Browsing by Author "Silva, Rosa Carla Gomes da"
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- Estimulação cognitiva em pessoas idosas : intervenção individual na fragilidade cognitivaPublication . Silva, Rosa Carla Gomes da; Apóstolo, João Luís AlvesÉ uma prioridade societal disponibilizar condições que promovam o envelhecimento da população na comunidade. A par do envelhecimento temos o aumento da prevalência de doenças crónicas, como é o caso das Perturbações Neurocognitivas (PNC). Neste contexto, viver na comunidade, pelo maior tempo possível, inclui a prestação de cuidados multimodais pelo cuidador familiar/informal. Este estudo centra-se na estimulação cognitiva (EC) individual, como uma intervenção a ser promovida pelo cuidador, em ambiente familiar. Objetivo: avaliar a aceitabilidade, aplicabilidade e o impacto de um programa de EC individual (PECI) em pessoas com PNC (PcPNC), implementado pelo cuidador em contexto domiciliário. Metodologia: O PECI testado foi o Making a Difference 3 - Individual Cognitive Stimulation Therapy (MD3), em português Fazer a Diferença 3 - Intervenção Individual de Estimulação Cognitiva (FD3). Metodologicamente o trabalho foi organizado em seis tarefas. As duas primeiras tarefas foram duas revisões sistemáticas da literatura (RSL) sobre a evidência de eficácia, segundo a metodologia do Joanna Briggs Institute. Estas duas RSL serviram de fundamentação conceptual para o presente trabalho. A primeira centra-se na eficácia das intervenções cognitivas promovidas pelo cuidador na cognição e a segunda sobre a eficácia da estimulação multissensorial (EM) na gestão dos sintomas neuropsiquiátricos (SNP). As três tarefas seguintes (Tarefa III, IV e V) consistiram na preparação do estudo piloto: a Tarefa III corresponde à tradução e adaptação para cultura e língua portuguesa do PECI-MD3, que metodologicamente segui as orientações do Formative Method For Adapting Psychotherapy; na Tarefa IV identifica-se o ponto de corte e as propriedade psicométrica do Teste de Declínio Cognitivo de Seis Itens (6CIT, instrumento de rasteio cognitivo); a Tarefa V corresponde à tradução e validação para a língua e cultura portuguesa da escala Quality of the Carer-Patient Relationship, que decorreu em quatro etapas (tradução, síntese, retroversão e criação da versão consensual). Por fim, na Tarefa VI, apresenta-se o estudo piloto que metodologicamente foi um ensaio clínico randomizado controlado (RCT). Resultados: A RSL sobre de eficácia das intervenções cognitivas promovida pelos cuidadores identifica efeitos benéficos a favor desta abordagem, em vários domínios cognitivos como memória, atenção, fluência verbal e resolução de problemas. Na segunda RSL (sobre a eficácia da EM) os resultados, dos estudos primários incluídos, apoiam o uso desta intervenção no controlo do comportamento fisicamente não agressivo, como agitação comportamental e verbal, do humor e da ansiedade. Pelo desenvolvimento da Tarefa III, obteve-se a versão pré-final do PECI-FD3 (versão β) que permitiu a condução do estudo piloto (Tarefa VI). Pela Tarefa V afere-se que o 6-CIT, pelas suas propriedades psicométricas e de precisão, é um instrumento de rastreio robusto; e também adequados pontos de corte, ajustados à população portuguesa, para o 6CIT são aferidos. A escala QCPR versão portuguesa apresenta propriedades psicométricas consistentes para uma das suas duas subescalas. É necessário o desenvolvimento de trabalhos futuros que permitam a continuidade deste processo de validação. Por último, na Tarefa VI, verifica-se pelo desenvolvimento do RCT, que grupo que recebeu a EC pelo programa FD3 apresenta ganhos na cognição, em comparação com o grupo controlo, mais especificamente na orientação e compreensão de ordens. Discussão/Conclusão: A evidência identificada pelas RSL e pelo RCT apoiam as intervenções não farmacológicas na gestão dos domínios cognitivos e SNP. Este trabalho colocou à disposição para a população portuguesa um PECI, com 75 sessões de EC, que permite ao cuidador familiar/informal ter um papel mais ativo no cuidado à PcPNC. Considera-se que, no global, este trabalho fornece instrumentos essenciais para o cuidado à PcPNC/cuidador, como o 6CIT (rastreio cognitivo) e a escala QCPR (que avalia da qualidade da relação entre a díade).
- Mental health, sexuality and old agePublication . Silva, Rosa Carla Gomes da; Candeias, Analisa Lia Silva; Santos, Silvana Sidney Costa; Sá, Luís Octávio de; Araújo, Beatriz RodriguesDuring the aging process, there is the emergence of various human answers in elderly people, and these answers need of a differentiated intervention. Sexuality, sexual health and mental health in elderly people have a relationship that awake the interest of health professionals and nurses. The objectives of this paper are: to understand to what extent sexuality during old age can be a field of attention of nurses; to explore the relationship existing between the experiences of sexuality of elderly people and the mental health; to propose a set of guiding principles for the practice related to this theme. This is a qualitative study from the opinions of nurses who were experts in the context of clinical practice/teaching. Content analysis was used. The corpus of analysis gave rise to categories that allowed us to infer that sexuality in old age is taken as a field that deserves the attention of nurses, and its balanced experience proves to be essential for the promotion and maintenance of mental health. The proposed interventions are focused on demystification, sensitization and empowerment of elderly people towards the information and abilities for the management of behaviors. The experts have considered that, through the nursing action focused on sexuality, sexual health and mental health, the elderly person benefits from effective health gains.
