La formación en enfermería de rehabilitación en Portugal desde 2006

Enquadramento: Desde o início do século que se verifica uma diminuição da natalidade e maior envelhecimento populacional, existindo mais pessoas com incapacidade e dependência, exigindo cuidados de enfermagem mais especializados. Objetivo: Descrever a evolução na formação da especialidade em enfermagem de reabilitação. Metodologia: Recolha documental no Diário da República, com análise e interpretação hermenêutica das fontes com referência à especialidade de enfermagem de reabilitação, publicadas desde 2006. Resultados: Foram aprovados vários planos de estudo de pós-licenciatura de especialização e mestrado em enfermagem de reabilitação. Progressivamente, houve inclusão de unidades curriculares como Epidemiologia Estatística e Demografia, Aspetos Psicossociais da Incapacidade, Políticas e Modelos de Cuidados de Saúde e Estágios de Cuidados de Enfermagem de Reabilitação à Pessoa com Problemas Oncológicos e em Fim de Vida. Conclusão: A formação em enfermagem de reabilitação desenvolveu-se com influência das alterações políticas e sociodemográficas. Com os avanços tecnológicos, científicos e a evolução dos sistemas de saúde, os cuidados de enfermagem de reabilitação têm evoluído na inovação e formação, com enquadramento legal e nas competências específicas.Background: Since the beginning of the 21st century, fertility rates have decreased and life expectancy has increased, with more people with disabilities and dependent on others requiring more specialized nursing care. Objective: To describe the evolution of education/training in rehabilitation nursing. Methodology: Documental search conducted in the Portuguese official journal (Diário da República), with hermeneutic analysis and interpretation of the sources on the specialty of rehabilitation nursing since 2006. Results: Several curricula of postgraduate specialization and master’s degrees in rehabilitation nursing have been approved since 2006. Several course units were gradually integrated into the curricula, such as Statistical Epidemiology and Demography, Psychosocial Aspects of Disability, Health Care Policies and Models, and Internships in Rehabilitation Nursing Care for People with Cancer and at the End of Life. Conclusion: Education/training in rehabilitation nursing evolved under the influence of political and socio-demographic changes. With the technological and scientific advances and the evolution of health systems, rehabilitation nursing care has evolved in terms of innovation and education/training within a legal framework and based on specific competencies.Marco contextual: Desde principios de siglo se ha producido un descenso de la natalidad y un mayor envejecimiento de la población, con más personas con discapacidad y dependencia, que requieren más cuidados especializados de enfermería. Objetivo: Describir la evolución en la formación de la especialidad en enfermería de rehabilitación. Metodología: Recopilación documental en el Diario de la República, con análisis e interpretación hermenéutica de las fuentes con referencia a la especialidad de enfermería de rehabilitación, publicadas desde 2006. Resultados: Se aprobaron varios planes de estudio de posgrado de especialización y máster en enfermería de rehabilitación. Progresivamente, se incluyeron unidades curriculares, como Epidemiología Estadística y Demografía, Aspectos Psicosociales de la Discapacidad, Políticas y Modelos de Atención Sanitaria y Prácticas de Atención de Enfermería de Rehabilitación a la Persona con Problemas Oncológicos y al Final de la Vida. Conclusión: La formación en enfermería de rehabilitación ha evolucionado con la influencia de los cambios políticos y sociodemográficos. Con los avances tecnológicos y científicos, así como con la evolución de los sistemas sanitarios, los cuidados de enfermería de rehabilitación han evolucionado en innovación y formación, con marcos legales y competencias específicas.info:eu-repo/semantics/publishedVersio

Changes in Clinical Training for Nursing Students during the COVID-19 Pandemic: A Scoping Review

Funding: This research received no external funding.(1) Background: The COVID-19 pandemic has cost social, economic, cultural, and educational life, distressing nursing training and practice. This study aimed to map the literature on changes in clinical training for nursing students during the COVID-19 pandemic. (2) Methods: A scoping review was conducted according to JBI methodology’s latest guidance. A set of relevant electronic databases and grey literature was searched to report results published in English, Spanish, and Portuguese. (3) Results: A total of 12 studies were included in the study, addressing changes in clinical training in undergraduate nursing students due to COVID-19 pandemic activity, published between 2020 and 2022. (4) Conclusions: Nursing schools made an effort to replace traditional clinical training with several activities, primarily based on simulation or virtual activities. However, contact with others is essential, and simulation programs or scenarios cannot provide it.info:eu-repo/semantics/publishedVersio

