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- Preparing the return home of the children with cancerPublication . Pires, Rita Alexandra; Reis Santos, Margarida; Pinto, CândidaChildren with oncologic disease, between treatments, if there are no complications, return home until the next treatment. Planning the discharge is essential to promote a continuity of cares at home. An adequate preparation for discharge leads to a better management of collateral e+ects and to a minor risk of rehospitalisation. The goals of this study were: to identify the preparation for discharge performed to the parents / caregivers of children / adolescents with cancer submitted to chemotherapy; to identify the strategies of preparation for discharge. A qualitative, exploratory, descriptive and transversal study was developed. After the return home, 11 parents of children with cancer submitted to chemotherapy treatment, participated in the study. Data was collected using a semi-structured interview and its treatment made using content analyses, based on Bardin. From the data analyses emerged the domain The Return Home that aggregates the category Preparation for Discharge and its subcategories: Oral Information, Written Information, Comprehensibility of the Information and Information Content. The return home is simultaneously a desired and feared moment. Parents and children return to their environment, but face di
- Elderly people with limited mobility: their families and the implications of their dependencyPublication . Pimenta, Susana Elisabete; Martins, MM; Monteiro, Clara; Reis Santos, Margarida; Martinho, JúliaINTRODUCTION AND OBJECTIVES. The family has su'ered several changes throughout the times, leading to many elderly people living alone or with other elderly. In a family the situation of the elderly that depended on others can compromise the family’s relationships, which leads to little availability to motivate them to mobilization. The objective of the study was to understand the way the family functions in view of to the dependence of the elderly with limited mobility in a community context. METHODOLOGY. Descriptive study, exploratory of a quantitive character. The data was gathered through a questionnaire, including the Lawton & Brody (1969) scales, the lifestyle pro+le (Nahas, 2013) and the familiar APGAR (Smilkstein, 1978). Nonprobabilistic sample, composed by 1298 elderly with limited mobility, from 26 civil parishes from the municipality of Vila Nova de Famalicão. RESULTS AND DISCUSSION. Most of the people polled considered that his own family was a functional one (64.8%) and 49.6% were moderately dependent. By analysing the physical activity lifestyle pro+le and the familiar functionality one could conclude that 65.2% had a positive pro+le, presenting typical behaviours of an active lifestyle. We think that the fact that 73.1% are inserted in functional families had something to do with it. We have veri+ed a perfect association (p = 0.000) between dependency, lifestyle physical activity and familiar functionality – APGAR. CONCLUSIONS: The results show that the family determines the lifestyle physical activity and the elderly’s dependency. A functional family in
- Management of bleeding in trauma victims by Portuguese nurses in prehospital settingPublication . Mota, Mauro; Reis Santos, Margarida; Santos, Eduardo JF; Figueiredo, Andrea; Melo, Filipe; Albuquerque, Sara; Cunha, MadalenaIntroduction: External bleeding is the leading preventable cause of death from traumatic injuries. Implementation of guidelines for its control have been associated with a significant reduction in mortality. The objectives of this study were to provide a characterisation of trauma patients with external bleeding and to compare the outcomes from specific autonomous interventions applied by nurses in prehospital care.Methods: A non-randomised prospective study was conducted in the Immediate Life Support Ambulances in Portugal, from 1 March 2019 to 30 April 2020. Patients were divided into two groups according to whether external bleeding was controlled or not on their arrival at the emergency room.Results: A total of 189 patients were included in this study (73.0% men; mean age of 53.6 years). Among these patients, 140 (74.1%) had their external bleeding controlled by prehospital nurse’s intervention. The average time of assistance at the incident site was 31.5 min. Patients with uncontrolled bleeding had a higher average rescue time (30.8 ±15.2 vs 33.7 ±13.0). Cryotherapy was administered to 15.9% of all patients and 93.3% of these patients arrived at the emergency room with