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- Health Literacy among Older Adults in Portugal and Associated Sociodemographic, Health and Healthcare-Related FactorsPublication . Costa, Andreia; Feteira-Santos, Rodrigo; Alarcão, Violeta; Henriques, Maria Adriana; Madeira, Teresa; Virgolino, Ana; Arriaga, Miguel; Nogueira, PauloAlthough the health literacy level of the general population was described recently, little is known about its specific levels among older adults in Portugal. Therefore, this cross-sectional study aimed to investigate the levels of health literacy demonstrated by older adults in Portugal and explore associated factors. Using a randomly generated list of telephone numbers, adults aged 65 years or more living in mainland Portugal were contacted in September and October 2022. Sociodemographic, health and healthcare-related variables were collected, and the 12-item version of the European Health Literacy Survey Project 2019–2021 was used to measure health literacy. Then, binary logistic regression models were used to investigate factors associated with limited general health literacy. In total, 613 participants were surveyed. The mean level of general health literacy was (59.15 ± 13.05; n = 563), whereas health promotion (65.82 ± 13.19; n = 568) and appraising health information (65.16 ± 13.26; n = 517) were the highest scores in the health literacy domain and the dimension of health information processing, respectively. Overall, 80.6% of respondents revealed limited general health literacy, which was positively associated with living in a difficult household financial situation (4.17; 95% Confidence Interval (CI): 1.64–10.57), perceiving one’s own health status as poorer (7.12; 95% CI: 2.02–25.09), and having a fair opinion about a recent interaction with primary healthcare services (2.75; 95% CI: 1.46–5.19). The proportion of older adults with limited general health literacy in Portugal is significant. This result should be considered to inform health planning according to the health literacy gap of older adults in Portugal
- Parents’ perception of health education practices in Neonatal UnitPublication . Souto, Nisa; Curado, Maria Alice dos Santos; Henriques, Maria AdrianaObjective: to analyze parents’ perception of health education practices developed by nurses in a Neonatal Unit that facilitated the acquisition of parenting skills for an informed decision-making. Method: this is an exploratory, descriptive and qualitative study. We included 13 parents with children hospitalized for the first time in a Portuguese Neonatal Unit. Data were collected between February and August 2020, through focus groups, processed in the software Interface de R pour Multidimensionnelles de Textes et de Questionneires, through Descending Hierarchical Classification and Similitude Analysis. Results: four classes emerged from the Descending Hierarchical Classification: “Information needs”; “Information gaps”; “Availability to inform”; “Facilitating health education practices”. Conclusion and implications for practice: parents considered digital technology combined with nurses’ availability to inform and explain, as well as provide an empathetic and informal environment as facilitating practices for health education. These results can support health education nursing interventions for parents at the Neonatal Units using digital technology.
- Gait ability and muscle strength in institutionalized older persons with and without cognitive decline and associatin with fallsPublication . Dixe, MA; Madeira, Carla; Alves, Silvia; Henriques, Maria Adriana; Baixinho, Cristina LavaredaFalls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, and increases in pain prevalence, and other comorbidities in older populations. The objectives of the present quantitative and longitudinal study were: (a) to characterize the cognitive state and fall frequency of older persons living in nursing homes; (b) to analyze the relationship between cognitive status and some fall risk factors; and (c) to associate cognitive decline, gait ability, and muscle strength of the examined institutionalized older persons with fall occurrence and recurrence over 12 months. The participants were 204 older persons who lived in Portuguese nursing homes, and data were collected from January 2019 to February 2020 by consulting medical records and applying the following instruments: the Mini-Mental State Examination, Timed Up and Go Test, and Medical Research Council Manual Muscle Testing Scale. Fall prevalence, assessed in two periods, 12 months apart, was similar in both samples (with and without cognitive decline) and close to 42%, and the annual recurrence rate was 38.3%. Older persons with no cognitive decline showed an association between gait speed and occurrence of first fall and recurrent fall (p < 0.05). Muscle strength and use of gait aid devices were not related to falls and their recurrence, regardless of mental state
- The fear of falls in the caregivers of institutionalized eldersPublication . Baixinho, Cristina Lavareda; Dixe, MA; Henriques, Adriana; Marques-Vieira, Cristina; Sousa, LuísAims: To understand how the fear of falls emerges and manifests itself in caregivers of institutionalized elders. Method: It is a qualitative study, based on the Grounded Theory and carried out with 24 informal caregivers, 5 nurses, 2 physicians and 2 directors of two Portuguese nursing homes. Data collection took place through interviews, participant observation, and documentation analysis, between October 2016 and January 2018. Data was collected and analyzed simultaneously, following the stages of open, axial, and selective coding. Results: The comparative analysis of the findings identified the conceptual category “Fear of falls in the caregivers of institutionalized elders”. The main category is associated with the categories: maintaining safety, hidden fear of falls, the perceived self-efficacy in the prevention of falls, falls and interpersonal relations, previous experiences, and team support. Conclusions: The fear has an influence on the self-efficacy perceived in the prevention of falls; the quality of the teamwork, in turn, is affected by previous negative experiences and by the support of the team.
