FCSE - Contribuições em Revistas Científicas / Contribution to Journals
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- Right to health: (In) congruence between the legal framework and the health systemPublication . Mitano, Fernando; Ventura, Carla Aparecida Arena; Lima, Mônica Cristina Ribeiro Alexandre d’Auria de; Balegamire, Juvenal Bazilashe; Palha, Pedro FredemirObjective: to discuss the right to health, incorporation into the legal instruments and the deployment in practice in the National Health System in Mozambique. Method: this is a documentary analysis of a qualitative nature, which after thorough and interpretative reading of the legal instruments and articles that deal with the right to health, access and universal coverage, resulted in the construction of three empirical categories: instruments of humans rights and their interrelationship with the development of the right to health; the national health system in Mozambique; gaps between theory and practice in the consolidation of the right to health in the country.Results: Mozambique ratified several international and regional legal instruments (of Africa) that deal with the right to health and which are ensured in its Constitution. However, their incorporation into the National Health Service have been limited because it can not provide access and universal coverage to health services in an equitable manner throughout its territorial extension and in the different levels of care. Conclusions: the implementation of the right to health is complex and will require mobilization of the state and political financial, educational, technological, housing, sanitation and management actions, as well as ensuring access to health, and universal coverage.
- Risk factors for mortality in end-stage kidney disease patients under online-hemodiafiltration: three-year follow-up studyPublication . Sousa-Martins, Pedro; Moura, Alexandra; Madureira, José; Alija, Pablo; Oliveira, José Gerardo; Lopez, Martin; Filgueiras, Madalena; Amado, Leonilde; Sameiro-Faria, Maria; Miranda, Vasco; Mesquita, Edgar; Teixeira, Laetitia; Santos-Silva, Alice; Lobato, Luísa; Costa, ElísioEnd-stage kidney disease (ESRD) patients under dialysis have high mortality rate. Infl ammation, poor nutritional status and disturbances in erythropoiesis and iron metabolism have been reported in these patients. Moreover, there is a growing concern about the health related quality of life (HRQOL) in the context of ESRD. The aim of this work was to study the predictive value of these disturbances, dialysis adequacy and of HRQOL for mortality risk, by performing a three-year follow-up study. Clinical, socio-demographical and analytical data (dialysis adequacy, nutritional status, hematological data, lipid profi le, iron metabolism and infl ammatory markers) were obtained from 236 patients (61.02% male; 67.50 [56.00-75.00] years old) under online-hemodiafi ltration. Patient’s reported HRQOL score was assessed by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF). 54 patients died during the 3 years follow-up period. Our data showed that mean cell hemoglobin concentration (MCHC), transferrin and albumin are signifi cant predictors of mortality. The risk of death was higher in patients presenting lower levels of MCHC (Hazard ratio [HR] = 0.70; 95% confi dence interval [CI] = 0.500-0.984), transferrin (HR = 0.99; 95% CI = 0.982 – 0.998), and albumin (HR = 0.96; 95% CI = 0.938- 0.994). Our study showed that poor nutritional status and an infl ammatory-induced iron depleted erythropoiesis are important factors for mortality in these patients. MCHC, transferrin and albumin may provide useful biomarkers of risk in ESRD patients under OL-HDF.
