Atitudes de estudantes de Enfermagem sobre o envelhecimento

Introdução: Em Portugal, tem aumentado o número de pessoas idosas com necessidades de cuidados de saúde específicos. Os cuidados prestados às pessoas idosas está diretamente relacionada com as atitudes dos profissionais de saúde, nomeadamente os enfermeiros e estudantes de enfermagem. O nosso objetivo é explorar as atitudes dos estudantes de enfermagem em relação à velhice. Metodologia: Estudo de natureza quantitativo, exploratório e descritivo. Cento e quarenta estudantes de enfermagem do primeiro ano, constituíram a amostra. O instrumento de colheita de dados utilizado foi o Inventário de Atitudes em Relação à Velhice, originalmente desenvolvido por Sheppard (1981) e adaptado para o português por Neri (1986). Na análise dos dados recorremos a medidas de tendência central. RESULTADOS: O estudo envolveu 14 estudantes do sexo masculino e 126 estudantes do sexo feminino, com uma idade média de 18,7 anos. A média das pontuações atribuídas pelos estudantes nos itens de Inventário de Sheppard foi de 2,05 (DP=0,32). Em geral, este valor indica que as respostas foram negativas. A pontuação para cada fator do Inventário de Atitudes em Relação à Velhice estavam abaixo do ponto médio nas dimensões "Expectativas quanto à atividade" e "Expectativas em relação a satisfação" (X=1,70, DP=0,39 e X=1,66, SD=0, 56, respetivamente) e valor acima do ponto médio da escala dimensão "A ansiedade sobre a morte" (X=2,82, DP=0,71). DISCUSSÃO: Estes resultados, espelhando atitudes negativas dos estudantes em relação à velhice, estão em consonância com os de Celik et al. (2010). CONCLUSÃO: Os estudantes de enfermagem do 1.º ano demonstram atitudes negativas, em relação à velhice X=2.05 (SD=0.32). Compete aos professores , do ensino superior, da área da saúde, desmistificar os estereótipos que acompanham o envelhecimento.Introduction: In Portugal, has increased the number of elderly people, with specific health care needs. Care of the elderly is directly related to the attitudes of health professionals, including nurses and nursing students. Objective: To explore the attitudes toward aging among nursing students. Method: A quantitative exploratory descriptive research study was undertaken. One hundred and forty nursing students of the first year, comprised the sample. The data collection instrument used was the Inventory of Attitudes Toward Aging, originally developed by Sheppard (1981) and adapted to Portuguese by Neri (1986). During data analysis we used central tendency measures. Results: The study involved 14 male students and 126 female students with a mean age of 18,7 years. The average of the scores given by the students in the Inventory items Sheppard was 2,05 (SD = 0,32). In general, this value indicates that the responses was negative. The scores for each factor Sheppard Inventory of Attitudes toward Aging were below the midpoint of the range in dimensions "Expectations regarding activity" and "Expectations regarding satisfaction" (X=1,70, SD=0,39 and X=1,66, SD=0,56, respectively) and value above the midpoint on the scale dimension "Anxiety about death" (X=2,82, SD=0,71). Discussion: These results, reflecting negative attitudes of students toward aging, are consistent with Celik et al. (2010). Conclusion: Nursing students of 1st year show negative attitudes toward aging X=2,05 (SD=0,32). Higher education teachers, related to health have responsibilities in demystify aging stereotypes.info:eu-repo/semantics/publishedVersio

Monitorização biológica da exposição a quimioterápios em profissionais de enfermagem

Dissertação de Mestrado em Saúde Pública, área de especialização em Saúde Ocupacional, apresentada à Faculdade de Medicina e ao Instituto de Ciências Biomédicas de Abel Salazar da Universidade do Port

A Technological-Based Platform for Risk Assessment, Detection, and Prevention of Falls Among Home-Dwelling Older Adults: Protocol for a Quasi-Experimental Study

