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- Contributions of a Rehabilitation Nursing Program in the Self-Care of Women Undergoing Breast SurgeryPublication . Rodrigues, Tânia; Moreira, Maria Teresa; Lima, Andreia; Fernandes, Rita; Gomes, BárbaraBackground: Although surgical treatments for breast cancer have exhibited advanced interventions, axillary lymph node dissection can limit functionality and compromise women’s self-care. This study aims to assess the effectiveness of a rehabilitation nursing program in improving self-care performance in women undergoing breast surgery with axillary lymph node dissection. Methods: This quantitative, quasi-experimental study involved 48 women recruited from a main hospital between 2018 and 2019. The participants completed a three-month rehabilitation program at home. The evaluation instrument used was the DASH questionnaire. This study was not registered. Results: The functionality of the upper limb ipsilateral to the surgery improved significantly (p < 0.001) after the implementation of the program, influencing the participants’ capacity for self-care, including washing/drying their hair, washing their back, and wearing a shirt. The average DASH total score increased from 54.4 to 8.1 after the program. Conclusions: The rehabilitation nursing program positively influenced the participants’ self-care ability. Incorporating rehabilitation nursing programs into breast cancer treatment can improve self-care performance and the overall quality of patients’ lives. This study was not registered.
- Impact of a rehabilitation program on the urinary management of patients affected by cerebrovascular accidentPublication . Chiado, Andreia Patrícia Azevedo; Ferreira, Maria Salomé Martins; Ribeiro, Olga; Gomes, Bárbara; Martins, MMObjective: to assess the effect of a Nursing Rehabilitation program on the urinary incontinence management of women after a CVA. Method: quantitative, quasi-experimental, and longitudinal study conducted in a convalescence unit in the Viana do Castelo district, Portugal, between September 2018 and March 2019. The sample included women (n=30) aged between 45 and 90, experiencing urinary incontinence after a CVA, assigned to two groups: experimental group (n=15) and control group (n=15). The functional rehabilitation program was applied to the experimental group for 4 weeks. The program comprises behavioral changes and an exercise plan to strengthen pelvic floor muscles, and the impact of urinary incontinence was assessed before and after the intervention. Results: a statistically significant correlation was found between the level of functional disability and the impact of urinary incontinence (r=-0.499; p=0.005). Hence, the level of functional disability influences the impact of urinary incontinence on quality of life. The functional rehabilitation program implemented in the experimental group obtained positive results and decreased the frequency (t=6.985, p=0.000) and amount (Z=-2.762, p=0.006) of urine loss. Conclusion: the functional rehabilitation program positively impacted and decreased the frequency and amount of urine loss.
- Municipalities and the promotion of architectural accessibilityPublication . Pereira, Rute Salomé; Martins, MM; Gomes, Bárbara; Schoeller, Soraia Dornelles; Laredo-Aguilera, José Alberto; Ribeiro, Isabel; Cunha, PauloBackground: Architectural barriers have a significant impact on the daily activities of people with reduced mobility. Objectives: To understand the weaknesses and/or opportunities in the responses of local authorities to eliminate the architectural barriers for people with reduced mobility in their social and residential context. Methodology: A descriptive, exploratory study was conducted with a sample of 21 parish council presidents from two municipalities using an accidental non-probabilistic sampling method. Results: In this sample, 76.2% of parish council presidents do not know how many people with disabilities live in their parish. The elimination of architectural barriers focused on accessible sidewalks and pedestrian routes (80%), pedestrian crossings (75%), access to public parks and gardens (70%), and access to cemeteries and markets (70%). Other equipment, even educational ones, represent less than 50%. Conclusion: Some public spaces still have architectural barriers. There is little cooperation between health professionals and society to promote accessibility.
