Do spirituality and emotional intelligence improve the perception of the ability to provide care at the end of life? The role of knowledge and self-efficacy.

OBJECTIVES: Spirituality, emotional intelligence, and palliative care (PC) knowledge have a positive and direct influence on self-efficacy and on perception of preparation and ability to provide end-of-life (EOL) care. The aim of this work is to propose a conceptual model that relates spirituality, emotional intelligence, PC knowledge, self-efficacy, and the preparation and ability to provide EOL care by doctors and nurses. METHODS: Quantitative, exploratory, descriptive, and inferential study applied to doctors and nurses in a hospital in the north of Portugal, between May and July 2022. The data collection instrument includes a questionnaire. The relationships between latent variables were evaluated using structural equation models by the partial least squares method using the Smart PLS 3.0 software. It was obtained the previous authorization of the ethics committee. RESULTS: The results (n = 380) indicate that self-efficacy, spirituality, and PC knowledge have a positive influence on the ability to provide EOL care. Emotional intelligence and spirituality have a direct and positive effect on self-efficacy. There is no direct influence of emotional intelligence on the ability to provide EOL care, but emotional intelligence has an indirect effect mediated by self-efficacy. SIGNIFICANCE OF RESULTS: Spirituality, self-efficacy, and emotional intelligence are very important for the ability of doctors and nurses to provide EOL care. The identification of predictive factors of the ability to provide EOL care and the determination of the relationship between them can improve the provision of EOL care, reduction of health costs, timely and early referral of people to PC, and increase life quality.

Can Acupuncture Improve the Flexibility of Hamstring Muscles? A Randomized, Blinded, and Controlled Pilot Study.

(1) Background: The lack of flexibility is frequently reported as a risk factor for hamstring muscle damage. Acupuncture, a therapeutic tool of traditional Chinese medicine (TCM), may play a role in both treatment and prevention by improving muscle strength, microcirculation, and reducing muscle soreness. The primary objective of this pilot study was to examine the immediate effects of acupuncture on hamstring muscle stretching and on the pain or discomfort reported during stretching. (2) Methods: To mitigate heterogeneity effects, and due to the small sample size, the study employed a crossover design in which each participant was tested at three different moments of the experimental period with verum (true acupuncture in selected acupoints), sham (fake acupuncture in zones of the skin not corresponding to any known acupoint but near the selected acupoints), and placebo (stimulation of the selected acupoints with a stainless steel wire and cannula, without puncturing) stimulations. Flexibility and pain or discomfort were assessed using the seat and reach test (SR) and a visual analogic scale (VAS). (3) Results: Significant changes in flexibility were observed after verum acupuncture (p = 0.03), while no significant changes were seen in sham and placebo (p = 0.86 and p = 0.18, respectively). No significant differences were found in pain or discomfort during any of the stimulations (verum, p = 0.55; sham, p = 0.50; placebo, p = 0.58). (4) Conclusions: The results of this pilot study suggest that acupuncture may improve flexibility in the hamstring muscles, though it does not significantly affect pain or discomfort during stretching.

Efetividade dos programas de reabilitação cardíaca home based / Efetividade dos programas de reabilitação cardíaca home based

Introdução: A evidência científica infere que o risco de novos eventos cardiovasculares em doentes com história de doença cardíaca isquémica, que realizam adequados programas de reabilitação cardíaca, é inferior ao risco dos que não usufruem desta resposta em saúde. Por conseguinte, assume-se como relevante a universalidade da implementação de programas de reabilitação cardíaca home based a nível nacional. Neste contexto, o objetivo deste estudo consiste em determinar a efetividade dos programas de reabilitação cardíaca home based na redução da taxa de reinternamento, na redução dos fatores de risco cardiovasculares modificáveis e na melhoria da qualidade de vida relacionada com a saúde em doentes com doença cardíaca isquémica. Métodos: Realizou-se uma revisão sistemática da literatura sobre estudos que avaliavam a efetividade dos programas de reabilitação cardíaca home based em doentes com doença cardíaca isquémica. Fez-se pesquisa na PUBMED, EBSCO, Google Académico e SciELO de estudos publicados entre 2012 a 2018, avaliados de acordo com os critérios de inclusão e exclusão, que posteriormente foram avaliados por dois investigadores de forma independente, respeitando os critérios de inclusão e exclusão previamente estabelecidos. O corpus da revisão ficou constituído por 3 artigos Resultados: A análise dos estudos demonstra que os programas de reabilitação cardíaca home based baseada em exercícios contribuem para a redução da taxa de reinternamento e associam-se à redução dos fatores de risco cardiovasculares modificáveis, incluindo o tabagismo, pressão arterial, peso corporal e perfil lipídico. Ficou demonstrada uma ligeira adesão de doentes para a reabilitação cardíaca home based do que para a reabilitação centre-based (1,04, IC 95% 1,01 a 1,07). O número de fatores de risco modificáveis apresentou correlação significativa com a reabilitação cardíaca home based, com uma redução dos fatores de risco cardiovasculares modificáveis. Houve diferenças significativas na atividade física (F=4,2, p=0,02), vitalidade (F=10,7, p<0,001) e saúde mental (F=15,9, p <0,001). No que respeita ao efeito sobre os índices de qualidade de vida de vida relacionada com a saúde, a reabilitação cardíaca home based oferece benefícios similares à reabilitação cardíaca centre-based. Conclusão: Partindo dos resultados obtidos, poderá inferir-se que os programas de reabilitação cardíaca home based se constituem como um recurso terapêutico com efeitos, transversalmente positivos, na reabilitação de pessoas com doença cardíaca isquémica, o que implica desafios constantes à enfermagem de reabilitação. Apesar dos benefícios clínicos, a oferta de programas de reabilitação cardíaca home-based ainda é uma realidade sub-representada em Portugal, daí a necessidade da sua promoção e implementação

