CIIS - Contribuições em Revistas Científicas / Contribution to Journals
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- Cross-cultural validation and psychometric evaluation of the birth beliefs scale among Portuguese pregnant WomenPublication . Lopes, Marlene; Neves, Teresa; Vieira, Margarida; Cardoso, AlexandrinaBackground: Beliefs about childbirth shape women’s expectations, decisions, and experiences. Although several tools assess related constructs such as fear or self-efficacy, few instruments focus specifically on childbirth beliefs. The Birth Beliefs Scale (BBS) addresses this gap by measuring 2 dimensions: beliefs in childbirth as a natural event and as a medical event. Objective: We sought to adapt the BBS to the Portuguese context and evaluate its psychometric properties. Methods: This methodological study involved cross-cultural adaptation and psychometric testing. The adaptation followed internationally recognized guidelines, including translation, synthesis, back-translation, expert review, and pretesting. Psychometric evaluation included exploratory and confirmatory factor analysis. The sample comprised 241 pregnant women enrolled in childbirth preparation programs in central Portugal. Findings: The original two-factor structure was partially confirmed following the removal of 3 items with low psychometric performance, including 2 related to labor pain. The Portuguese version (BBS-pt) demonstrated acceptable internal consistency for the Natural subscale (α=0.68) and lower consistency for the Medical subscale (α=0.58), suggesting cultural and contextual nuances in how birth beliefs are expressed. Conclusion: The BBS-pt is a promising instrument for assessing birth beliefs among Portuguese women. While further refinement is needed, particularly regarding pain-related items, the scale provides a valuable foundation for both research and clinical practice. It may assist nurse-midwives and other maternity care providers in tailoring antenatal education and intrapartum support to women’s individual belief patterns, thereby contributing to more personalized and womancentered care.
- A grounded theory of spiritual development within holistic professional formation in undergraduate nursing studentsPublication . Shapira, Revital; Caldeira, SilviaPurpose: To explore how undergraduate nursing students from different academic years experience and describe their spiritual development, and to explain how this process contributes to holistic professional formation. Design: A qualitative grounded theory study informed by Corbin and Strauss was conducted. Methods: Twenty-one undergraduate nursing students from different academic years participated in semi-structured interviews, and 11 of them also completed reflective online diaries. Data collection and analysis were conducted concurrently using constant comparative analysis. Ethical approval was obtained. Findings: Spiritual development emerged as a meaning-oriented process situated within holistic professional formation, characterized by a movement from externally guided reassurance toward internally grounded meaning-making. Emotionally demanding clinical experiences disrupted students’ assumptions and generated uncertainty. When supported through reflection and relational engagement, these experiences contributed to self-awareness, internal grounding, and students’ capacity for presence, compassion, and engagement in care. Conclusions: Findings challenge the assumption that clinical exposure alone supports students’ spiritual development. The MAMA–BEAR model offers a substantive grounded theory explaining how academic and clinical environments may support spiritual development as part of holistic professional formation, with implications for curricula, educator preparation, and whole-person care.
