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- Construction and evaluation of an educational video: nursing assessment and intervention of patients’ spiritual needsPublication . Rodrigues, Juliane Cristina; Miranda, Talita Prado Simão; Fulquini, Francine Lima; Guilherme, Caroline; Caldeira, Sílvia; Carvalho, Emilia Campos deSpirituality is particularly important in health and illness transitions and is a fundamental dimension of healthcare. However, nurses often feel underprepared to provide spiritual care and the use of dynamic and interactive strategies, such as educational videos, can facilitate the development of this competency in undergraduate education. This study aimed to construct and evaluate an educational video lasting 10 min and 52 s for nursing students concerning the assessment of patients’ spiritual needs. The methodological study was based on the pre-production, production, and post-production phases of the video with an evaluation of the comprehension and comprehensiveness of the content. The results demonstrated the pre-production phase was considered appropriate by the judges and allowed the phase of production of the educational video, considered an educational resource by 100% the experts. Nursing students were enrolled in the evaluation and 75% considered the content and the learning experience useful for their future roles as nurses. So, the educational video was considered a tool that facilitated deepening knowledge about spirituality and motivated students to assess spirituality in clinical practice.
- Translation and adaptation of the Spirituality and Spiritual Care Rating Scale in portuguese palliative care nursesPublication . Martins, Andreia Raquel; Pinto, Sara; Caldeira, Sílvia; Pimentel, FranciscoTheoretical framework: The knowledge on spirituality in Nursing has increased in Portugal, but there is still low evidence on the nurses’ perception of this dimension of care, as well as limited instruments in portuguese which allow measuring related phenomena. The Spirituality and Spiritual Care Rating Scale (SSCRS) allows assessing the nurses’ perception of spirituality and spiritual care. Objectives: To translate, adapt and validate the SSCRS into portuguese in a sample of portuguese palliative care nurses. Methodology: Methodological study using a sample composed of 94 palliative care nurses. Results: The original structure of the 17-item scale was maintained during the scale validation process. A Cronbach’s alpha between 0.59 and 0.69 in the subscales and 0.76 in the total scale was obtained. These values are indicators of the scale’s reasonable reliability to be used in the population under study. Conclusion: The portuguese version of the SSCRS proved to be a reliable scale with content validity to assess the nurses’ perception of spirituality and spiritual care.
- Depression and spiritual distress in adult palliative patients: a cross-sectional studyPublication . Velosa, Teresa; Caldeira, Sílvia; Capelas, Manuel LuísPalliative care patients have been associated with a high probability of having depression and spiritual distress. However, there is a gap in research about the clinical indicators that can promote an effective differential diagnosis of depression and spiritual distress. This study aimed to identify the prevalence and the clinical indicators of depression and spiritual distress in palliative patients in primary care. An observational and cross-sectional study was conducted in 2016 in a Portuguese primary care unit. From a General Practitioners patients’ file of 1457 adult patients, a sample of 30 palliative patients was recruited throughout two steps: (1) selection of patients with chronic disease criteria; (2) selection of patients with Prognostic Indicator Guidance criteria. Exclusion criteria included cognitive impairment and psychotic disorders. Participants completed the self-assessment Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Chronic Illness Therapy—Spiritual Well-Being Scale (FACIT-Sp12) scales, which were sealed in opaque envelopes. Clinical data collection used semi-structured interviews for the diagnosis of depression and spiritual distress. The prevalence of depression was 23% (n = 7), while the prevalence of spiritual distress was 23% (n = 7). Four patients (13%) fulfilled both the depression and the spiritual distress criteria. Depression and spiritual distress seem to be both linked to the spiritual dimensions of the human being, but seem to differ in the dimensions of suffering and pharmacologic treatment.
- Spirituality in nursing: an overview of research methodsPublication . Martins, Helga; Romeiro, Joana; Caldeira, SílviaSpirituality has been widely considered important for patients’ health and for healthcare practice and is related to connectedness, meaning in life, and transcendence. Research concerning spirituality is growing rapidly, and the implementation of spiritual care should be based on evidence. This literature review aims to describe the methods that have been used in nursing research focusing on spirituality. The electronic search on databases through EBSCOhost identified 2091 citations, and a total of 231 studies were included. The methods used in research on spirituality in nursing are mostly quantitative (52.4%), but some are qualitative (42.8%) and mixed (4.8%). Regarding the quantitative research, most studies are observational (90.9%), and these are mainly descriptive (82.7%) and correlational (17.3%). Most studies used a cross-sectional design (98.7%), and few used longitudinal design (1.3%). The qualitative research is descriptive (39.4%), phenomenological (26.3%), and grounded theory (14.1%). Research on spirituality in nursing is based on both main paradigms (quantitative and qualitative), but also on mixed methods. Studies have mainly been conducted using cross-sectional designs when compared to longitudinal designs. The latter seem to constitute a gap in nursing knowledge and evidence regarding the changes of spirituality over time, which is particularly important for nurses’ delivery of spiritual care.
