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- Hope in mental health and psychiatric nursing: a scoping reviewPublication . Barbosa, Ana; Nunes, Inês Robalo; Nunes, Joana; Sá, Luís; Charepe, ZaidaBackground: In recent decades, efforts have been made to define and understand hope in health care, particularly in the prevention and treatment of mental illness. Given the contextual nature of hope, this article aimed to map the available scientific evidence on hope in mental health and psychiatric nursing. Methods: The Joanna Briggs Institute methodology was used for scoping reviews. The following inclusion criteria were used: studies with adults (??18 years) with a mental illness, family members/carers or nurses who addressed the concept of hope in the context of mental health and psychiatric nursing. The search process was carried out between March and December 2023, and the CINAHL database was searched via EBSCOhost, MEDLINE via PubMed and via EBSCOhost, PsycArticles and Psychology and Behavioural Sciences Collection. The articles that met the inclusion criteria were analysed in full, and the data were recorded in a document adapted from the JBI extraction tool. The data were searched, analysed, and synthesized by 5 independent reviewers. Results: This review included 43 articles. Several themes were identified, including the meaning of hope, hope assessment instruments, hope-promoting interventions, objects of hope for both caregivers and people with mental illness, inhibiting factors and consequences of hope. Conclusions: Hope is fundamental in mental health and psychiatric nursing care. Hope has been mainly approached from the patient’s perspective. Studies on hope of family carers and mental health nurses are still limited. Despite the recognition of the role of mental health nurses in maintaining and managing hope, additional evidence is needed on how to promote hope in specialized practice. These results open new perspectives for research and training for mental health professionals.
- Unmet needs of ambulatory cancer patients undergoing cancer treatments in a Portuguese hospital: a cross-sectional studyPublication . Simões, Filipa; Fortuna, Ana; Magalhães, Joana; Cerullo, Giovanni; Capelas, Manuel Luís; Pereira, José LuísBackground: Patients with cancer experience a variety of needs at every stage of their illness. Many of these needs can be addressed with palliative care. Cancer patients’ palliative needs should therefore be proactively identified and managed. This study aimed to identify the needs of oncology patients receiving out-patient cancer treatment at a Portuguese cancer center. Methods: A cross-sectional study was undertaken of consecutive patients presenting to an outpatient cancer clinic over the course of 5 days for cancer treatments. The primary outcome measure was the validated Portuguese version of the Integrated Palliative Care Outcome Scale (IPOS). “Unmet needs” were defined as symptoms/needs rated as greater than 2 out of 4. Results: Of 211 patients registered for clinic visits, 167 were potentially eligible and 113 (67.7%) completed the questionnaire. Cancers of the breast (31%), colorectum (18%), and lung (14%) were the most common, and 52% were stage IV cancers. Functional levels as assessed by the Eastern Cooperative Oncology Group (ECOG) were 31.8% (ECOG 1), 54.9% (ECOG 1) and 12.4% (ECOG 2). Almost all patients (99%) reported at least one symptom or need regardless of severity; 76%, 57% and 16% reported at least one, two to four, and five or more severe symptoms/needs, respectively. The most frequently reported physical “unmet” symptoms were pain (12%), poor mobility (12%) and weakness (11%). The psychological and social needs included anxiety (18%), depression (11%), difficulty sharing feelings (25%), information needs (23%), and family concerns (47%). The prevalence of unmet needs increased notably if moderate-intensity needs (2 out of 4) were included as “unmet” needs. Female sex and higher ECOG scores were associated with higher (worse) IPOS scores. Conclusions: A high burden of unmet needs was identified among ambulatory cancer patients at this center, particularly among female patients and patients with poorer ECOG. Quality improvement initiatives are needed to improve the systematic screening of patient needs and integrate a palliative care approach earlier to help address them.
- Comparação do carvão ativado vs. outras pastas branqueadoras sobre resina compostaPublication . Carreiro, E.; Cardoso, M.; Correia, A.; Fernandes, C.; Almeida, C.
