Editorial

info:eu-repo/semantics/publishedVersio

a case study

Objectives: to characterize the interventions of specialist nurses of community health and public health of a Group of Health Centers, to identify the main facilitating factors for the performance of competences, and the contribution to public health policies. Method: this is a case study carried out with nurses specialized in community health and public health nursing. Data were collected through interviews from October to December 2019. Analysis was guided by two strategies: starting from the theoretical propositions and working the data from the ground up; and two techniques: pattern matching and explanation building. Results: from the constructed matrix, ten theoretical propositions, ten emerging evidences, five patterns and five explanatory hypotheses emerged. There are interventions for epidemiological surveillance, planning and project management. Personal training and communication stand out as facilitating factors. Conclusion and implications for practice: the intervention of the nurses of these specialties presents a dimension centered on project planning and management identifies and reflects the facilitating factors of the performance of their competencies, as an applicator of public health policiesinfo:eu-repo/semantics/publishedVersio

Parents’ perception of health education practices in Neonatal Unit

Objective: to analyze parents’ perception of health education practices developed by nurses in a Neonatal Unit that facilitated the acquisition of parenting skills for an informed decision-making. Method: this is an exploratory, descriptive and qualitative study. We included 13 parents with children hospitalized for the first time in a Portuguese Neonatal Unit. Data were collected between February and August 2020, through focus groups, processed in the software Interface de R pour Multidimensionnelles de Textes et de Questionneires, through Descending Hierarchical Classification and Similitude Analysis. Results: four classes emerged from the Descending Hierarchical Classification: “Information needs”; “Information gaps”; “Availability to inform”; “Facilitating health education practices”. Conclusion and implications for practice: parents considered digital technology combined with nurses’ availability to inform and explain, as well as provide an empathetic and informal environment as facilitating practices for health education. These results can support health education nursing interventions for parents at the Neonatal Units using digital technology.info:eu-repo/semantics/publishedVersio

Special issue on pests and pathogens in Apiculture: Navigating Old Challenges and Unveiling New Threats

In the realm of apiculture, the delicate balance between colonies, bees and the challenges posed by pests and pathogens has been a longstanding concern for researchers and beekeepers alike. The decision to dedicate a special edition to pests and pathogens in apiculture arose from the fact that a myriad of pests and pathogens are some of the main threats to bees across the world. Moreover, the increase in submissions during the recent period indicates a heightened research interest and an urgent imperative to confront the challenges associated with pests and pathogens in apiculture.info:eu-repo/semantics/publishedVersio

Uma abordagem socioecológica ao problema do autocuidado nas atividades de vida diária das pessoas idosas em contexto domiciliário

Há hoje várias respostas a nível dos cuidados de longa duração para a pessoa idosa, contudo carecemos ainda de verdadeiras respostas integradas que se foquem na multidimensionalidade da pessoa humana. Assim, o nosso puzzle de investigação assenta neste paradoxo. A avaliação da situação de saúde de cada idoso em sua casa carece de uma compreensão sobre o seu contexto, para que seja possível identificar a conjugação de factores que conduzem à melhoria da autonomia da pessoa idosa nas suas actividades de vida diária. É necessário pois que se entenda que a promoção do autocuidado na pessoa idosa não está apenas na esfera individual ou interpessoal, mas depende igualmente de factores sociais, estruturais e de contexto. O presente artigo tem como objectivo identificar, na literatura, os factores fundamentais para a promoção do autocuidado da pessoa idosa, em contexto domiciliário, nas actividades de vida diária. A questão orientadora é a seguinte: “Quais os factores que promovem o autocuidado da pessoa idosa nas actividades de vida diária, em contexto domiciliário”. Seleccionaram-se cinco revistas científicas (Ageing & Society; European Journal of Ageing; Geriatric Nursing; International Journal of Nursing, BMC Geriatrics), das quais analisámos os artigos científicos, com conteúdo original, segundo o título e resumo, entre o ano de 2005 e 2015 que tivessem os critérios de inclusão e descritores identificados. Foi utilizado igualmente o método de revisão de literatura tipo bola de neve, o que nos conduziu a outras revistas científicas e múltiplos autores. Foram encontrados 2889 artigos, dos quais foram excluídos 2680 após leitura dos títulos e resumos. Foram seleccionados para leitura integral 206 artigos, dos quais foram excluídos 77 artigos de acordo com os critérios de inclusão e exclusão, língua e repetição de artigos. Assim, obteve-se 129 artigos para a revisão sistemática de literatura. Com base na análise dos artigos foram identificados os seguintes factores: factores intrapessoais; factores interpessoais; factores de contexto.info:eu-repo/semantics/publishedVersio

COMO AVALIAR O RISCO DE QUEDA EM IDOSOS INSTITUCIONALIZADOS?

