Effects of a nursing care program on functional outcomes in older acute medical in-patients: protocol for a randomized controlled trial

Background: Hospitalization often leads to long periods of bed rest and inactivity which is associated with an increase in length of hospital stay, loss of capacity for basic self-care and discharge into a nursing home. Objective: This trial aims to verify if a nursing care program centered on basic self-care and predefined physical activity, improves functional outcomes in older hospitalized patients. Methods: This is a 2-group randomized controlled trial with repeated measures: 182 older acute medical patients will be blindly randomly allocated to the control group (n = 91) or intervention group (n = 91). The intervention will consist of nursing care intervention centered on basic self-care that includes a twice daily walking training, plus privileging pre-established trips to the toilet by walking and all daytime meals seated, off the bed. The main outcome was changes in the number of independent activities of daily living from 2 weeks before admission (baseline) to discharge. Trial registration: ClinicalTrials.gov (Identifier NCT03106064). Results: This intervention has the potential to change the outcomes of the older patient in the acute setting. Conclusion: The loss of independence in self-care is determinant in future health care needs. If our hypothesis is correct and demonstrate that this nursing care program centered on basic self-care for older acute medical patients improves functional outcomes, a change in the paradigmatic organization of hospital care may be justifiable

Predictors for changing to a non-Nursing profession

Background: Nurses’ predisposition to change their profession lies within the scope of nurse turnover. Understanding the reasons why nurses want to switch to another organization or even leave the profession is important because this movement has a negative impact on the workgroup and the organization. Objective: To determine the propensity to leave the nursing profession. Methodology: Descriptive, correlational, cross-sectional, and quantitative study. The non-probability sample of 463 nurses was recruited through the snowball method. Results: The nurses who were under the age of 40 and worked in the public sector were more willing to leave the nursing profession. The greater the satisfaction with the profession and the greater the professional autonomy and recognition, the lower the nurses’ probability to change to another profession. Conclusions: Health organizations should concentrate on retaining their nurses by adopting human resource strategies that value them and organizational models focused on motivation and satisfaction.Enquadramento: A predisposição dos enfermeiros para mudar de profissão enquadra-se na rotatividade em enfermagem. Compreender os motivos que levam os enfermeiros a querer mudar de organização ou até mesmo abandonar a profissão é fundamental, visto que essa movimentação traz consigo implicações negativas no grupo de trabalho e na organização. Objetivo: Determinar a propensão para o abandono da profissão de enfermagem. Metodologia: Estudo descritivo, correlacional, transversal e quantitativo. A amostra, do tipo não-probabilístico, é constituída por 463 enfermeiros acedidos mediante a técnica de snowball. Resultados: São os enfermeiros com idades inferiores a 40 anos e a desempenhar funções no setor público que apresentam maior vontade de abandonar a profissão de enfermagem. Verifica-se também que quanto maior for a satisfação com a profissão e maior a autonomia e reconhecimento profissional, menor será a probabilidade de os enfermeiros mudarem de profissão. Conclusão: É fundamental que as organizações de saúde se preocupem com a retenção dos seus enfermeiros, adotando estratégias de recursos humanos que valorizem os mesmos e com modelosinfo:eu-repo/semantics/publishedVersio

Optimising medication management for polymedicated home-dwelling older adults with multiple chronic conditions

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Functional trajectories of older acute medical inpatients: increased vulnerability with age

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Calidad de los cuidados de enfermería: un estudio en hospitales portugueses

