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- Development of a structured family reception procedure in adult intensive carePublication . Silva, Ana; Alves, José; Martins, Sónia; Osório, José; Pereira, Maria AuroraIntroduction: Family reception in adult intensive care units is a critical yet inconsistently structured practice, despite recommendations for family-centered care. Objective: To develop a structured procedure for family reception in adult intensive care and achieve expert consensus on its content. Methods: A two-phase methodological study was conducted. Phase 1 comprised a focus group with nine experienced intensive care professionals to explore current reception practices and key procedural components. Phase 2 used a two-round e-Delphi technique with ten expert critical care nurses to evaluate item relevance and clarity. Predefined consensus criteria were applied. Results: Focus group analysis identified four thematic areas that informed the draft procedure. e-Delphi consensus was achieved for 42 items, organized into three components: a pre-visit reception moment, a post-visit communication moment, and provision of standardized written information. Conclusion: This study produced a structured, expert-agreed family reception procedure for adult intensive care. Further studies should examine the feasibility, effectiveness, and family perspectives in clinical settings.
- Obesity and tolerance to neoadjuvant chemotherapy in breast cancer: a retrospective cohort studyPublication . Machado, Madalena Silveira; Santos, Madalena P.; Relvas, Catarina; Pereira, Margarida Quinto; Sousa, Mafalda; Santos, Eugénia; Pereira, Bernardo Alves; Parreira, Joana; Esteves, Susana; Ravasco, Paula; Vaz, Fátima; Nunes, HugoSimple Summary Obesity is becoming increasingly common and may influence chemotherapy tolerance and survival outcomes. However, its effect on tolerance to neoadjuvant chemotherapy in real-world practice is not fully understood. This study assessed the prevalence of overweight and obesity among patients with high-risk early breast cancer receiving chemotherapy before surgery and whether obesity is associated with a higher risk of treatment-related side effects. We also explored whether obesity is associated with treatment response and survival outcomes. By better understanding the relationship between obesity and treatment tolerance, these findings may help clinicians identify patients at greater risk of complications and tailor supportive care, as well as treatment planning. Background: Obesity is increasingly prevalent and has been associated with poorer outcomes and higher toxicity in breast cancer treatment. Its impact on tolerance to neoadjuvant chemotherapy (NAC) remains understudied. Objectives: This study aimed to determine the prevalence of overweight and obesity among patients with high-risk early-stage breast cancer (BC) treated with NAC. It evaluated the association between obesity and clinically significant chemotherapy-related toxicities. Pathological complete response (pCR), progression-free survival (PFS), and overall survival (OS) were explored. Methods: This is a retrospective cohort study on stage I-III BC assigned for NAC between January 2020 and December 2022. Patients were categorized by body mass index. Patients with obesity were compared with an age-matched non-obese cohort (1:1). The toxicities evaluated were hospitalization, dose reduction, treatment delay, or treatment discontinuation. Multivariable logistic regression models were performed, adjusting for age, comorbidity burden, and carboplatin use. Results: Of 487 eligible patients, 31.2% were overweight and 27.7% were obese. Peripheral neuropathy was more frequent and severe in obese patients (63.7% vs. 36.3%, p < 0.001). In multivariable analysis, obesity was independently associated with increased odds of global toxicity (OR = 1.83; 95% CI: 1.08-3.15; p = 0.027) and treatment discontinuation (OR = 2.30; 95% CI: 1.18-4.59; p = 0.016). Conclusions: Obesity is highly prevalent among high-risk early BC patients. It is independently associated with increased treatment-related toxicity, particularly discontinuation. These findings highlight the need for closer toxicity monitoring in patients with obesity. Reliance on BMI alone may be insufficient, underscoring the potential value of incorporating body composition assessment into clinical practice.