- Evaluation of the effectiveness of an intervention in a health team to prevent falls in hospitalized elderly peoplePublication . Cunha, Luis Filipe Correia da; Baixinho, Cristina Lavareda; Henriques, Maria Adriana; Sousa, Luís; Dixe, MAObjective: To evaluate the effectiveness of an intervention program in practices and behaviors of a health team to prevent falls in hos pitalized elderly people. Method: This was an action, mixed-methods, and longitudinal study that applied an intervention based on TeamSTEPPS®, and organized into five domains: team training, communication, leadership, monitoring, and mutual support. The population was nurses and nursing aides who worked at the medical service of a Portuguese hospital center. Data were obtained by consulting process records and interviews, and by applying the Scale of Practices and Behaviors of Teams for Fall Prevention. Results: There was improvement in all indicators of the scale, with evident progress in discussion of risk factors and preventive measures to be implemented. Conclusion: This intervention promoted decision-making regarding the preventive measures to be applied to each elderly person and improved communication and the interest in identifying the causes of falls to prevent their recurrence.
- Educational Interventions for Nursing Homes Support Workers During the Pandemic:Publication . Sousa, Diana; Pinto, Joana; Faria, José; Pereira, Isabel; Henriques, Maria Adriana; Henriques, Helgantroduction:The current pandemic caused by the circulation of the SARS-CoV-2virus places the population in general, and aging people living in nursing homes in particular, in a situation of great vulnerability, with a high risk of morbidity and mortality. In these contexts, educational interventions with professionals have shown to be associated with changes in practices. However, data on educational interventions carried out in a pandemic situation in these contexts are still scarce, as well as their content and/or methodologies used. Goal:We aimed to describe educational interventions for nursing home support workers during the COVID-19 pandemic. Methods:An integrative literature review was carried out. Results:Of the 349articles identified, 4 were included in the final sample. The results show that the educational programs aimed at nursing home employees, including support workers, have great variability in terms of intervention, target audience, content, duration, how it is made available, and the scientific area of the trainers. There seems to be an association between the education provided and the reduction of virus transmission. Conclusions:This integrative review points to the importance of educational interventions, taught by health professionals, with support workers, as a way of preventing the transmission of SARS-CoV-2in nursing homes and reducing morbidity and mortality rates. Distance learning proves to be an educational opportunity for people in remote locations. Face-to-face training was also shown to be essential in demonstrating and training safe care practices. We recommend future research to achieve greater consistency in the conclusions.