controlled bleeding (p=0.01).Discussion: Despite the substantial reduction in the number of patients who keep bleeding after prehospital care, it was observed that one fifth of patients have external bleeding on arrival at the emergency room. Cryotherapy has been shown to be effective in controlling external bleeding. Failure to use haemostatic agents may explain the ineffective control of more complex external bleeding.Contribution to Emergency Nursing Practice: The current literature on management of bleeding in trauma patients is scarce and contradictory, especially in terms of interventions provided by AUTHORSMAURO AL MOTA PhD, RN1,2,3,4,5MARGARIDA REIS SANTOS PhD, RN6,7EDUARDO JF SANTOS PhD, RN2,3ANDREA FIGUEIREDO MSN, RN5FILIPE MELO MSN, RN5,8,9SARA ALBUQUERQUE MSc, MD10MADALENA CUNHA PhD, RN2,31. Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal2. Health School of the Polytechnic Institute of Viseu, Portugal3. Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Portugal4. Hospital Nossa Senhora da Assunção, Local Health Unit of Guarda, Seia, Portugal5. INEM – National Institute of Medical Emergency. Portugal6. Nursing School of Porto, Porto, Portugal7. CINTESIS – Center for Health Technology and Services Research, University of Porto, Porto, Portugal8. Hospital de Faro. University Hospital Center of Algarve. Faro, Portugal9. ABC – Algarve Biomedical Centre. Faro, Portugal10. Group of Health Centers – Greater Porto VII – Gaia, USF Nova Salus, Gaia, PortugalRESEARCH ARTICLESManagement of bleeding in trauma victims by Portuguese nurses in prehospital setting rehospital teams led by a registered nurse. In addition, interventions vary from country to country.This article increases awareness of autonomous interventions implemented by prehospital nurses to manage external bleeding.Key implications for emergency nursing practice identified in this study suggest greater fluid therapy appears harmful while cryotherapy achieved the best results (control of the bleeding on emergency room arrival). This may contribute to the review of institutional algorithms and training in this area.
- Distance supervision in nursing: a reality desired by nursesPublication . Silva Rocha, Inês Alves da Rocha e; Reis Santos, Margarida; Pires, ReginaBackground: Distance supervision strategies facilitate the supervision process since the supervisee has easier access to the supervisor for obtaining support. Objectives: To identify the frequency of implementation of distance supervision strategies, as well as the strategies that nurses would like to see implemented more often in hospital and primary health care settings. Methodology: Descriptive, exploratory and cross-sectional study with a quantitative approach using a sample of 273 nurses. Data were collected through the Questionnaire of Frequency Assessment of Clinical Supervision in Nursing Strategies (Questionário de Avaliação da Frequência de Estratégias de Supervisão Clínica em Enfermagem). Results: Nurses would like distance supervision strategies to be more often implemented. In comparison with hospital nurses, primary health care nurses argue that distance supervision strategies by telephone and email should be more often implemented. Conclusion: The study contributes to improve the knowledge on Clinical Supervision in Nursing, particularly on distance supervision strategies.
- Nursing students’ health profile: epidemiological diagnosis based on the PRECEDE-PROCEED modelPublication . Ferreira, Fernanda; Mota, Liliana; Brito, Irma; Reis Santos, MargaridaBackground: The identification of nursing students’ health profile is essential to develop healthy academic communities. Objective: To analyze students’ health profile with a view to designing intervention strategies based on the PRECEDE- PROCEED model. Methodology: Quantitative study. Data were collected using the Portuguese version of the following questionnaires: the Fantastic Lifestyle Assessment, the Stunkard Figure Rating Scale, the Rosenberg Self-esteem Scale, and the Psychological General Well-Being Index. A total of 224 undergraduate and postgraduate nursing students participated in this study. Results: Students’ overall lifestyle is very good. However, lower scores were found in the Physical activity/Affiliation, changes in Nutrition, altered sleep and low stress management ability, Work/Personality type, and Insight, which suggests that students are less optimistic and positive about life. Conclusion: The intervention plan includes support, education, protection, and prevention should be adapted to students’ individual needs and integrated into the curricula.