- Effects of early mobilisation in the functional rehabilitation of critically ill patients: a systematic reviewPublication . Azevedo, Paulo; Gomes, BárbaraContexto: A mobilização precoce vem sendo considerada uma intervenção capaz de modificar factores de risco de morbilidade, com impacto na reabilitação funcional em doentes críticos. Objetivo: Determinar os efeitos da mobilização precoce na reabilitação funcional de doentes internados em cuidados intensivos. Método de revisão: Utilizando a estratégia PICO, realizou-se uma revisão sistemática da literatura entre 2003 e 2013, considerandose artigos científicos em texto integral de estudos realizados com adultos internados em cuidados intensivos e submetidos à mobilização precoce. Pesquisaram-se as bases de dados PubMed, CINAHL, Cochrane Controlled Trial Database, Elsevier, LILACS, British Nursing Index e SciELO, revistas científicas de referência e as citações dos artigos selecionados. Na análise final dos estudos utilizaram-se ferramentas para avaliação da qualidade metodológica. Interpretação dos resultados: Dos seis trabalhos identificados resulta que a mobilização precoce pode facilitar a reabilitação funcional destes doentes, promovendo ganhos de força muscular e maior participação nas atividades de vida diária. Conclusão: São necessários estudos que usem as mesmas ferramentas de avaliação e que demonstrem o interesse da intervenção para a disciplina de Enfermagem.
- The effects of early rehabilitation on functional exercise tolerance in decompensated heart failure patients: Results of a multicenter randomized controlled trial (ERIC-HF study)Publication . Delgado, Bruno; Novo, André; Lopes, Ivo; Rebelo, Carina; Almeida, Cecília; Pestana, Sandra; Gomes, Bárbara; Froelicher, Erika; Klompstra, LeonieObjective: To analyze (1) the effect of an aerobic training program on functional exercise tolerance in decompensated heart failure (DHF) patients; (2) to assess the effects of an aerobic training program on functional independence; and (3) dyspnea during activities of daily living. Design: A randomized controlled clinical trial with follow-up at discharge. Settings: Eight hospitals. Recruitment took place between 9/ 2017 and 3/2019. Group Assignments: Patients with DHF who were admitted to the hospital, were randomly assigned to usual rehabilitation care guideline recommended (control group) or aerobic training program (exercise group). Main outcome: Functional exercise tolerance was measured with a 6-min walking test at discharge. Results: In total 257 patients with DHF were included, with a mean age of 67±11 years, 84% (n=205) had a reduced ejection fraction and the hospital stay was 16±10 days. At discharge, patients in the intervention group walked further compared to the control group (278±117m vs 219±115m, p < 0.01) and this difference stayed significant after correcting for confounders (p < 0.01). A significant difference was found favoring the exercise group in functional independence (96±7 vs 93±12, p=0.02) and dyspnea associated to ADL (13±5 vs 17±7, p < 0.01) and these differences persisted after correcting for baseline values and confounders (functional independence p < 0.01; dyspnea associated with ADL p=0.02). Conclusion: The ERIC-HF program is safe, feasible, and effective in increasing functional exercise tolerance and functional independence in hospitalized patients admitted due to DHF.
- Investigação em Enfermagem de Reabilitação: Um novo conhecimento para guiar a prática de cuidadosPublication . Gomes, Bárbara; Rocha, Maria Do Carmo; Martins, MM; Gonçalves, Maria Narcisa
- Elderly residents in the community: gaining knowledge to support a rehabilitation nursing programPublication . Faria, Ana da Conceição Alves; Martins, MM; Ribeiro, Olga; Gomes, Bárbara; Fernandes, Carla SílviaTo analyze the socio-demographic and health conditions of the elderly living in the community and describe the pillars for the design of a rehabilitation nursing program in the community.