Monitoring and Management of the Palliative Care Patient Symptoms: A Best Practice Implementation Project

Acknowledgments: The authors acknowledge the support provided by Health Sciences Research Unit: Nursing (UICISA: E), hosted by the Nursing School of Coimbra (ESEnfC), and the Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Portugal.Background: In palliative care, symptoms are multiple and combined, evolving and changing, with a multidimensional character and multifactorial causes, and a high prevalence, negatively influencing the patient’s and family’s quality of life. Nurses who provide palliative care need to recognize and respond effectively to their patients’ symptoms. Methods: A project will be applied to implement the best practice in monitoring and managing palliative care patients’ symptoms. The Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool will be used. The JBI PACES and GRiP framework for promoting evidence-based healthcare involves three phases of activity. First, a baseline audit. In a second phase, feedback will be given to the project team after the conclusion of the baseline audit report. Then, a third phase will be conducted as a follow-up audit. Conclusions: This project will improve the practice of the nursing team in monitoring and managing the symptoms of palliative care patients, positively influencing the quality of life of the patient and his family. The implementation and dissemination of this project could boost its replication in other centres.info:eu-repo/semantics/publishedVersio

Nonpharmacological interventions used in the perioperative period to prevent anxiety in adolescents: a scoping review

Objective: The objective of this scoping review was to examine and map the range of nonpharmacological interventions used in the perioperative period to prevent anxiety in adolescents. Introduction: Undergoing surgery involves experiencing fears and uncertainties that lead to an increase in anxiety levels. The interventions used to prevent anxiety in the perioperative period in adolescents must be appropriate to their developmental stage. Inclusion criteria: Studies involving adolescents (10 to 19 years of age) undergoing any type of surgical procedure and specifying any nonpharmacological interventions administered to prevent anxiety, implemented in the perioperative period, were included in this review. Methods: A comprehensive search strategy using multiple databases was employed to find relevant studies. The databases search included MEDLINE via PubMed; CINAHL Plus with Full Text via EBSCO; Cochrane Central Register of Controlled Trials; LILACS; Scopus; Library, Information Science and Technology Abstracts; PsycINFO; JBI Connectþ; and Cochrane Database of Systematic Reviews. Sources of unpublished studies and gray literature were TDX – Tesis Doctorals en Xarxa (Spain); RCAAP – Reposito´ rio Cientı´fico de Acesso Aberto de Portugal; OpenGrey – System for Information on Grey Literature in Europe; and MedNar. Studies published in English, Spanish, or Portuguese were included. There was no date restriction, or geographical or cultural limitation applied to the search. The relevant studies and their reported outcomes were organized and analyzed. Results: The database search yielded 1438 articles, and three additional records were added after hand searching. Title, abstract, and full-text review identified 11 papers that met the inclusion criteria. The final data set represented 947 participants. The data were analyzed according to the type of nonpharmacological intervention, population, concept (outcome measured and tool used), context (physical location; preoperative vs. postoperative), frequency and duration of the intervention, and which professional team member implemented the intervention. Eight nonpharmacological interventions were identified, applied either in the preoperative or postoperative context. The nurses were the main professionals administering the nonpharmacological interventions to the adolescents. Conclusions: A variety of nonpharmacological interventions were used in the perioperative period to prevent anxiety in adolescents. The most common interventions were music/musicotherapy and hypnosis/guided imagery. However, other interventions such as therapeutic play, preoperative preparation program, mothers’ presence during the anesthesia induction, distraction, relaxation training, massage therapy, and reading were also identified. These interventions were used alone or in a combination of two interventions, either preoperatively or postoperatively. The adolescents in the early stage (10 to 14 years) were the most studied group and the adolescents in the late stage (17 to 19 years) were the least studied. Future research should focus on the implementation of nonpharmacological interventions in the perioperative period involving adolescents, particularly late adolescents. A systematic review on the effect of nonpharmacological interventions for anxiety management in adolescents in the perioperative period should be conducted.info:eu-repo/semantics/publishedVersio

Intervenções não farmacológicas implementadas por enfermeiros no controlo da dor em cuidados paliativos: protocolo scoping review.