Background: According to the United Nations, it is estimated that by 2050, the number of people aged 80 years and older will have increased by 3 times. Increased longevity is often accompanied by structural and functional changes that occur throughout an individual’s lifespan. These changes are often aggravated by chronic comorbidities, adopted behaviors or lifestyles, and environmental exposure, among other factors. Some of the related outcomes are loss of muscle strength, decreased balance control, and mobility impairments, which are strongly associated with the occurrence of falls in the elderly. Despite the continued undervaluation of the importance of knowledge on fall prevention among the elderly population by primary care health professionals, several evidence-based (single or multifaceted) fall prevention programs such as the Otago Exercise Program (OEP) have demonstrated a significant reduction in the risk of falls and fall-related injuries in the elderly within community settings. Recent studies have strived to integrate technology into physical exercise programs, which is effective for adherence and overcoming barriers to exercise, as well as improving physical functioning. Objective: This study aims to assess the impact of the OEP on the functionality of home-dwelling elderly using a common technological platform. Particularly, the impact on muscle strength, balance, mobility, risk of falling, the perception of fear of falling, and the perception of the elderly regarding the ease of use of technology are being examined in this study. Methods: A quasi-experimental study (before and after; single group) will be conducted with male and female participants aged 65 years or older living at home in the district of Porto. Participants will be recruited through the network COLABORAR, with a minimum of 30 participants meeting the study inclusion and exclusion criteria. All participants will sign informed consent forms. The data collection instrument consists of sociodemographic and clinical variables (self-reported), functional evaluation variables, and environmental risk variables. The data collection tool integrates primary and secondary outcome variables. The primary outcome is gait (timed-up and go test; normal step). The secondary outcome variables are lower limb strength and muscle resistance (30-second chair stand test), balance (4-stage balance test), frequency of falls, functional capacity (Lawton and Brody - Portuguese version), fear of falling (Falls Efficacy Scale International - Portuguese version), usability of the technology (System Usability Scale - Portuguese version), and environmental risk variables (home fall prevention checklist for older adults). Technological solutions, such as the FallSensing Home application and Kallisto wearable device, will be used, which will allow the detection and prevention of falls. The intervention is characterized by conducting the OEP through a common technological platform 3 times a week for 8 weeks. Throughout these weeks, the participants will be followed up in person or by telephone contact by the rehabilitation nurse. Considering the COVID-19 outbreak, all guidelines from the National Health Service will be followed. The project was funded by InnoStars, in collaboration with the Local EIT Health Regional Innovation Scheme Hub of the University of Porto. Results: This study was approved on October 9, 2020 by the Ethics Committee of Escola Superior de Enfermagem do Porto (ESEP). The recruitment process was meant to start in October, but due to the COVID-19 pandemic, it was suspended. We expect to restart the study by the beginning of the third quarter of 2021. Conclusions: The findings of this study protocol will contribute to the design and development of future robust studies for technological tests in a clinical context.info:eu-repo/semantics/publishedVersio

Quais as barreiras à participação de cuidadores informais de pessoas dependentes num programa psico-educacional?

