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- Learning evidence based practice through involvement in investigation actiities:Publication . CARDOSO, MÁRIO; Baixinho, Cristina Lavareda; Ferreira, Óscar Manuel Ramos; Nascimento, Patricia; Pedrosa, Ana Rita; Gonçalves, PauloObjective: to understand how students perceive their involvement in investigation activities and how they contribute for the development of evidence-based practices. Method: qualitative, cross-sectional, descriptive, and exploratory study, carried out in Portugal, in August 2019. A focus group of eight participants was formed to answer the question: “What are the advantages of the participation of nursing students in investigations for the development of knowledge, attitudes, and performance in the use of evidence?” The software NVivo was used for a content analysis. Results: five categories and subcategories emerged from the qualitative analysis of findings: selflearning, integration of theory and practice, interdisciplinary work, evidence-based decision making, and scientific literacy. Conclusion: creating an effective learning experience helps building knowledge and can contribute for the health of the community, for improved educational results during the internship, and for the development of the abilities necessary for Evidence Based Practice.
- Being a nursing student in times of COVID-19Publication . Baixinho, Cristina Lavareda; Ferreira, Óscar Manuel RamosAim: To understand how the pandemic has affected nursing students in clinical teaching contexts. Method: This was a qualitative, exploratory, cross-sectional, and descriptive study. The participants were five newly graduated nurses who had completed the last clinical internship of their program during the COVID-19 pandemic. The narratives were analyzed using content analysis. Results: Five categories emerged: Difficulties felt in integration; difficulties in completing clinical internship; the influence of the pandemic on students’ expectations regarding the clinical internship for integration into professional life; fears related to COVID-19, and suggestions for training nursing graduates to prepare them to manage pandemic situations. Conclusions and implications for practice: The clinical internship was experienced with anxiety, fear, and pressure to achieve the skills required for professional practice, with the possible support provided by clinical supervisors, who were also under pressure given the increased work overload caused by the pandemic. The study allows for recommendations for the area of nursing education and research.
- Algorithm for transitional care for caregivers of dependent older adults: a validation studyPublication . Gomes, Thawanna; Ferreira, Bruna; Baixinho, Cristina Lavareda; Ferreira, Óscar Manuel RamosObjective: To construct and validate an algorithm for transitional care for caregivers of dependent older adults. Method: This was a methodological study developed in three phases: a literature review, designing an algorithm, and its validation by a peer panel with twenty seven experts selected according to pre-defined inclusion criteria. Results: The algorithm predicted interventions in transitional care (hospital stay, at discharge, and 30 days at home post-discharge) aimed at the exercise of the caregiver role; needs assessment; training in care management of dependent older adults and management of self-care, and ensuring continuity of care (of older adults and caregivers). Conclusion: Agreement between expert raters and a reliability test of 0.92 indicate that the algorithm can be used by professionals to decide the transitional care interventions to be administered to the caregivers of dependent older adults. Future studies should be conducted to perform its clinical validation.
- Definição do conteúdo da mnemónica posicionarPublication . Baixinho, Cristina Lavareda; Ferreira, Óscar Manuel Ramos; Marques, Maria de Fátima Mendes; Presado, Maria Helena; CARDOSO, MÁRIO; Henriques, HelgaIntrodução: A Terapêutica de Posição é uma terapêutica essencial na prestação de cuidados de saúde, coadjuvante no tratamento de várias morbilidades, importante para a promoção do conforto e bem-estar em pessoas de maior fragilidade, auxiliando na prevenção de várias complicações decorrentes da doença e/ou tratamento. Objetivo: Definir os indicadores da Mnemónica – POSICIONAR, para futura validação por um painel de peritos. Método: Estudo de abordagem mista, desenvolvido em 3 fases. Apenas nos centramos na abordagem qualitativa do segundo estudo. Participaram 9 enfermeiros peritos que responderam, em duas rondas, a dois formulários, que foram sujeitos a análise temática de conteúdo segundo Bardin. Resultados: A análise de conteúdo permitiu a organização de um conjunto de intervenções para as 10 categorias definidas a priori e que são representativas da terapêutica de posição. Conclusões: O instrumento proposto, possibilita sistematizar um conjunto de critérios a utilizar na avaliação e promoção da segurança da pessoa a posicionar, bem como, facilitar a comunicação entre os profissionais de saúde e a continuidade de cuidados.