- A nursing staff model: the impact in nursing carePublication . Parreira, Pedro Miguel; Freitas, Maria João; Marôco, JoãoBackground: The need for adequate nursing resources to the real needs of customers is a key priority for excellence in the quality of nursing care. Hence, it is important to create nursing staff models that assess the impact in nursing care. However there has been no consensus on what variables include, constituting a current concern for managers, in particular with regard the safety in health care. Aim: This research aimed to evaluate the fit of a nursing staff model and their impact on the Nursing Care. Materials And Methods: A quantitative study, transversal and correlational was conducted. Data collection was collected through a questionnaire with three samples: nurses (629), nurses bosses (43) and clients (1290), from 43 hospitals in 8 units with different management models. The psychometric assessment study was conducted through exploratory factor analysis and confirmatory factor analysis who demonstrated adequate validity and reliability for the evaluation of the variables of nursing staff model. Results: The trajectory "Safe Environment → Quality Nursing Care" is statistically significant (BMAS.CESQ = 0.18; SE = 0.08; βMAS.CESQ = 0.15; p = 0.026) so, higher in security work environment, increase the perception of nursing care insurance and quality. Moderate and significant linear correlation (r = 0.49) between the "availability of nurses in adequate quantity" and "availability of nurses with appropriate mix of skills.“ The trajectories "Availability of nurses with appropriate mix of quality nursing skills and care" (BQUAL.CESQ = -0.02, SE = 0.04; βQUAL.CESQ = -0.03; p = 0.663) and "Availability of nurses in adequate quantity and quality of nursing care "(BQUAN.CESQ = 0.04; SE = 0.16; βQUAN.CESQ = -0.02; p = 0.791) did not reveal statistically significant. Discussion and conclusions: The indicators (manifest variables) associated with each of the latent variables from the nursing staff model are relevant to the explanation of the model. The indicators range globally, from moderate relevant to highly relevant. Latent variables presenting β> 0.6. The model reveals acceptable indices of goodness of adjustment, so it is appropriate to explain the relationships between variables. The variables "Availability of nurses with appropriate mix of skills and the adequate quantity” have weak correlations with the perception of "quality nursing care", and the skills of nurses are perceived as less relevant. The Safe Environment is not interdependent on the availability of nurses, yet it is perceived as a very important factor for the promotion of "quality nursing care." The "availability of nurses with the right mix of skills", the "availability of nurses in adequate quantity" and the "safe environment" (Structure variables) explain 2% of the variance of the variables of "quality nursing care" (process variables).
- Social representation about entrepreneurship in high education: an empirical study about the acquisition of entrepreneurial skills with portuguese nursing studentsPublication . Parreira, Pedro Miguel; Salgueiro, Anabela; Castilho, Amélia; Arreguy-Sena, Cristina; Oliveira, Denize; Carvalho, Carla; Mónico, Lisete; Freitas, Maria JoãoBackground: The social representations are socially produced that guide behavior and intervene in the individual and social identity. It is important to understand how the cognitive dimension is assimilated by entrepreneurship students and the changes that they are able to perform in the rational domain in the event of attending training sessions. Aim: To describe the content and structure of the social representations of entrepreneurship among Portuguese students, before and after educational interventions. Materials and methods: Qualitative research based on the Theory of Social Representations, in its structural approach, conducted at a higher education institution in Portugal (Coimbra). A population of 4th-year (final year) undergraduate nursing students in Portugal (Nursing School of Coimbra) was analyzed in two moments, 192 students in the first moment and 139 in the second moment. Participants were asked to answer the following question: “Write down the first five words or expressions that come to your mind when you read the word –Entrepreneurship. Answers were analyzed by specific software, the EVOC and SIMI software (Vèrges, 1993a), 2005 version, through the techniques developed by Vèrges (1987-1994). Results: The results indicate stabilization in both structures of representations. However, the prototypical categorization highlighted a richer and more organized structuring of students after the training sessions in entrepreneurship. This structure was more in line with the concepts of entrepreneurship, from the idea to business, where a path to success is visible. Concepts such as dynamism, research, discovery, proactivity, taking a risk, challenge, commitment, ambition, bet, and challenge emerged in a second periphery and, therefore, it is necessary to invest even more in training, thus stimulating the need for determination to undertake. Conclusions: A consistency in the formative and learning processes was observed, consistent with the dimensions of concepts considered as important to undertake. Positive attitudes emerged that guided the representation under study, in line with the development of the core competencies to undertake.
