R - Dissertações de Mestrado / Master Dissertations
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- Intervenções de enfermagem especializadas ao doente crítico portador de dispositivo de assistência ventricular esquerdaPublication . Simões, Andreia Ferreira; Marques, Rita Margarida DouradoThis Report falls within the scope of the Master’s degree in Nursing with specialization in Medical-Surgical Nursing, in the area of Nursing for the Critically-Ill Person, at the Lisbon School of Nursing at the Catholic University of Portugal, aiming to describe in a reasoned, critical and reflective way, the skills acquisition process inherent to the role of Specialist Nurse. To this end, an internship was carried out in two contexts diverging in its field of action – prehospital emergency and general intensive care unit. Overarching objectives were set for each context, such as the development of technical, scientific, ethical, and relational nursing skills specialized in caring for people with a critical condition and their families in the prehospital emergency context and in the intensive care unit. These objectives were achieved through the development of activities and/or experiences carried out in each context, which will be points of reflection in this Report, supported by scientific evidence. In addition to the skills of a Specialist Nurse, the competences inherent to a Master's degree were developed by carrying out a Scoping Review on Nursing Interventions for the Critically Ill Patient with Left Ventricular Assist Devices. Through this research, it was possible to map the evidence on nursing interventions in the areas of hemodynamics, infection control, hemorrhagic and thromboembolic control, interventions associated with the device, emotional support, nutritional support, among others, transferring the contributions of this research into specialized nursing practice during the internship. This report uses a descriptive and critical-reflective methodology to present and analyze the situations experienced, supported by scientific evidence and a theoretical background, allowing the development of Master's and Specialist Nurse’ competencies. The internship provided me with learning opportunities that led to the acquisition of a range of specialized skills, thus contributing to the development and construction of my identity as a future Specialist Nurse, consolidated through the production of this report.
- Abordagem à família em processo de doação de órgãos : um cuidado especializadoPublication . Silva, Ana Rita Ribeiro; Fernandes, Filipa Alexandra VeludoThe present report is carried out in the framework of the Medical-Surgical Nursing Specialization and master’s degree in nursing for the Person in Critical Situation, from the Nursing School of Lisbon, a division of the Universidade Católica Portuguesa, and intends to mirror the path taken in the acquisition and development of specialised clinical skills. While serving has a moment of evaluation in the scope of the curricular unit entitled “Final Internship and Report”, this work also aims to awarding of the academic title of Master and Medical-Surgical Specialist Nurse. The main goals of this endeavor are the methodical description and reflective analysis of the skills of a Master and Specialist Nurse, which were acquired and developed along the way, and to share the results obtained during this research. For this critical and reflective analysis, which integrates the theoretical “know how”, a path was carefully outlined that, while contemplating different experiences, ultimately lead to the acquisition of skills that are required for a specialist nurse. For that, three traineeship environments were selected: General Emergency Room, Specialised Intensive Care Unit and the General-purpose Intensive Care Unit. Besides the countless experience and knowledge exchanges during the traineeships, in different multidisciplinary teams, the work carried out allowed, along with the research work, the launch of a Scoping Review, which is, now, under review, with the aim of being submitted to scientific journals and presented in seminars. The research work carried out concerns a Scoping Review, conducted in the context of the needs of the family during organ and tissue donation, which, in turn, relates transversally to many of the traineeship’s scopes. Organ and tissue transplantation is a highly successful procedure due to the strives it witnessed in such a short amount of time. The technical and scientific advancements have allowed the enhancement of therapeutic options and quality of life. During the donation process, the family experiences several challenges that arise from the fear and lack of information that are inherent to it, which makes essential supporting the family while they cope with all the feelings and doubts. The role of the nurse is determinant in the provision of care not only to the donor, but also to the family, resulting in the creation of a therapeutical relationship. The experiences that the family goes through during the entirety of the process have been the target of discussion in many studies, since the acknowledgment of the needs of the family by healthcare professionals allows for a better adaptation of the former to the donation process. For that reason, the authors consider pertinent the conduction of a Scoping Review, based on the proposed methodology, with the goal of mapping the needs of the family during the donation process. By mapping the evidence on the chosen topic, four categories emerged: the need for information, emotional support, material and environmental needs and, finally, the need for follow-up. The theoretical points of reference, which contributed to the development of an excellent specialised care and guided the nursing doctrine behind this journey and work, were the Transitions Theory from Afaf Meleis and the study conducted by Patricia Benner entitled “Novice to expert”.