- Validation of nursing diagnoses - The Differential Diagnostic Validation Model as a strategyPublication . Caldeira, Sílvia Maria Alves; Chaves, Érika de Cássia Lopes; Carvalho, Emília Campos de; Vieira, Margarida Maria da SilvaObjective: to analyze the contribution and limits of the use of Richard Fehring’s differential diagnostic validation model, as a methodological strategy in the validation of diagnoses. Method: theoretical review about the differential diagnostic validation model for the validation of NANDA-I nursing diagnoses. Results: the nursing diagnosis constitutes the step that precedes and promotes the appropriate nursing intervention. The correct identification of the diagnosis is fundamental for effective interventions.The presentation of a structured classification of diagnoses, such as for example the taxonomy II of NANDA-I, facilitates the clinical judgment of the nurse. It is necessary that the diagnoses are clear and that the defining characteristics are specific, and the validation studies contribute to this objective. Conclusions: the differential diagnostic validation model permits the validation of differences between diagnoses with very similar meanings; however, it is little known and applied in the validation studies. It is a methodology that can be useful for the accuracy of diagnoses and for contribution to the current discussion of taxonomy II and its new proposals. Descriptors: nursing; nursing diagnosis; validation studies. RESUMO Objetivo: analisar a contribuição e limites no uso do modelo diferencial de diagnósticos de Richard Fehring, como estratégia metodológica na validação de diagnósticos. Método: revisão teórica sobre o modelo diferencial para a validação de diagnósticos de enfermagem da NANDA-I. Resultados: o diagnóstico de enfermagem constitui a etapa que precede e favorece a intervenção adequada do enfermeiro. A identificação correta do diagnóstico é fundamental para que as intervenções sejam eficazes. A apresentação sistematizada dos diagnósticos em classificações, como por exemplo a taxonomia II da NANDA-I, facilita o julgamento clínico do enfermeiro. É necessário que os diagnósticos sejam claros e que suas características definidoras sejam específicas, e os estudos de validação contribuem para esse objetivo. Conclusão: o modelo de validação diferencial permite validar as diferenças entre diagnósticos com significados muito semelhantes; contudo, está pouco divulgado e aplicado nos estudos de validação. É uma metodologia que pode ser útil para a acurácia dos diagnósticos e para a contribuição na discussão atual da taxonomia II e suas novas propostas. Descritores: enfermagem; diagnóstico de enfermagem; estudos de validação. RESUMEN Objetivo: analizar la contribución y límites en el uso del modelo diferencial de diagnósticos de Richard Fehring, como estrategia metodológica en la validación de los diagnósticos. Metodología: revisión teórica sobre el modelo diferencial para validación de diagnósticos de enfermería de NANDA-I. Resultados: el diagnóstico enfermero es la etapa que precede y promueve la adecuada intervención de la enfermera. La identificación de un diagnóstico correcto es fundamental para que las intervenciones sean de clasificación efectiva. La presentación estructurada de diagnósticos, tales como la taxonomía II de NANDA-I, facilita el juicio clínico de las enfermeras. Se espera que los diagnósticos sean claros y que sus características definitorias sean especificas y son los estudios de validación que contribuyen a este objetivo. Conclusiones: el modelo diferencial de validación de diagnóstico se utiliza para validar el diagnóstico diferencial con las diferencias entre los significados muy similares, sin embargo, es poco conocido y aplicado en los estudios de validación. Se trata de una metodología que puede ser útil para la exactitud del diagnóstico y por su contribución actual a la discusión de la II taxonomía y sus nuevas propuestas.Parte superior do formulario. Descriptores: diagnósticos de enfermería; enfermería; estudios de validación.
- Undergraduate nursing students’ competencies in disaster scenarios: from educational needs to curricula regulationPublication . Santos, Paulo Alexandre Figueiredo dos; Rabiais, Isabel Cristina Mascarenhas; Berenguer, Sílvia Maria Alves Caldeira; Amendoeira, José Joaquim PenedosBackground: Nurses play a central role in disaster preparedness, so appropriate disaster-related education is essential. However, almost all Portuguese undergraduate nursing curricula do not address disaster situations. Objective: To understand nursing schools’ contribution to developing undergraduate students’ knowledge and skills in disaster scenarios and the existing constraints on integrating this content into undergraduate nursing curricula. Methodology: A qualitative study with methodological triangulation, including interviews and focus group, was carried out to explore the perceptions of 35 nurse teachers and 6 nurses with experience in health care provision in disaster scenarios, about integrating disaster-related content into nursing curricula. Results: The study reveals that disaster management and preparedness should be integrated into undergraduate nursing education to guarantee the effective development and more objective regulation of students’ skills in this area. Conclusion: Portuguese nursing schools need to promote and develop undergraduate training in disaster preparedness and a more inclusive and objective regulation of this area.