- Midwifery interventions to reduce fear of childbirth in pregnant women: a scoping review protocolPublication . Souto, Sandra Patrícia Arantes do; Albuquerque, Rosemeire Sartori de; Silva, Rosa Carla Gomes da; Guerra, Maria João; Prata, Ana PaulaObjective: The objective of the review is to map and analyze midwifery interventions to reduce fear of childbirth in pregnant women. Introduction: Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy, as well as after childbirth. During the previous few decades, there has been a growing interest in research into interventions to reduce the fear of childbirth in childbearing women. Currently, providing an appropriate model of care for pregnant women with fear of childbirth is a challenge in midwifery care. Therefore, further efforts are needed to identify and examine the characteristics of different midwifery interventions to reduce fear of childbirth in pregnant women. Inclusion criteria: This scoping review will consider studies that include interventions to reduce fear of childbirth in pregnant women, led and implemented by midwives, during the antenatal period, in all possible birth scenarios. Quantitative, qualitative, and mixed methods studies will be included. Methods: The JBI methodology for conducting scoping reviews will be employed. Published and unpublished literature in English, Portuguese, and Spanish, from 1981 to the present, will be included. MEDLINE, CINAHL Complete, Scopus, Web of Science, Embase, and Cochrane Library databases will be searched. Searches for gray literature will be performed. Data will be extracted using a tool developed specifically for the scoping review objectives.
- Midwives' interventions for reducing fear of childbirth in pregnant women: a scoping reviewPublication . Souto, Sandra Patrícia Arantes do; Silva, Rosa Carla Gomes da; Prata, Ana Paula; Guerra, Maria João; Couto, Cristina; Albuquerque, Rosemeire Sartori deOBJECTIVE: The objective of this review was to map and analyze midwives' interventions for reducing fear of childbirth in pregnant women. INTRODUCTION: Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy. Over the past few decades, there has been growing research interest in interventions for reducing fear of childbirth in pregnant women. One of the challenges in midwifery care is to provide an appropriate model of care for pregnant women with fear of childbirth. Further research efforts are needed to identify midwives' interventions for reducing fear of childbirth in pregnant women and to examine their characteristics. INCLUSION CRITERIA: This scoping review considered studies that included interventions for reducing fear of childbirth in pregnant women led and/or implemented by midwives during the antenatal period, and integrating all possible midwifery practice settings. Quantitative, qualitative, and mixed methods studies were included. This review also considered systematic reviews, text and opinion papers, and conference abstracts. METHODS: An a priori protocol was published and the JBI methodology for conducting scoping reviews was used. Published and unpublished literature in English, Portuguese, and Spanish from January 1981 to October 2020 were included. MEDLINE (PubMed), CINAHL Complete, APA PsycINFO, Scopus, Embase, Web of Science, SciELO, MedicLatina, Academic Search Complete, ERIC, Psychology and Behavioral Sciences Collection, and the Cochrane Library databases were searched. Searches for gray literature were also undertaken on the Repositório Científico de Acesso Aberto de Portugal, ProQuest Dissertations and Theses, British Library EThOS, OvidSP Resource Center, Banco de Teses da CAPES, and OpenGrey. A three-step search strategy was followed and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist was used. Two independent reviewers extracted the data using a data extraction tool developed specifically for this scoping review. RESULTS: A total of 3704 articles were identified and screened, of which 34 articles were included. The majority of studies had been published in the past 10 years (88.2%) in Scandinavian countries and Australia (79.4%). Several midwives' antenatal interventions were found, such as midwife-led team models of care. Midwives played a facilitator role that varied significantly across the included studies. In 20 studies (58.8%), midwives led and implemented the interventions alone (n = 13; 38.2%) or with the participation of other health professionals (n = 7; 20.6%). In the remaining 14 studies (41.2%), midwives were part of a multidisciplinary team that included different health professionals (mainly obstetricians and psychologists) who had been involved in delivering interventions alongside midwives or with minor participation from midwives. Counseling (n = 12; 35.3%) and psychoeducation (n = 8; 23.5%) were the most common midwife interventions for reducing fear of childbirth in pregnant women. CONCLUSIONS: Midwives working across their full scope of practice play a pivotal role in reducing fear of childbirth, which may help explain the variety of midwives' antenatal interventions. Reducing fear of childbirth in pregnant women and promoting normal childbirth as a positive experience are key features of midwives' interventions, which should include women's empowerment measures. Evidence-based midwife-led intervention programs for pregnant women with fear of childbirth should be designed and tested to improve clinical practice and women's reproductive outcomes and perinatal experiences.