- Effect of short-term practice of breathing exercises on the breathing capacity in school-age girlsPublication . Costa, Hélder J. T.; Moreia, Cristiano C. F.; Gomes, Elisabete M. C.; Leão, António A. I.Background: The breathing mechanism has existed since our birth and accompanies us throughout life. Breathing is an important function in the regulatory process of numerous body functions, its optimization can bring many health benefits. However, many children are unaware of the mechanisms of breathing, namely abdominal or diaphragmatic breathing, and in addition to this, many breathe normally through their mouths. Methods: The present study aimed to verify the influence of a short-Term breathing exercise program in school-Age girls breathing capacity. Fourteen female students aged between 8 and 10 years were selected, from this selection two groups were formed, the control group (CG) with 7 children and the experimental group (EG) with 7. Through a spirometric test, an assessment of breathing capacity (ABC) was carried out for both groups. The GE participated in a program of breathing exercises (BEP) lasting 15 to 20 minutes for 5 weeks. Then, the ABC was performed again for both groups. Discussion: The results demonstrate a significant increase in the values (p 0.01) of the forced vital capacity (FVC) of the EG, thus suggesting that the application of a BEP promotes the breathing capacity of school-Aged girls. Further studies should be performed with larger samples and with a longer protocol.
- Critical patient’s comfort: strategies to reduce environmental noise levelsPublication . Ramos, Telma; Veludo, FilipaBackground: Noise may have harmful effects. For critically ill patients, highlights have main consequences cardiovascular disorders, reduction of arterial oxygen saturation, increase in gastric secretion, stimulation of the pituitary gland, sleep disturbance, immunosuppression and reduction of the cicatrisation process [1]. Noise has an overall negative impact on patients’ recovery. Identification and dissemination of strategies to reduce environmental noise empowers nurses towards changes in their professional practice. Objective: Identify evidence in Literature of nursing care strategies to reduce environmental noise in critical patient care. Methods: This research was conducted in two phases. 1st Phase: Mediated by an integrative literature review (16/04/2017) we carried out data-base research through the Academic Search Complete; Complementary Index; CINAHL Plus with Full Text; Directory of Open Access Journals; Supplemental Index; Psychology and Behavioural; Sciences Collection; SPORTDiscus with Full Text; RCAAP; SciELO; Europeana; Business Source Complete; Education Source; IEEE Xplore Digital Library; MedicLatina; JSTOR Journals; PsycARTICLES; ScienceDirect. Descriptors: (TI (Noise*or sleep*) AND (Nurs*) AND (intervention or care or patient care or care plan* or critical care), non-temporal. Inclusion criteria: Primary, secondary, opinion/reflexion studies. Exclusion Criteria: Paediatrics context, REM, pharmacological intervention. From the initially 441 articles obtained, we excluded 391 by reading abstracts, 22 by summary and 15 by the complete text, concluding with 13 articles as final sample. 2nd Phase: Content analysis according to [2] in order to categorize results. Results: We have identified 6 feasible categories for environmental noise reduction, which we present as main strategies: Behavioural changes (creation of awareness to the importance of the tone of voice and silent handling of equipment and materials); Material and Equipment management (mobile phones, televisions and radios volume configuration; determination of correct parameters for alarm configuration); Management of silence promotion care (implementation of periods of silence, avoid noisy tasks); Training in environmental noise (behavioural change programs and health education about negative effects of noise); Care quality control (usage of ear plugs); Others (infrastructural adaptations, encourage suppliers to produce more silent products). Conclusions: This study systematizes strategies to be implemented by nursing professionals in order to reduce environmental noise within health structures and improve patient comfort. The implementation of a silence culture enables an adequate and essential physical environment to patient recovery [3]. Empower nurses with the identified strategies allows the improvement of people’s quality of life. The shortage of published research reflects the need of forward research.