Introdução: Os programas psico-educacionais têm sido amplamente recomendados como estratégia para fornecer informações e apoio aos cuidadores informais de pessoas dependentes. No entanto, a literatura aponta para níveis muito baixos de participação nestes programas devido a várias barreiras. Assim, o nosso objetivo foi analisar as barreiras para a participação dos cuidadores informais de idosos dependentes num programa psico-educacional realizado numa unidade de saúde na Trofa. Metodologia: Estudo qualitativo realizado com 13 cuidadores informais de pessoas idosas dependentes. Como técnica de colheita de dados foi utilizada a entrevista semi-estruturada. Na análise dos dados recorremos à técnica de análise de conteúdo de Bardin. Resultados: As barreiras “situacionais” foram as mais relatadas pelos participantes (n = 9), ou seja, ter que acompanhar as pessoas dependentes a consultas médicas, a falta de tempo devido á prestação de cuidados. Dois participantes referiram barreiras “psicossociais”, ou seja, a falta de interesse em aprender e dois apontaram barreiras “informativas”, ou seja, desconheciam o horário da sessão. Os resultados deste estudo vão de encontro aos de outros estudos. Conclusão: Os resultados deste estudo podem ajudar os enfermeiros a identificar as barreiras para a participação das pessoas cuidadoras em programas psico- educacionais e a desenvolver estratégias específicas para eliminar essas barreiras.Introduction: Psycho-educational programs have been widely recommended as a strategy to provide information and support to informal caregivers of dependent people. Nevertheless, the literature points to very poor levels of participation in such programs as a function of several barriers. Thus, our objective were to analyze the barriers to the participation of informal caregivers of dependent older adults in a psycho-educational program conducted at a health center in Trofa – Portugal. Methods: A qualitative study among 13 informal caregivers of dependents elders was conducted. A semi-structured, in-depth, face- to-face interviews as method of data collection was used. The analysis of the qualitative data was based on Bardin´s technique of content analysis. Results: The barriers most frequently reported by the participants (n= 9) were “situational”, i.e., having to escort the care recipients to medical visits, lack of time due to caregiving tasks. Two volunteers reported “psychosocial” barriers, i.e., lack of interest in learning, and two other volunteers reported “informational” barriers, i.e., did not know the session schedule. Several barriers related to the use of support services were reported, thus agreeing with the results of other studies. Conclusion: The results of this study will help nurses to understand the barriers to participation in the psycho-educational program, and to develop specific strategies to eliminate such barriers.info:eu-repo/semantics/publishedVersio

Impact of a physical exercise program on the functional capacity of the institutionalized elderly

Introduction: Preventive, promotion and rehabilitation actions such as physical exercise have been able to improve the functional capacity of the institutionalized elderly. Aims: To evaluate the impact of a physical exercise program on the functional capacity of institutionalized elderly. Method: Quantitative study with a quasi-experimental design, without control group, with pre and post intervention evaluation, in a convenience sample of 23 elderly. The instrument for data collection was the form with outcome and independent variables. The study was approved by the Ethics Committee of the Escola Superior de Enfermagem do Porto. Results: The majority are female (60.9%), with a mean age of 82.4 years and a high prevalence of cerebrovascular disease (91.3%). ¾ of the sample (74%) is polymedicated. The occurrence of falls in the last 12 months was low (13%). There was a significant improvement in joint amplitude and muscular strength in all movements and joints of the upper and lower limbs. Palmar grip strength improved in both hands. A better performance was observed in the implementation of POMA I, and the number of risk-free elderly people with a high risk of falls increased. The repercussion of improvements in self-care capacity was not effective in some domains, although the mean scores obtained showed a slight improvement trend. Of the psychosocial effects, most participants (60.9%) agreed that they improved health and mood. Conclusions: The physical exercise program implemented to institutionalized elderly, without cognitive deficit, improved the functional and psychosocial capacity.info:eu-repo/semantics/publishedVersio

O processo de supervisão em ensino clinico: Organização do trabalho do tutor

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Physical Exercise Program on Fall Prevention Using Technological Interface: Pretest Study