- Prognostic value of aI-based quantitative coronary CTA vs human reader-based visual assessment: results from the CONFIRM2 registryPublication . Rosendael, Alexander van; Nakanishi, Rine; Bax, Jeroen J.; Pontone, Gianluca; Mushtaq, Saima; Buechel, Ronny R.; Gräni, Christoph; Feuchtner, Gudrun; Lacaita, Pietro G.; Patel, Amit R.; Singulane, Cristiane C.; Choi, Andrew D.; Al-Mallah, Mouaz; Andreini, Daniele; Karlsberg, Ronald P.; Cho, Geoffrey W.; Rochitte, Carlos E.; Alasnag, Mirvat; Hamdan, Ashraf; Cademartiri, Filippo; Maffei, Erica; Marques, Hugo; Gonçalves, Pedro de Araújo; Gupta, Himanshu; Hadamitzky, Martin; Khalique, Omar; Kalra, Dinesh; Mills, James D.; Nurmohamed, Nick S.; Knaapen, Paul; Budoff, Matthew; Shaikh, Kashif; Martin, Enrico; German, David M.; Ferencik, Maros; Oehler, Andrew C.; Deaño, Roderick; Nagpal, Prashant; Assen, Marly van; Cecco, Carlo N. de; Kamperidis, Vasileios; Foldyna, Borek; Brendel, Jan M.; Cheng, Victor Y.; Branch, Kelley R.; Bittencourt, Marcio; Bhatti, Sabha; Polsani, Venkateshwar; Wesbey, George; Cardoso, Rhanderson; Blankstein, Ron; Delago, Augustin; Pursnani, Amit; Alsaid, Amro; Singh, Vasvi; Aquino, Melissa; Park, Jisuk; Danad, IbrahimBackground: The severity and extent of whole heart coronary plaque volume and stenosis can be reliably measured by artificial intelligence–guided quantitative coronary computed tomography angiography (AI-QCT). Limited data are available on the potential incremental prognostic value compared with currently recommended qualitative coronary computed tomography angiography (CTA) reads and the coronary artery calcium score (CACS). Objectives: The aim of this study was to evaluate the prognostic value of AI-QCT compared with human coronary CTA reads, including the CAD-RADS (Coronary Artery Disease–Reporting and Data System), CACS, and the modified Duke Index. Methods: CONFIRM2 (Quantitative COroNary CT Angiography Evaluation For Evaluation of Clinical Outcomes: An InteRnational, Multicenter Registry) is a multicenter, international, observational cohort study of patients undergoing clinically indicated coronary CTA with follow-up for major adverse cardiac events (MACE). Asymptomatic patients and those with cardiac history were excluded. Coronary artery disease presence, extent, and composition were quantified by AI-QCT across the coronary tree, yielding 24 patient-, vessel-, and plaque-level variables. On the basis of prior analyses, noncalcified plaque burden and diameter stenosis were identified as the strongest predictors and combined for statistical modeling as “AI-QCT.” Comparator computed tomography scores included CAD-RADS, CACS, and the modified Duke Index, whereas clinical predictors were summarized in the risk factor–weighted clinical likelihood score. Area under the curve (AUC) and continuous net reclassification index (NRI) were calculated to assess the incremental value. The primary endpoint was MACE (death, myocardial infarction [MI], stroke, heart failure, late revascularization, or hospital stay for unstable angina), and the secondary endpoint was death or MI. Results: In 1,916 patients with all risk scores available, 87 (4.5%) MACE and 27 (1.4%) death/MI events occurred during 3 years of follow-up. There was a stepwise risk increase with higher coronary artery disease classifications with CAD-RADS and CACS. The addition of AI-QCT significantly improved risk stratification for MACE compared with CAD-RADS (AUC: 0.81 vs 0.79; P < 0.001 and NRI: 0.47; P < 0.001), CACS (AUC: 0.79 vs 0.70; P < 0.001 and NRI 0.61; P < 0.001), the modified Duke Index (AUC: 0.81 vs 0.76; P < 0.001 and NRI: 0.52; P < 0.001), and CAD-RADS + CACS model (AUC: 0.81 vs 0.79; P = 0.004 and NRI: 0.54; P < 0.001). AI-QCT also improved discrimination when results were adjusted for the risk factor–weighted clinical likelihood and for the prediction of death/MI. Excluding 195 patients with severe stenosis (?70%), in a multivariable model of CAD-RADS and AI-QCT, only AI-QCT was significantly associated with MACE and death/MI, and AI-QCT significantly improved risk stratification compared with CAD-RADS for MACE (AUC: 0.77 vs 0.72; P < 0.001 and NRI: 0.54; P < 0.001) and death/MI (AUC: 0.81 vs 0.73; P = 0.011 and NRI: 0.69; P = 0.001). Conclusions: AI-QCT provided incremental prognostic information compared with CAD-RADS 2.0, CACS, and the modified Duke Index for the prediction of MACE as well as the secondary endpoint of death or nonfatal MI.