- Nursing diagnosis of ‘‘spiritual distress’’ in women with breast cancer prevalence and major defining characteristicsPublication . Caldeira, Sílvia; Timmins, Fiona; Carvalho, Emília de; Vieira, MargaridaBackground: Spirituality and spiritual needs of cancer patients are frequently mentioned in the nursing literature, but the most significant defining characteristics of spiritual distress in the context of clinical reasoning and nursing diagnosis are rarely explored. Understanding of these is important for effective spiritual intervention. Objective: The aim of this study was to identify the prevalence and the defining characteristics of the nursing diagnosis ‘‘spiritual distress,’’ as classified according to NANDA International, among women with breast cancer. Methods: This was a quantitative and cross-sectional study, comprising the third phase of a larger study investigating the clinical validation of spiritual distress in cancer patients undergoing chemotherapy. Fehring’s clinical diagnostic validation model was used to identify the prevalence and the major defining characteristics of the diagnosis. A convenience sample was used, and data were collected by structured interview. Results: A total of 70 women participated; most were married (62.9%) and had a mean age of 54 years, and 55.7% reported having at least 1 person depending on them. The average length of time since the cancer diagnosis was 30.9 months. Twenty-seven participants were experiencing spiritual distress (38.6%). Eleven defining characteristics were classified as major. Conclusions: The prevalence of spiritual distress and the major defining characteristics give clinical evidence about the nurse’s role in providing spiritual care. The results are useful for the improved use of the NANDA International diagnoses within this domain. Implications for Practice: The findings highlight the importance of assessing the defining characteristics of the diagnosis as an objective strategy to improve clinical reasoning related to spirituality and to facilitate more effective interventions.
- Clinical indicators of sexual dysfunction in pregnant women: integrative literature reviewPublication . Carteiro, Dora Maria Honorato; Sousa, Lisete Maria Ribeiro de; Caldeira, Sílvia Maria AlvesObjective: to identify the nursing diagnosis clinical indicators of sexual dysfunction in pregnant women. Method: it is an integrative literature review, with research in databases using the keywords “sexual*”, “pregnan*” and “function*”. Studies included had an abstract available for analysis, referring to pregnant women over 18 years old, written in Portuguese, French, Spanish and English, with publication date between 2010 and 2014. Studies that reporting pregnant women with an associated pathology were excluded. Results: sexual dysfunction in pregnant women is consistent in the literature. Nine defining characteristics were identified and 16 related factors, some not classified in NANDA International. Conclusion: clinical indicators can be added to the nursing diagnosis to favor an accurate diagnosis and effective interventions in the surveillance of pregnancy as a period of healthy sexual experience.
- Oxford Textbook of Spirituality in HealthcarePublication . Caldeira, Sílvia Maria AlvesA primeira edição do livro “Oxford textbook of spirituality in healthcare” foi publicada em Outubro de 2012 e vem reunir, de um modo sistematizado e abrangente, o conhecimento fundamental para a atenção que é esperada dos profissionais de saúde perante a espiritualidade dos seus pacientes. Esta obra resulta da colaboração de oitenta e uma personalidades com reconhecida investigação e publicação científica sobre a temática, em diversas vertentes e que representam diferentes disciplinas aferentes à área da saúde, como por exemplo a teologia, a filosofia e a ética. Entre esses contribuidores encontram-se os três editores, Mark Cobb, Christina Puchalski e Bruce Rumbold, cuja investigação se evidencia na área da espiritualidade e nos cuidados paliativos. O prólogo é de Edmundo Pellegrino, eticista, que enfatiza a natureza multidisciplinar da obra e a sua importância para clínicos, investigadores ou professores.
- A systematic literature review toward the characterization of comfortPublication . Pinto, Sara; Caldeira, Sílvia; Martins, José CarlosComfort integrates the taxonomies and the classifications of nursing knowledge. Its meaning is not yet clear, although it is an important construct from which theories are developed. This article aims to analyze comfort in nursing scientific literature. The results highlight a particular interest in comfort at crisis situations such as illness, palliative care, or intensive care. Comforting seems to be a complex intervention. More studies are needed to achieve its operational assimilation and implementation in clinical practice, as well as the evaluation of its efficiency and effectiveness.