- Artificial intelligence technologies supporting clinical judgement in nursing: a scoping reviewPublication . Alves, José Carlos Fernandes; Azevedo, Ana Rita Ribeiro de; Encarnação, Rúben Miguel Câmara; Pais-Vieira, Carla Ferreira da Silva; Alves, Paulo Jorge PereiraAim: To map and analyse how artificial intelligence technologies interact with and support clinical judgement processes in nursing across practice and educational contexts. Design: Scoping review. Methods: JBI methodology for scoping reviews. Data Sources: An electronic search was conducted on 1 July 2025 across MEDLINE, CINAHL, Scopus, Web of Science, and IEEE Xplore to identify studies published since January 2015. Additional sources of grey literature included ProQuest Dissertations & Theses Global, preprint servers (medRxiv and arXiv), and websites of relevant organisations. Results: Eleven studies were included. Mapped against Tanner's Clinical Judgement Model, AI applications predominantly supported early cognitive phases (noticing and interpreting) through predictive models and decision support systems, while responding and reflecting phases received minimal attention. Conclusion: Current AI research in nursing concentrates on computational pattern recognition, with the reflective processes central to expertise development remaining largely unexamined. Future research should examine how AI influences nurses' cognitive and interpretative processes across all phases of clinical judgement, with primary studies in nursing education representing a particularly underdeveloped priority. Implications for the Profession and/or Patient Care: The integration of artificial intelligence into nursing practice should be guided by a clear understanding of how these technologies support clinical judgement. Artificial intelligence-enabled tools must be rigorously developed, implemented, and evaluated to enhance nurses' reasoning processes while safeguarding patient safety, professional autonomy, and quality of care. Impact: Research on artificial intelligence in nursing rarely employs theoretical frameworks of clinical judgement, limiting understanding of how these technologies interact with cognitive processes central to professional expertise. This review provides a theoretically grounded synthesis, identifying research gaps and implementation priorities for AI development aligned with nursing clinical judgement. Reporting Method: PRISMA-ScR. Patient or Public Contribution: This study did not include patient or public involvement in its design, conduct or reporting.: Trial Registration: Protocol registered in Open Science Framework (https://osf.io; DOI: https://doi.org/10.17605/OSF.IO/UH7RA), and subsequently published in a peer-reviewed journal, DOI: https://doi.org/10.62741/ahrj.v2i4.73.
- Experiences of family hope and hopelessness in the context of pregnancy and care for high-risk newbornsPublication . Ramos, Bruna Camargos de Lima; Costa, Renata de Oliveira; Duarte, Elysângela Dittz; Charepe, Zaida Borges; Braga, Patrícia PintoObjective: to understand family experiences of hope, from pregnancy to the care for high-risk newborns. Method: qualitative research, guided by the Theoretical Model for Understanding the Complex Nature of Hope, which took place in a multiprofessional outpatient clinic for high-risk newborn care. A total of 28 individuals from 14 families participated through oral history interviews. This allowed for the construction of family narratives, which were submitted to deductive thematic analysis. Results: family experiences of hope are established based on four dimensions: understanding, judgment, and interpretation about hope; affective aspects and feelings regarding the lived experience; actions, behaviors, and strategies that strengthen family hope; and influence of context and life situations. These are influenced by the temporality in which the family finds itself. At the beginning of the experience of risk, hope appears fragile and uncertain, with negative feelings and desires for better days. Over time, strategies, such as spirituality and intrapersonal relationship skills, are strengthened and maintained, reframing feelings. Conclusion: understanding family experiences of hope and hopelessness can enable healthcare providers to strengthen and contribute to a more positive experience in the presence of gestational and neonatal risk.
- Seguimento de crianças filhas de mulheres diagnosticadas com sífilis na gravidez: revisão de escopoPublication . Wernet, Monika; Barboza, Natália Simão Godoy; Nakao, Patrícia Akari; Corrêa, Carla Regina de Almeida; Silva, Katia Gomes da; Ruiz, Mariana Torreglosa; Yamamura, Mellina; Charepe, Zaida BorgesObjetivo: mapear evidências da assistência de seguimento de crianças filhas de mulheres diagnosticadas com sífilis na gravidez na atenção em saúde. Métodos: Revisão de escopo, conforme o Institute Joanna Briggs e o PRISMA-ScR. Foram incluídos estudos primários de quatro bases de dados eletrônicas, com delimitação de idioma em português, inglês e espanhol, sem restrição de tempo. Resultados: Foram alcançados 283 documentos, após etapas seletivas 19 foram analisados, a maioria originário do Brasil, todos publicados entre 2011 e 2024. As evidências relativas à assistência de seguimento estão apresentadas a partir dos temas: Exames diagnósticos da sífilis e de danos associados; Tratamento medicamentoso; Seguimento na Rede de Atenção em Saúde e Apoio social. Conclusão: Foi identificado estar a assistência de seguimento fragilizada, com destaque para inconsistências em relação ao diagnóstico e tratamento medicamentoso, e incipiências na articulação da rede de cuidados, desenvolvida sob uma abordagem centrada na doença, com insuficiências na consideração das determinações da vida e saúde.