- Intervenção à pessoa vítima de trauma : atuação do enfermeiro especialistaPublication . Rolo, Beatriz Mateus de Matos; Rabiais, Isabel Cristina MascarenhasAs trauma is one of the main causes of death and temporary or permanent disability in most countries and considering the high rates of mortality and morbidity associated, it is required that healthcare professionals adopt an organized approach in providing care to the patient, highlighting the importance of decision-making and a systematic approach, with the aim of improving these results. Given my personal interest in providing care to people in critical situations with a personal motivation in the area of trauma and previous professional experience in an Emergency Service, I sought to ensure continuity of humanized, differentiated and essential care for people with this type of specificity and great complexity. In methodological terms, a scoping review was carried out and common and specific skills of specialist nurses and master’s in medical-surgical nursing were developed in nursing for People in Critical Situations, in three different locations: in an Extra Service-Hospital in a Multipurpose Intensive Care Unit, and in a prestigious Emergency Department in a Trauma Center in London. The analysis and reflection on the common and specific skills of specialist nurse led to the culmination of a constructive and enriching professional process, contributing to the awareness of acquired skills. Finally, the increase in the body of knowledge regarding trauma, acquired as a result of the research carried out, I think has been conductive to obtaining better clinical results in internship sites, as well as will certainly be beneficial in my daily clinical practice, as a nurse in an Emergency Department.
- Cuidados à pessoa vítima de trauma : contributo do enfermeiro especialistaPublication . Matos, Melissa Martins Silva de; Rabiais, Isabel Cristina MascarenhasTrauma can be defined as the result of energy exchange between the environment and the body, causing various injuries to different systems and organs, with implications for the mental, physical, social, emotional, and spiritual well-being of the individual. It is considered one of the main causes of death, reduced quality of life, and temporary or permanent disability in Portugal, requiring adjustments in the life of the individual/family and significant social and economic losses. Given the importance of the topic, specific training of professionals involved in the approach to individuals in critical trauma situations is necessary, ensuring a sequential and hierarchical approach aimed at stabilization and problem resolution. This report, conducted within the scope of the Master's Degree in Nursing with Specialization in Medical-Surgical Nursing in the Critical Care Nursing Area at the Lisbon School of Nursing of the Universidade Católica Portuguesa, aims to reflect on the acquisition and development of common and specific competencies of the Nurse Specialist. The main objectives of this report are to describe and critically analyze the formative journey that took place over the three semesters of the Master's program and to share the results of the research conducted, aiming at obtaining the academic degree of Master and the professional title of Specialist Nurse in Medical-Surgical Nursing. To achieve the proposed objectives, I interned in a Polyvalent Intensive Care Unit, in an Emergency Department of a Polyvalent Trauma Center in London, and in a Polyvalent General Emergency Department. In order to map out autonomous and interdependent nursing interventions for trauma victims, a Scoping Review was conducted in co-authorship with the research team titled "Nursing Interventions for Trauma Victims in the Emergency Department: A Scoping Review." The Theory of Transitions by Meleis et al. (2000) and the Theory of Clinical Wisdom in Acute and Critical Care by Benner et al. (2011) stand out as the theoretical frameworks that integrated the development of excellent specialized care and guided my academic journey.
- Abordagem à pessoa vítima de trauma no serviço de urgência : cuidado especializadoPublication . Gonçalves, Nuno Afonso; Rabiais, Isabel Cristina MascarenhasThe current Internship Report was developed within the Curricular Unit “Estágio Final e Relatório”, integrated in the Master's Degree in Medical-Surgical Nursing in the Specialization Area of Nursing for the Person in Critical Situation at the Nursing School of Lisbon from Universidade Católica Portuguesa. This report aims to defend and acquire the Master academic degree, supported by sharing the educational journey that took place throughout these three semesters of the master’s studies, by sharing the general and specific competences developed, communicating the results of clinical learning, and critically reflecting on the complex issues of the professional practice. Furthermore, this report aims to share the results of the research component, materialized in Scoping Review, focused on the theme “Nursing Interventions to the trauma victim in the Emergency Department: a Scoping Review”. Trauma can be defined as an illness resulting from the energy exchange between the environment and the body, causing various injuries to different systems and organs. In the Portuguese context, the accident and mortality rates attributed to trauma are among the highest in Europe. Road accidents in Portugal showed one of the worst indexes when compared to other European partners. Most individuals involved in accidents is young, of working age, which exacerbates the social impact of trauma. In this context, and given the problem outlined above, the importance of the Specialist Nurse’s role in caring for victims of trauma becomes clear. Thus, a Scoping Review was conducted with the goal of mapping the Specialist Nurse’ interventions in caring for trauma victims in the emergency department. Throughout this academic journey, my reflection and caregiving practices were primarily grounded in two Nursing theories, notably Patricia Benner’s Theory “Novice to expert” and “Transitions Theory” by Afaf Meleis.