- Nursing and midwifery interventions for fall prevention in women in the maternity cycle: a scoping reviewPublication . Risso, Sandra; Soares, Tânia; Sá, Luís; Teixeira, Ana Catarina; Marques-Vieira, CristinaBackground Women sustain falls throughout the maternity cycle, which can lead to maternal-child injuries. To avoid fall-related negative outcomes in the maternity cycle, it is necessary that nurses and midwives are aware of interventions focused on fall prevention. Objective To identify and map nursing and midwifery interventions for fall prevention in women in the maternity cycle. Methods The search was conducted in the following databases: CINAHL Ultimate, MEDLINE Ultimate, Cochrane Central Register of Controlled Trials, Cochrane Clinical Answers, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, MedicLatina, RCAAP, SciELO, Scopus, and Web of Science. All types of reports related to nursing and midwifery interventions for fall prevention in women in the maternity cycle were included, in all contexts, published until May 5, 2025, in English, French, Portuguese, and Spanish. Results Regarding interventions for fall prevention, a total of 22 reports were found: 11 for the postpartum period; 6 for pregnancy; 4 for the three stages of the maternity cycle; and 1 for both pregnancy and the postpartum period. There are specific interventions for fall prevention for each maternity stage. Some interventions are transversal to the three maternity stages. When developing care plans, nurses and midwives should consider the following: fall risk assessment, documentation of interventions and their results, managing a safe environment, organizing care, and monitoring safety indexes. The interventions should include educating women about this issue, the risk factors, and the preventive interventions. These interventions are applicable to inpatient settings and to the community. In the community, nurses and midwives can use public statements and social media to promote women’s awareness. Conclusions Interventions for fall prevention in women in the maternity cycle vary, according to the stage. Nurses and midwives can use this knowledge during decision-making, in their practice, whether at an individual level or in the community.
- Assessing students’ perceptions of a new problem-based learning curriculum in medical educationPublication . Gaspar, Andreia; Mateus, Pedro; Menéres, SofiaThis study explores whether students' perceptions of aspects to be improved in pedagogical activities can contribute to understanding their level of adaptation to the Problem-Based Learning (PBL) methodology in Medical Education. A clear understanding of academic tasks is essential for effective learning. The transition from traditional teacher-centered to a student-centered active learning model requires students to adjust their perceptions to new ways of learning to maximize their learning experiences. However, assessing students’ adaptation to the new method through purpose-designed instruments and sessions can be extremely demanding and overwhelming for educational researchers, those responsible for curriculum implementation and educational quality assurance, as well as for students themselves. Using content analysis, we evaluated the responses of 56 first-year students of an integrated Master's degree in Medicine to two open-ended questions in a pedagogical evaluation survey, already answered by the students, about suggestions for improvement in lectures and tutorial sessions. The identified categories indicate that responses to the questions in the pedagogical evaluation questionnaires offers valuable insights into students' perceptions of the new PBL educational approach. Regarding students' progressive adaptation to the new method, our findings suggest a gradual adjustment to the new learning model. However, by the end of Year 1, students still offer suggestions that align more with a teacher-centered approach rather than the student-centered philosophy inherent to PBL. Limitations of the study and suggestions for future research are proposed. Capturing students’ perceptions of the new learning model and their evolution provides valuable insights for developing strategies to enhance students’ learning experiences and achieve better educational outcomes, particularly in contexts where PBL has recently been implemented.
- Standardizing oral microbiome sampling for qPCR: methodological and exploratory insights into nutritional statusPublication . Mendes, Karina; Gomes, Ana T. P. C.; Resende, Cristina Maria Mendes; Ribeiro, Isabela S.; Oliveira, Rafael M. C.; Rosa, Nuno; Muniz, Maria T. C.; Correia, Maria J.Standardization of oral sample collection methods is essential for accurate and reproducible microbiota quantification. This methodological study aimed to evaluate different oral collection methods to identify the most consistent approach for bacterial quantification by qPCR using samples from adolescent individuals. In addition, to assess the biological applicability of the best method, an exploratory analysis compared bacterial profiles between eutrophic and overweight/obese adolescents and explored associations between bacterial abundance and body composition parameters. Samples of unstimulated saliva, cheek swabs, and biofilm were collected from the same individuals, and qPCR was used to quantify total bacteria (16 S rRNA gene), Bacillota, and Bacteroidota phyla. Unstimulated saliva produced the lowest variability in bacterial quantification compared with other methods (p?