- Compassion assessment instruments in palliative care - scoping reviewPublication . Gomes, Carolina Bento; Marcelino, Patrícia Andreia Weber; Capelas, Manuel LuísBackground Compassion is often described in literature as an indication of quality of care, and it is imperative in the healthcare context, more specifically in the practice of palliative care. This scoping review aimed to identify assessment tools for compassion available in the context of palliative care and describe the psychometric characteristics of the identified assessment tools. Methodology A Systematic Review of Literature, a Scoping review. A search was performed in PubMed, CINAHL, MedicLatina, Scopus, Web of Science, and PsycARTICLES computerized databases on March 9, 2022. The participants included were adults, the concept considered was “compassion assessment instruments,” and all studies conducted in the context of palliative care were considered. The protocol was obtained from The Joanna Briggs Institute. Results A total of 1371 publications were identified. Of these, only five fulfilled the inclusion criteria. The information was collated in tabular form. Of the five publications selected, only one comprised the original development of the scale, where the other four included studies on palliative care, where the scales were used. It was possible to obtain the original publications in which the scales were developed. Therefore, five instruments for assessing compassion in palliative care were identified: “Patient Assessment of Physician Compassion”; “Sinclair Compassion Questionnaire”; “Compassion from Others Scale”; “Santa Clara Brief Compassion Scale”; “Compassion Scale”. Conclusion Only one compassion assessment scale has been developed for palliative care. In addition, of the other four instruments, only one was developed in the healthcare context. This research also indicates that the assessment of compassion in palliative care is recent. The only instrument developed in the context of palliative care was created in 2021, and the first article to describe the assessment of compassion in palliative care was developed in 2018. It also concluded that the assessment of compassion in the field is important, whether from the perspective of the patient or from the perspective of the professional. The instruments have good or excellent internal consistency.
- Nursing interventions to reduce health risks from climate change impact in urban areas: a scoping reviewPublication . Costa, Maria João Salvador; Azeiteiro, Ulisses; Ryan, Robert; Ferrito, Cândida; Melo, PedroIn recent studies, public health has been considered a key stakeholder in climate mitigation and adaptation in cities since they are more exposed to the impact of climate change. Nurses represent a vast majority of public health professionals, playing a key role in health promotion that allows them to influence individuals, families, and communities in adopting healthier behaviours and decarbonized lifestyles. Therefore, the purpose of this study is to map the existing evidence on nursing interventions, which are being led or implemented to reduce the health risks related to climate change in urban areas. The present review follows the JBI methodological framework, including a search on PubMed, MEDLINE complete, CINAHL Complete, Scopus, Web of Science, SciELO (Scientific Electronic Library Online), BASE (Bielefeld Academic Search Engine), and RCAAP. Hand searched references were also considered, including quantitative, qualitative, and mixed-methods studies between January 2014 and October 2024, for a more contemporary perspective. A three-step search strategy and data extraction tool were used by two independent reviewers. Twenty-seven studies in English and Portuguese were eligible for inclusion, all targeting a population of professionals with nursing-related roles: two case studies, one Delphi panel, one descriptive study, one historical research paper, two using a methodological design format, four narrative reviews, one observational study, nine review articles, three scoping reviews, and three systematic reviews. Eight categories of nursing interventions that contribute to decarbonized lifestyles, reducing health risks in relation to climate change, were acknowledged. Nurses play a key role in empowering individuals, families, and communities, promoting climate awareness and literacy, supporting health policy change, advocating for the most vulnerable and engaging in environmental activism, using evidence-based research, and taking advantage of marketing strategies and social media.