- Estratégias de comunicação na transição de saúde - doença junto de crianças com necessidades especiais de saúde e pais : o papel do enfermeiro especialistaPublication . Ferreira, Ana Margarida Santos; Charepe, Zaida BorgesCommunication is a therapeutic tool in the discipline of Nursing and in the area of Child and Pediatric Health it is important for Specialist Nurses to develop communication skills, given the complexity of communicating with children/young people and their families in the context of the health-disease transition. Through therapeutic communication, it is possible to understand the needs of the person being cared for and, in this way, draw up a specific, holistic care plan with therapeutic intent, achieving health gains and, consequently, improving the quality of life of children/young people and their families, which I recognize as a paediatric patient. Recognizing the complexity of the subject, the central objective of this academic journey was: “To recognize communication strategies in the health-illness transition, with children and parents with special health needs, within the scope of the role attributed to the Specialist Nurse in Child Health and Paediatric Nursing”. In order to meet this objective, I would like to highlight Afaf Meleis's theoretical framework in terms of the fact that the literature considers communication to be a facilitating condition in the pediatric patient's healthdisease transition process. In addition, the applicability of Care Partnership Models is recognized as a facilitating strategy in communication with this target population. The contexts in which I traced my path were: the neonatology intermediate care unit, the pediatric emergency room and the pediatric inpatient ward. The main activities developed along this path included analyzing the care provided to pediatric patients who are going through the health-disease transition process, as well as identifying intervention strategies that promote the quality of life of this population, highlighting the opportunity to intervene in the field of communication of bad news and communication that promotes hope, developing information supports on existing support parental resources with the presentation of training actions in the context of the service, subordinated to the theme under study.
- Promover cuidados de saúde culturalmente competentes à criança e famíliaPublication . Aires, Débora Gutierrez Castanheira Ferreira; Charepe, Zaida BorgesThis report presents my internship experience in different contexts within the scope of the "Final Internship and Report" curricular unit of the master’s degree in Child and Pediatric Health Nursing at Universidade Católica Portuguesa, with a focus on providing culturally competent care. It aims to reflect the journey undertaken between September 14 and December 16, 2023, in three different contexts: The Pediatric Emergency Department, the Pediatric Medicine and Surgery Inpatient Department and the Neonatal and Pediatric Intensive Care Unit. Throughout the report I highlight the growing multiculturalism of the population and the importance of adapting nursing practices to meet the needs of these families. This report includes a review of the literature on culturally competent nursing care, based on Madeleine Leininger's Theory of Diversity and Universality of Cultural Care. The structure of the report covers the theoretical foundation, analysis of the training path in clinical internships and reflection on the skills acquired. Regarding the training path, it is worth highlighting the acquisition of master's and specialist nurse skills, based on some activities carried out, namely the presentations addressed to the teams on Culturally Competent Health Care and the case study developed within the scope of neonatology on the Therapeutic Communication in Cultural Care.
