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- “Feixe de intervenções” para a prevenção da pneumonia associada à intubaçãoPublication . Carvalho Pinto, Cristina; Bastos, Celeste; Cerqueira, Carla
- Abordagem da via aérea para aspiração de secreçõesPublication . Carvalho Pinto, Cristina; Bastos, Celeste; Cerqueira, Carla
- Impact of a simulation-based interprofessional workshop (LINKS) on Portuguese healthcare students’ perception of roles and competencies: a quasi-experimental pilot studyPublication . Sa-Couto, Carla; Fernandes, Filipa; Carvalho Pinto, Cristina; Loureiro, Elizabete; Cerqueira, CarlaIntroduction There is a scarcity of simulation-based interprofessional (IP) programs in Portugal, with a notorious absence in undergraduate education. This paper describes the first step towards the development of an interprofessional education (IPE) undergraduate program, namely the implementation and preliminary assessment of the workshop LINKS – Lifting INterprofessional Knowledge through Simulation. The aim of this pilot study was to assess the educational effect of LINKS, in medical and nursing undergraduate students’ attitudes towards IP teamwork and collaborative practices, and their perception of roles and competencies within an IP team. Methods A total of 23 final-year students participated in the workshop. Teams of three or four elements (medical and nursing students) were exposed to two critical patient management simulation scenarios. To assess the impact of the workshop on students’ perception of IP collaborative practice, two surveys (ATTITUDES and IPEC) were applied before and after the workshop. Additionally, students’ opinion/satisfaction towards the workshop and its curricular integration was explored. Results Students’ awareness of the relevancy of IP learning and self-competency in IP practice improved. For all subdomains and overall scores, statistically significant differences were found when comparing the pre- and post-scores, for both medical and nursing students, in both surveys. All students agreed that the workshop added educational value to their training, and recommended its integration in the formal curriculum, with a first round in the penultimate year and repeated in the last year. Discussion Considering the pre–post test results and anecdotal comments shared during the session, we may infer that this single IPE event contributed to a clearer understanding of the team dynamic and individual role definition, increased the motivation to engage in collaborative practice between physicians and nurses and potentially challenged pre-existent stereotypes of each professional group. These findings corroborate the need for sustainable simulation-based IP programs, integrated in the undergraduate curricula, promoting early clinical interactions of different professional groups. We envision that the results of this study can help to inform future curriculum planning and provide useful insights that can be used within and between Portuguese institutions to develop a common IP undergraduate program.
- Patiente -reported experience in colorectal cancer continuum of care. How to translate them in a helping program for patients and family ?Publication . Carvalho Pinto, Cristina; Pereira, Filipe Miguel Soares; Santos, Cristina Mendes; Teixeira, Fátima; Moreira-Gonçalves, Daniel; Santos, Lúcio LaraBackground: Patient-focused interventions recognize the role of patients as active participants in the process of delivering effective, safe and responsible healthcare. When equipped with appropriate knowledge, patients can play an important role in their own care by early diagnosing self-limiting conditions and establishing a beneficial relationship with the healthcare team. The purpose of this study was to identify the main changes in bodily processes and their impact on dependency and self-care during colorectal cancer multimodal treatment to further develop a consistent patient-focused intervention protocol. Methods: A prospective longitudinal design was chosen to describe the evolution of the health condition of colorectal cancer patients during multimodal treatment. Patients were assessed (N = 129) in three separate moments, namely: T1 – after multi-disciplinary-team treatment decision; T2 – three months after T1; and T3 – six months after T1. Results: The results of this study show that, during treatment, patients with colon or rectal cancer experience significant changes in their health condition. They present a negative evolution on health status related with impairment in the gastrointestinal, circulatory and nervous systems and in psychological, neurovascular and resting processes. Chemotherapy adverse effects significantly reduce the ability to self-care. These patients reveal a higher dependency level in self-care areas, such as: instrumental activities of daily life (IADL) “bathing”, “to dress and undress”, “rising”, “taking medication” and “colostomy”. Conclusion: The results of this study pose a challenge to health care providers in the sense that these professionals are in a privileged position to help with an appropriate program, patients with colorectal cancer and their family in transition from dependence to supported self-care.
- Try to be a nurse. It’s Cool! - manual de apoioPublication . Cerqueira, Carla; Reisinho, Maria Da Conceição; Carvalho Pinto, Cristina; Oliveira, Manuel Fernando; Lima, Ligia; Cruz, Márcia; Barbieri-Figueiredo, MC; Nilza Caldevilla, Maria; Marques, Paulo; Parente, Paulo; Cruz, SandraA área da saúde cativou desde sempre os jovens, pelos desafios que comporta, pela proximidade e relação com os outros, saudáveis ou doentes; e a enfermagem em particular tem-se constituído como uma opção de grande significado, valendo por isso conhecer por dentro a sua riqueza de conteúdos, o seu dinamismo, a diversidade de abordagens. Uma semana entre nós, no ambiente onde tudo começa a acontecer, proporcionar-te-á uma ideia mais concreta sobre o que é ser enfermeiro na actualidade, sem esquecer o caminho que outros percorreram, mas dando-te a possibilidade de experimentar nos contextos de prática laboratorial, práticas em domínios que vão das crianças aos adultos, recorrendo a simuladores, manequins e dispositivos utilizados no dia-a-dia destes profissionais. A evolução e as mudanças que já se fazem sentir na sociedade, abrem novas perspectivas e caminhos nesta área do saber, que estamos dispostos a ajudar-te a descobrir.
- Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic ReviewPublication . Carvalho Pinto, Cristina; Oliveira, Palmira; Fernandes, Olga; Padilha, José Miguel Santos Castro; Machado, Paulo Alexandre Puga; Ribeiro, Ana; Ramos, JoséPurpose: 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.