- Assessment of digital health literacy among university students: influence of course type and online health information seekingPublication . Almeida, Sofia; Pinto, Elisabete; Correia, Marta; Veiga, Nélio; Almeida, ArmandoBackground and Objective: E-health literacy involves the ability to search for, find, estimate and evaluate information about health and/or health services. Online sources of health information are now a privileged way of accessing information, especially among students. The aim of this study was to access the level of e- health literacy in a sample of Portuguese university students; and to relate the level of e-health literacy with sociodemographic characteristics; analyze differences between health and non-health students and with the use of online health information. Material and Methods: An observational cross-sectional study was conducted on Portuguese university students. All students completed a questionnaire consisting of social-demographic characteristics, and sources of health online information used. The digital health literacy score was assessed by the eHEALS scale validated for the Portuguese population. Descriptive and inferential analysis was applied, as well as multivariate regression models. Results: In this study, 534 university students participated; the median age was 21.0. The level of e-health literacy was 28.8 (5.6). Health-sciences students had higher digital health literacy scores than students from other fields. Most students considered the internet to be useful and very useful in making health decisions. Students' use of health online information sources such as official health websites (OR= 2.6; CI 95%= 1.5;4.3) and professional health websites (OR= 2.3; CI95%= 1.4; 3.8) increased their likelihood of having a sufficient level of e-health literacy. While the use of information sources such as social networks (OR= 0.5; 95%CI: 0.3;0.9) decreases the likelihood of having a sufficient level of e-health literacy. Conclusion: Health students showed higher levels of health literacy, demonstrating the importance of including health education in the curricula of other areas. As a practical implication, there is a need to include health education, health campaigns, and the promotion of healthy lifestyles in curricula in order to increase health literacy in university.
- O conceito de vulnerabilidade em saúde na população pediátrica no contexto dos cuidados de enfermagem: uma scoping reviewPublication . Mestre, Cristina Moura; Charepe, Zaida; Ferreira, Filipa de Goulart Corte RealIntroduction: Children's health vulnerability is multifactorial; it arises from a combination of several factors that place children at risk.Objectives: To map the existing scientific evidence and literature regarding health vulnerability in the pediatric population and in nursing care. Materials and Methods: A Scoping Review was conducted following the methodology suggested by the Joanna Briggs Institute. A search was conducted in the CINAHL Complete®, Pubmed®, and Scopus® databases from February to April 2024, using DeCS/MeSH descriptors in Portuguese and English.Results: In this scoping review, 13 studies were eligible for inclusion, primarily exploratory and literature reviews. Their publication dates were between 2006 and 2024. The selected articles address the topic of health vulnerability in children, which were grouped as follows: health diagnoses with a higher risk of vulnerability; belonging to the LGBTI+ group; Habits, behaviours, and lifestyles; and the impact of context. The data highlight the important role of nursing interventions in preventing disease, developing healthy behaviours, empowering children and families, and improving health outcomes.Conclusion: The need to promote and streamline scientific research in Portugal on health vulnerability in children is emphasised to enable better, more individualised nursing care for the pediatric population. The relationship between the concept of health vulnerability and specific health diagnoses, minority populations, high-risk habits, and context was verified.
