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  • Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review
    Publication . Carvalho Pinto, Cristina; Oliveira, Palmira; Fernandes, Olga; Padilha, José Miguel Santos Castro; Machado, Paulo Alexandre Puga; Ribeiro, Ana; Ramos, José
    Purpose: To identify nonpharmacological clinically effective interventions for constipation in adults. Methods: A systematic review of experimental studies of nonpharmacological interventions addressing participants’ management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693. Results: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant’s modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage. Conclusions: Specific nonpharmacological interventions are crucial for nurses’ clinical practice and of major importance for clients and families. Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice. Clinical Relevance: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.
  • Clinical Virtual Simulation in Nursing Education: Randomized Controlled Trial
    Publication . Padilha, José Miguel Santos Castro; Machado, Paulo Alexandre Puga; Ribeiro, Ana; Ramos, José; Costa, Patrício
    In the field of health care, knowledge and clinical reasoning are key with regard to quality and confidence in decision making. The development of knowledge and clinical reasoning is influenced not only by students' intrinsic factors but also by extrinsic factors such as satisfaction with taught content, pedagogic resources and pedagogic methods, and the nature of the objectives and challenges proposed. Nowadays, professors play the role of learning facilitators rather than simple "lecturers" and face students as active learners who are capable of attributing individual meanings to their personal goals, challenges, and experiences to build their own knowledge over time. Innovations in health simulation technologies have led to clinical virtual simulation. Clinical virtual simulation is the recreation of reality depicted on a computer screen and involves real people operating simulated systems. It is a type of simulation that places people in a central role through their exercising of motor control skills, decision skills, and communication skills using virtual patients in a variety of clinical settings. Clinical virtual simulation can provide a pedagogical strategy and can act as a facilitator of knowledge retention, clinical reasoning, improved satisfaction with learning, and finally, improved self-efficacy. However, little is known about its effectiveness with regard to satisfaction, self-efficacy, knowledge retention, and clinical reasoning.
  • Non-pharmacological interventions in the control of urinary incontinence and the instruments that allow the diagnosis: integrative review
    Publication . Nilza Caldevilla, Maria; Carvalho Pinto, Cristina; Cerqueira, Carla; Ramos, José; Teixeira, Leonor Olímpia
    Introduction: Urinary incontinence is a major health problem resulting in physical, psychological and social changes with economic repercussions on the health system. Is a multifactorial condition associated with age-related changes and disorders of the genitourinary system, which corroborates the fact that it is the most often recurring geriatric syndrome. Aims: To identify non-pharmacological interventions for adults with urinary incontinence and to identify tools for urinary incontinence diagnosis in adults. Method: An integrative review study design was completed. Two electronic databases was search (MEDLINE and Web of Science). Three independent reviewers searched databases according to a predetermine inclusion and exclusion criteria. Results: Twelve articles were included in the review. Eleven articles mentioned non-pharmacological interventions, such as physical therapies, lifestyle strategies, behavioural therapies and alternative conservative management options. These interventions should be targeted and individualized to the type of incontinence to result in health gains for the population. One article mentioned an assessment tool for urinary incontinence - The Gaudenz-Fragebogen tool. The evaluation tools can help to systematize the diagnostic activity and consequently improve the clinical practice in the field of urinary incontinence. Conclusion: In care conception, nurses should target their interventions to personal data to address individual symptoms and use assessment tools that can help in the differential diagnosis of UI. Then, to advancing the quality and rigor of nursing care, we advocate that providing nurses with skills in attaining a differential diagnosis of UI presents an added value to the improvement of quality of care in a multidisciplinary context.
  • Simulação clínica virtual na educação em enfermagem: estudo randomizado controlado
    Publication . Ribeiro, Ana; Puga Machado, Paulo Alexandre; Ramos, José; Costa, Patrício; Padilha, José Miguel Santos Castro