- Promotion of Self-Care in Clinical Practice: Implications for Clinical Supervision in NursingPublication . Abreu, Wilson; Carvalho Pinto, Cristina; Segadães Moreira, Maria de Fátima; Teixeira, SilviaAbstract—Self-care is a human function that should be carried out by the individuals themselves, in order to preserve their life, health and self-esteem. During the past ten years, some approaches used by physicians and nurses to support self-care were identified to complement professional practices and structures, such as clinical supervision or leadership. This quantitative study was developed in a hospital in the North of Portugal. The start question was: “How to organize the system of clinical supervision in order to promote self-care and to contribute to the quality of care?” Participants were 110 patients hospitalized in a ward of the above-mentioned hospital. Two instruments were used to collect data. The first was a questionnaire focused on self-care and was filled out by rehabilitation nurses. The second instrument evaluated self-care as recorded in nurses’ electronic records filled during the caring process. Data analysis pointed out that self-care notes in patient anamnesis were limited to hygiene, while the degree of dependence was often ignored. There appears to be some confusion in the records regarding concepts and evaluation of the degree of dependence in self-care. Suggestions are made to promote self-care inside the system of clinical supervision, in order to provide appropriate healthcare to patients.
- Developing Ethical Thinking in Clinical Settings: A Case StudyPublication . Carvalho Pinto, Cristina; Abreu, WilsonDuring their clinical learning, nursing students face complex realities. These require the mobilisation of scientific knowledge but also provide taxonomies of moral reasoning skills to develop ethical thinking. The main questions of the study were: how do students' clinical experiences affect the development of their ethical thinking? How can clinical teachers help students to overcome ethical tensions? The purposes were to explore students' experiences that might lead to ethical tensions and dilemmas; to identify opportunities to develop ethical thinking and ethical reasoning, and to evaluate the effectiveness of educational strategies that encourage students to value acting with good intentions and achieving the best outcome. An ethnographic study was conducted involving students from a nursing school in the North of Portugal. Data were collected using three methods. A questionnaire was used to identify the students’ moral orientation. Participant observation was carried out to identify tensions or ethical dilemmas. Semi-structured interviews were conducted to clarify and deepen the information gathered. Six dimensions emerged from the content analysis: the environment; learning styles; the influence of role models; mentorship processes; previous experience and the meaning of the ethical dilemmas to the students. These dimensions allowed us to understand the way students develop their ethical reasoning and show that educational strategies can improve the skills required to overcome moral dilemmas. Developing ethical thinking is an ecological process that takes place through processes of complex interactions between students, clinical teachers and patients. Students' ethical thinking is determined by what they experience in the settings they spend time in. Teachers should understand that clinical reasoning is dependent upon ethical thinking and is influenced by cultural experiences.
- The effectiveness of negative pressure therapy for the treatment of diabetic foot wound: an umbrella studyPublication . Fernandes, Olga; Oliveira, Palmira; Carvalho Pinto, CristinaIntroduction and objectives: Diabetic foot is one of the disabling complications of diabetes affecting more than one million people in Portugal. Negative pressure therapy is relatively recent, describing itself as facilitating wound bed preparation and inducing granulation and angiogenesis. It is our goal to provide an overview of available evidence on the clinical efficacy of negative pressure in the treatment of diabetic foot in adults. Methodology: This is an umbrella review, with research in Scopus, Web of Science and Ebsco (Cinahl Complete and Medline), with the time limit (2014-2019), English and Spanish language, after defining the PICO review question, descriptors and inclusion and exclusion criteria. Two investigators performed methodological quality assessment, independently using JBI Critical Assessment Instrument. Results and discussion: 14 systematic reviews were identified, 3 were duplicated, 9 were eliminated after application of the inclusion criteria. Two articles were included, one with meta-analysis. The reviews included 23 studies indicating that negative pressure therapy is effective and safe, generally reflecting greater amounts of granulation tissue and shorter healing time. The existence of few randomized controlled trials and small samples are some of the limitations mentioned. Conclusions: The availability of evidence synthesized with this review may support clinical decision-making leading to an improvement in the quality of health care provided to people with diabetic foot injury.
- Transição de um membro da família para o exercício do papel de prestador de cuidados de um doente com cancro colo-rectalPublication . Carvalho Pinto, Cristina; Pereira, Filipe Miguel SoaresObjectivo: Descrever como lida o membro da família na transição para o exercício do papel de prestador de cuidados de um doente com cancro colorectal à luz da Teoria das Transições em Enfermagem. Método: Realizamos a revisão da literatura segundo os passos preconizados pela Cochrane Reviewers Handbook, durante os meses de Novembro e Dezembro de 2010. Resultados: Foram analisados 10 artigos, em que 8 são estudos primários e 2 de revisão sistemática da literatura. A partir da análise dos dados, constatamos que os estudos demonstram que a condição de saúde dos doentes com cancro varia no decurso da doença e/ou tratamentos, mas não aprofundam ou descrevem em que momentos essas alterações ocorrem; que factores as precipitam e qual o impacto no exercício do papel de Membro da Família Prestador de Cuidados. Conclusões: Os estudos descrevem o impacto da doença oncológica no seio da família, no entanto, pouco exploram os momentos/eventos em que o membro da família prestador de cuidados reconhece e percepciona o processo de transição para o exercício do novo papel. Os enfermeiros podem ajudar os “Membros da Família Prestadores de Cuidados” em processo de transição através da utilização de instrumentos capazes de monitorizar e acompanhar estes clientes, com base nos condicionalismos pessoais e comunitários que influenciam o exercício do papel, bem como os padrões de resposta decorrentes do exercício do papel.