Escola superior de Enfermagem do Porto

Mendes D.T., Tibúrcio P.D., Cirqueira G.D., Marcheti P.M., Zerbetto S.R., Fernandes C.S., Nóbrega M.D.

Psychic suffering is typical of the human condition and involves multideterminant factors in its origin, with significant influence from affective–relational–economic issues, invariably marked by negative and positive experiences. Objective: The objective of this study is to describe the process of construction and content validation of a set of nursing actions to integrate a mobile educational technology to assist individuals in psychic distress in primary health care. Methods: This was a methodological study in four stages: scope review, qualitative research, elaboration of a set of nursing actions and content validation. It was carried out from December/2022 to December/2023, with 16 Brazilian specialists, a minimum Content Validity Index of 80% and Cronbach’s Alpha (α). Results: Six sets of actions were elaborated and evaluated: nursing actions in the initial assessment of the individual in psychic distress (99% α 0.47); nursing actions towards individuals in psychic distress with complaints associated with Depressive Disorder (93.4% α 0.84); nursing actions towards individuals in psychic distress with complaints associated with Anxiety Disorder (95.4% α 0.88); nursing actions towards individuals in psychic distress with Suicidal Ideation (96.3% α 0.71); nursing actions towards individuals in psychic distress resulting from the use of psychoactive substances (99.6% α 0.77) and; nursing actions towards individuals in psychic distress as a result of grief situations (98.6% α 0.28). Conclusions: The set of actions proved to be validated and to have acceptable reliability, thus contributing to supporting the development of educational technology. The conclusions of this research highlight the possibility for nurses to conduct nursing actions in the care of people in psychic distress, in a non-specialized context. In addition, this is a resource to improve the routine mental health care of nurses who work in primary health care.

Cardoso C., Lumini M.J., Martins T.

Background and aimCaring for someone can be physically and psychologically demanding, predisposing caregivers to muscle injuries, fatigue, exhaustion, depression, anxiety, and burnout. The literature suggests several approaches to reducing caregiver burden, one of which is physical exercise. The aim of this systematic review was to analyze the effectiveness of exercise-based programs or muscle relaxation in reducing caregiver burden and stress among family caregivers.MethodA systematic literature review was conducted following the PRISMA guidelines. The search was performed in the Web of Science, Cochrane Library and Scopus databases and through the EBSCOhost aggregator (CINAHL Plus, MEDLINE, and SportDiscus). Studies were selected based on the PICOD acronym.ResultsEleven randomized controlled trials (RCTs) and two other experimental studies were included. The reviewed programs encompassed aerobics, strengthening, and muscle relaxation exercises, delivered by various professionals in diverse settings, such as caregivers' homes, gyms, and hospital environments. Although the programs varied in type, duration, and structure, the majority of the studies demonstrated positive effects on caregivers' physical and psychological well-being, along with reductions in burden and stress.ConclusionThe results suggest that physical exercise interventions are effective in reducing caregiver burden and stress, while also enhancing overall well-being. Future strategies should emphasize the importance of raising awareness among caregivers about adopting healthy lifestyles, with a particular focus on regular physical activity, as a means of relaxation and self-care. To maximize the effectiveness of these interventions, incorporating flexible, home-based components and engaging multidisciplinary teams could enhance accessibility, adherence, and impact.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023446129, PROSPERO 2023 CRD42023446129.

Sabrina Sousa A., Bastos C., Ferrito C., Matos Pereira L., Artur Paiva J.

Soares V.L., Lemos S., Sequeira C., Morais C.S., Barbieri-Figueiredo M.D.

IntroductionThe considerable influence that family members can have on diabetes management is well recognized. Therefore, it is crucial for professionals to acknowledge the impact of the diagnosis on family members. This study aimed to comprehensively identify and understand the needs of family members with an adult diagnosed with diabetes using a two-phased research design.MethodsPhase 1 was a scoping literature review using databases such as MEDLINE®, CINAHL®, SciELO, and PsycINFO, and gray literature from the Scientific Open Access Repository of Portugal and OpenGrey, focusing on studies from 2017 to 2023, adhering to the Joanna Briggs Institute and PRISMA guidelines. Phase 2 involved a focus group to gather qualitative data on family experiences, which was analyzed using content analysis and following the Consolidated Criteria for Reporting Qualitative Research.Results from both phases revealed five themesCommunication and emotional expression within families, the impact of diabetes on the family, diabetes-specific knowledge, socio-cultural and environmental influences on diabetes management, and communication with healthcare providers. Integrating these findings highlighted the specific needs of families, suggesting that tailored interventions should be developed to enhance diabetes management support and promote overall family well-being.