Background: Prevention of falls among older adults has boosted the development of technological solutions, requiring testing in clinical contexts and robust studies that need prior validation of procedures and data collection tools. Objective: The objectives of our study were to test the data collection procedure, train the team, and test the usability of the FallSensing Games app by older adults in a community setting. Methods: This study was conducted as a pretest of a future pilot study. Older adults were recruited in a day care center, and several tests were applied. Physical exercise sessions were held using the interactive FallSensing Games app. Nurse training strategies was completed. Results: A total of 11 older adults participated. The mean age was 75.08 (SD 3.80) years, mostly female (10/11, 91%) and with low (3-6 years) schooling (10/11, 91%). Clinically, the results show a group of older adults with comorbidities. Cognitive evaluation of the participants through the Mini Mental State Examination showed results with an average score of 25.64 (SD 3.5). Functional capacity assessed using the Lawton Instrumental Activities of Daily Living Scale (overall score from 0-23, with lower scores reflecting worse capacity to perform activities) showed impairment in different instrumental activities of daily living (average score 14.27). The data collection tool proved to enable easy interpretation; however, its structure needed small adjustments to facilitate the data collection process. Despite the length of the questionnaire, its implementation took an average of 21 minutes. For the assessment of the prevalence of fear of falling, the need to add a question was identified. The performance of functional tests under the guidance and presence of rehabilitation nurses ensured the safety of the participants. The interactive games were well accepted by the participants, and the physical exercises allowed data collection on the functionality of the older adults, such as the number of repetitions in the tests, range of movement (angle), duration of the movements, and execution of each cycle. Concerning the training of the nurses, it was crucial that they had experience with the platform, specifically the position of the chair facing the platform, the position of the feet, the posture of participants, and the use of sensors. Conclusions: In the future pilot study, the researchers point out the need to design a study with mixed methods (quantitative and qualitative), thus enriching the study results.info:eu-repo/semantics/publishedVersio

Intervenções não farmacológicas no controle da incontinência urinária e os instrumentos que permitam o seu diagnóstico: revisão integrativa

Introduction: Urinary incontinence is a major health problem resulting in physical, psychological and social changes with economic repercussions on the health system. Is a multifactorial condition associated with age-related changes and disorders of the genitourinary system, which corroborates the fact that it is the most often recurring geriatric syndrome. Aims: To identify non-pharmacological interventions for adults with urinary incontinence and to identify tools for urinary incontinence diagnosis in adults. Method: An integrative review study design was completed. Two electronic databases was search (MEDLINE and Web of Science). Three independent reviewers searched databases according to a predetermine inclusion and exclusion criteria. Results: Twelve articles were included in the review. Eleven articles mentioned non-pharmacological interventions, such as physical therapies, lifestyle strategies, behavioural therapies and alternative conservative management options. These interventions should be targeted and individualized to the type of incontinence to result in health gains for the population. One article mentioned an assessment tool for urinary incontinence - The Gaudenz-Fragebogen tool. The evaluation tools can help to systematize the diagnostic activity and consequently improve the clinical practice in the field of urinary incontinence. Conclusion: In care conception, nurses should target their interventions to personal data to address individual symptoms and use assessment tools that can help in the differential diagnosis of UI. Then, to advancing the quality and rigor of nursing care, we advocate that providing nurses with skills in attaining a differential diagnosis of UI presents an added value to the improvement of quality of care in a multidisciplinary context.info:eu-repo/semantics/publishedVersio

Risk factors for falls in the community: based on self-report of elderly persons

Introduction: Several studies have shown independent risk factors for falling among community older people. However, there is few researches showing the importance of older person’s perception of their own fall risk. Aims: The study purpose was to identify independent risk factors for falls and to explore predictive factors related to the occurrence of falls in community-dwelling older people. Method: A cross-sectional study was conducted from January to April 2015. All data were based on self-report of older persons. An study-specific questionnaire was used. Univariate and logistic regression analyses were used. Results: The sample comprised 562 men and 760 women. Among the participants, 24.5% reported having had falls in the previous six months, scoring a total of 467 falling events. Of the individuals who had fallen, 36.8% had experienced recurrent falls. The risk of fall was nearly twice as high in women than in men (OR=1.85; 95% CI: 1.40-2.43). Being 75 years old or older was associated with an increased risk of falling compared with being 65-74 years old (OR=2.38; 95% CI:1.82-3.11). The elderly who had fallen reported injuries (48.3%) associated with falls, and 36% required health care. Conclusion: Six independent risk factors for falling into the community dwelling older people were identified, some of which are potentially modifiable.info:eu-repo/semantics/publishedVersio

A fragilidade no contexto da saúde

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