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- Self‐Care Dependency Evaluation Form: Psychometric properties of the revised version with 27 itemsPublication . Parente, Paulo; Costa, Andreia; Pereira, Soraia; Puga Machado, Paulo Alexandre; Martins, Teresa; Pereira, Filipe Miguel Soares; Silva, AbelAbstract Introduction: The Self-Care Dependency Evaluation Form assesses dependency in performing self-care activities, but its original version is extensive and provides redundant information. The present study aims to scrutinise the items of the scale with the purpose of creating a revised version and to evaluate its psychometric properties. Methods: The study was conducted in two phases. In the first phase, an exploratory and correctional analysis of the items of the original form was performed from a database with 282 participants, followed by a review by a panel of experts who analysed the discriminatory ability and the contribution and relevance of each item, which resulted in the revised version. In the second phase, a new study with a sample comprising 150 participants was conducted to test the psychometric properties of the revised version. All ethical aspects and matters of confidentiality and privacy were assured. Results: The scale with 27 items shows good internal consistency, ranging from 0.67 (taking medication) to 0.96 (walking). It was moderately correlated with the Barthel Index and the Lawton and Brody Scale, proven to be a discriminatory measurement instrument. Discussion/Conclusion: This measure will enable health professionals to better evaluate self-care activities and provide more efficient, simple and effective prescriptions.
- Gestão da pandemia COVID-19 numa Escola de Enfermagem Portuguesa: um relato de experienciaPublication . Vilar, Ana Isabel; Bastos, Celeste; Araújo, F.; Joana Campos, Maria; Puga Machado, Paulo Alexandre; Abreu, MargaridaIntrodução: A pandemia COVID-19, decretada pela OMS em março de 2020, originou enormes desafios. As instituições de ensino viram-se confrontadas com a necessidade de tomar medidas para controlar a disseminação da doença. Para manter a comunidade escolar segura, desenvolveu- se um plano de contingência abrangente para que toda a comunidade educativa se sentisse envolvida e apta a seguir as medidas propostas. Objetivos: (I) Descrever o processo de construção de um plano de contingência para responder à situação de pandemia COVID-19, numa Escola Superior de Enfermagem; (II) Descrever a implementação do plano de contingência e sua adequação, em função da evolução da situação pandémica e (III) Descrever os principais desafios encontrados e as estratégias corretivas adotadas. Metodologia: Relato de experiência da construção e implementação do plano de contingência da Instituição. Foi nomeada uma Equipa de Plano de Contingência que elaborou um plano em conformidade com as orientações das diversas entidades reguladoras da saúde, estruturado em quatro tópicos: 1) organização de estruturas; 2) formação; 3) organização das atividades letivas e laborais; 4) acompanhamento e monitorização. Foram, ainda, elaborados vários documentos orientadores de práticas seguras, destinados à readequação do processo ensino-aprendizagem e à segurança dos colaboradores e estudantes. Resultados: Foi instituída uma sala de isolamento para apoio às situações de casos suspeitos, em cada edifício. Reorganizaram-se os espaços para garantir distâncias de segurança; disponibilizaram-se antisséticos em pontos estratégicos para promover a higienização das mãos; adotou-se sinalética para facilitar a circulação das pessoas; alteraram-se dinâmicas internas e procedimentos específicos; organizaram-se sessões de esclarecimento dirigidas aos professores e formação online, para estudantes e funcionários não docentes, e formação presencial para as equipas de limpeza e de apoio e vigilância. Para monitorizar a evolução da pandemia na comunidade escolar, foi criado um processo de notificação/registo de casos. Conclusões: O plano de contingência tem respondido às necessidades da instituição. Mostrou-se dinâmico e flexível, sendo sempre ajustado de acordo com as normas/orientações nacionais e em parceria com as Autoridades de Saúde Locais. As mudanças implementadas mostraram-se eficazes e tiveram a adesão da comunidade escolar, que passou a integrar as novas regras no seu dia a dia. O número muito reduzido de casos com origem na instituição parece ser revelador do sucesso das medidas implementadas.
- Avaliação da dependência no autocuidado: estudo exploratório do fenómeno em contexto comunitárioPublication . Pereira, Soraia; Martins, Teresa; Machado, Paulo Alexandre PugaThe assessment of the dependent person’s self-care ability, through measurement instruments, and the assessment of the level and kind of dependency, may provide nurses a more assertive method for understand the nature of the problems that affect dependency and for establish an action plan tailored to the development of new practices centered on the dependent person, looking forward to promote autonomy. Within this context, and in order to develop nursing practice in self-care dependency context, this paper serves the goal of the characterization of dependent people in self-care in a community context and the analysis of the different domains of self-care according to sociodemographic and clinical variables. It was used the non-probabilistic sampling method, of the accidental type and for data collection was used the reduced version of the Self-Care Dependency Assessment Form. The results found show that women and the elderly are more dependent, and that the dependence settles mainly gradually. Regarding the level of dependence by self-care domain, the one that registered the highest level of dependence was self-care “taking medication”, followed by “dressing and undressing” and self-care “taking a bath”. The “global level of dependence” has an average of 2.64 and a standard deviation of 0.83, which reveals high degrees of dependence on self-care. With current demographic changes and consequent health needs and their implications for health policy preparation and planning, the measurement and evaluation of the dependent person and their caregiver is becoming increasingly essential, enabling a holistic and adjusted approach.
