CIIS - Contribuições em Revistas Científicas / Contribution to Journals
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- More patterns on palliative care identity: an autoethnography contributionPublication . Neto, Isabel Galriça; Sapeta, Paula; Almeida, António; Menéres, SofiaObjectives. To identify, describe and analytically interpret relational recurrent patterns shaping interactions in PC settings, and to offer practical guidance to haelth care professionals navicating complex end-of-life-scenarios. Background. This study explores the dynamics influencing relational interactions in palliative care (PC) settings. Building upon 1 author’s extensive clinical experience, reflection, and prior research, we aim to further illuminate the clinical and cultural factors that shape relational interactions and scenarios within PC. By integrating personal observations with scholarly literature and describing specific recurring global patterns of interaction, this article seeks to deepen understanding of PC culture and to provide healthcare professionals with practical strategies to improve engagement with patients and families. Methods. This study aimed to explore and analytically describe recurrent relational patterns shaping interactions in PC settings through an analytic autoethnographic lens. Short evocative phrases were used to define the identified patterns as clinical vignettes. Based on recurrent clinical observations and reflexive positioning, and through an iterative analytic process, patterns were progressively identified, named, and situated within a theoretical framework. Ethical standards were upheld. Results. Three end-of-life scenarios – “The Palliative Honeymoon,” “The Cousin of France,” and “Do Everything!” – emerged and were analyzed. The findings emphasize the importance of understanding these behavioral patterns in order to educate health professionals and enhance care provision. Significance of results. This original Portuguese analytic autoethnographic study is grounded in extensive experiential knowledge and addresses a gap in the literature regarding interactional patterns in PC. By integrating long-standing personal clinical experience with scholarly evidence, this autoethnographic study renders explicit what is often tacit in PC practice – the hidden cultural elements that shape clinical interactions. It is part of a continuum of research that willcontinue and be relate to elements of PC identity. By describing clinically relevant phenomena and integrating them with existing literature, this work offers strong practical implications and contributes to better preparing clinicians for the complex realities of PC practice.
- Obstetric nurses’ approach to evidence-based practice in breastfeeding within the context of HIV: a scoping reviewPublication . Fonseca, Catarina; Palma, Sara; Antunes, MónicaBackground/Objectives: Human immunodeficiency virus remains a significant public health challenge, with breastfeeding contributing to the risk of mother-to-child transmission. Although antiretroviral therapy significantly reduces this risk, obstetric nurses face complex challenges in translating evolving guidelines into clinical practice. This scoping review aims to map existing scientific evidence on obstetric nurses’ approaches to evidence-based practice regarding breastfeeding in the context of HIV. Methods: Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a search was conducted across PubMed, Scopus and EBSCOhost (MEDLINE Complete, CINAHL Complete, Cochrane Central Register of Controlled Trials, and Nursing & Allied Health Collection: Comprehensive) for studies published in English and Portuguese between 2015 and 2025. Studies were included if they focused on the role of obstetric nurses, nurse-midwives, or midwives in infant-feeding practices for women living with HIV. Results: Eight studies were included, predominantly from sub-Saharan Africa, with additional evidence from Europe and Canada. Findings reveal that infant-feeding counseling is shaped by a complex interplay of clinical protocols and personal beliefs. Significant gaps in knowledge translation were identified. While nurses demonstrate high technical confidence in lactation support, their distinct professional contribution is often obscured by research that aggregates all healthcare providers. Conclusions: The challenge of supporting breastfeeding in the context of HIV extends beyond technical protocol adherence. It points to persistent gaps in knowledge translation, variability in counselling practices, and the influence of contextual and professional factors on guideline implementation. Strengthening care requires sustained investment in profession-specific education, institutional support, and evidence-informed practice frameworks that enable obstetric nurses to exercise informed clinical judgement.
- Get a grip! – Baseline handgrip strength and sarcopenia as predictors of survival in patients with head and neck squamous cell carcinomaPublication . Orell, Helena; Pohju, Anne; Ravasco, Paula; Schwab, Ursula; Osterlund, Pia; Mäkitie, Antti A.Background Low handgrip strength (HGS) and sarcopenia are common in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to explore associations between baseline HGS, fat-free mass index (FFMI), nutritional indices, and survival. Methods This was a prospective observational sub-study of a randomized nutritional intervention trial, including 50 male patients with HNSCC undergoing curative-intent treatment (surgery and/or (chemo)radiotherapy). Sarcopenia was defined as low HGS (<27 kg) and FFMI (<17 kg/m2). Chi-square, Kaplan–Meier, and Cox analyses were used. Results Low HGS was observed in 16%, low FFMI in 46%, and sarcopenia in 12%. Patients with low HGS had lower body weight, BMI, and FFMI, alongside more malnutrition, elevated CRP, and heavy smoking. Low HGS and sarcopenia were associated with shorter overall survival (HR 3.7, [95% CI 1.5–9.1] and 5.5, [2.2–14.5], respectively); FFMI was not. Adjustment removed significance. Findings should be interpreted cautiously due to the small, all-male cohort size. Conclusion In this small exploratory cohort HGS may serve as a simple screening surrogate for sarcopenia and survival. Clinical trial registration www.ClinicalTrials.gov , identifier NCT02159508.