- Competency-based spiritual care education program for undergraduate nursing students: a quasi-experimental studyPublication . Sitefane, Sara; Afonso, Ana; Ross, Linda; Mcsherry, Wilfred; Rabiais, Isabel; Caldeira, SílviaBackground: The International Council of Nurses underscores the importance of integrating spirituality into holistic nursing care, advocating for the recognition and respect of individuals’ spiritual beliefs and values. Addressing this need, the European project EPICC (Enhancing Nurses’ and Midwives’ Competence in Providing Spiritual Care through Innovative Education and Compassionate Care) promotes the development of spiritual care competencies within nursing curricula. In Portugal, however, the integration of spiritual care education in undergraduate nursing programmes remains inconsistent. Aim: This study aimed to evaluate the effectiveness of a digitally mediated pedagogical intervention, based on the EPICC Spiritual Care Education Standard, in enhancing spiritual care competencies among undergraduate nursing students in Portugal. Methods: This quasi-experimental study, conducted in partnership with the University of South Wales during the first semester of 2024, employed a non-equivalent control group pre-test and post-test design to evaluate the impact of implementing the EPICC matrix. A total of 36 undergraduate nursing students from a Portuguese nursing school participated in a hybrid course, using a digital tool to support learning. The EPICC Spiritual Care Education Standard and the EPICC Spiritual Care Competency Self-Assessment Tool, both translated, validated, and culturally adapted into European Portuguese, were utilised to measure outcomes. Results: A significant improvement in self-reported competencies across all four EPICC domains: Intrapersonal Spirituality, Interpersonal Spirituality, Spiritual Care Assessment and Planning, and Spiritual Care Intervention and Evaluation were demonstrated. Course satisfaction was reported by 80.5% of participants, usability of the digital resource by 77.7%, and 94.4% indicated they would recommend the course to others. Conclusions: The study demonstrates the potential of the EPICC framework to enhance spiritual care competencies among nursing students. These results support the integration of evidence-based spiritual care education into Portuguese undergraduate nursing curricula, facilitated through digital pedagogical approaches.
- Culturally adapted lifestyle and mental health intervention for low-income pregnant women: a feasibility studyPublication . Nunes, Maria Arminda; Melnyk, Bernadette; Almeida, Sofia; Vieira, Margarida; Cardoso, AlexandrinaBackground: Low-income pregnant women face challenges in maintaining a healthy lifestyle during pregnancy and protecting their mental health, increasing their risk of adverse perinatal outcomes. The Creating Opportunities for Personal Empowerment (COPE) program, culturally adapted for the Portuguese context, aims to promotes a healthy lifestyle and mental health.Objective: We aimed to assess the feasibility, acceptability, and preliminary effects of the culturally adapted intervention among low-income pregnant women, comparing in-person and online modalities.Methods: This mixed-methods study followed the Medical Research Council framework. Phase I involved cultural and linguistic adaptation of COPE using the ADAPT model. Phase II was a pre-post feasibility study with 45 low-income pregnant women attending in-person or online sessions. Feasibility was assessed through recruitment and retention. Acceptability was evaluated via engagement in skill-building activities, session rescheduling, and qualitative feedback. Preliminary effects were measured at T0 (baseline), T1 (post-intervention), and T2 (4-6 weeks postpartum).Results: Recruitment was 65.2%, with 68.9% retention, higher in the online group. On average, participants completed 3 skill-building activities and rescheduled 2.3 sessions. Qualitative feedback supported the intervention's acceptability. Anxiety and depressive symptoms significantly decreased from T0 to T1, with anxiety reduction sustained at T2. Postpartum depression declined in the in-person group but increased online. Perceived stress remained unchanged, while healthy lifestyle beliefs and behaviors improved significantly.Conclusion: The COPE intervention was feasible and acceptable, demonstrating improvements in lifestyle behaviors and mental health. Its cultural adaptation supports applicability in the Portuguese context and highlights potential for broader international transfer. Trial Registration: Open Science Framework doi.org/10.17605/OSF.IO/SQ5GK).