- Transitional Care Management from Emergency Services to Communities :Publication . Batista, José; Pinheiro, Carla Munhoz; Madeira, Carla; Manuel Gomes, Pedro; Ferreira, Óscar Manuel Ramos; Baixinho, Cristina LavaredaIn recent years, nurses have developed projects in the area of hospital to community transition. The objective of the present study was to analyze the transitional care offered to elderly people after they used emergency services and were discharged to return to the community. The action research method was chosen. The participants were nurses, elderly people 70 years old or older, and their caregivers. The study was carried out from October 2018 to August 2019. The data were collected by means of semi-structured interviews with the nurses, analysis of medical records, participatory observation, phone calls to the elderly people and caregivers, and team meetings. The qualitative data were submitted to Bardin’s content analysis. Statistical treatment was carried out by applying SPSS version 23.0. The institution’s research ethics committee approved the research. Only 31.4% of the sample experienced care continuity after discharge, and the rate of readmission to emergency services during the first 30 days after discharge was 33.4%. The referral letters lacked data on information provided to patients or caregivers, and nurses mentioned difficulties in communication between care levels, as well as obstacles to teamwork; they also mentioned that the lack of health policies and clinical rules to formalize transitional care between the hospital and the community perpetuated non-coordination of care between the two contexts. The low level of literacy of patients and their relatives are mentioned as a cause for not understanding the information regarding seeking primary health care services and handing the discharge letter. It was concluded that there is an urgent need to mobilize health teams toward action in the patients’ process of returning home, and this factor must be taken into account in care planning.
- Autopercepção dos estudantes sobre a participação em atividades extracurriculares de transferência de conhecimento :Publication . Baixinho, Cristina Lavareda; Ferreira, Óscar Manuel Ramos; CARDOSO, MÁRIO; Nascimento, Patricia; Pedrosa, Rita; Gonçalves, PauloIntrodução: A emergência de um novo paradigma na formação na área da saúde apela ao aumento das competências associadas à ciência, para que os futuros profissionais tenham conhecimento sobre métodos e técnicas de investigação e utilizem a literacia científica como uma ferramenta de trabalho. Objetivos: Compreender como os estudantes percepcionam o seu envolvimento nas atividades do projeto da Transição Segura e o contributo para o desenvolvimento de uma prática baseada na evidência. Métodos: Focus Group com oito estudantes finalistas de enfermagem, que respeitavam os critérios de inclusão e que participaram no projeto. A análise qualitativa dos achados seguiu as etapas da codificação; armazenamento/recuperação e interpretação. Estudo aprovado por uma Comissão de Ética. Resultados: A análise do discurso dos participantes permitiu a definição de cinco categorias sobre o seu envolvimento no projeto: trabalho interdisciplinar, integração teórico-prática, tomada de decisão clínica baseada na evidência, autoaprendizagem e literacia científica e respectivas subcategorias. Conclusões: O envolvimento dos estudantes em projetos de translação do conhecimento para a clínica contribui para a sua aprendizagem, promove a tomada de decisão baseada na evidência, desenvolve competências de pesquisa, análise e transferência do conhecimento para a práxis.
- Conhecimento na clínica em saúde:Publication . Baixinho, Cristina Lavareda; Ferreira, Óscar Manuel Ramos; Marques, Maria de Fátima Mendes; Presado, Maria Helena; CARDOSO, MÁRIO; Sousa, Armando David; NASCIMENTO, TIAGOA produção de investigação e a utilização dos seus resultados não têm evoluído da mesma forma. O crescimento exponencial de estudos na área da saúde tem possibilitado o aumento da evidência para sustentar uma prática clínica de qualidade e segura. A revisão da literatura e a experiência do grupo de investigadores demonstram que a transferência do conhecimento para a clínica é mais lenta, com implicações na práxis e impacto negativo nos sistemas de saúde e nos custos associados. O grupo tem trabalhado aspetos relacionados com a transferência do conhecimento para a prática clínica e advoga que, desde o desenho do projeto de investigação à obtenção dos achados, importa prever a utilização do novo conhecimento. Evidenciar os melhores resultados e indicadores de saúde, através de cuidados centrados na pessoa, pode influenciar as políticas e os decisores políticos, contribuindo para um sistema mais equitativo e sustentável, com participação e envolvimento dos profissionais.
- Nursing Intervention to Prevent and Manage Delirium in Critically Ill Patients: A Scoping ReviewPublication . Fernandes, Filipa; Santos, Mariana; Anacleto, Ana Margarida; Jerónimo, Cátia; Ferreira, Óscar Manuel Ramos; Baixinho, Cristina LavaredaDelirium is an acute neuropsychiatric syndrome of multifactorial etiology with a high incidence in people admitted to intensive care units. In addition to reversible impairment of cognitive processes, it may be associated with changes in thinking and perception. If, in the past, it was considered an expected complication of severe disease, nowadays, delirium is associated with a poor short-term and long-term prognosis. Knowing that its prevention and early identification can reduce morbidity, mortality, and health costs, it is vital to investigate nursing interventions focused on delirium in critically ill patients. This study aimed to identify nursing interventions in the prevention and management of delirium in critically ill adults. The method used to answer the research question was a scoping review. The literature search was performed in the Medline (via PubMed), CINAHL (via EBSCOhost), Scopus, Web of Science, and JBI databases. The final sample included 15 articles. Several categories of non-pharmacological interventions were identified, addressing the modifiable risk factors that contribute to the development of delirium, and for which nurses have a privileged position in their minimization. No drug agent can, by itself, prevent or treat delirium. However, psychoactive drugs are justified to control hyperactive behaviors through cautious use. Early diagnosis, prevention, or treatment can reduce symptoms and improve the individual’s quality of life. Therefore, nursing professionals must ensure harmonious coordination between non-pharmacological and pharmacological strategies.