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Browsing by Author "Bernardes, Rafael A."

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  • Baropodometric assessment of the podiatric profile of nursing students in clinical settings: a study protocol
    Publication . Bernardes, Rafael A.; Caldeira, Silvia; Parreira, Pedro; Sousa, Liliana B.; Almeida, Inês F.; Santos-Costa, Paulo; Paiva-Santos, Filipe; Cruz, Arménio Guardado
    Introduction: Nursing students are exposed to increased risks of developing foot and ankle disorders due to prolonged standing and walking positions during clinical settings. This can lead to high dropout rates from nursing degree, thus contributing to a future shortage in nursing professionals. This protocol aims to develop a study to understand the influence of prolonged standing and walking positions on nursing students' foot health, and specifically to study the relationship between the podiatric profile (regional force and pressure exerted on the foot) and related signs and symptoms. Methods and Analysis: A prospective observational cohort study will be conducted with 194 nursing students. Participants will be asked to walk through a baropodometric platform before and after a 5-month clinical training session. Assessment will focus on the change in podiatric profile, namely foot posture and foot function, at 5 months, and changes in foot health at 5 months. The study will start in January 2022 and it's expected to end by June 2022. Discussion: The study aims to perform an innovative assessment of nursing students' podiatric profile, which will allow for a comprehensive description of foot/ankle changes and their relationship with prolonged standing and walking contexts. Ethics and Dissemination: The study was approved by The Ethical Committee of the Health Sciences Research Unit: Nursing (UICISA: E), of the Nursing School of Coimbra (ESEnfC), with the approval code nr. P799_07_2021. The study was also recorded in ClinicalTrials.gov on the number NCT05197166. Findings will be used to publish articles in peer-review scientific journals and oral communications and posters at scientific meetings.
    2022Journal article Open access Show more
  • Editorial: user-centered technology for exercise optimization in older adults
    Publication . Bernardes, Rafael A.; Giannouli, Eleftheria; Neves, Hugo; Parola, Vítor
    2025-02-04Journal editorial Open access Show more
  • Evidence-informed development of a bundle for peripheral intravenous catheterization in Portugal: a delphi consensus study
    Publication . Santos-Costa, Paulo; Paiva-Santos, Filipe; Sousa, Liliana B.; Bernardes, Rafael A.; Ventura, Filipa; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, João
    Contrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses’ clinical decision-making in this scope. Methods: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward’s nurses. Results: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter’s functionality and performance at each shift. Conclusion: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.
    2022-07-07Journal article Open access Show more
  • Foot and ankle disorders in nurses exposed to prolonged standing environments: a scoping review
    Publication . Bernardes, Rafael A.; Caldeira, Sílvia; Parreira, Pedro; Sousa, Liliana B.; Apóstolo, João; Almeida, Inês F.; Santos-Costa, Paulo; Stolt, Minna; Guardado Cruz, Arménio
    Background: Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses’ ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences. Methods: This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format. Findings: The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future. Conclusion/Applications to Practice:: Few studies have focused on nurses’ foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses’ workplaces.
    2023-03-01Journal article Open access Show more
  • Functional rehabilitation for medial gastrocnemius silent contractures to prevent foot and ankle disorders: a review
    Publication . Bernardes, Rafael A.; Parola, Vítor; Cruz, Arménio; Correia, Nuno; Neves, Hugo
    Medial gastrocnemius silent contractures (MGSCs) are prevalent, notably impacting functional status and increasing the risk of foot and ankle disorders, especially among aging populations. Although traditionally managed by podiatrists and physiotherapists, the role of rehabilitation nursing in addressing MGSCs is gaining recognition. This paper elucidates the contributions of rehabilitation nursing to the functional rehabilitation of MGSC patients and underscores its vital role within the multidisciplinary team. Initially, the paper defines the clinical and physiological characteristics of MGSCs and their implications in foot and ankle disorders. It then meticulously explores rehabilitation nursing interventions—including personalized stretching regimens, vibration therapy, balance exercises, and judicious footwear selection—emphasizing their efficacy in enhancing muscle flexibility, joint mobility, and postural stability. The emphasis is on patient-centered approaches and education to foster treatment adherence and positive rehabilitation outcomes. The significance of interdisciplinary collaboration is highlighted, focusing on how rehabilitation nursing optimizes patient care and mitigates complications. The paper advocates for recognizing and integrating rehabilitation nursing in managing MGSC-related disorders, emphasizing its importance in achieving successful functional outcomes.