Objetivo: identificar os instrumentos utilizados para avaliar o risco de queda em pessoas idosas institucionalizadas. Método: Revisão Integrativa da Literatura, realizada entre abril e julho de 2018, conforme protocolo pré-definido, com definição de critérios de elegibilidade para 18 estudos da amostra bibliográfica, para resposta à questão “Quais os instrumentos de avaliação usados para determinar o risco de queda em pessoas idosas institucionalizadas?” Resultados: os estudos utilizam instrumentos diferentes, isolados ou em conjugação, para determinar o risco de queda. Identificaram-se escalas específicas para avaliar o risco (Easy-Care risk of the Falls, St. Thomas Risk Assessment Tool, a Escala de Downton, entre outras), testes de avaliação funcional e testes de avaliação do estado mental. Conclusão: os instrumentos mais usados para a avaliação do risco de queda nos idosos institucionalizados são o Timed Up and Go Test e o Performance-Oriented Mobility Assessment, em associação com a pergunta “Caiu nos últimos 12 meses?”Descritores: Acidentes por Quedas. Idosos. Avaliação em Enfermagem. Risco

Adesão ao regime medicamentoso em idosos na comunidade : eficácia das intervenções de enfermagem

Tese de doutoramento, Enfermagem, Universidade de Lisboa, com a participação da Escola Superior de Enfermagem, 2011A não adesão à medicação é considerada como um aspecto de saúde relevante para a prática de enfermagem, que afecta grande parte dos idosos. Estudar a adesão à medicação foi o modo de percebermos como as pessoas idosas gerem a sua medicação e como os enfermeiros os podem ajudar no processo de gestão da doença crónica. Realizámos o Estudo I, observacional, transversal e descritivo, com pessoas com 65 ou mais anos, que residiam na comunidade, em domicílio familiar, em meio urbano, inscritos num Centro de Saúde Lisboa; Estudo II, de intervenção, não farmacológico, do tipo experimental, em que a exposição foi a participação do idoso polimedicado num plano individualizado de intervenções de enfermagem; Estudo III, focus group que permitiu compreender as necessidades que os idosos tinham na gestão do regime medicamentoso e na adesão à medicação. Os 341 idosos incluídos no estudo I apresentaram uma média de 76 anos de idade, em que 7% tinha mais de 85 anos, 72,4% eram mulheres, apresentavam baixa escolaridade, fraco estado de saúde percepcionado, excesso de peso, sem quedas no último ano, autónomas na locomoção, na autonomia física e instrumental, com insatisfatório estado emocional, bom estado cognitivo, insatisfatório estado social e com hábitos (exercício e alimentação) satisfatórios. A qualidade de vida geral percepcionada apresentou uma média de 55,9, no domínio físico 59,8, no psicológico 63,1, nas relações sociais 75,50 e no ambiente 57,78. Declararam uma média de 2,82 doenças auto-relatadas (DP=1,59;Min= 0 e Max = 7), em que as doenças mais prevalentes são hipertensão (61,5%), hipercolesterolémia (50,6%), doenças osteo-articulares (40,6%) e diabetes (15,6%). Os idosos inquiridos têm uma média 5,61 medicamentos prescritos (DP = 3,13; Min=0 e Max =18) e 72,1% tomam 4 ou mais medicamentos, sendo por isso considerados polimedicadas. Dos 1902 medicamentos prescritos, os grupos de medicamentos mais utilizados são: sistema cardiovascular 41%, sistema nervoso 20,4%, tracto gastrointestinal 14,2% e músculo-esquelético 9,6%. O Índice de Complexidade Medicamentosa (ICM) tem um valor médio de 13,25 (DP= 7,87; Min = 0 e Max = 40) com fraca associação com o número de doenças auto-relatadas (r de Spearman = 0,37, p <0,001). Cerca de 87% dos idosos declaram aderir à medicação. Os preditores de adesão são a autonomia física (p=0,012;OR = 0,28; IC = 0,10-0,84), a polimedicação (p = 0,011;OR = 0,47;IC=0,26-0,86), conhecimentos dos medicamentos (p=0,035;OR= 1,90; IC= 1,02-3,51), as multipatologias (p = 0,047; OR = 0,53;IC = 0,28-0,98) e a doença auto-declarada – hipercolesterolémia (p=0,014;OR = 0,50; IC = 0,28-0,87). Das razões de não adesão à medicação, o esquecimento surge em 60,5% dos inquiridos, 24,4% não os tinha consigo na hora da toma, 14,5% considera que não tomar de vez em quando não faz mal, 12,8% não tinha dinheiro para os comprar e 7,6% tentou poupar dinheiro. A necessidade de ajuda para gerir a medicação é declarada por 36,1% das pessoas idosas. O estudo II permite concluir que as intervenções de enfermagem (aconselhamento sobre os medicamentos, controlo dos medicamentos e ensino sobre os medicamentos) revelam eficácia no aumento de adesão ( Χ2 =33,70; p <0,001). RR =5,33; IC (95%) = [2,50-11,37]). O score de adesão no grupo de intervenção, no momento final é de 4,6 e 4,4 no grupo de controlo. Não se verifica diferença entre o grupo de intervenção e o grupo de controlo, na qualidade de vida das pessoas idosas e nas idas às urgências e internamento hospitalar. O Estudo III permitiu identificar e compreender, dando “voz” às pessoas idosas, que viver com medicamentos é um processo dinâmico e complexo, que tomar medicamentos é percepcionado pelas pessoas idosas como uma consequência da idade, integrando essa acção na sua vida como um hábito que implica mudanças nas rotinas da vida diária. As crenças que as pessoas têm sobre os medicamentos explicam uma parte da não adesão. A disponibilidade do profissional de saúde, nomeadamente o enfermeiro, para ouvir e ajudar as pessoas de forma individualizada e continuada são consideradas pelos idosos como ajudas úteis na gestão da doença, da medicação e podem contribuir para o aumento da adesão à medicação. A consulta de enfermagem como contexto de cuidados, onde as intervenções de enfermagem contribuíram para um aumento de adesão à terapêutica