- Promover o conforto nos procedimentos dolorosos : intervenção do enfermeiro especialista em saúde infantil e pediátricaPublication . Costa, Catarina Isabel de Sousa; Berenguer, Sílvia Maria Alves CaldeiraPain is a complex and subjective, multifactorial experience with sensory components, but also emotional, cognitive, and behavioral components. It is a frequent experience in a child’s life that can result from trauma, illness, or invasive procedures. When a family and child or young person seek health care (either hospital units or primary health care units) painful procedures may occur and lead to pain discomfort. Pain in the child and/or youth and his family is complex in the way it is expressed, due to the specificities of each age group. Painful procedures are associated with pain and/or discomfort and these lead to fear and anxiety in children and their families. This report aimed at providing a critical and reflective perspective that contributed to the development of common skills of generalist specialist nurses, specialist nurses in Child Health and Pediatrics, and skills of specialist nurses with a master’s degree. Throughout the course of the Master’s in Nursing with a specialization in Child Health and Pediatrics Nursing, Katharine Kolcaba’s Theory of Comfort and the scooping review were used as support. General objectives were defined in all internship settings with a focus on comfort promotion and, subsequently, specific objectives were defined for each internship through the project methodology. This report includes the introduction to the report, the theoretical framework, its application in the area of pediatrics and the scooping review, the journey and the development of the nurse specialist’s skills in the different internship settings, and the conclusion.
- Crescer offline : intervenção de enfermagem comunitáriaPublication . Almeida, Ricardo José Mota de; Resende, Ana Maria Vieira SoaresPNS 2021-2030 establishes excessive internet use as a vulnerable need. In PNSE (2015), Qualification is a priority strategic axis and one of the areas of intervention related to the prevention of substanceless addictive behaviours, including the internet. The excessive and problematic increase in internet use has led WHO to develop activities related to its implications in public health (Poznyak, 2018). Since the community health and education systems are interconnected (DGS, 2015), school is an excellent space for health promotion. Thus, the project “Grow Offline – Community Nursing Intervention” was born. It was developed in a Community Care Unit, with the School Health team, belonging to a Group of Health Centres of the Regional Health Administration of Lisbon and Vale do Tejo. Its main objective is to contribute to the qualification of teenagers in a 6th year class, from a school in the UCC geodemographic region, to use the internet responsibly. The project was based on the Health Planning methodology and used Nola Pender's Health Promotion Model as a theoretical reference. The application of a data collection instrument, Internet Addiction Test, allowed the formulation of the situation diagnosis, subsequently the prioritization of problems and the enunciation of nursing diagnoses, according to the International Classification for Nursing Practice. In the strategy selection phase, a scoping review was carried out, with the main goal of identifying and maping interventions to aim internet addiction in teenagers: “Prevention and Control of Internet Addiction in Adolescents: Scoping Review”, contributing to the health education session and the delivery of leaflets to teenagers and their guardians. The project’s evaluation demonstrates gains in health, through increased knowledge by the adolescents regarding the intervention theme. This project allowed the acquisition and development of skills of Nurse Master Degree and Specialist Nurse in Community and Public Health Nursing, cooperating in the visibility of nursing as a science and profession.
- Capacitar os adolescentes para prevenir as infeções sexualmente transmissíveis : intervenção de enfermagem de saúde públicaPublication . Cardoso, Bárbara Marisa Franco Nunes da Silva; Garcia, Elisa Maria BernardoAdolescence is characterized by changes in development, causing ambivalence in the adolescent, in a process of seeking balance within themselves and with society. The school environment is a privileged place for nurses specializing in community and public health to intervene, to promote healthy lifestyles, health literacy and health-promoting environments. Worldwide adolescents, despite tending to be a healthy group, due to their curiosity and propensity to experiment and/or adopt risky behaviours, become a target of concern, with a high incidence of sexually transmitted infections. Portugal is no exception, which is why it is essential to invest in health policies that promote safe sexual behaviour. During the internship carried out at the Arnaldo Sampaio Public Health Unit (USPAS), a community intervention project “Let's Talk without Taboos – Practicing Safe Sex” was developed based on the Health Planning methodology, supported by theoretical framework Nola Pender's Health Promotion Model. The project's general objective was to contribute to the training of adolescents in the 11th year of Escola Secundária Jorge Peixinho to adopt safe sexual behaviours in the period between September 4, 2023, and January 31, 2024. To achieve this, it was defined specific objectives, targets, and indicators. Educational strategies used through a peer education methodology, as well as the establishment of partnerships, and a numerous activities were carried out, such as an awareness campaign on school grounds in reference to World AIDS Day, the dissemination of a video with the campaign's key messages and health education sessions for 11th grade classes. The entire project disclosed to the USPAS team, and the educational community involved in the project. The results of the evaluation demonstrated that the established goals achieved, with an improvement in the group's knowledge and awareness among the remaining 11th grade students on the topic.