- Mental health of Portuguese nurses in 2024: what has changed since 2017? A cross-sectional observational comparative studyPublication . Seabra, Paulo; Lopes, Joaquim Oliveira; Pessoa, Ezequiel; Capelas, ManuelBackground: Nurses’ mental health has become an increasingly pressing concern worldwide because of its impact on health systems, patient health outcomes, job satisfaction, and workforce attrition. Aim: This study updates and compares findings from a national survey initially conducted in 2017 to assess the mental health of Portuguese nurses and examine associations with socio-professional variables. Methods: This cross-sectional observational study was expanded to include 1894 nurses working in hospitals, primary care, and other settings. The General Health Questionnaire-24 was used to assess mental health perception. Results: Results indicate a substantial decline in mental health perceptions across all indicators compared with 2017. Participants reported more negative assessments of overall mental health, with notable increases in somatic symptoms, anxiety and insomnia (the most affected domain), social dysfunction, and severe depression. Moreover, participants reported increased use of psychotropic drugs. Protective factors identified include specialised training, increased time off (particularly weekends), and engagement in sports or hobbies. Conclusions: Being the largest group in Portugal’s healthcare workforce, and reflected globally, nurses play a pivotal role in the health system. Their mental well-being directly impacts patient care quality and safety. These findings support the implementation of targeted strategies to safeguard nurses’ mental health and enhance healthcare delivery.
- Promoting the role of parents in preventing child sexual abuse: scoping review protocolPublication . Terra, Penélope Morais; Fernandes, Rita; Alves, José; Oliveira, Fernando; Sousa, Paula; Torres, CâniaIntroduction: Child sexual abuse includes any sexual act involving children, with or without physical contact. Understanding its complexity and promoting anticipatory parental competencies are essential for guiding effective preventive interventions. Objectives: To map clinically relevant scientific evidence on nursing interventions aimed at the parental role in preventing child sexual abuse. Methodology: A Scoping Review will be conducted following the JBI methodology. The search will cover peer-reviewed databases, including MEDLINE Ultimate, CINAHL Ultimate, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science, and Scopus, as well as Portugal's Open Access Scientific Repository and ProQuest. The database search was performed on September 4, 2025. Results: Data will be presented descriptively, using figures and tables, accompanied by a narrative summary synthesizing nursing interventions that promote parental roles in the prevention of child sexual abuse. Conclusion: This review will consolidate evidence to support the practice of Specialist Nurses in Child and Pediatric Health, enhancing preventive strategies based on the promotion of parental roles.
- Descrição e reflexão crítica da teoria do cuidar de Simone RoachPublication . Condeço, Luís; Vieira, Margarida; Cunha, MadalenaIntrodução: Simone Roach concetualiza o cuidar como o modo humano de ser, destacando que o cuidado não é apenas uma caraterística profissional, mas uma expressão fundamental da humanidade. A aplicabilidade da sua teoria em contexto formativo de enfermeiros ou em início de carreira profissional, pode revelar-se bastante útil, pelo seu foco no desenvolvimento da prática clínica centrada no paciente. A sua utilização limitada destaca a necessidade de uma análise crítica do seu contributo para a disciplina. Objetivo: Com este estudo teórico, procura-se analisar criticamente a teoria do cuidar de Simone Roach, segundo a metodologia proposta por Chinn, Kramer e Sitzman. Métodos: A análise realizou-se em duas fases, na primeira fase é realizada uma descrição da teoria, considerando o objetivo, os conceitos, as definições, as relações, a estrutura e os pressupostos, e na segunda fase é realizada uma reflexão crítica da teoria, considerando a clareza, a simplicidade, a generalidade, a acessibilidade e a importância. Resultados: A teoria apresenta uma estrutura simples, assente nos seis Cs, que demonstram elevada clareza conceptual e aplicabilidade prática. Foi identificada a sua utilização em contextos paliativos, pediátricos, psiquiátricos e formativos, evidenciando o seu valor pedagógico e clínico. A análise crítica da teoria permitiu reconhecer limitações relacionadas com a aplicabilidade multicultural e ausência de representação visual estruturada. Conclusão: Este modelo pode fornecer um valioso contributo para a prática clínica, a educação e a investigação em enfermagem.