nas pessoas idosas, deve ser integrada na organização dos cuidados de enfermagem, em cuidados de saúde primários, no cuidado à pessoa idosa. Este contexto de cuidados permite individualizar um plano de intervenção de cuidados de enfermagem às pessoas idosas. O nosso trabalho evidência que a adesão à medicação é um indicador sensível aos cuidados de enfermagem, onde a intervenção do enfermeiro, numa unidade de cuidados de saúde primários, privilegia a qualidade da comunicação e relação com os idosos e os ajuda a melhorar a gestão da sua medicação e do seu estado de saúde, sendo por eles reconhecida.Non-adherence to medication is a phenomenon in nursing perceived to be an important health issue for the practice of nursing (CIPE) and which affects large numbers of elderly people. Studying adherence to medication enabled us to understand how the elderly manage their own medication intake and how nurses can help them manage chronic disease. Study I was observational, cross-sectional and descriptive, and involved studying people aged 65 or above living in the community, at home, urban, and registered at a Health Centre in Lisbon; Study II was interventional, non-pharmacological and experimental, involving aged people taking distinct types of drugs and subject to individual nursing intervention. Study III was carried out by means of a focus group which allowed understanding the needs of the elderly in managing their medicine intake and adherence to medication. The average age of the 341 elderly people who took part in Study I was 76 years, of whom 7% were above 85 years of age, while 72.4% were women. The group had a low education level, weak health, was overweight, had suffered no falls in the previous year, and could walk unassisted, denoting physical and instrumental autonomy, low emotional condition, good cognition, inadequate social conditions and satisfactory habits (exercise and dietary). The perceived quality of life indicated an average of 55.9 59.8 in physical terms, 63.1 in psychological terms, 75.0 with regard to social relations, and 57.78 in environmental terms. They declared an average of 2.82 self-reported illnesses (DP=1.59;Min= 0 and Max = 7), the most prevailing diseases being hypertension (61.5%), high cholesterol levels (50.6%), joint diseases (40.6%), and diabetes (15.6%). The elderly who were interviewed took an average of 5.61 prescribed medicines (DP =3.13; Min=0 and Max =18) and 72.1% took 4 or more drugs, for which reason they are considered multiple drug takers. Out of the 1902 drugs prescribed, the most used groups addressed the following medical conditions: cardiovascular system 41%, nervous system 20.4%, gastrointestinal tract 14.2%, and muscular-skeletal system 9.6%. The Medication Complexity Index (MCI) showed an average value of 13.25 (DP= 7.87; Min = 0 and Max = 40) and a weak association with the number of self-reported illnesses (Spearman’r = 0.37, p <0.001). About 87% of the elderly stated they adhered to prescribed medication. The predictors of adherence were physical autonomy (p=0.012; OR = 0.28; IC =0.10-0.84), multiple drug intake (p = 0.011; OR = 0.47; IC=0.26-0.86), knowledge of drugs (p=0.035; OR= 1.90; IC= 1.02-3.51), multiple pathologies (p = 0.047; OR = 0.53; IC= 0.28-0.98) and self-declared diseases –high cholesterol level (p=0.014; OR = 0.50; IC = 0.28-0.87). As part of the reasons for non-adherence to medication, 60.5/ of the patients indicated forgetfulness, 24.4% stated they did not have them with them at the time of intake, 14.5% said that missing medication occasionally was not a problem, 12.8% indicated they had no money to buy them, and 7.6% did it as a means to save money. The need of assistance in managing drug intake was advanced by 36.1% of the elderly. Study II allowed us to conclude that nursing interventions (giving advise on drugs, drugs control and drug education) are effective in increasing adherence (Χ2 = 33.70; p <0.001). RR = 5.33; IC (95%) = [2.50-11.37]). The adherence score of the intervention group was, at the final stage, of 4.6, and of 4.4 with regard to the control group. There was no difference between the intervention and the control groups in terms of life quality of the elderly and in attendance of emergency rooms and of hospitalization. Study III enabled us to identify and understand, by giving a “voice” to the elderly, that living with drugs is a dynamic and complex process, and that taking medication is perceived by elderly people as a consequence of their ageing, which requires them to include that process in their lives as a habit implying changes in their daily routines. Beliefs people have about drugs account, to some extent, for non-adherence. The elderly consider that the willingness of health professionals, namely nurses, to listen and offer individual and ongoing assistance are useful forms of help in managing their illnesses and medication, and, accordingly, may contribute to increasing adherence to medication. Nursing appointments as part of care, where nursing interventions have contributed towards an increase in adherence to therapy by the elderly, should be included in the organization of nursing care, in primary health care, and in the care of the elderly. This care allows individualized nursing intervention plans for the elderly. This work demonstrates that adherence to medication is a sensitive indicator for nursing care, where the intervention of the nurse within a primary health care unit privileges the quality of communication and the relationship with the elderly, helping them to improve the management of their drug intake and health, a fact that they actually acknowledg

