Browsing by Author "Marques, Raquel"
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- Applying mHealth for assessment of complex wounds: insights from a focus groupPublication . Marques, Raquel; Mira, Helena I. M. F.; Lopes, Marcos V. O.; Neves-Amado, João D.; Ramos, Paulo A. S.; Alves, Paulo J. P.Background. It is a reality of care praxis that it is difficult for healthcare professionals to assess and monitor the local status of wounds objectively and regularly. This study aims to identify the minimum data required to evaluate patients with complex wounds to be incorporated into mHealth. Methods. Descriptive qualitative study, based on thematic analysis, using the online focus group technique. An intentional sample was selected, and two separate sessions were held, attended by 6 experts and 7 nurses. The data were coded by two researchers, with a deductive method, using NVivo software. Results. 5 themes emerged which are described as follows: assessment of patients with complex wounds, distinctive criteria based on the type of wound, flowcharts for approaching patients with wounds, characteristics of a mobile application focused on wound care, and alerts to be included in a mobile health application dedicated to wound treatment. The theme characteristics of a mobile application for approaching the patient with wounds raised 4 subthemes: (1) image, (2) communication, (3) decision-making, and (4) safety. Conclusion. The use of wound assessment tools provides data capable of generating quality care outcome indicators. These serve as good practice guides, enhancing health gains, whether they are economic or quality-of-life improvements.
- Decision-making support system in the diagnosis and treatment of person with chronic wounds: clinical wound supportPublication . Marques, Raquel; Lopes, Marco; Ramos, Paulo; Oliveira, Irene; Sá, Luís; Neves-Amado, João; Vasconcelos, Maria; Salgado, Pedro; Alves, Paulo
- Identificação dos fatores de risco associados à cicatrização da ferida a integrar num sistema de informação em enfermagem - estudo de coortePublication . Marques, Raquel; Lopes, Marcos; Neves-Amado, João; Sá, Luís; Oliveira, Irene; Ramos, Paulo; Alves, Paulo
- Integrating factors associated with complex wound healing into a mobile application: findings from a cohort studyPublication . Marques, Raquel; Lopes, Marcos Venícios Oliveira de; Neves‐Amado, João Daniel; Ramos, Paulo Alexandre Silva; Sá, Luís Octávio de; Oliveira, Irene Maria Silva da; Amado, João Manuel Costa da; Vasconcelos, Maria João Medeiros de; Salgado, Pedro Miguel Faria; Alves, Paulo Jorge PereiraComplex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann–Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.
- Learning from health professionals: a user-centred approach to design a wound monitoring platformPublication . Félix, Beatriz; Melo, Ricardo; Marques, Raquel; Alves, Paulo; Salgado, Pedro FariaHealth professionals are able to improve the care quality of chronic wounds by monitoring and reporting the wound status. Resorting to visual representations of wound status enhances comprehension by facilitating knowledge transfer to all stakeholders. However, selecting appropriate healthcare data visualisations is a critical challenge and healthcare platforms must be designed to meet their users' needs and constraints. This article describes the methods used to identify the design requirements and inform the development of a wound monitoring platform through a user-centred approach.
- Leveraging deep neural networks for automatic and standardised wound image acquisitionPublication . Sampaio, Ana Filipa; Alves, Pedro; Cardoso, Nuno; Alves, Paulo; Marques, Raquel; Salgado, Pedro; Vasconcelos, Maria João M.Wound monitoring is a time-consuming and error-prone activity performed daily by healthcare professionals. Capturing wound images is crucial in the current clinical practice, though image inadequacy can undermine further assessments. To provide sufficient information for wound analysis, the images should also contain a minimal periwound area. This work proposes an automatic wound image acquisition methodology that exploits deep learning models to guarantee compliance with the mentioned adequacy requirements, using a marker as a metric reference. A RetinaNet model detects the wound and marker regions, further analysed by a post-processing module that validates if both structures are present and verifies that a periwound radius of 4 centimetres is included. This pipeline was integrated into a mobile application that processes the camera frames and automatically acquires the image once the adequacy requirements are met. The detection model achieved mAP@.75IOU values of 0.39 and 0.95 for wound and marker detection, exhibiting a robust detection performance for varying acquisition conditions. Mobile tests demonstrated that the application is responsive, requiring 1.4 seconds on average to acquire an image. The robustness of this solution for real-time smartphone-based usage evidences its capability to standardise the acquisition of adequate wound images, providing a powerful tool for healthcare professionals.
- Prognostic factors for delayed healing of complex wounds in adults: a scoping reviewPublication . Marques, Raquel; Lopes, Marcos; Ramos, Paulo; Neves‐Amado, João; Alves, PauloComplex or hard-to-heal wounds continue to be a challenge because of the negative impact they have on patients, caregivers, and all the associated costs. This study aimed to identify prognostic factors for the delayed healing of complex wounds. Five databases and grey literature were the sources used to research adults with pressure ulcers/injuries, venous leg ulcers, critical limb-threatening ischaemia, or diabetic foot ulcers and report the prognostic factors for delayed healing in all care settings. In the last 5 years, a total of 42 original peer-reviewed articles were deemed eligible for this scoping review that followed the JBI recommendations and checklist PRISMA-ScR. The most frequent prognostic factors found with statistical significance coinciding with various wound aetiologies were: gender (male), renal disease, diabetes, peripheral arterial disease, the decline in activities of daily life, wound duration, wound area, wound location, high-stage WIfI classification, gangrene, infection, previous ulcers, and low ankle brachial index. It will be essential to apply critical appraisal tools and assessment risk of bias to the included studies, making it possible to make recommendations for clinical practice and build prognostic models. Future studies are recommended because the potential for healing through identification of prognostic factors can be determined, thus allowing an appropriate therapeutic plan to be developed.
- Prognostic factors for delayed healing of complex wounds in adults: a scoping review protocolPublication . Marques, Raquel; Lopes, Marcos; Ramos, Paulo; Amado, João Neves; Alves, Paulo(1) Background: The high prevalence of persons with wounds and its consequences for a person’s quality of life makes the issue a relevant focus of attention for healthcare professionals. Through prognostic factors for healing, the individual risk of complications can be predicted, is possible to predict imminent delays and guide decision-making, thus helping healthcare professionals. (2) Methods: A scoping review performed according to JBI methodology and guided by the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR) checklist will aim to identify the studies that meet predefined eligibility criteria. Five databases and gray literature will be the sources used to research adults with pressure ulcers, venous leg ulcers, arterial ulcers, or diabetic foot ulcers and report the prognostic factors for delayed healing in any care setting. (3) Results: This review will consider all quantitative and mixed studies in the last five years. The selection of articles will be carried out by two reviewers independently, using EndNoteWeb and Rayyan. Prognostic factors will be presented by design study, sampling, setting, outcome, wound type, and statistical methods. (4) Conclusions: Mapping prognostic factors for delayed healing could also be a starting point for a systematic review and meta-analyses to quantify the value of each factor.