Aim: To identify and map the existing scientific evidence within the scope of non-pharmacological interventions implemented by nurses with the objective of providing pain relief to the people in a palliative situation. Method: This study followed the scoping review protocol based on the Joanna Briggs Institute methodology. In regard to the research strategy and identification of studies, the following electronic databases were consulted: MEDLINE (via Pubmed), CINAHL Complete (via EBSCOhost), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scielo, JBI Library of Systematic Reviews, and Scopus. In addition, the search for unpublished studies included the Scientific Repository for Open Access of Portugal (RCAAP) and OpenGrey. The research strategy included all the articles published in Portuguese, Spanish and English in the last 5 years. Results: Following the main objective, focus and research question, the results will be presented in a narrative format, using tables. The mapping of the non-pharmacological interventions implemented by nurses focused on pain relief will contribute to the dissemination of the available evidence. Conclusion: It is expected that the present scoping review will contribute to the critical analysis of non-pharmacological interventions implemented by nurses in this area given the potential impact of these on pain relief and the quality of care provided.Objetivo: Identificar y mapear la evidencia científica existente en el ámbito de las intervenciones no farmacológicas implementadas por enfermeras, con el objetivo de proporcionar el control del dolor a la persona en situación paliativa. Método: Protocolo de scoping review, según la metodología de Instituto Joanna Briggs. En la estrategia de investigación e identificación de estudios, se utilizarán las bases de datos electrónicas CINAHL Complete (vía EBSCOhost), MEDLINE (vía Pubmed), Registro Cochrane Central de Ensayos Controlados, Base de Datos Cochrane de Revisiones Sistemáticas, Scielo, JBI Library of Systematic Reviews. Scopus. A su vez, la búsqueda de estudios inéditos incluirá el Repositorio Científico de Acceso Abierto de Portugal (RCAAP) y OpenGrey. La estrategia de búsqueda incluirá todos los artículos publicados en portugués, español e inglés en los últimos 5 años. Resultados: Los resultados se presentarán en formato narrativo, mediante tablas, de acuerdo con el objetivo, enfoque y pregunta de revisión. El mapeo de las intervenciones no farmacológicas, en el ámbito del control del dolor, contribuirá para la difusión de la evidencia disponible. Conclusión: Se espera que la presente revisión contribuya para el análisis crítico de las intervenciones no farmacológicas en esta área, dado el potencial impacto de estas en el control del dolor y en la cualidad de los cuidados prestados.Objetivo: Identificar e mapear a evidência científica existente no âmbito das intervenções não farmacológicas implementadas por enfermeiros, com o objetivo de proporcionar controlo da dor, da pessoa em situação paliativa. Metodologia: Protocolo de Scoping review com base na metodologia proposta pelo Joanna Briggs Institute. Na pesquisa e identificação dos estudos, serão usadas as bases de dados eletrónicas MEDLINE (via Pubmed), CINAHL Complete (via EBSCOhost), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scielo, JBI Library of Systematic Reviews, Scopus. Adicionalmente, a pesquisa de estudos não publicados incluirá o Repositório Científico de Acesso Aberto de Portugal (RCAAP) e o OpenGrey. A estratégia de pesquisa abrangerá todos os artigos publicados em português, espanhol e inglês, nos últimos 5 anos. Resultados: Os resultados serão apresentados em formato narrativo, recorrendo a tabelas, de acordo com o objetivo, foco e questão de revisão. O mapeamento das intervenções não farmacológicas implementadas por enfermeiros, no âmbito do controlo da dor, irá contribuir para a disseminação da evidência disponível. Conclusão: Espera-se que a presente scoping review contribua para a análise crítica das intervenções não farmacológicas implementadas pelos enfermeiros neste âmbito, dado o potencial impacte destas no controlo da dor e na qualidade dos cuidados prestados

Impacto da espirometria de incentivo na redução de complicações respiratórias no pós-operatório da laparotomia: Revisão Sistemática