    2024-12Research article Open access Show more
  • Nurses' involvement in the development and usability assessment of an innovative peripheral intravenous catheterisation pack: a mix-method study
    Publication . Santos-Costa, Paulo; Alves, Mariana; Sousa, Carolina; Sousa, Liliana B.; Paiva-Santos, Filipe; Bernardes, Rafael A.; Ventura, Filipa; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, João
    Guaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. Methods: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. Results: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = −2.482, p = 0.013) and avoided omissions while preparing the required material (Z = −1.977, p = 0.048). The participating nurses emphasised the pack’s potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. Conclusions: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.
    2022-09-05Journal article Open access Show more
  • Nurses’ practices in the peripheral intravenous catheterization of adult oncology patients: a mix-method study
    Publication . Santos-Costa, Paulo; Paiva-Santos, Filipe; Sousa, Liliana B.; Bernardes, Rafael A.; Ventura, Filipa; Fearnley, William David; Salgueiro-Oliveira, Anabela; Parreira, Pedro; Vieira, Margarida; Graveto, João
    A significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses’ practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses’ adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.
    2022-02Journal article Open access Show more
  • A saúde do pé de estudantes de enfermagem em ensino clínico: resultados preliminares de um estudo observacional
    Publication . Bernardes, Rafael A.; Caldeira, Sílvia; Stolt, Minna; Almeida, Inês F.; Parreira, Pedro; Sousa, Liliana B.
    Introdução O Ensino Clínico (EC), pela necessidade de permanecer em pé por longos períodos, constitui-se como um ambiente potencialmente agressivo para a saúde do pé. De facto, as posições ortostáticas prolongadas são consideradas como um dos fatores mais importantes para a diminuição da saúde do pé (Stolt et al., 2018). As lesões associadas ao pé contribuem para cerca de 39.9% das intenções de desistência do curso e, a longo prazo, escassez de enfermeiros (Bakker et al., 2019; Kox et al., 2022). Objetivos O presente estudo teve como objetivos: (i) caracterizar a saúde do pé de estudantes de Enfermagem em Ensino Clínico; e (ii) descrever a influência de posições ortostáticas prolongadas na saúde do pé de estudantes de Enfermagem. Metodologia Estudo observacional descritivo com aplicação da versão portuguesa da escala Self-Administered Foot Health Assessment Instrument (S-FHAI; Stolt et al., 2013) entre novembro de 2021 e janeiro de 2022. Recrutaram-se estudantes da Licenciatura em Enfermagem de várias escolas em Portugal que, no momento do estudo, estivessem em Ensino Clínico. O método de amostragem foi de conveniência, especificamente em “bola de neve”. Utilizou-se o software Qualtrics e a o SPSS v24. Aprovação pela Comissão de Ética da Unidade de Investigação em Ciências da Saúde: Enfermagem – P799_07_2021. Resultados Dos 100 participantes, a maioria (86%) é do sexo feminino, com média de idades de 23,09 anos (DP=5,07). Grande parte dos estudantes passa mais de 3 horas em pé na mesma posição durante um dia de EC (68%) e/ou a caminhar (76%). Relativamente à saúde do pé, 42% dos estudantes apresentam pele seca, 33% calos ou calosidades, 69% pés frios, 24% cãibras e 21% unhas encravadas. Entre os participantes, 37% referem dor nos pés nas últimas duas semanas, sendo a localização mais afetada a planta do pé (29%). 161 Conclusões A maioria dos estudantes permanece longos períodos em pé ou a caminhar, o que influencia a saúde do pé. Este contexto favorece o surgimento de quadros dolorosos, sobretudo a nível da planta do pé. Um maior conhecimento da saúde podológica dos estudantes, em conjunto com o desenvolvimento de intervenções preventivas, poderá permitir aumentar a qualidade de vida e a satisfação durante o Ensino Clínico. No futuro, os estudantes terão ferramentas para prevenir lesões enquanto enfermeiros.
    2022-03Conference object Open access Show more
  • 2021-10-13Journal article Open access Show more