- Senses and meanings attributed to hope by children with orofacial clefts and their family caregiversPublication . Mori, Mariana Martire; Piran, Camila Moraes Garollo; Cargnin, Alana Vitória Escritori; Trettene, Armandos dos Santos; Shibukawa, Bianca Machado Cruz; Charepe, Zaida Borges; Furtado, Marcela DemittoObjective: To understand the senses and meanings attributed to Hope by children with orofacial clefts and their family caregivers. Method: This is a qualitative, descriptive, and exploratory study, based on the Hope-Promoting Mutual Help Intervention Model and Symbolic Interactionism. It was conducted at an association in Paraná, with children aged five to ten years, with orofacial clefts, and with family caregivers of children under ten years old with the same condition. Data were collected through Dramatic Therapeutic Play and semi-structured interviews. Thematic analysis was of the deductive type, with the support of Atlas.ti®. Results: Sixteen children with orofacial clefts and 26 family caregivers participated. For children, Hope was associated with the expectation of good things, including professional aspirations and a transformation of self-image. For caregivers, Hope was associated with inner strength and spirituality, essential for giving meaning to life. Conclusion: Hope is an essential dimension for children with orofacial clefts and their family caregivers in coping with rehabilitation, and is fundamental to the care process.
- The experience of young women with gestational syphilis from the conceptual perspective of hopePublication . Wernet, Monika; Charepe, Zaida; Festas, Constança; Silveira, Aline Oliveira; Nakao, Patrícia AkariObjective: To understand the hope of young women diagnosed with gestational syphilis in the context of prenatal care. Method: Qualitative research, based on thematic analysis, from the conceptual perspective of hope. It was developed in the state of São Paulo with young women diagnosed with gestational syphilis during prenatal care through semi-structured interviews and audio recordings conducted between July 2023 and April 2024. Results: Sixteen young women participated in the study, all self-identifying as black or mixed-race, four of whom were first-time mothers, and most had up to nine years of schooling. The experience of hope is portrayed in the following thematic units: “Threats to hope”, with the subtopics “Stigma and suffering” and “Restricted informational and social support”; and “Promoters of hope”, with the subtopics “Child protection” and “Self-preservation”. Conclusion: In prenatal care, women faced a dialectic of threatening and hope-promising contexts. In this sense, the following stood out, respectively: the incomplete professional support for emotional and informational needs, and the clarity of the desired objective (non-contamination of their child) associated with internalized reflection on the exercise of their maternal role.
- Distinct structural determinants of failure in morse taper and internal hex implant systemsPublication . Gehrke, Sergio Alexandre; Coura, Gustavo; Mello, Bruno Freitas; Formiga, Márcio de Carvalho; Scarano, Antonio; Fernandes, Juliana Campos Hasse; Fernandes, Gustavo Vicentis Oliveira; Buzzi, Fátima de CamposObjectives: To evaluate the influence of implant–abutment connection design, implant diameter, and simulated marginal bone loss on fracture resistance and failure patterns of dental implant systems. Materials and Methods: A total of 180 implant–abutment assemblies were tested, including Morse taper (MT) and internal hex (IH) connections with diameters of 3.5, 4.0, and 5.0 mm. Implants were embedded at two simulated bone levels (0 and 3 mm) and loaded at 30° until failure, in accordance with ISO 14801:2015. Fracture resistance (N) was analyzed using three-way ANOVA. Results: Connection type, implant diameter, bone level, and their interactions significantly affected fracture resistance (p < 0.001). Internal hex implants showed a marked diameter-dependent increase in resistance and greater reduction under simulated bone loss, particularly in reduced diameters. In contrast, Morse taper implants demonstrated similar resistance values regardless of implant diameter or bone level. Failure patterns also differed between systems: internal hex implants exhibited cervical implant fractures in reduced diameters, whereas Morse taper implants showed progressive abutment deformation and/or abutment fracture without implant body fracture. Conclusions: Implant fracture resistance is strongly influenced by implant–abutment connection geometry. Within the limitations of this static in vitro study, MT systems demonstrated diameter-independent mechanical stability and prosthetic-controlled failure patterns, whereas IH systems were highly sensitive to diameter reduction and simulated bone loss.