The Effect of Interventions on Preventing Musculoskeletal Injuries Related to Nurses Work: Systematic Review

Funding: The present study was funded by the Center for Research, Innovation, and Development in Nursing, in Portugal, by means of grants provided to some of the authors.info:eu-repo/semantics/publishedVersio

Preventing falls in hospitalized elderly: design and validation of a team intervention

The objective of the present study was the design and validation, by a panel of experts, of a team intervention to manage the risk of falls in the hospitalized elderly.info:eu-repo/semantics/publishedVersio

Learning from the covid-19 outbreaks in long-term care facilities: a systematic review

© The Author(s) 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: The COVID-19 pandemic has devastatingly affected Long-Term Care Facilities (LTCF), exposing aging people, staff members, and visitors. The world has learned through the pandemic and lessons can be taken to adopt effective measures to deal with COVID-19 outbreaks in LTCF. We aimed to systematically review the available evidence on the effect of measures to minimize the risk of transmission of COVID-19 in LTCs during outbreaks since 2021. Methods: The search method was guided by the preferred reporting items for systematic reviews (PRISMA) and the reporting guideline synthesis without meta-analysis (SWiM) in systematic reviews. The search was performed in April 2023. Observational and interventional studies from the databases of PubMed, Web of Science, Scopus, Cochrane Systematic Reviews, CINAHL, and Academic Search were systematically reviewed. We included studies conducted in the LTCF with outbreaks that quantitatively assess the effect of non-pharmacological measures on cases of COVID-19. Two review authors independently reviewed titles for inclusion, extracted data, and undertook the risk of bias according to pre-specified criteria. The quality of studies was analyzed using the Joanna Briggs Institute Critical Appraisal. Results: Thirteen studies were included, with 8442 LTCF experiencing COVID-19 outbreaks and 598 thousand participants (residents and staff members). Prevention and control of COVID-19 infection interventions were grouped into three themes: strategic, tactical, and operational measures. The strategic measures reveal the importance of COVID-19 prevention and control as LTCF structural characteristics, namely the LTCF size, new admissions, infection control surveillance, and architectural structure. At the tactical level, the lack of personal and long staff shifts is related to COVID-19's spread. Operational measures with a favorable effect on preventing COVID-19 transmission are sufficient. Personal protective equipment stock, correct mask use, signaling, social distancing, and resident cohorting. Conclusions: Operational, tactical, and strategic approaches may have a favorable effect on preventing the spread of COVID-19 in LTCFs experiencing outbreaks. Given the heterogeneous nature of the measures, performing a meta-analysis was not possible. Future research should use more robust study designs to explore similar infection control measures in LTCFs during endemic situations with comparable outbreaks. Trial registration: The protocol of this systematic review was registered in PROSPERO (CRD42020214566).info:eu-repo/semantics/publishedVersio