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- Effectiveness of multisensory stimulation in managing neuropsychiatric symptoms in older adults with major neurocognitive disorder: a systematic review protocolPublication . Silva, Rosa; Cardoso, Daniela; Apóstolo, JoãoREVIEW QUESTION/OBJECTIVE: This review aims to identify and synthesize the effectiveness of multisensory stimulation in managing neuropsychiatric symptoms in older adults with major neurocognitive disorder.More specifically, this review focuses on the following questions: what are the effects of multisensory stimulation in managing neuropsychiatric symptoms such as delusion, hallucination, agitation, aggression, mood liability, anxiety, apathy, motor disturbances, night-time behavior and eating disorders in elderly patients with major neurocognitive disorder?
- Effects of caregiver-provided individual cognitive interventions on cognition, social functioning and quality of life in older adults with major neurocognitive disorders: a systematic reviewPublication . Silva, Rosa; Bobrowicz-Campos, Elzbieta; Cardoso, Daniela; Costa, Paulo; Couto, Filipa; Camarneiro, Ana Paula; Abrunheiro, Sérgio; Almeida, Maria; Apóstolo, JoãoObjective: The objective of this review was to investigate the effectiveness of caregiver-provided individual cognitive interventions for improving cognition, social functioning and quality of life in older adults with major neurocognitive disorders. Introduction: A large number of people with major neurocognitive disorders live in their homes, requiring ongoing community care. Different individual cognitive intervention programs have been explored as a potential approach for implementation by caregivers on a one-to-one basis. These programs have the advantage of being implemented in a home setting and in the real-life context of the older adult, in a society that is increasingly aging and where aging in place is being fostered. Inclusion criteria: This review considered experimental studies that included older adults aged 60 years and over with major neurocognitive disorders who were receiving individual cognitive interventions (e.g. cognitive stimulation, cognitive training or cognitive rehabilitation) provided by their caregivers. The comparator was usual care, waitlist control or alternative therapeutic intervention. The primary outcomes of interest included cognition, social functioning and quality of life. Additionally, behavior, mood and activities of daily living were considered. Methods: A comprehensive search strategy was used to identify relevant published and unpublished studies from January 1995 to March 2018, written in English, Spanish and Portuguese. Studies meeting the inclusion criteria were retrieved and their methodological quality was assessed by two independent reviewers using the JBI critical appraisal checklists for randomized controlled trials and quasi-experimental studies. Quantitative data were extracted using the standardized data extraction tool from the JBI System for the Unified Management, Assessment and Review of Information. Due to the clinical and methodological heterogeneity in the included studies, statistical pooling was not possible. Therefore, findings are presented in a narrative format. Results: Eight randomized controlled trials and two quasi-experimental studies were included, with a total sample of 844 dyads (older adults and caregivers). The number of dyads included in the studies ranged from 16 to 356. Beneficial effects of the caregiver-provided individual cognitive interventions were observed in various cognitive domains, including memory, attention, verbalfluency and problem-solving. Two studies additionally reported the positive impact of the intervention of interest on general cognitive functioning. None of the reviewed studies revealed significant changes in quality of life. Social functioning was not analyzed in any of the included studies. Beneficial effects were also reported in relation to behavior and activities of daily living, despite the low level of evidence. Conclusions: This review responds to a gap in current international literature on the synthesis of evidence on the use of caregiver-provided individual cognitive interventions. The intervention of interest is associated with improvement in cognitive performance, revealing some benefits for the stabilization of neuropsychiatric symptoms and an increase in autonomy in activities of daily living. Further research on the impact of sociodemographic and clinical factors on the intervention effects is needed, as these factors seem to interfere with successful intervention implementation. To reinforce current evidence, the methodological quality of future studies should be improved.
- Effectiveness of caregiver-provided cognitive interventions on cognition, social functioning and quality of life among older adults with major neurocognitive disorder: a systematic review protocolPublication . Silva, Rosa; Cardoso, Daniela; Abrunheiro, Sérgio; Almeida, Maria; Apóstolo, João
- Os focos de atenção em enfermagem comunitária e o empoderamento comunitárioPublication . Melo, Pedro; Silva, Rosa; Figueiredo, MariaEnquadramento: A capacitação de comunidades, enquan-to competência específica do especialista em enfermagem comunitária, remete para o empoderamento comunitário.Objetivos: Identificar os focos de atenção dos enfermei-ros que desenvolvem intervenção comunitária, conside-rando a comunidade como unidade de cuidados.Metodologia: Estudo de natureza qualitativa desenvol-vido através da técnica de grupos focais. Os dados foram analisados recorrendo-se à técnica de análise de conteúdo. O sistema de categorias sustentou-se no Modelo Contínuo de Empoderamento Comunitário de Laverack (2005). Foi estabelecido um sistema de categorias para a análise dos dados, sustentado nos focos da Classificação Internacional para a Prática de Enfermagem (versão 2.0). Resultados: Identificou-se 1 foco de enfermagem prin-cipal associado ao empoderamento comunitário (gestão comunitária) e 3 focos integrados como dimensões de diagnóstico do foco principal (participação comunitá-ria, processo comunitário e liderança comunitária). Conclusão: Identificaram-se áreas de atenção que poten-ciam a tomada de decisão clínica dos enfermeiros asso-ciada ao empoderamento comunitário. Existem focos em enfermagem comunitária, relacionados com o empodera-mento comunitário, conferindo um processo identitário alicerçado às competências desta área de especialidade.