Background: In a constant pursuit for professional excellence, nurses are required to comply with the quality standards of nursing care. Thus, it is essential to understand this phenomenon in the hospital setting. Objectives: To analyze nurses’ perception of the implementation of quality standards in nursing care. Methodology: A quantitative, descriptive-exploratory study was conducted in 36 public hospital institutions located in mainland Portugal, involving a total of 3.451 nurses. Data were collected using a questionnaire. Results: Most nurses often or always performed activities that enhance the quality of nursing care. This analysis showed that nurses perceive activities related to Health Promotion, Well-being and Self-care, and Functional Readaptation as less implemented. On the other hand, activities related to Responsibility and Rigor and Prevention of Complications are implemented most often. Conclusion: The findings suggest that nursing practices should be redesigned and adjusted based on the activities that are less often implemented.Enquadramento: Numa procura permanente da excelência no exercício profissional, é exigido aos enfermeiros uma atuação congruente com os padrões de qualidade dos cuidados de enfermagem, sendo pertinente perceber o fenómeno no contexto hospitalar. Objetivos: Analisar a perceção dos enfermeiros relativamente à concretização dos padrões de qualidade dos cuidados de enfermagem. Metodologia: Estudo exploratório-descritivo, de carácter quantitativo, realizado em 36 instituições hospitalares EPE de Portugal continental, com a participação de 3,451 enfermeiros. Como instrumento de colheita de dados usámos o questionário. Resultados: A maioria dos enfermeiros concretiza às vezes ou sempre as atividades que contribuem para a qualidade dos cuidados de enfermagem. Decorrente da análise efetuada, as atividades inerentes às dimensões Promoção da saúde, Bem-estar e autocuidado e Readaptação funcional, são aquelas que os enfermeiros percecionam como menos executadas. Por outro lado, as atividades mais frequentemente concretizadas, reportam-se às dimensões Responsabilidade e rigor e Prevenção de complicações. Conclusão: Os dados sugerem a necessidade de se repensarem as práticas, no sentido de uma atuação congruente com os enunciados descritivos menos frequentemente concretizados.Marco contextual: En una búsqueda permanente de la excelencia en el ejercicio profesional, se exige que los enfermeros actúen de forma congruente con los patrones de calidad de los cuidados de enfermería, para lo cual es pertinente comprender el fenómeno en el contexto hospitalario. Objetivos: Analizar la percepción de los enfermeros en relación a la concretización de los patrones de calidad de los cuidados de enfermería. Metodología: Estudio exploratorio y descriptivo, de carácter cuantitativo, realizado en 36 instituciones hospitalarias EPE de Portugal continental, en el que se contó con la participación de 3.451 enfermeros. Como instrumento de recogida de datos se usó el cuestionario. Resultados: La mayoría de los enfermeros realiza a veces o siempre las actividades que contribuyen a la calidad de los cuidados de enfermería. A partir del análisis efectuado, las actividades inherentes a las dimensiones Promoción de la salud, Bienestar y autocuidado y Readaptación funcional son aquellas que los enfermeros perciben como menos ejecutadas. Por otro lado, las actividades que se realizan con más frecuencia se refieren a las dimensiones Responsabilidad y rigor y Prevención de complicaciones. Conclusión: Los datos sugieren que es necesario repensar las prácticas con el objetivo de realizar una actuación congruente con los enunciados descriptivos que se ponen en práctica con menos frecuencia.info:eu-repo/semantics/publishedVersio

Cuidados paliativos en la formación inicial de enfermería: Un estudio de métodos mixtos

Background: With the progression of the epidemiological transition, palliative care skills should be acquired already in undergraduate nursing education. However, most nursing schools have been slow to adapt to the needs emerging from this new context. Objectives: To identify the perceptions and knowledge of final-year undergraduate nursing students in Brazil and Portugal about palliative care and compare them with their experiences in clinical practice. Methodology: Multicenter, exploratory, and descriptive study with a qualitative approach. Fifteen students were interviewed in 2018: 10 Brazilian students and five Portuguese students. Data were analyzed using Bardin’s content analysis technique. Patricia Benner’s model was used as theoretical framework. Results: The narratives revealed dissatisfaction with the palliative care content in the curricula, frustration with the experiences in clinical practice, and conceptual misconceptions about the theme. Conclusion: The curricula should be adapted and palliative care content integrated into mandatory subjects.info:eu-repo/semantics/publishedVersio

Musculoskeletal symptoms of hospital nurses: contribution of rehabilitation nurses

Background: Nurses make up the major professional category in the National Health Service, and their work a"ects their musculoskeletal well-being. Objective: To determine the prevalence of musculoskeletal symptoms of nurses and identify their risk factors. Methodology: A quantitative, descriptive, and correlational study, conducted in a Portuguese hospital center, used a non-probabilistic sample by convenience of 260 nurses. A questionnaire was used as data collection instrument, divided into two parts (sociodemographic and professional data/Nordic Musculoskeletal Questionnaire). Results: #e majority of nurses (65.1%) manifests musculoskeletal symptoms, the lumbar spine being the most a"ected body segment. #e female gender, aging, body mass index, time of professional experience, and workload are related to the worsening of symptoms. Conclusion: #e results point out the need to raise awareness of the risk factors among nurses, as well as to promote the adoption of strategies, like workplace gymnastics, to minimize musculoskeletal symptoms.info:eu-repo/semantics/publishedVersio

Ejercicio profesional de los enfermeros sostenido en los referentes teóricos de la disciplina: realidad o utopía