- Quantum caring for parents :Publication . Souto, Nisa; Curado, Maria Alice dos Santos; Henriques, Maria Adriana; Garcia, Ana; Coughin, Mary; Vasconcellos, TherezaObjetivo: Traduzir e adaptar para a língua e cultura portuguesa a aplicação móvel Quantum Care for Parents- Neonatal Intensive Care Unit. Método: Estudo metodológico que contemplou as etapas de tradução, síntese das traduções, retroversão, síntese das retroversões, avaliação por 20 peritos em neonatologia para fazer a validação de conteúdo, e teste piloto aplicado a 20 pais portugueses com filhos internados na unidade de neonatologia. A validade de conteúdo foi suportada pelo Modelo de Lawshe e para a análise lexicográfica do conteúdo das sugestões dos peritos, recorreu-se ao software IRaMuTeQ. Resultados: Os critérios de avaliação foram a equivalência semântica, cultural e concetual entre a app original e a tradução. A Validade de Conteúdo foi boa para o número de peritos. Da análise lexicográfica das sugestões emergiram as classes: Adequação da informação, Disponibilização da Informação aos pais, Simplificação da Informação e Facilitação da Usabilidade. No teste piloto todos os itens foram classificados como claros. Conclusão: A aplicação móvel apresentou validade de conteúdo indicativa de boa adaptação à língua e cultura portuguesa e, após a introdução das sugestões dos peritos e teste piloto, considera-se um bom recurso de apoio à educação para a saúde e literacia parental em saúde, na unidade de neonatologia
- Como avaliar o risco de queda em idosos institucionalizados?Publication . Baixinho, Cristina Lavareda; Bernardes, R. A.; Henriques, Maria AdrianaObjetivo: identificar os instrumentos utilizados para avaliar o risco de queda em pessoas idosas institucionalizadas. Método: Revisão Integrativa da Literatura, realizada entre abril e julho de 2018, conforme protocolo pré-definido, com definição de critérios de elegibilidade para 18 estudos da amostra bibliográfica, para resposta à questão “Quais os instrumentos de avaliação usados para determinar o risco de queda em pessoas idosas institucionalizadas?” Resultados: os estudos utilizam instrumentos diferentes, isolados ou em conjugação, para determinar o risco de queda. Identificaram-se escalas específicas para avaliar o risco (Easy-Care risck of the Falls, St. Thomas Risk Assessment Tool, a Escala de Downton, entre outras), testes de avaliação funcional e testes de avaliação do estado mental. Conclusão: os instrumentos mais usados para a avaliação do risco de queda nos idosos institucionalizados são o Timed Up and Go Test e o Performance-Oriented Mobility Assessment, em associação com a pergunta “Caiu nos últimos 12 meses?”
- Effectiveness of Social Prescribing Programs in the PrimaryHealth-Care Context:Publication . Costa, Andreia; Sousa, Carla Joana; Seabra, Paulo; Virgolino, Ana; Santos, Osvaldo; Lopes, Joaquim Manuel de Oliveira; Henriques, Maria Adriana; Nogueira, Paulo; Alarcão, VioletaSocial prescribing (SP) is an approach that promotes the use of local non-clinical activities by people. The referral is usually made by primary health-care professionals, in a process wherein local providers play a pivotal role. The main objective of this study was to identify domains of intervention and evidence about the effectiveness of SP programs regarding health-related outcomes. A systematic literature review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in PubMed, CINHAL, and SCOPUS. Inclusion criteria of the reviewed papers were as follows: (i) effectiveness studies of interventions designated as SP or interventions entailing SP conceptual components; (ii) interventions with adults. Quality assessment was performed with the Cochrane tool for assessing risk of bias in randomized trials; an assessment tool developed by the US National Heart, Lung and Blood Institute was applied to observational studies. Overall, 13 articles were included for analysis, with a total of 4603 patients. Although three studies comprised a control group, only two followed a randomized controlled trials (RCT) design. Nine principal domains of intervention within SP were identified, with three categories of outcome measures: Physical and psychological wellbeing; Health behaviors and self-efficacy; and Health care resources end economic evaluation. SP is an emergent and promising health-care intervention, and it has been used to promote different health behaviors. Evidence of SP effectiveness on patient’s health and wellbeing is not strong. Further research is needed for understanding how SP can be applied efficiently.
- Public health nursing and public health policies:Publication . Cunha, Carmen; Henriques, Maria Adriana; Costa, AndreiaObjectives: to characterize the interventions of specialist nurses of community health and public health of a Group of Health Centers, to identify the main facilitating factors for the performance of competences, and the contribution to public health policies. Method: this is a case study carried out with nurses specialized in community health and public health nursing. Data were collected through interviews from October to December 2019. Analysis was guided by two strategies: starting from the theoretical propositions and working the data from the ground up; and two techniques: pattern matching and explanation building. Results: from the constructed matrix, ten theoretical propositions, ten emerging evidences, five patterns and five explanatory hypotheses emerged. There are interventions for epidemiological surveillance, planning and project management. Personal training and communication stand out as facilitating factors. Conclusion and implications for practice: the intervention of the nurses of these specialties presents a dimension centered on project planning and management identifies and reflects the facilitating factors of the performance of their competencies, as an applicator of public health policies
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