- Sensorimotor rehabilitation using viscoelastic material for upper limb recovery after stroke: a case reportPublication . Agostinho, Inês; Temudo, Ana; Bacelo, Sérgio; Oliveira, Vítor; Bernardes, Rafael; Sousa, LuísUpper limb impairment after stroke is a major contributor to functional dependence and reduced quality of life. Although sensorimotor rehabilitation strategies are recommended to promote motor recovery, evidence regarding the therapeutic use of viscoelastic materials remains limited. This case report describes the outcomes of a rehabilitation nursing intervention using a viscoelastic product in a 56-year-old man with multifocal ischemic stroke and left upper limb impairment. The patient completed a 21-day rehabilitation nursing program comprising eight sessions that combined conventional upper limb rehabilitation exercises with sensorimotor stimulation using a viscoelastic product. Functional outcomes were assessed using the Medical Research Council Scale, the Barthel Index, and the Functional Independence Measure. Muscle strength improved from grades 1–3 to grades 4–5 on the Medical Research Council Scale. Functional recovery included improvements in dynamic balance, gait performance, and independence in activities of daily living, with the Barthel Index increasing from 75 (moderate dependence) to 95 (mild dependence). No follow-up data beyond hospital discharge were available to evaluate the long-term maintenance of these functional gains. This case suggests that incorporating a viscoelastic product into a rehabilitation nursing program is feasible and may contribute to improvements in upper limb motor performance and functional independence following stroke. Further prospective studies with larger samples and longer follow-up are warranted.
- Adhesion of Candida albicans and Streptococcus mutans to the surface of a 3D-printed resin used for the fabrication of prosthetic basesPublication . Quezada, Margarida Martins; Fonseca, Patrícia; Gomes, Ana T. P. C.; Duarte, Ana S.; Fernandes, Hugo R.; Correia, André; Salgado, HelenaBackground: Surface roughness and microbial adhesion are key determinants of the biological performance of prosthetic base resins. This study evaluated Candida albicans (ATCC 11225) and Streptococcus mutans (DSM 20523) adhesion to a conventional heat-polymerized acrylic resin (Probase Hot) and a 3D-printed resin (V-Print dentbase) fabricated at 0° and 90° build orientations. Methods: Fifteen disc-shaped specimens (10 mm × 2 mm) were polished using a standardized protocol and surface roughness was characterized by contact profilometry (Ra). After UV sterilization, specimens were incubated for 24 h with standardized suspensions of C. albicans or S. mutans. Microbial adhesion was assessed qualitatively by scanning electron microscopy (SEM). Statistical analysis was performed using one-way ANOVA with Tukey’s post hoc test after confirmation of normality (Shapiro–Wilk) and homogeneity of variances (Levene). Statistical significance was set at p < 0.05, and Cohen’s d was calculated to estimate effect size. Results: Surface roughness differed significantly among fabrication conditions (p = 0.017), with the conventional heat-polymerized resin showing the highest Ra values and the 3D-printed resin fabricated at 90° presenting the lowest roughness. SEM observations suggested a similar adhesion pattern for both C. albicans and S. mutans, with greater apparent microbial presence on 90°-printed specimens, followed by the conventional heat-polymerized resin, whereas 0°-printed specimens showed lower apparent adhesion in the analyzed fields. Conclusions: These findings suggest that printing orientation may influence surface-associated microbial adhesion patterns in 3D-printed prosthetic resins; however, further studies with larger sample sizes, orientation-specific surface characterization, and mono- and multispecies biofilm models are warranted to confirm these preliminary findings.