- Predicting progression from subjective cognitive decline to dementia using different neuropsychological criteria: a longitudinal studyPublication . Pestana, Pedro Câmara; Cardoso, Sandra; Guerreiro, Manuela; Jessen, Frank; Couto, Frederico Simões do; Marôco, João; Mendonça, Alexandre deBackground: Subjective Cognitive Decline (SCD) is considered a risk stage for future cognitive impairment and dementia. Objective: This study examined whether different neuropsychological criteria for defining cognitive normality influence SCD's ability to predict conversion to dementia. Methods: Participants from the Cognitive Complaints Cohort were diagnosed according to the Subjective Cognitive Decline Initiative criteria. Normal cognition was defined by the absence of Mild Cognitive Impairment according to five Jak and Bondi criteria. Sociodemographic, clinical, and neuropsychological data were analyzed using descriptive statistics. Bootstrap methods characterized group profiles given overlap between SCD definitions. Kaplan–Meier curves illustrated time to dementia, and a clustered Cox proportional hazards model accounted for overlapping group membership and adjusted for baseline variables. Results: Among 838 subjects, the five SCD groups showed similar age and sex distributions but differed in education, cognition, and functional status, while subjective complaints and depressive symptoms did not differ meaningfully. Kaplan–Meier curves showed variability in conversion probabilities. At five years, conversion ranged from 3.9% (Liberal) to 25.5% (Conservative); at ten years, from 16.2% to 40.9%. Clustered Cox analysis showed that Conservative and Historical SCD remained associated with higher hazard of conversion after adjustment, whereas Typical and Comprehensive SCD were associated with lower hazard estimates. Conclusions: Neuropsychological criteria for cognitive normality define SCD groups with distinct clinical profiles and risks of dementia. Broader definitions identify individuals at higher risk, whereas more stringent definitions capture populations with lower likelihood of decline, highlighting the importance of criterion selection according to clinical and research objectives.
- Perda da visão adquirida e conceito de autoimagem: experiência segundo o gênero - uma revisão de escopoPublication . Duarte, Cátia Isabel Marranita dos Santos; Mesquita, Isabel Cristina Boavida; Dias, Cecília Raquel CavacoIntrodução: As imagens visuais desempenham um papel central na organização da cognição social, da autonomia funcional e da identidade pessoal. A perda de visão adquirida constitui uma experiência potencialmente disruptiva, com repercussões que ultrapassam a dimensão sensorial e interferem nos processos de construção e reconstrução da autoimagem. Objetivo: Considerando a relevância deste constructo e a influência dos determinantes socioculturais associados ao gênero, esta revisão de escopo teve como objetivo mapear a evidência científica disponível sobre a relação entre a perda visual adquirida e a perceção da autoimagem em homens e mulheres. Métodos: A revisão foi conduzida de acordo com a metodologia do Joanna Briggs Institute, com protocolo registado na Open Science Framework. A pesquisa bibliográfica incluiu as bases de dados Medline Complete, Scopus e Web of Science, complementada por literatura cinzenta, contemplando estudos publicados em português, inglês e espanhol. Resultados: Após o processo de seleção, cinco estudos foram incluídos na análise. Os resultados indicam que a perda de visão adquirida afeta múltiplas dimensões da vida, nomeadamente a autonomia, as atividades de vida diária, o bem-estar psicossocial e as relações interpessoais. Contudo, a literatura disponível aborda de forma indireta e limitada a perceção da autoimagem no contexto da cegueira, sendo particularmente escassa a análise sensível ao gênero. Conclusão: Esta lacuna evidencia a necessidade de investigação futura que explore, de forma aprofundada, as vivências subjetivas associadas à autoimagem após a perda visual adquirida, contribuindo para o desenvolvimento de intervenções mais humanizadas, integradas e centradas na pessoa, com impacto positivo na qualidade de vida.
