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- Does symptom recognition improve self-care in patients with heart failure? A pilot study randomised controlled trialPublication . Sousa, Joana Pereira; Neves, Hugo; Pais-Vieira, MiguelPatients with heart failure have difficulty in self-care management, as daily monitoring and recognition of symptoms do not readily trigger an action to avoid hospital admissions. The purpose of this study was to understand the impact of a nurse-led complex intervention on symptom recognition and fluid restriction. A latent growth model was designed to estimate the longitudinal effect of a nursing-led complex intervention on self-care management and quality-of-life changes in patients with heart failure and assessed by a pilot study performed on sixty-three patients (33 control, 30 intervention). Patients in the control group had a higher risk of hospitalisation (IRR 11.36; p < 0.001) and emergency admission (IRR 4.24; p < 0.001) at three-months follow-up. Analysis of the time scores demonstrated that the intervention group had a clear improvement in self-care behaviours (beta Slope. Assignment_group = -0.881; p < 0.001) and in the quality of life (beta Slope. Assignment_group = 1.739; p < 0.001). This study supports that a nurse-led programme on symptom recognition and fluid restriction can positively impact self-care behaviours and quality of life in patients with heart failure.
- The effectiveness of education on symptoms recognition in heart failure patients to manage self-care: a systematic review protocolPublication . Sousa, Joana Pereira; Neves, Hugo; Lobão, Catarina; Gonçalves, Rui; Santos, MiguelAIM: Heart failure is a chronic disease with a complex regimen treatment. Patients must have to enroll in a disease management program to engage in self-care. However, symptom recognition is a difficult step to manage by patients, as they tend to wait for the symptoms to disappear. The aim of this study is to verify if patients with heart failure can recognize early signs of the disease. METHOD:A systematic review will be carried out to analyze the effectiveness of patient education in detecting heart failure symptoms. RESULTS:The systematic review will provide data to understand if patient education on heart failure symptom recognition is effective on reducing hospital admissions. CONCLUSIONS:Patients with heart failure struggle daily in balancing self-care. If not taught about what symptoms to expect, patients will sit and wait at home, resulting in severe hospital admissions. Previous systematic reviews and meta-analysis focused on associations among symptoms in individuals with heart failure, or on a multicomponent Heart failure management programs, with several teaching topics. This protocol for a new review, which will focus on symptom monitoring by patients with heart failure, and the development of this skill positively interferes with self-care and avoids hospital readmissions.
- Tradução e adaptação cultural da escala de confusão de NEECHAMPublication . Neves, Hugo; Silva, Abel; Marques, PauloApesar dos problemas e dos riscos associados à Confusão Aguda (CA), a literatura sugere grandes dificuldades no seu diagnóstico, por parte dos profissionais de saúde, nomeadamente, pelos enfermeiros. O uso de instrumentos de avaliação que, através da aplicação de critérios, permitam uma avaliação rigorosa sistematizada e que conduza a níveis de detecção mais eficazes, torna-se necessário. Com este estudo pretendeu-se traduzir e validar uma escala capaz de diagnosticar a CA de forma a promover a saúde e segurança do doente confuso. Após uma revisão sistemática da literatura optou-se pelo uso da escala NEECHAM Confusion Scale. O processo de tradução utilizado baseou-se no método recomendado pela International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Após a utilização da NEECHAM Confusion Scale observou-se uma elevada consistência interna (Alpha Cronbach=0,913), uma boa correlação com os scores da Escala de Glasgow (r=0,866 p=0,000) e divisão da escala em duas dimensões pela análise das cargas factoriais e pela análise da rotação varimax. Sugerimos e defendemos a importância da utilização da NEECHAM, associada a formação sobre o fenómeno, o que permitirá produzir melhores índices de reconhecimento, ao mesmo tempo que permitirá a validação de intervenções adequadas ao doente confuso.
- Delirium no idoso hospitalizado: alteração aguda dos domínios cognitivosPublication . Silva, Rosa; Sousa, Joana Pereira; Neves, Hugo Leiria; Faria, Honório Claúdio Moreira
- A nursing clinical data model for neuromuscular processes: content analysis of the Portuguese nursing customizationPublication . Neves, Hugo; Parente, PauloThis study targets the development of a nursing clinical data model for neuromuscular processes. To achieve this purpose, content analysis based on Bardin’s perspective was performed on the Portuguese nursing local customizations regarding neuromuscular processes, with the International Classification for Nursing Practice concepts and the ISO 18104:2014 used as encoding rules. From analysis of the data, a total of 1766 diagnoses were related to neuromuscular processes. After application of exclusion criteria, a corpus with a total of 900 diagnoses was subjected to content analysis. After application of the encoding rules, a total of 81 context units were obtained, and through an inductive approach, were defined into three categories: clinical findings (e.g. aphasia); negative judgment diagnoses (e.g. impaired communication); transition properties (e.g. preparation and knowledge). These interpretations were validated by experts in the field. This study not only demonstrates the need to standardize data, but also the importance of neuromuscular processes in nursing practice. We hope this study will guide the definition of a nursing clinical data model that will help in increasing complexity in the level of care provided with high impact in the patient’s quality of life.