Araújo O., Freitas O., Sousa G., Ribeiro I., Carvalho J.C., Martins S.

BackgroundThe concept of psychological vulnerability is associated with the individual’s maladaptive cognitive beliefs, such as self-criticism, perfectionism, and the need for external validation and approval, reducing the individual’s ability to cope with negative life experiences. This study aimed to explore psychometric proprieties of the Psychological Vulnerability Scale in secondary school students.MethodsA psychometric study was conducted with a non-probabilistic sample of 1,875 secondary school students (55.5% female) aged 15 to over 18 years. Participants completed a self-report questionnaire that included demographic information, the Psychological Vulnerability Scale, and a Positive Mental Health questionnaire.ResultsAnalysis revealed acceptable skewness values (between −0.557 and 0.6385) and kurtosis (ranging from −1.29 to −0.704). Confirmatory factor analysis (CFA) indicated excellent global fit indices, confirming the original structure. Invariance testing between genders demonstrated that the Psychological Vulnerability Scale was consistent for boys and girls (configural invariance) and that each item contributed similarly to the construct (metric invariance). The Psychological Vulnerability Scale showed good internal consistency, with an ordinal Cronbach’s alfa above 0.70. Reliability estimates, including inter-item reliability or MacDonald’s Omega, indicated mean item-inter correlations falling within the recommended range of 0.15–0.50.ConclusionThe Psychological Vulnerability Scale is a reliable tool that allows health professionals to assess the psychological vulnerability of individuals in both clinical (e.g., hospitals, health centers) and non-clinical (e.g., schools, universities) contexts throughout the life cycle (e.g., young people, adults, and older adults).

Queirós C.M., Martins T., Correia T.

IntroductionProviding healthcare in emergency services is a multifaceted challenge that demands prompt approaches. Ensuring safety and efficacy becomes even more challenging in ‘remote locations’, referring to geographical areas located far from urban centres or densely populated regions, often characterised by insufficient access to services, infrastructure and communication channels. Despite the pivotal role of healthcare professionals’ skills and knowledge in risk management in these contexts, academic literature has largely overlooked this aspect. Thus, addressing healthcare professionals’ perceptions of risks within remote areas is crucial for informed decision-making and improved service administration.Methods and analysisThis scoping review protocol adopts the methodology outlined by the Joanna Briggs Institute. The objective is to delineate the current scientific evidence regarding the perception of both direct and indirect risks associated with healthcare practice in remote emergency settings. Employing the Population, Concept, and Context dimensions, inclusion criteria were established for each dimension: Population—nurses or other healthcare professionals with overlapping roles; Concept—perception of risk; Context—remote community or site and emergency care. The search will encompass the Scopus, PubMed, LILACS, Cochrane, CINAHL and Web of Science databases. A specific time frame for the selection of articles was not delimited. Observational, quantitative, qualitative studies and reviews will be eligible for inclusion if they meet the predetermined criteria. Two reviewers will undertake the document review process. Eligible documents may be in English or Portuguese, and only those subjected to peer review will be considered for inclusion.Ethics and disseminationEthical approval will not be necessary for this study as it entails a scoping review based on previously published evidence. The findings from the scoping review will be disseminated through scientific conferences and published in academic journals.

Gomes de Souza B., Nascimento L.D., Fioresi M., Furieri L.B., Balbino F.S., Andrade L.M., Bringuente M.E.

This study was undertaken to structure and validate a Multi-Professional Family Support Programme that was collectively developed at a Neonatal Intensive Care Unit (NICU). This is participative research of the action-research category with a qualitative–quantitative approach conducted at a University Hospital in the southeast of Brazil with the participation of their multi-professional staff. The study was done in four interdependent stages, adapted from the method proposed by Thiollent (2011): organisation, structuring, validation, and diffusion. Qualitative data were analysed following Bardin’s (2016) Content Analysis Technique and presented in categories and sub-categories. The evaluation instruments followed the evaluation criteria proposed by Pasquali (2010). In the analysis of quantitative data, Cronbach’s Alpha coefficient was used to verify reliability, Fleiss’ Kappa coefficient for measuring agreement, and the Content Validity Index for relevance and representativeness. The programme was built collectively and is based on the Family-Centred Care model. Cronbach’s Alpha reached values above 0.90, which is excellent reliability. There was varying agreement between substantial/perfect and significant (k = 0.68–1.00; p < 0.001), and all the evaluation criteria were considered relevant and representative (CVI > 90.0%). The programme and its guiding technologies were structured and validated with high levels of reliability, agreement, relevance, and representativeness.