- Nursing interventions for people with musculoskeletal injuries during physical activity: a scoping reviewPublication . Pinheiro, J.; Costa, A.; Pedrosa, P.; Marques-Vieira, C.Introduction: Physical inactivity is a major public health concern, with Portugal ranking among the European countries with the lowest levels of regular physical activity. Poorly managed physical activity is associated with a high incidence of musculoskeletal injuries, increasing the need for effective nursing interventions focused on prevention, rehabilitation, and safe return to activity. In orthopedic and trauma care, nurses play a key role in clinical assessment, patient education, functional recovery, and interdisciplinary coordination; however, nursing-specific interventions in this area remain insufficiently mapped. Objective: To map the scientific literature on nursing interventions for individuals with musculoskeletal injuries related to physical activity. Method: A scoping review was conducted following the Joanna Briggs Institute methodology, guided by the PCC framework: Population (individuals with musculoskeletal injuries), Concept (nursing interventions), and Context (physical activity). Searches were performed in MEDLINE Ultimate, CINAHL Ultimate, SPORTDiscus, Psychology and Behavioral Sciences Collection, and Scopus, complemented by grey literature. Studies published in English, Portuguese, Spanish, or French were included. Study selection and data extraction were conducted independently by two reviewers, following PRISMA 2021 guidelines. Results: 36 studies were included. Most originated from the United States and Europe, and were situated within medicine, physiotherapy, and rehabilitation sciences. Nursing-relevant interventions included comprehensive clinical assessment, pain management, health education, psychosocial support, multidisciplinary rehabilitation coordination, therapeutic exercise guidance, balance and proprioception training, activity modification, and reinjury prevention. Conclusion: The evidence highlights multiple nursing interventions applicable to musculoskeletal injury rehabilitation of individuals with physical activity, reinforcing the importance of nurses within orthopedic and trauma care.
- Treatment of gingival recession type 1 using coronally advanced flap with leucocytes-platelet rich fibrin: a randomized controlled trialPublication . Santos, Nuno Bernardo Malta Dos; Fernandes, Gustavo Vicentis Oliveira; Marques, Tiago; Sousa, Manuel Correia; Correia, André; Vázquez, María Pilar Batalla; Blanco-Carrión, JuanObjective: This study aimed to evaluate the clinical outcomes of gingival recession Type 1 (RT1) treatment using a coronally advanced flap (CAF) alone and in combination with L-PRF at 6 months. Materials and methods: A total of 70 RT1 from 19 patients were included. Participants were randomly assigned to the test group (TG, CAF+L-PRF, n=42) and the control group (CG) (CAF alone, n=28). Clinical parameters were assessed at baseline and at 6 months: the primary outcomes were percentage of root coverage (%RC) and complete root coverage (CRC); and the secondary outcomes included mean root coverage (MRC), changes in gingival thickness (GT) and volumetric tissue gain, recession area reduction, analgesic consumption, healing quality (the Inflammatory Proliferative Remodeling [IPR] score), and patient-reported outcome measures (PROMs). Statistical analyses were performed to determine differences between groups; a random-intercept mixed-effects model was used for all site-level outcomes. Results: At six months, %RC was 89.30% ± 20.33% (TG) and 81.60% ± 27.93% (CG) (p>0.05). For the TG and CG, respectively, %CRC was 73.81% and 57.14%; the mean GT gain was 0.16±0.10 mm and 0.11±0.10 mm (p=0.08); the mean volume gain was 1.13±1.25 mm3 and 0.86±0.84 mm3 (p=0.32); the mean number of pills taken was 1.67±0.98 and 2.25±1.02 (p=0.04); the esthetic satisfaction was 95% ± 5% and 90% ± 7% (p=0.31); willingness to undergo the procedure again: 93% ± 4% and 88% ± 6% (p=0.22); sensitivity reduction: 85% ± 6% and 80% ± 8% (p=0.19). There was no statistically significant difference in healing quality and PROMs. Conclusion: Both CAF alone and CAF combined with L-PRF yielded comparable clinical and volumetric outcomes in RT1 treatments. No statistically significant advantages were observed with the adjunctive use of L-PRF. Clinical relevance: Because CAF alone achieves high predictability for RT1 defects, the routine adjunctive use of L-PRF provides limited additional clinical benefits.