Background: Supporting nursing practice on the discipline’s conceptions is currently one of the biggest challenges, which is why it is important to understand nurses’ views. Objective: Analyzing hospital nurses’ perception of the relevance of the theoretical framework for sustaining their professional practice. Methodology: A qualitative, exploratory and descriptive study carried out in 19 hospitals, involving 56 nurses. The tool used for collecting data was a semi-structured interview. Results: Data analysis resulted in the following categories: Relevance of the theoretical framework for professional practice in nursing; Theoretical framework guiding professional practice in nursing; Constraints to the integration of the theoretical nursing framework and Strategies for the integration of theoretical nursing framework. Conclusion: Nurses’ intention to adopt a practice based on the theoretical framework of the discipline has been negatively influenced by their practice environment and by the difficulty in understanding and integrating the theoretical framework, thus resulting in the need to adopt strategies.Enquadramento: Sustentar a prática de enfermagem nas conceções da disciplina constitui atualmente um dos maiores desafios, motivo pelo qual importa conhecer a perspetiva dos enfermeiros. Objetivo: Analisar a perceção dos enfermeiros que exercem funções em instituições hospitalares, sobre a pertinência dos referenciais teóricos para a sustentação da sua prática profissional. Metodologia: Estudo de abordagem qualitativa, exploratório e descritivo, realizado em 19 centros hospitalares, com a participação de 56 enfermeiros. Como instrumento de colheita de dados foi usada a entrevista semiestruturada. Resultados: Da análise dos dados emergiram como categorias: Relevância dos referenciais teóricos para a prática profissional dos enfermeiros; Referenciais teóricos orientadores da prática profissional dos enfermeiros; Constrangimentos à integração dos referenciais teóricos de enfermagem e Estratégias para a integração dos referenciais teóricos de enfermagem. Conclusão: A intenção dos enfermeiros em adotar uma prática sustentada nos referenciais teóricos da disciplina tem sido negativamente influenciada pelos ambientes da prática, bem como pela dificuldade em compreender e integrar os referenciais teóricos, de onde emerge a necessidade de se adotarem estratégias.Marco contextual: Sostener la práctica de la enfermería en las concepciones de la disciplina constituye actualmente uno de los mayores desafíos, motivo por el cual importa conocer la perspectiva de los enfermeros. Objetivo: Analizar la percepción de los enfermeros que ejercen funciones en instituciones hospitalarias sobre la pertinencia de los referentes teóricos para sostener su práctica profesional. Metodología: Estudio de enfoque cualitativo, exploratorio y descriptivo, realizado en 19 centros hospitalarios, con la participación de 56 enfermeros. Como instrumento de recogida de datos se usó la entrevista semiestructurada. Resultados: Del análisis de los datos surgieron como categorías: Relevancia de los referentes teóricos para la práctica profesional de los enfermeros; Referentes teóricos orientadores de la práctica profesional de los enfermeros; Limitaciones a la integración de los referentes teóricos de enfermería y Estrategias para la integración de los referentes teóricos de la enfermería. Conclusión: La intención de los enfermeros en adoptar una práctica sostenida en los referentes teóricos de la disciplina se ha visto influida negativamente por los ambientes de la práctica, así como por la dificultad de comprender e integrar los referentes teóricos, de donde surge la necesidad de que se adopten estrategias.info:eu-repo/semantics/publishedVersio

Impacto de um programa de reabilitação na gestão urinária do doente acometido por acidente vascular cerebral

Objective: to assess the effect of a Nursing Rehabilitation program on the urinary incontinence management of women after a CVA. Method: quantitative, quasi-experimental, and longitudinal study conducted in a convalescence unit in the Viana do Castelo district, Portugal, between September 2018 and March 2019. The sample included women (n=30) aged between 45 and 90, experiencing urinary incontinence after a CVA, assigned to two groups: experimental group (n=15) and control group (n=15). The functional rehabilitation program was applied to the experimental group for 4 weeks. The program comprises behavioral changes and an exercise plan to strengthen pelvic floor muscles, and the impact of urinary incontinence was assessed before and after the intervention. Results: a statistically significant correlation was found between the level of functional disability and the impact of urinary incontinence (r=-0.499; p=0.005). Hence, the level of functional disability influences the impact of urinary incontinence on quality of life. The functional rehabilitation program implemented in the experimental group obtained positive results and decreased the frequency (t=6.985, p=0.000) and amount (Z=-2.762, p=0.006) of urine loss. Conclusion: the functional rehabilitation program positively impacted and decreased the frequency and amount of urine loss.info:eu-repo/semantics/publishedVersio