Context: Laparotomy is a surgery involving an incision in the abdominal wall to access the abdominal cavity. There is controversial data regarding the benefits of the implementation of early respiratory exercises in the prevention of pulmonary complications after laparotomy surgery. Objective: To examine the evidence about the effect of incentive spirometry in reducing respiratory complications in laparotomy's postoperative patients. Methodology: A systematic review, following the Joanna Briggs Institute methodology. Multiple databases were searched: CINAHL Plus with Full Text, PubMed and Scopus, as well as gray literature for studies comparing adult patients submitted to laparotomy surgery with incentive spirometry prophylaxis in the postoperative versus adult patients submitted to abdominal surgery with no postoperative respiratory exercises and also Adult patients submitted to laparotomy abdominal surgery with incentive spirometry prophylaxis postoperative versus Adult patients submitted to abdominal surgery with any other type of postoperative respiratory exercises. Results: Of the 160 studies retrieved, 1 randomized prospective trial was included in this review. This study states that there’s no significant difference between the use of incentive spirometry and positive intermittent pressure. Conclusion: Although the efficacy of incentive spirometry was demonstrated, further research is needed to explore the incentive spirometry among patients submitted to abdominal surgery.Contexto: Laparotomía es una cirugía que involucra una incisión en la pared abdominal para acceder a la cavidad abdominal. Los beneficios de la implementación de ejercicios respiratorios tempranos en la prevención de complicaciones pulmonares después de la cirugía de laparotomia son controvertidos. Objetivo: examinar la evidencia sobre el efecto de la espirometría de incentivo en la reducción de complicaciones respiratorias en pacientes postoperatorios de laparotomía. Metodología: Se realizaron búsquedas en múltiples bases de datos: CINAHL Plus con texto completo, PubMed y Scopus, así como literatura gris para estudios publicados desde 2008 que comparan pacientes adultos sometidos a cirugía de laparotomía con profilaxis de espirometría de incentivo en postoperatorios versus pacientes adultos sometidos a cirugía abdominal sin ejercicios respiratorios postoperatorios y versus pacientes adultos sometidos a cirugía abdominal con cualquier otro tipo de ejercicios respiratorios postoperatorios. Resultados: De los 160 estudios recuperados, se incluyó 1 ensayo prospectivo aleatorizado en esta revisión. Este afirma que no existe diferencia significativa entre el uso de la espirometría de incentivo y la presión positiva intermitente. Conclusión: aunque se demostró la eficacia de la espirometría de incentivo, se necesita más investigación para explorar la espirometría de incentivo entre los pacientes sometidos a cirugía abdominal.Contexto: Laparotomia é uma cirurgia que envolve uma incisão na parede abdominal para aceder à cavidade abdominal. O benefício da implementação de exercícios respiratórios profiláticos, na prevenção de complicações pulmonares após cirurgia abdominal é controverso. Objetivo: Analisar a evidência acerca do efeito do inspirómetro de incentivo na redução de complicações no pós-operatório de pacientes submetidos a laparotomia. Metodologia: Foram incluídas nas pesquisas diversas bases de dados: CINAHL Plus with Full Text, PubMed e Scopus, assim como literatura cinzenta para estudos publicados desde 2008 comparando pacientes adultos submetidos a laparotomia com inspirómetro de incentivo como profilaxia no pós operatório e pacientes adultos submetidos a cirurgia abdominal sem exercícios respiratórios no pós operatório e também pacientes adultos submetidos a laparotomia com inspirómetro de incentivo como profilaxia no pós operatório e pacientes adultos submetidos a cirurgia abdominal com outro tipo de exercícios respiratórios no pós operatório. Resultados: Dos 160 estudos analisados, 1 estudo prospetivo randomizado foi incluído. Este concluiu que não há diferença significativa entre a utilização de inspirómetro de incentivo e pressão positiva intermitente. Conclusão: Apesar da eficácia do inspirómetro de incentivo ter sido demonstrada, é necessária mais investigação para explorar o seu impacto nos pacientes submetidos a cirurgia abdominal

(Contornos da) Formação especializada em enfermagem de reabilitação (1965 - 1987) em Portugal

