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- Nursing epidemiological approach of hypertension management in a Public Health Service from the Northern Region of PortugalPublication . Melo, Pedro; Miranda, Dário; Santos, Sandra; Sousa, Sérgio; Cardoso, Teresa; Pereira, AlexandraBackground: Epidemiological surveillance of a nursing diagnosis is an approach anchored in a post-modern epidemiology focused on a person’s health disease responses. Regarding public health priorities, the population where our study occurred had as a priority problem arterial hypertension. Related to this chronic disease, nursing diagnoses about health disease responses in primary healthcare has, as a major focus, Therapeutic Regimen Management. Our aim was to study the nursing diagnosis in this issue from an epidemiological approach. Methods: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. Results: We found 17.7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. Conclusions: Nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology for the future.
- Tradução para português e validação cultural da Empowerment Assessment Rating ScalePublication . Melo, Pedro; Teixeira, Maria Alice; Fernandes, Catarina; Ferreira, Luísa; Santos, Sandra; Sousa, Maria Isabel Costa de; Pereira, Alexandra; Ferreira, Maria Amélia; Maciel, Cândida; Pinto, Dulce; Pinto, Carlos; Sousa, Sérgio; Cardoso, Teresa; Freitas, Cláudia Telles de; Dimande, Matilde MabuiIntroduction | To assess the level of community empowerment, Laverack proposes an instrument called the Empowerment Assessment Rating Scale (EARS), which has nine assessment domains related to community empowerment. Objectives | Translate to Portuguese and culturally validate the EARS for an ACeS community, a hospital community, a business community, and a school community. A review of the Portuguese translation was developed, a review group was set up to analyze the resulting document, by consensus a new scale called the Escala de Avaliação do Empoderamento Comunitário (EAvEC) was developed, and the retroversion was developed. Same review group conducted a new evaluation of the resulting version, comparing them with the original in English. The study was carried out at a Hospital in the Azores Archipelago, three Health Centers Organizations in the North of Portugal, an Education-oriented Company in Greater Porto and a School Communityin Mozambique, where the focus group scale was applied based on a problematic chosen for intervention. Results | EVaECretained the nine evaluation domains of the original scale and its translated version did not change after its cultural adaptation. The level of community empowerment was identified in each of the communities, analyzed in the form of a radar chart, with the clustered image of all domains. Discussion / Conclusions | EVaEC is a useful tool for community intervention and is being used to assess community empowerment in the MAIEC project of theCentre for Interdisciplinary Research in Health at Universidade Católica Portuguesa.
- Qualitative analysis by experts of the essential elements of the nursing practice environments proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health CarePublication . Martínez-Riera, José Ramón; Juárez-Vela, Raul; Díaz-Herrera, Miguel Ángel; Montejano-Lozoya, Raimunda; Doménech-Briz, Vicente; Benavent-Cervera, José Vicente; Cabellos-García, Ana Cristina; Melo, Pedro; Nguyen, Tam H.; Gea-Caballero, VicenteBackground: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved.
- Assessing community empowerment for an innovative epidemiologic approachPublication . Melo, Pedro; Neves-Amado, João; Pereira, Alexandra; Maciel, Cândida; Vieira Pinto, Tiago; Cardoso, TeresaCommunity empowerment can be a process, but also the result of nursing care. To analyze it as a result there is an instrument that allows to quantify its level in nine domains. According to Melo (2020), health centers can be considered communities, becoming the potential target of community and public health nurses care, especially in the public health unit. One of the main functions of a public health unit is the epidemiological surveillance of the population’s health state. However, traditional epidemiological surveillance is focused on diseases and Melo (2020) proposes a new approach for epidemiology focused on people in what concerns nursing diagnosis. The aim of this research is to identify the level of empowerment of four Portuguese primary healthcare structures, named as ACeS, so as to improve the epidemiological surveillance of nursing diagnoses. As methodology, we developed four focus group with all nursing leaders from all primary care units of the four ACeS, using the Portuguese version of the empowerment assessment rating scale. The results present the level of community empowerment of each ACeS according to the nine domains of the scale. The needs of intervention to improve the ACeS empowerment were also identified in order to develop the epidemiological surveillance of nursing
- 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.
