identifying potentially unnecessary cesarean deliveries. Key objectives include developing clinical decision support systems for cesarean deliveries using interoperability standards, identifying predictive factors influencing delivery type, assessing the economic impact of implementing this tool, and comparing system outputs with clinicians’ decisions. Methods: This study used retrospective data collected from 9 public Portuguese hospitals, encompassing maternal and fetal data and delivery methods from 2019 to 2020. We used various machine learning algorithms for model development, with light gradient-boosting machine (LightGBM) selected for deployment due to its efficiency. The model’s performance was compared with clinician assessments through questionnaires. Additionally, an economic simulation was conducted to evaluate the financial impact on Portuguese public hospitals. Results: The deployed model, based on LightGBM, achieved an area under the receiver operating characteristic curve of 88%. In the trial deployment phase at a single hospital, 3.8% (123/3231) of cases triggered alarms for potentially unnecessary cesarean deliveries. Financial simulation results indicated potential benefits for 30% (15/48) of Portuguese public hospitals with the implementation of our tool. However, this study acknowledges biases in the model, such as combining different vaginal delivery types and focusing on potentially unwarranted cesarean deliveries. Conclusions: This study presents a promising system capable of identifying potentially incorrect cesarean delivery decisions, with potentially positive implications for medical practice and health care economics. However, it also highlights the challenges and considerations necessary for real-world application, including further evaluation of clinical decision-making impacts and understanding the diverse reasons behind delivery type choices. This study underscores the need for careful implementation and further robust analysis to realize the full potential and real-world applicability of such clinical support systems.
- Lacunas de conhecimentos e habilidades de mães portuguesas associados à saúde do recém-nascidoPublication . Cardoso, Alexandrina; Marín, Heimar de FátimaObjetivos: Caracterizar o nível de conhecimentos e habilidades associadas à competência parental: promover e vigiar a saúde da criança, até aos seis meses de idade e, caracterizar o perfil das mães mais bem preparadas. Método: estudo transversal, realizado em três centros de saúde de uma Unidade Local de Saúde do Norte de Portugal. Para a seleção de dados foi realizada entrevista clínica a mulheres grávidas ou cujo filho tivesse até seis meses. O instrumento foi constituído por 21 indicadores relacionados com a promoção e a vigilância da saúde da criança, nos momentos – gravidez, 1ª-2ª semana, 1º-2º, 3º-4º e 5º-6º mês. Resultados: foram avaliados os conhecimentos e as habilidades de 629 mulheres. Foram identificadas necessidades de aprendizagem em todos os indicadores avaliados. As mães bem preparadas tinham maior nível de escolaridade; coabitavam com o pai do filho; já tinham outros filhos; a gravidez foi planejada e tinham intenção de amamentar. Conclusões: nos momentos em que foram avaliadas, as mães demonstraram falta de conhecimentos e de habilidades. Pode ser considerado um grupo vulnerável, as mães: solteiras, primíparas, cuja gravidez não foi planeada e sem preparação prévia
- Análise da parametrização nacional do Sistema de Apoio à Prática de Enfermagem - SAPEPublication . Silva, Abel; Cardoso, Alexandrina; Sequeira, Carlos; Morais, Ernesto; Bastos, Fernanda; Pereira, Filipe Miguel Soares; Padilha, José Miguel Santos Castro; Cruz, Inês; Oliveira, Manuel Fernando; Brito, Alice; Silva, Maria Antónia; Machado, Natália; Sousa, Paula Cristina; Sousa, P.; Marques, Paulo
- Representação do conhecimento em enfermagem do trabalho: dados relevantes face à saúde individual do trabalhador sob influência do ambiente laboralPublication . Bastos, Fernanda; Morais, Ernesto; Joana Campos, Maria; Brito, Alice; Cardoso, Alexandrina; Sousa, P.Introduction: Occupational health presents itself as a whole area to ensure healthy work environments and a better quality of life for workers. In the information systems in use, it was found that this area was missing, and a representation of existing knowledge in occupational nursing is urgent, particularly concerning the data that allow the characterization of health needs in a work environment. Objectives: Formally represent the available knowledge related to data relating to the assessment of the client under the influence of the work environment, which represent the first element of the planning and description of the nursing care process, thus constituting a fundamental resource for the design of clinical decision support systems. Methodology: This work derives from a global project developed by the Center for Research and Development of Information Systems at the Porto School of Nursing, in collaboration with the Ordem dos Enfermeiros, which consolidated itself in the construction of a Nursing Ontology. A qualitative study of inferential nature was carried out for its conception, with content analysis to national parameterization and literature review. For content validation, a focus group was used. Results: Nineteen assessment data were identified, most of which could generate sensitive indicators for nursing care, organized into three domains: i) data related to the characterization of the work activity, its context and physical intensity; ii) data related to occupational exposure potentially leading to changes in bodily and psychological processes; and iii) data that characterize aspects related to health-seeking behaviours related to the adaptive process (transition) of the client in the work context, such as knowledge and awareness. Conclusions: The identification of data is decisive for the diagnostic process, with centrality in the characterization of the data centred on physical intensity and exposure to risk factors in the work activity and the adaptive process related to areas that will influence the choice of health-promoting behaviours.
- Challenges of motherhood in the voice of primiparous mothers: Initial difficultiesPublication . Carvalho, Júlia; Gaspar, Maria; Cardoso, AlexandrinaObjective. To identify the main difficulties first-time mothers experience in the postpartum period, during the first six months of the baby’s life. Methods. Level I qualitative, exploratory-descriptive study. The sample consisted of 11 first-time mothers of full-term healthy newborns. The data were collected through the “focus group” method. The mothers’ discourse was subject to content analysis, categorizing the registry units. Results. Three categories emerged from the data analyzed that indicate the mothers’ main difficulties in this period: postpartum recovery; baby care; marital relationship. Conclusion. The results indicate that, although motherhood is an event marked by positive emotions, the difficulties that emerge in the mothers’ daily life can interfere negatively in the quality of parenthood. In this scenario, the nurses play a determinant role in the enhancement of interventions that are sensitive to these needs and that, at the same time, favor these mothers and their families’ empowerment, thus optimizing the children’s development trajectories.
- 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.
- Potencialidades e limitações da atuação do enfermeiro no Centro Parto NormalPublication . Ferreira Júnior, Antonio Rodrigues; Brandão, Luciana Camila dos Santos; Teixeira, Ana Carolina de Melo Farias; Cardoso, AlexandrinaObjective: To know the potentialities and limitations of the nurse’s performance in the Center for Normal Birth (CPN). Method: Qualitative approach, exploratory-descriptive type, carried out in 2018, with six nurses working in public intra-hospital CPN in the metropolitan region of Fortaleza, Ceará, Brazil. The collection of information occurred through individual interview, with analysis from the assumptions of the sociology of professions, focusing on the themes: knowledge and autonomy; credentialism; division of labor; labor market and value chart. Result: The nurse’s performance in the Center for Normal Birth (CPN)enhances good practices for childbirth and birth, as well as increases the importance and visibility of this professional in maternal and child care. Clinical care and management emerge as the focus of the nurse’s action in the CPN. However, even with the induction of the State to this action, there is still the need for recognition of the competencies and autonomy of the nurse in obstetric care by other professionals. Conclusion and implications for practice: There are challenges that need to be overcome such as the expansion of autonomy and respect for the accreditation of the nurse to work in the CPN and the harmonization between the management of the work process and management of clinical care by this professional.