- Adverse events associated with the use of the peripheral venous catheter: a prospective studyPublication . Monteiro, Natalia da Conceição Andrade; Júnior, Aurean D’Eça; Anjos, Matheus Kirton dos; Paes, Graciele OroskiINTRODUCTION. The peripheral venous catheter is an invasive device widely used to enable infusional therapy in the hospital environment. Thus, patients with infusion therapy are more exposed to factors that tri-gger the occurrence of adverse events. OBJECTIVE. To estimate the incidence of local adverse events and identify risk factors associated with peripheral venous catheter management. MATERIAL AND METHOD. Prospective longitudinal study performed in the surgical hospitalization unit of a university hospital in the city of Rio de Janeiro, Brazil. It was observed the use of 114 catheters inserted in 58 patients. The research was conducted between March 2019 and February 2020. The data analysis was performed by descriptive and inferential statistics. RESULTS. The incidence of adverse events was 61,4%. Phlebitis and obstruction were the most frequent, both with 26,3%. The risk factors that presented a significant association were infiltration with administration of cefazolin (41,7%, p-value=0,029) and phlebitis with the act of touching the puncture site after antisepsis (47,8%, p-value=0,009). CONCLUSION. The nursing professionals’ care practice in the management of peripheral venous catheter is associated with the occurrence of adverse events.
- Palliative care in intensive care units: nurses' perspectives on challenges and strategiesPublication . Cunha, Daniela Filipa Almeida da; Alves, José Carlos Fernandes; Marques, Ana Jorge Santos; Santos, Rui Filipe Sá; Mota, Liliana Andreia Neves daBackground: The integration of palliative care into intensive care units is increasingly recognised as essential to ensuring quality end-of-life care, yet persistent barriers continue to challenge its implementation. Nurses, as continuous bedside providers, are central to delivering comfort, but their perspectives remain underexplored in the Portuguese context. Aim: To explore the challenges and strategies identified by intensive care nurses in the provision of palliative care, guided by Kolcaba's Comfort Theory. Study Design: A qualitative descriptive design was adopted. Data were collected through a broader questionnaire on palliative care that included two open-ended questions. Written responses were analysed using Bardin's content analysis, with interpretation informed by Kolcaba's Comfort Theory. Results: From 52 intensive care nurses, five categories emerged: physical comfort (symptom control and proportionality of interventions), psychospiritual comfort (emotional and spiritual support), sociocultural comfort (family involvement and shared decision-making), environmental comfort (privacy and humanisation of care) and organisational factors (training needs, institutional resistance and protocols). Nurses highlighted barriers such as therapeutic obstinacy, insufficient training and organisational constraints, while proposing strategies centred on communication, teamwork and education. Conclusions: Kolcaba's Comfort Theory provided a meaningful lens to interpret the multidimensional nature of comfort in intensive care palliative care. The findings extend understanding of how nurses perceive and address structural and cultural barriers, contributing to theory-informed nursing knowledge. Relevance to Clinical Practice: Grounding practice in nurses' perspectives and comfort theory may enhance education, organisational policies and models of care, promoting a more consistent integration of palliative care in intensive care units.