Araújo M.I., Duarte A.C., Figueiredo M.H., Andrade C.M.

RESUMO Objetivos: identificar e sintetizar os elementos caracterizadores do processo de transição da família face ao primeiro filho. Métodos: efetuou-se revisão de escopo baseada na metodologia do JBI, em seis bases de dados, seguindo o checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Resultados: incluíram-se dez artigos com fatores caracterizadores da transição, como condições dificultadoras/facilitadoras que influenciam o processo, as estruturas de apoio importantes na adaptação e estratégias/respostas utilizadas no processo de transição. Considerações Finais: foram identificados elementos caracterizadores do processo de transição face ao primeiro filho. No entanto, não foi identificada nenhuma explicação teórica do mesmo. Investigação adicional deverá ser realizada para obter uma compreensão mais profunda desse processo.

Araújo M.I., Duarte A.C., Figueiredo M.H., Andrade C.M.

ABSTRACT Objectives: to identify and summarize the elements that characterize the family transition process in relation to the first child. Methods: a scoping review was carried out based on JBI methodology, in six databases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Results: ten articles were included with factors characterizing the transition, such as hindering/facilitating conditions that influence the process, important support structures in adaptation and strategies/responses used in the transition process. Final Considerations: elements characterizing the transition process in relation to the first child were identified. However, no theoretical explanation for this was identified. Further research should be carried out to obtain a deeper understanding of this process.

Alves I., Moreira A.P., Sousa T., Teles P., Magalhães B.M., Goncalves F., Fernandes C.S.

Abstract Purpose Exergames, which combine digital games and physical exercise, have become increasingly popular for rehabilitation in the health domain. This study aimed to assess the effectiveness of exergame rehabilitation on the quality of life of cancer patients undergoing abdominal surgery. Methods This randomized controlled trial evaluated the effectiveness of exergame rehabilitation on the quality of life of cancer patients who had undergone abdominal surgery. Seventy postoperative patients were included, and data collection took place between January 2023 and May 2023. The patients were randomly assigned to either an exergame rehabilitation program (n = 35) or a traditional rehabilitation program (n = 35). The assessed outcome was the quality of life, and data collection occurred at three different time points: upon admission, 48 h postoperatively, and on the 7th day after surgery. Results Quality of life was evaluated using the WHOQOL-BREF Scale. At the third assessment, a statistically significant difference was observed between the two groups (p = 0.016), indicating that the intervention group had a higher quality of life than the control group. Conclusions The study showed a positive effect of exergames on the population under investigation. By the 7th day after surgery, the intervention group demonstrated an improvement in their quality of life compared to the control group. Clinical trial registration Center of Open Science OSF https://osf.io/286zb/, registered in July, 2023.

Rodrigues D.J., Teixeira C., Parola V., Marques P.

Background: Nursing care in interventional cardiology is vital during perioperative stages, especially with coronary angiography. Radial artery access is now preferred, requiring proper haemostasis to prevent complications. Standardised protocols are needed for effective and economical haemostasis methods. This review aims to map the literature on haemostasis of the radial artery after coronary angiography, an area not previously reviewed. Methods: Following the Joanna Briggs Institute methodology for scoping reviews, two reviewers independently selected studies based on eligibility criteria. Data were extracted using a specially developed tool, with disagreements resolved through discussion or a third reviewer. Data synthesis is presented in tabular form and narrative summary. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews guidelines were followed. Searches were conducted in PubMed, CINAHL Complete, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus, Opengrey, DART-Europe e-theses portal and six key interventional cardiology reference sites. Results: From 43 manuscripts, four haemostasis methods for the radial artery after coronary angiography were identified: manual compression ( n = 5), compression bandages ( n = 16), compression devices ( n = 30) and haemostatic patches ( n = 7). Nearly 70% ( n = 30) of references focused on compression devices. Nine techniques were used to evaluate haemostasis methods, with visual inspection (34 references) and Doppler ultrasound (17 references) being the most common. Only nine haemostasis methods lacked an associated protocol. Conclusion: This scoping review identifies four primary haemostasis methods post coronary angiography: manual compression, compression bandages, compression devices and haemostatic patches, with compression devices being the most frequently discussed. The variability in evaluation techniques, predominantly visual inspection and ultrasound, underscores the need for standardised guidelines. The absence of protocols for some methods further highlights the necessity for uniform standards to improve consistency and reliability in clinical practice. Standardising these methods and protocols is essential to enhance patient outcomes and advance the field.