- O diagnóstico da GRT no contexto da Saúde Pública: da Investigação ao resultadoPublication . Melo, PedroIntrodução e objetivos| O empoderamento comunitário (EC) é processo e resultado do cuidado de Enfermagem Comunitária (1,2). No Centro de Investigação Interdisciplinar em Saúde (CIIS) da Universidade Católica Portuguesa, integrado na Nursing Research Platform, integra-se o projeto MAIEC (Modelo de Avaliação, Intervenção e Empoderamento Comunitário). No domínio deste projeto que apresentamos neste resumo, pretendemos avaliar o impacto da aplicação do MAIEC, tendo como epicentro uma Unidade de Saúde Pública e como Comunidade um ACeS da região Norte de Portugal, no contexto da Vigilância Epidemiológica dos Diagnósticos de Enfermagem (VEDE). Neste contexto pretendemos identificar a prevalência de vários diagnósticos, entre eles, a Gestão do Regime Terapêutico Comprometida nos utentes com Diabetes Mellitus. Metodologia| Desenvolvemos um estudo de natureza mista. Para a avaliação do nível de empoderamento do ACeS para a VEDE aplicamos a Escala de Avaliação do Empoderamento Comunitário (3) num grupo focal com os membros da comunidade ACeS e para avaliar do ponto de vista epidemiológico o foco de Enfermagem Gestão do Regime Terapêutico nas pessoas com Diabetes, consultámos os dados do Sistema de Informação da ARSN (SIARS) e aplicamos as formulas previstas no processo de contratualização da ACSS, fazendo um estudo transversal. Resultados e Discussão| A mobilização de recursos e a participação comunitária e as estruturas organizativas foram os domínios com menor nível de empoderamento no ACeS, indicando a necessidade de uma abordagem intencionalmente empoderadora para promover a VEDE. Quanto à avaliação epidemiológica do foco GRT, não conseguimos avaliar a prevalência do diagnóstico porque identificamos uma taxa de avaliação anual média do foco no ACeS de 40,9%, com um índice de acompanhamento de 0,47. A prevalência anual da DM foi de 8% e a incidência de 6,11%. Conclusões| É necessário empoderar o ACeS para melhorar o diagnóstico e acompanhamento dos utentes diabéticos em consulta de Enfermagem nos Cuidados de Saúde Primários. Estamos a aplicar o MAIEC e foi criado o primeiro Observatório dos Diagnósticos de Enfermagem numa USP Portuguesa.
- Diabetes e gestão do regime terapêuticoPublication . Melo, PedroNeste artigo apresentam-se algumas noções da complexidade da abordagem da Gestão do Regime Terapêutico na Pessoa com Diabetes. Fica a convicção da necessidade de aprofundar outras áreas de atenção em Enfermagem que se relacionarão com a eficácia na promoção desta Gestão, nomeadamente áreas relacionadas com a Família, como a interação de papéis.
- Community empowerment and community partnerships in nursing decision-makingPublication . Melo, Pedro; Alves, OdeteCommunity empowerment has been studied as a process and result phenomenon throughout the last 40 years. Community partnership, which has been studied during the last 20 years, has been identified as a key process to promote intervention and research within communities. In this paper, we introduce the relation between these two concepts, from the research that is being developed at the Centre for Interdisciplinary Health Research (CIIS) in Universidade Catolica Portuguesa. We comment on the available evidence regarding community partnership and community empowerment within the Nursing Decision-Making process. There is a particular focus on Community Health Nursing Specialists (CHNS) and the aim to promote the identification of CHNS as potential community partnership developers within society. It is also important to analyze how community partnership processes are intentionally integrated as a nursing intervention within the nursing process. This analysis should occur from the nursing diagnosis to the evaluation of health gains in communities sensitive to CHNS care in a Nursing Theoretical Model developed from a Nursing PhD process-the Community Assessment, Intervention, and Empowerment Model.
- Community Empowerment Assessment in a School of the North of Portugal - a qualitative studyPublication . Melo, Pedro; Costa, Joana; Moreira, Patrícia; Pinto, Carlos; Moura, Sandra; Freitas, Cláudia Telles de; Vieira, Margarida
- Descriptive study of children’s nutritional status and identification of community-level nursing diagnoses in a school community in AfricaPublication . Melo, Pedro; Sousa, Maria Isabel Costa de; Dimande, Matilde Mabui; Taboada, Sónia; Nogueira, Assunção; Pinto, Carlos; Figueiredo, Maria; Nguyen, Tam; Martínez-Riera, José RamónEffectively responding to children’s nutritional status and eating behaviors in Mozambique requires a community-based care approach grounded in sound nursing research that is evidence-based. The Community Assessment, Intervention, and Empowerment Model (MAIEC) is a nursing theoretical model that is based upon clinical decision-making for community health nurses using communities as a unit of care. We used the MAIEC to identify a community-based nursing diagnosis to address children’s nutritional status and eating behaviors in Mozambique. Objectives: (1) to conduct a descriptive study of children’s nutritional status and eating behaviors in a school community in Mavalane, Mozambique, and (2) to identify a community-based nursing diagnosis using the MAIEC clinical decision-making matrix in the same school community. Method: a cross-sectional, quantitative study was conducted to assess the nutritional status of children using anthropometric data, including brachial perimeter and the tricipital skinfold, and standard deviation for the relation of weight–height, in a sample of 227 children. To assess community management of the problem and identify a community-based nursing diagnosis, we surveyed 176 parents/guardians and 49 education professionals, using a questionnaire based on the MAIEC clinical decision matrix as a reference. Results: malnutrition was identified in more than half of the children (51.3%). We also identified a community-based nursing diagnosis of impaired community management related to the promotion of child health and healthy eating evidenced by the lack of community leadership, participation, and processing among more than 70% of the community members (parents/guardians and education professionals). Conclusion: a nursing diagnosis and diagnostic criteria for nutritional status and community management were identified. The need to intervene using a multidisciplinary public health approach is imperative, with the school community as the unit of care. In addition, reliable anthropometric data were identified as important criteria to complement the nursing diagnosis and guide future public health interventions.
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