- The prevalence and risk factors related to erosive tooth wear in an adult population: a cross-sectional study in Saudi ArabiaPublication . Aljulayfi, Ibrahim S.; Alshenaiber, Rafif F.; Alali, Murtadha A.; Almatrafi, Ali H.; Alsaggaf, Arwa U.; Nassief, Sarah; Althubaitiy, Ramzi O.; Fernandes, Gustavo Vicentis OliveiraThis study assessed the prevalence and risk factors associated with erosive tooth wear (ETW) among the adult population. Clinical examinations were conducted using the Basic Erosive Wear Examination index, which assesses the severity of ETW in six sextants of the oral cavity. The risk factors for ETW included: (1) socio-demographic characteristics, (2) general health conditions, (3) vitamin C consumption, (4) beverage consumption, (5) acidic foods and drinks, (6) dairy products, (7) use of fluoridated mouthwashes and toothpastes, and (8) type of toothbrush. A one-way ANOVA test and an independent sample t-test were used; a p-value of 0.05 was considered the threshold for statistical significance. A total of 312 participants were included; 174 (55.8%) were females. In terms of age distribution, the majority of participants were between 23 and 59 years old (n = 261). Regarding education, predominantly (154, 49.4%) held a bachelor’s degree. Regarding socioeconomic factors, 214 participants (68.6%) were framed into the lowest socioeconomic status (SES). The highest prevalence of ETW was observed in the maxillary anterior teeth (90.2%), followed by the mandibular anterior teeth (79.8%). Participants who used hard-bristled toothbrushes (teeth abrasion), consumed acidic products, and belonged to high SES groups had significantly higher erosive tooth wear scores. The overall prevalence of ETW among participants was 69%, with the highest prevalence observed in males, older age groups, and those with higher SES. The findings highlight the significant role of dietary habits, oral hygiene practices, and socioeconomic factors in the development of ETW.
- Strategies for teaching nursing diagnosis in undergraduate nursing education: a scoping reviewPublication . Napoleão, Anamaria Alves; Diogo, Regina Célia dos Santos; Eduardo, Aline Helena Appoloni; Silva, Marcos Barragan da; Beltrão, Beatriz Amorim; Miguel, SusanaAim: Identify the characteristics of strategies employed in teaching nursing diagnoses in undergraduate nursing programs. Background: The ability to formulate accurate nursing diagnoses is a core component of clinical reasoning and nursing diagnoses are the primary drivers of nursing processes. The optimal approach for students to acquire this competence remains insufficiently understood. Ongoing changes in nursing education have heightened the need to investigate which pedagogical strategies support students in learning and applying diagnostic reasoning. Design: Scoping review conducted following the JBI methodology in March 2025. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was followed. Methods: Seven databases were searched. Twenty-nine studies published between 1993 and 2024 were included. The review protocol was registered in the Open Science Framework DOI:10.17605/OSF.IO/UC3ZH. Results: Strategies identified include simulation (n=7), virtual tools (n=6), educational programs (n=6), group work (n=3), case studies (n=3) and other methods (n=4), such as board games, outcome present state test model, guided visual metaphorical strategy and arch method. Conclusions: The findings reveal the predominance of active, student-centred methodologies that foster critical thinking and reflective practice. These approaches appear to support the development of diagnostic competence and may contribute to preparation for clinical decision-making. This review point to the need for standardized evaluation tools and longitudinal research to explore the sustainability and scalability of these approaches in diverse educational contexts. Integrating these strategies into undergraduate curricula has the potential to strengthen students’ engagement with clinical decision-making, promote reflective evidence‑based practice and contribute to safer decision‑making processes. Tweetable abstract: Active, student-centred strategies—especially simulation and virtual tools—enhance nursing students’ diagnostic reasoning and documentation, but standardized evaluation and long-term impact remain underexplored.
- Simulação clínica na saúde: a relevância pedagógica do debriefingPublication . Martins, HelgaDebriefing constitutes a central stage in simulation-based learning in healthcare, establishing itself as a fundamental pedagogical strategy. It corresponds to a structured moment of reflection that enables participants to analyze their performance, identify gaps, and consolidate knowledge. This process should be previously planned and integrated into the simulation experience, guiding students toward the defined learning objectives and thereby reinforcing its pedagogical intentionality. Its effectiveness depends on the existence of a psychologically safe environment that fosters active participation, critical reflection, and the free expression of ideas, essential elements in the pedagogical process. Various models and frameworks support the conduct of debriefing, notably PEARLS, which organizes the process into four phases: reactions, description, analysis, and summary. The analysis phase is particularly significant, as it promotes critical exploration of performance and the development of clinical reasoning, contributing to meaningful learning. In debriefing, the facilitator plays a crucial role as a pedagogical mediator of learning, promoting reflection, communication, and constructive feedback. The integration of technical and interpersonal skills is essential to ensure the effectiveness of this pedagogical process. The use of assessment instruments also contributes to the quality of debriefing and to the enhancement of the facilitator’s pedagogical competencies. In summary, debriefing is the core element of clinical simulation, playing a decisive role in meaningful learning and in bridging theory and practice, thereby consolidating itself as a powerful pedagogical tool in healthcare education.