Ferreira C.M., Santos D.M., Real V.T., Marques P.A.

ABSTRACT Introduction: this article sought to deepen knowledge about the subcutaneous lymphatic drainage technique as a form of palliative treatment for secondary lymphedema in prostate cancer patients. Development: literature review carried out between November 13 and 17, 2023, in the Medline and CINHAL databases. The literature supporting this analysis is scarce, both in terms of studying the technique on site and standardizing the procedure. These considerations explain the benefits that the technique offers in improving men’s quality of life, in the sexual, psychological and social contexts, and in the economic repercussions. Conclusion: subcutaneous lymphatic drainage is a technique that is little known, and little used in clinical practice, but it is an option to consider in the treatment of secondary lymphedema in a palliative context, as it can improve the patient’s quality of life.

Ferreira C.M., Santos D.M., Real V.T., Marques P.A.

RESUMO Introdução: este artigo procurou aprofundar o conhecimento acerca da técnica de drenagem linfática subcutânea, como forma de tratamento paliativo do linfedema secundário em doentes com câncer da próstata. Desenvolvimento: revisão da literatura realizada entre os dias 13 e 17 do mês de novembro de 2023, nas bases de dados Medline e CINHAL. A literatura que suporta esta análise revela-se escassa, quer para o estudo da técnica no local, quer para a padronização do procedimento. Estas considerações explanam os benefícios que a técnica oferece na melhoria da qualidade de vida do homem, no contexto sexual, psicológico, social e nas repercussões econômicas. Conclusão: a drenagem linfática subcutânea é uma técnica pouco conhecida e pouco utilizada na prática clínica, porém é uma opção a considerar no tratamento de linfedema secundário em contexto paliativo, uma vez que pode melhorar a qualidade de vida do doente.

Ferreira C.M., Santos D.M., Real V.T., Marques P.A.

RESUMEN Introducción: este artículo buscó profundizar el conocimiento sobre la técnica de drenaje linfático subcutáneo como forma de tratamiento paliativo del linfedema secundario en pacientes con cáncer de próstata. Desarrollo: revisión de la literatura realizada entre el 13 y 17 de noviembre de 2023, en las bases de datos Medline y CINHAL. La literatura sobre el tema es escasa, tanto sobre el estudio de la técnica en el sitio como sobre la estandarización del procedimiento. Estas consideraciones explican los beneficios que tiene la técnica para mejorar la calidad de vida de los hombres, a nivel sexual, psicológico, social y las repercusiones económicas. Conclusión: el drenaje linfático subcutáneo es una técnica poco conocida y poco utilizada en la práctica clínica, pero es una opción que se debe considerar en el tratamiento del linfedema secundario en el contexto paliativo, ya que puede mejorar la calidad de vida del paciente.

Cunha L.D., Ventura F., Pestana‐Santos M., Lomba L., Santos M.R.

ABSTRACTThrough technical rationality, healthcare professionals address instrumental problems by applying the theory and technique arising from scientific knowledge. Nevertheless, the divergent situations of practice characterised by uncertainty, instability, and uniqueness place nurses in a positivist epistemological dilemma. Decision‐making under uncertainty is a challenge that nurses face in clinical practice daily. Nurses anticipate critical events based on the interaction between (un)known factors of clinical reasoning, putting uncertainty tolerance into perspective. With undeniable epistemological relevance, few nursing researchers have addressed this issue. Based on the insights garnered from the panel held at the 26th International Nursing Philosophy Conference, this discussion paper examines the inception of uncertainty within nursing reasoning, intertwining introspection, abstraction, and the rich discussions from the conference. Accordingly, the philosophical underpinnings of the perceived experience of uncertainty will be briefly addressed, while framing the decision‐making challenges faced by nurses. A compelling dimension of nursing care emerges when we delve into the inception of uncertainty, prompting a deeper examination of the interplay between its perception and consciousness in clinical practice, and the gravitation of uncertainty in the process of empirical reasoning. Navigating uncertainty involves varying individual responses, influenced by tolerance levels. Moral appropriateness is determined by their adaptability rather than solely their positivity or logical consistency, highlighting constancy as a quality demanding alignment with an understanding of challenges.