Introdução: O surgimento da formação especializada em enfermagem de reabilitação foi um marco importante na História da Enfermagem em Portugal e na década de 60 do século XX surgiram medidas pioneiras que prepararam a sua programação. O primeiro plano de estudos surgiu em 1965 e foi reformulado quatro vezes até 1987. Metodologia: Recurso ao método histórico, com análise documental narrativa e descritiva de fontes primárias constantes dos planos de estudos dos cursos de especialização em enfermagem de reabilitação de 1965 a 1987. As principais variáveis de interesse foram: motivo da criação dos cursos, conhecimento científico nos planos de estudo, relação com contexto nacional, carga letiva, e relação com as funções desempenhadas pelos enfermeiros em resposta aos cuidados de saúde. Resultados: Os sete planos de estudos analisados revelaram a constante evolução da especialidade, sobretudo pela alteração da carga horária, progressivamente mais intensa, e com maior interligação entre teoria e prática. A introdução de novos conteúdos mais especializados, foi fruto da complexidade de cuidados e da influência de revisões por grupos de trabalho constituídos por enfermeiros e médicos. A introdução de áreas transversais como pedagogia e investigação permitiram enriquecer e afirmar a Enfermagem de Reabilitação no seio da disciplina e da área da saúde em Portugal. Discussão: A criação do primeiro curso de especialização, segundo o modelo norte-americano, foi pressionada pelo elevado número de vítimas da Guerra colonial, iniciada em 1961. Com o avanço do conhecimento científico e atendendo ao contexto do país, os planos de estudos foram reestruturados, sendo reconhecida a especialidade através do Decreto-Lei n.º 265/83, levando ao surgimento de escolas Pós-Básicas em Lisboa, Porto e Coimbra. Neste processo houve sempre aumento progressivo da carga letiva dos diferentes planos de estudos associada a um aumento da complexidade das funções desempenhadas pelo enfermeiro especialista. Conclusão: A formação especializada em enfermagem de reabilitação desenvolveu-se através de diferentes influências, primeiramente norte-americanas e inglesas associadas ao contexto do país, que possuía diferentes carências relacionadas com o processo reabilitativo. Houve um acompanhamento da evolução dos conhecimentos técnico-científicos e das alterações sociodemográficas que se consolidavam no país

Physical rehabilitation programs for bedridden patients with prolonged immobility: a scoping review

Bedridden patients usually stay in bed for long periods, presenting several problems caused by immobility, leading to a long recovery process. Thus, identifying physical rehabilitation programs for bedridden patients with prolonged immobility requires urgent research. Therefore, this scoping review aimed to map existing physical rehabilitation programs for bedridden patients with prolonged immobility, the rehabilitation domains, the devices used, the parameters accessed, and the context in which these programs were performed. This scoping review, guided by the Joanna Briggs Institute’s (JBI) methodology and conducted in different databases (including grey literature), identified 475 articles, of which 27 were included in this review. The observed contexts included research institutes, hospitals, rehabilitation units, nursing homes, long-term units, and palliative care units. Most of the programs were directed to the musculoskeletal domain, predominantly toward the lower limbs. The devices used included lower limb mobilization, electrical stimulation, inclined planes, and cycle ergometers. Most of the evaluated parameters were musculoskeletal, cardiorespiratory, or vital signs. The variability of the programs, domains, devices and parameters found in this scoping review revealed no uniformity, a consequence of the personalization and individualization of care, which makes the development of a standard intervention program challenging.This research was co-financed by the European Regional Development Fund (ERDF) through the partnership agreement Portugal 2020—Operational Programme for Competitiveness and Internationalization (COMPETE2020) under the project POCI-01-0247-FEDER-047087 ABLEFIT: Desenvolvimento de um Sistema avançado para Reabilitação

A study protocol for development and validation of a clinical prediction model for frailty (ModulEn): a new European commitment to tackling frailty

There is a growing need to implement and evaluate the technological solutions that allow the early detection of age-related frailty and enable assessment of the predictive values of frailty components. The broad use of these solutions may ensure an efficient and sustainable response of health and social care systems to the challenges related to demographic aging. In this paper, we present the protocol of the ModulEn study that aims to develop and validate a predictive model for frailty. For this purpose, the sample composed by older adults aged 65-80 years and recruited from the community will be invited to use an electronic device ACM Kronowise® 2.0. This device allows proactive and continuous monitoring of circadian health, physical activity, and sleep and eating habits. It will be used during a period of seven to ten days. The participants will also be given the questionnaires evaluating the variables of interest, including frailty level, as well as their experience and satisfaction with the device use. Data provided from these two sources will be combined and the relevant associations will be identified. In our view, the implications of this study' findings for clinical practice include the possibility to develop and validate tools for timely prevention of frailty progress. In the long term, the ModulEn may contribute to the critical reduction of frailty burden in Europe