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- Physical examination of arteriovenous fistula: The influence of professional experience in the detection of complicationsPublication . Sousa, Clemente Neves; Teles, Paulo; Dias, Vanessa Filipa Ferreira; Apóstolo, João Luís Alves; Figueiredo, Maria; Martins, MMVascular access is one of the leading causes of mobilization of financial resources in health systems for people with chronic kidney disease on hemodialysis. Physical examination of the arteriovenous fistula (AVF) has demonstrated its effectiveness in identifying complications. We decided to evaluate the influence of nurses' professional experience in the detection of complications of the AVF (venous stenosis and steal syndrome). The study took place in eight hemodialysis centers between May and September of 2011 in the north of Portugal. Sample was constituted by registered nurses. The nurses involved in the experiment were divided in two groups: those who had more than 5 years of experience and those who had less than 5 years of experience. Ninety-two nurses participated in the study: 34 nurses had less than 5 years of professional experience and 58 had more than 5 years of professional experience. In the practices considered by nurses in the detection of venous stenosis, there were no differences observed between the groups (P > 0.05). In steal syndrome, there were no differences observed between the groups in the practices of the nurses in the detection of this complication of the AVF (P > 0.05). We concluded that professional experience does not influence the detection of venous stenosis and steal syndrome.
- The informal caregiver's socioeconomic prism and its implications on state of mindPublication . André, Suzana; Cunha, Madalena; Martins, MM; Rodrigues, VítorIntroduction: The act of caring for a dependent elderly victim of cerebrovascular accident exerts different impacts on caregivers. Knowledge of their socioeconomic level by health professionals supports the planning and implementation of actions appropriate to the reality of the elderly and their caregivers. Objective: To determine whether socioeconomic status predicts informal caregivers’ state of mind (depression). Design: Cross-sectional, descriptive study in the Dão Lafões sub-region. Participants: Non-probabilistic sample of 636 informal caregivers, aged 17-85 years (mean = 50.19 ± 14.30). Measuring instruments: The Beck Depression Inventory and the Graffar Socioeconomic Level Scale. Results: We found class III (middle class family/reasonable socioeconomic status) was the most common (40.4%), class IV (upper lower class family/low socioeconomic level) with 37.7%. A majority of the sample (62.9%) does not have depressive symptoms, with their presence observed in 37.1% of informal caregivers, in which 24.3% are men and 39.6% women. The results sustain that socioeconomic level (P = .004) in the total sample predicts state of mind, inferring that caregivers with poorer socioeconomic status have a worse state of mind. Conclusions: The evidence found from the research show that informal caregivers with depressive symptoms have a poorer socioeconomic status, so that it is compulsory to consider these variables when planning interventions whose primary focus of attention is aimed at caregivers and elderly cerebrovascular accident victims experiencing situations of transition
- Prevalence and determinants in cytology testing for cervical cancer screening in Spain (2006–14)Publication . Cobo-Cuenca, Ana; Rodríguez-Borrego, María-Aurora; Hidalgo-Lópezosa, Pedro; Rodríguez-Muñoz, Pedro M; Martins, MM; Carmona-Torres, Juan MBackground: Cervical cancer has decreased in developed countries thanks to cytology screening programmes. The aims of this study were To analyse the frequency and evolution of performing cytology tests and to determine the variables that influence their use. Methods: Cross-sectional study of non-institutionalized women who participated in the national health survey (2006, 2011/12) and the European Health Survey in Spain (2009, 2014). Study variables: cytology-testing, time since last cytology-test, reason for performing the test, age, nationality, marital status, social status, education level and place of residence. Results: The study evaluated 53 628 women in Spain over 15 years old, with a mean age of 52.68 (SD 19.12). About 94.1% were Spanish, 49.2% were married and 77.2% lived with a partner. In 2014, 72% had a cytology test, a number that increased significantly. Women aged 25–65 were 5.13 times more likely to undergo a cytology test than those aged 15–24 years old (odds ratio (OR): 5.13; P < 0.001); women with university educations were 9.23 times more likely to undergo a cytology test than those without university educations (P > 0.001); those of social classes I and II (high) were 1.2 more likely to undergo a cytology test than those of low social class (P = 0.026); and Spanish women were 1.74 times more likely to undergo a cytology test than foreigners living in Spain (P < 0.001). Conclusion: Frequency of cytology testing has increased in the last few years. Screening for cervical cancer is associated with higher social status, education level, age, and not being foreign.
- Construction and validation of a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysisPublication . Sousa, Clemente Neves; Apóstolo, João Luís Alves; Figueiredo, Maria; Dias, Vanessa Filipa Ferreira; Teles, Paulo; Martins, MMSeveral guidelines recommend the importance of educating the patient about the care of vascular access. Nurses have a key role in promoting the development of self-care behaviors by providing the necessary knowledge to patients, so that they develop the necessary skills to take care of the arteriovenous fistula (AVF). This article describes the process of building a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis (ASBHD-AVF). This is a cross-sectional study in which the development, construction, and validation process followed the directions of the authors Streiner and Norman. This is a convenience sample, sequential, and nonprobabilistic constituted by 218 patients. The study was conducted in two stages during 2012-2014. The first phase corresponds to the scale construction process, 64 patients participated, while the second corresponds to the evaluation of metric properties and 154 patients participated. The principal component analysis revealed a two-factor structure, with factorial weights between 0.805 and 0.511 and between 0.700 and 0.369, respectively, explaining 39.12% of the total variance of the responses. The Cronbach's alpha of the subscale management of signs and symptoms is 0.797 and from the subscale prevention of complications is 0.722. The ASBHD-AVF revealed properties that allow its use to assess the self-care behaviors in the maintenance and conservation of the AVF.
- Qualidade dos cuidados de enfermagem: construção e validação de um instrumentoPublication . Martins, MM; Gonçalves, Maria Narcisa da Costa; Ribeiro, Olga; Tronchin, Daisy Maria Rizattoto describe the development and validation process of a scale to measure the nurses' perception of the activities that contribute to nursing care quality.