- Criar e reinventar o futuro: diferentes abordagens, novos caminhos na literacia em saúde em adolescentesPublication . Carvalho, Margarida; Lourenço, Margarida
- Burned patient care at the emergency servicePublication . Amaral, Carla; Rabiais, Isabel; Antunes, Anabela; Francisco, MariaIntroduction: The burned patient is deined as a trauma patient, who requires multidisciplinary care, since the severity of the burns go far beyond the partial or total destruction of the skin thickness, whence, can compromise several organs and, according to its severity, may lead to multiple organ failure, therefore, an early approach imposes clinical procedures and protocols based on evidence (DGS, 2012). Objectives: Standardize the interventions of burn patients in the emergency service, in order to correctly assess and proceed to prevent complications. Methods: We conducted a integrative literature review of 7 scientiic articles, in Portuguese language, in the last 5 years, which identiied a set of interventions and recommendations, according to the criteria of the CDC/HICPAC, which categorizes them based on existing scientiic data, logical reasoning, applicability and economic impact thus integrating the category IA (evidence level A, recommendation grade I). Results: The irst set of treatments done to the burned patient on care, not only includes the injuries originated by the causal agent, but also the maintenance of airway permeability, luid replacement and pain control, with the purpose to decrease the complications due to trauma. The treatment is established according to the severity of injuries from exposure, type and degree of commitment. Conclusions: An updated knowledge, allows the identiication and prevention of subtle changes that can trigger major complications, minimizing both the mortality and morbidity rates, as the longterm injuries, helping these patients to have a satisfactory life quality allowing them a social, professional and family integration.
- A segurança do doente é influenciada pelo ambiente da prática de cuidados dos enfermeiros que trabalham em serviço de urgência? Uma revisão integrativaPublication . Azevedo, Luciana Ramos de; Sousa, Ana Sabrina; Coelho, Sílvia Patrícia FernandesIntrodução: A identificação de fatores que possam influenciar a segurança do doente possibilita a implementação de melhorias nos cuidados prestados reduzindo a ocorrência de possíveis danos para os doentes. A realização deste estudo prende-se com a necessidade de identificar os erros ocorridos na prestação de cuidados a doentes num serviço de urgência. Objetivo: Identificar os fatores que influenciam a segurança do doente em serviço de urgência. Materiais e Métodos: Revisão integrativa realizada na base de dados Ebsco no período de 2017 a 2019, descritores MeSH combinados por operador boleano AND: “medication errors or drug errors or medication administration errors or drug administration errors”, “emergency room or emergency department” e “nurse or nurses or nursing”. Como critérios de inclusão foram definidos os artigos que se adequavam ao objetivo deste estudo e foram excluídos todos os artigos duplicados, artigos referentes a unidades de cuidados intensivos e a pediatria e artigos que não se adequavam ao objetivo do estudo. Resultados: Os 17 artigos analisados revelaram que os fatores relacionados com a elevada afluência de doentes ao serviço de urgência, a sobrecarga de trabalho, a escassez de recursos humanos e as interrupções constantes levam a ocorrência de erros e consequente risco para a segurança do doente. Conclusão: Devem ser criadas condições físicas e humanas para a prática segura dos cuidados, reduzindo a ocorrência de erros e assegurando a segurança do doente em serviço de urgência.
- Instrumentos de avaliação da dispneia e tosse em cuidados paliativos: revisão sistemática da literaturaPublication . Cruz, Ângela; Oliveira, Cátia; Capelas, Manuel LuísA uniformização de instrumentos de avaliação de sintomas em cuidados paliativos facilita a comunicação e promove a melhoria dos cuidados.Contribuindo para essa uniformização em Portugal, pretendeu-se conhecer quais os instrumentos mais frequentemente utilizados em investigação em cuidados paliativos no período de Fevereiro de 2000 a Fevereiro de 2014 para avaliação da dispneia e da tosse, e se estes estavam validados para a população portuguesa. Método: Revisão sistemática da literatura realizada em 2014 utilizando as bases de da-dos eletrónicas, Pubmed e EBSCO. Resultados: Selecionadas 31 publicações relativas à dispneia. Identificados 8 instrumentos diferentes (3 unidimensionais, 2 multidimensionais e 3 de qualidade de vida).Selecionadas 4 publicações relativas à tosse. Identificados 3 instrumentos diferentes; 2 multidimensionais e 1 de qualidade de vida.Conclusão: Relativamente à dispneia a maioria dos estudos utilizou instrumentos de avaliação unidimensionais destacando-se a Edmonton Symptom Assessment Scale(ESAS) e a Visual Analogue Scale (VAS). O total de publicações relativas à tosse não permitiu com evidência garantir tais conclusões. Quanto à validação para Portugal dos instrumentos identificados, existe espaço para melhoria..