- A experiência das mulheres após um cancro - uma abordagem fenomenológicaPublication . Pinto, Cândida; Gomes, BárbaraCom o aumento das opções de diagnóstico e tratamento do cancro, os problemas decorrentes da sobrevida tem aumentado. São identificadas necessidades físicas e psicossociais específicas nas pessoas sobreviventes de cancro. As mulheres, dentro da população adulta sobreviventes de can cro, são o maior grupo. Isto, porque o cancro da mama é o cancro mais frequente no sexo feminino, e o diagnóstico precoce e o desenvolvimento das intervenções terapêuticas tem levado a um gran de sucesso, e consequentemente a períodos cada vez mais longos de sobrevida. A percepção da magnitude deste problema levou-nos a desenvolver esta investigação, com o objec tivo de compreender as implicações do cancro na vida das mulheres. Esta investigação decorre de uma outra investigação realizada sobre a avaliação da qualidade de vida junto de 426 sujeitos, so breviventes de cancro. Dentro destes, 68,1% eram mulheres sobreviventes de cancro. Durante as en trevistas as mulheres expressavam sentimentos, experiências e falavam das múltiplas implicações do cancro nas suas vidas. Foram efectuadas notas de campo, que posteriormente foram analisadas e codificadas em categorias. Este trabalho permitiu identificar as seguintes unidades de análise: incerteza/síndrome de Damocles; aspectos positivos; sentido de controlo; o preço da cura; impli cações familiares; revolta; auto-imagem; necessidades de escuta; espiritualidade/religiosidade. Conclusões: A análise de dados permitiu-nos concluir que o cancro, mesmo após o seu controlo, tem múltiplas implicações na vida das mulheres. Os profissionais de saúde em geral, e os profis sionais de enfermagem em particular, devem ser capazes de compreender e ajudar estas mulheres a gerir o impacto do cancro nas suas vidas, promovendo uma abordagem holística dos cuidados, de forma a dar respostas às necessidades e às transições de vida que decorrem do confronto com este problema
- Twin parenting experience – reshaping the family webPublication . Andrade, Luísa; Martins, MM; Ângelo, Margateth; Pinto, Cândida; Gomes, BárbaraBeing a parent of twin siblings is a major challenge for parents and requires a family restructuring to adapt to a new family environment. OBJECTIVE. To understand the experiences of parents of twins and meanings attributed to them. METHODS: a qualitative study was conducted, having the symbolic interactionism as a theoretical referential and the interpretative interactionism as the methodological referential. Twenty-nine parents with children under 4 years participated in this study. A semi-structured interview was conducted for data collection. RESULTS. The twins family responses to parenting challenges are conditioned by the management and articulation of their di*culties, their strengths and personal resources. There is a clear choice in being a family with children that privileges negotiation and involvement of the couple in caring for the family, or, at least, part of the family, meaning the children and playing the parenting role. CONCLUSIONS. The family grows as a complex web, including its elements and interactions. The symbolic construction evidences the way the family adjusts to this environment of twin parenting. The health professionals should be able to anticipate the needs of families going through this process.
- Intervenção do Enfermeiro Especialista em Reabilitação na mobilidade da pessoa idosa institucionalizada – Programa TEIAPublication . Pires, Rita; Martins, MM; Gomes, Bárbara; Monteiro, Clara; Ribeiro, OlgaIntrodução: O envelhecimento produz alterações fisiológicas, anatómicas, comportamentais, sociais e culturais. Indiscutivelmente, o enfermeiro especialista em reabilitação, assume cada vez mais um papel importante nos cuidados prestados durante o envelhecimento, através da elaboração de planos de cuidados especializados que maximizem a funcionalidade do idoso, capacitando-o para uma maior autonomia e independência no autocuidado, incrementando desta forma a sua qualidade de vida. Nesta perspetiva, apresentamos o programa TEIA que se foca no treino do equilíbrio, da continência urinaria e a cognição em idosos ativos. Objetivo: Avaliar o impacto do programa de 12 semanas, em idosos ativos institucionalizados, sobre o estado de equilíbrio, cognição, sintomatologia de incontinência urinária e qualidade de vida. Método: Estudo quasi-experimental, antes-depois, com grupo de controlo. Amostra total de 30 idosos, 16 no grupo de programa e 14 no grupo de controlo. Foram aplicados vários instrumentos de avaliação funcional, na versão portuguesa, nomeadamente: Falls Efficacy Scale Internacional (FES I); Teste de Tinetti; Escala de Equilíbrio de Berg (EEB); Teste Timed Up and Go (TUG); International Consultation on Incontinence Questionnaire - Short Form (ICIQSF); Índice de Lawton-Brody; Escala Geriátrica de Depressão de 15 questões (GDS15); Teste de Declínio Cognitivo de 6 itens (6CIT); e Questionário de vida associado à saúde (SF-36). Resultados: Os idosos do grupo de programa melhoraram no equilíbrio, estático e dinâmico, no medo cair e na execução da marcha (Tinetti, Z=-3,126; p=0,002; EEB, Z=-3,304; p=0,001; FES I, Z=-3,059; p=0,002 e TUG, Z=-3,516; p=0,0001). Trouxe-lhes benefícios no desempenho da cognição (6CIT, Z=-3,088; p=0,002) e na perceção da qualidade de vida associada à incontinência urinária (ICIQ-SF, Z=-2,680; p=0,007). Conclusão: A implementação do Programa TEIA traduz-se em ganhos significativos para a saúde dos idosos, melhorando o equilíbrio, a competência dos músculos do assoalho pélvico e no desempenho da cognição potenciado a qualidade de vida dos participantes.
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