- Prehospital interventions to prevent hypothermia in trauma patients: a scoping reviewPublication . Mota, Mauro; Cunha, Madalena; Reis Santos, Margarida; Santos, Eduardo; Melo, Filipe; Abrantes, Tito; Santa, AnaObjective: The aim of this review is to map the prehospital rewarming measures used to prevent hypothermia among trauma victims. Background: Hypothermia is responsible for an increase of the mortality and morbidity in trauma victims and its recognition and early treatment are crucial for the victim’s haemodynamic stabilisation. Prehospital interventions are particularly important, especially those that target bleeding control, haemodynamic stability, and safe body temperature. Registered nurses may be pivotal to prevention and minimisation of the dangerous effects of hypothermia. Study design and methods: A scoping review was used to identify articles from several online databases from 2010 to 2018. Studies in English, Spanish, and Portuguese were included. Two reviewers performed data extractions independently. Results: Seven studies were considered eligible for this review: two quantitative research studies, one qualitative research study, and four literature reviews. Rewarming measures can be divided into two main groups: passive rewarming, which includes the use of blankets, positioning the response unit to act as a windbreak, removing the patients’ wet clothes, drying the patient’s body, and increasing the ambient temperature; and active rewarming which includes the use of heating pads, heated oxygen, warmed intravenous fluids, peritoneal irrigation, arteriovenous rewarming, and haemodialysis. Discussion: Active measures reported by the included studies were always used as a complement to the passive measures. Active rewarming produced an increase in core temperature, and passive rewarming was responsible for intrinsic heat-generating mechanisms that will counteract heat loss. Patients receiving passive warming in addition to active warming measures presented a statistically significant increase in body core temperature as well as an improvement in the discomfort caused by cold. Conclusion: Rewarming measures seem to be essential for the prevention of hypothermia and to minimise the discomfort felt by the patient. In many countries registered nurses can play important roles in the prehospital context of trauma victim’s assistance. Greater understanding of these roles is necessary to the development of better practice.
- Indicadores de qualidade do exercício profissional dos enfermeiros: o papel do cuidadorPublication . Vieira, Joana; Reis Santos, Margarida; Pires, Regina; Pereira, Filipe Miguel SoaresIntroduction: Quality in health is one of the key requirements that clients demand. To improve their practice nurses use quality indicators as an important strategy for assessment and changes in care. Objective: To identify the indicators that nurses of Integrated Continuous Care at Home Teams consider adequate to monitor the quality of their professional practice in the ambit of the caregiver. Methods: Qualitative, descriptive and cross-sectional study. Data collection using a semi-structured interview, recorded in audio, to a focus group of 11 nurses. The information was analyzed using Bardin's content analysis technique. Results: Identified 32 indicators, related to the acquisition of cognitive and instrumental skills necessary to meet the needs of the dependent person in self-care. Conclusion: The identified indicators are related to the process and outcomes of the Donabedian’s triad and highlights the importance of using a standardized terminology in nursing.
- Perceção dos pais sobre o futuro da criança com cancroPublication . Pires, Rita; Reis Santos, Margarida; Pinto, CândidaCancer in the child affects the whole family, which experiences the uncertainty of the prognosis, projecting itself into an unpredictable future. Parents come to live with the disease, the treatments and their effects, in a sinuous path lined by the uncertainty of the next day. The aim was to identify parents’ perceptions regarding the future of children / adolescents with cancer undergoing chemotherapy. A qualitative, exploratory, descriptive and transversal study was developed. Eleven parents of children with cancer who underwent chemotherapy after their homecare were enrolled. Data were collected by semi-structured interview and analyzed according to Bardin. From the content analysis emerged the domain “Future Uncertain”, which integrates the category “Syndrome of Damocles” and the subcategories “Fear” and “Unpredictability of the Future”. Fear is a negative emotion experienced by parents of children with cancer, from the time of diagnosis and throughout the course of the disease. The unpredictability of the future is a constant in the life of parents, generating a continuous concern, so they resort to the strategy of thinking and living only in the present. However, uncertainty can catalyze psychological growth, leading them to value small moments, and to incorporate uncertainty as an integral part of life. Nurses must carry out interventions aimed at better management of uncertainty, as they help in the process of adaptation and management of stress. These interventions should lead to a “new normality” in family life, in which confrontation with adversity leads to a whole new meaning of existence.