- 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.
- Programas de intervenção para familiares cuidadores de pessoas dependentesPublication . Freire, R.M.A.; Martins, Teresa; Peixoto, Maria José; Puga Machado, Paulo Alexandre; Vilela, Carlos
- Easiness, usefulness and intention to use a MOOC in nursingPublication . Padilha, José Miguel Santos Castro; Puga Machado, Paulo Alexandre; ALVES RIBEIRO, ANA LEONOR; Ribeiro, Rui; Vieira, Francisco; Costa, PatrícioBackground: The growing ageing population and the increasing prevalence of non-communicable diseases call for innovation and healthcare mastered professional skills. Emerging digital learning contents envisioning to complement education, lifelong learning and in-service training. The use of digital platforms allows nurses to access contents in several formats, enabling the required pedagogical autonomy and personal time management. This allows nurses to enrol in education wherever accessible, reducing personal and professional costs and ensuring high-quality standards. Objectives: To assess students and nurses’ easiness, usefulness and intention to use a Massive Open Online Course (MOOC) as an educational resource to enhance self-management intervention skills in COPD patients. Methods: An exploratory, descriptive and transversal study was conducted. Participants were nursing students, registered nurses and rehabilitation nurses. A questionnaire supported by Davis Technology Acceptance Model and on the determinants of the ease-of-use perception of Venkatesh was applied. An EFA was performed and two dimensions were obtained (perceived easiness and global quality of the course and perceived usefulness and intention to use the MOOC) and groups were compared in these dimensions. Results: From the total participants (n = 93), 65.6% were nursing students, 15.1% were Portuguese nurses and 19.4% were Portuguese rehabilitation nurses. The perceived easiness and global quality score of the course were 4.70 (SD = 0.314) and the perceived usefulness and intention to use the MOOC was 4.73 (SD = 0.346). Rehabilitation nurses, who are older, scored higher than nurses and students (χ2(2, n = 93) = 8.43, p = .015, ε2 = 0.092). The dropout rate was 25%. Conclusions: The MOOC showed usefulness and nurses’ intention to use this educational resource in future education and yielded high average rates of perceived easiness and global quality. These massive courses unlock new opportunities for nursing education and to lifelong learning in nursing, enhancing safety and quality of the healthcare services in supporting patients to achieve a better quality of life.
- Risk Factors Associated with Falls among Nursing Home Residents: A Case-Control StudyPublication . Imaginário, Cristina; Martins, Teresa; Araújo, F.; Rocha, Magda; Puga Machado, Paulo AlexandreIntroduction: To identify factors predictive of falls and enable appropriate management of fall risk it is necessary to understand the behaviour and health conditions of older adults living in nursing homes. Objective: This study had two main objectives. The first was to find significant predictors for falls in older adults living in nursing homes. The second main goal was to build a predictive model to find the best predictors for falls. Methods: Out of 56 nursing homes with the same legal statute, 25 agreed to participate. The sample was randomly selected and only the independent or slight/ moderately dependent participants were included in the study (n = 325). Results: There was a mean of 1.47 ± 0.99 falls (range from 1 to 7) per resident in nursing homes. By using the t test and odds ratio analysis, ten factors related to falls were identified. Through the binary logistic regression, a model was tested identifying four robust predictors: static balance, resorting to emergency services, polypharmacy, and an independent self-care profile. Conclusions: The present study replicated the main results of contemporary research on the risk factors of falls. More importantly, it suggests that the self-care profile model should be taken into account in future studies and early interventions. It is crucial to implement preventive measures consistent with safer environments and to establish an individual plan for integrated activities according to older adults’ health needs.
- Maintaining Effects of Pulmonary Rehabilitation at Home in Chronic Obstructive Pulmonary Disease: A Systematic Literature ReviewPublication . Pinto, Duarte; Spencer, Lissa; Pereira, Soraia; Puga Machado, Paulo Alexandre; Sousa, P.; Padilha, José Miguel Santos CastroTo systematize strategies that may support patients with Chronic Obstructive Pulmonary Disease to maintain the effects of pulmonary rehabilitation over time. This systematic literature review was conducted, and the evidence was electronically searched in the Web of Science, Scopus, and EBSCO databases. This review included randomized controlled clinical trials, published until September 2019, that addressed components of an unsupervised home-based pulmonary rehabilitation program, maintenance strategies following outpatient pulmonary rehabilitation programs, as well as data on outcomes for quality of life, exercise performance, and dyspnea. A final sample of 5 articles was obtained from a total of 1693 studies. Data for final synthesis were grouped into 2 categories: components of unsupervised home-based pulmonary rehabilitation programs and maintenance strategies. An unsupervised home-based pulmonary rehabilitation program should consist of an educational component, an endurance training component, and a strength training component. When patients are transferred to the home environment, it is important to include more functional exercises specifically adapted to the patient’s condition, goals, and needs.