Introduction: The scientific evidence infers that the risk of new cardiovascular events in patients with a history of ischemic heart disease, who perform adequate cardiac rehabilitation programs, is lower than the risk of those who do not benefit from this health response. Therefore, the universality of the implementation of home-based cardiac rehabilitation programs at national level is assumed to be relevant. In this context, the purpose of this study is to determine the effectiveness of home-based cardiac rehabilitation programs in reducing re-hospitalization rate, reducing modifiable cardiovascular risk factors, and improving health-related quality of life in patients with heart disease ischemic. Methods: A systematic review of the literature was conducted on studies evaluating the effectiveness of home-based cardiac rehabilitation programs in patients with ischemic heart disease. We searched PUBMED, EBSCO, Google Academic and SciELO for studies published between 2012 and 2018, evaluated according to the inclusion and exclusion criteria, which were subsequently evaluated by two researchers independently, respecting the inclusion and exclusion criteria previously established. The corpus of the review consisted of 3 articles Results: Analysis of the studies demonstrates that exercise-based home-based cardiac rehabilitation programs contribute to reduced rehospitalization rate and are associated with a reduction in modifiable cardiovascular risk factors, including smoking, blood pressure, body weight and profile lipid. There was a slight adherence of patients to home-based cardiac rehabilitation than to center-based rehabilitation (1.04, 95% CI 1.01 to 1.07). The number of modifiable risk factors showed a significant correlation with home-based cardiac rehabilitation, with a reduction in modifiable cardiovascular risk factors. There were significant differences in physical activity (F=4.2, p=0.02), vitality (F=10.7, p<0.001) and mental health (F=15.9, p<0.001). With regard to the effect on health-related life quality of life indices, home-based cardiac rehabilitation offers similar benefits to center-based cardiac rehabilitation. Conclusion: Based on the results obtained, it can be inferred that home-based cardiac rehabilitation programs constitute a therapeutic resource with transversely positive effects on the rehabilitation of people with ischemic heart disease, which implies constant challenges to rehabilitation nursing. Despite the clinical benefits, the offer of home-based cardiac rehabilitation programs is still underrepresented in Portugal, hence the need for its promotion and implementation.

Capacitação de trabalhadores em suporte básico de vida / Training workers in basic life support / Capacitación de trabajadores en soporte básico de vida

Resumo Introdução A capacitação dos cidadãos no auxílio a vítimas em risco de vida é fundamental em qualquer sociedade. Objetivo avaliar os conhecimentos sobre Suporte Básico de Vida dos trabalhadores de uma Câmara Municipal do norte de Portugal, antes e após a implementação do programa de intervenção "Capacitar para Salvar" e avaliar as competências demonstradas, após a participação no programa de intervenção. Materiais e Métodos Trata-se de um estudo do tipo quase-experimental e longitudinal, onde foi utilizado um questionário, constituído por 2 partes (caraterização sociodemográfica e avaliação de conhecimentos) e uma grelha de avaliação de competências. No 1º momento foram avaliados os conhecimentos sobre Suporte Básico de Vida e implementado um programa de intervenção, sendo que no 2º momento, foram avaliados os conhecimentos e competências sobre Suporte Básico de Vida. Resultados Participaram no estudo 97 trabalhadores. Os resultados mostraram que os trabalhadores possuem conhecimentos e competências insuficientes em Suporte Básico de Vida. Discussão e Conclusões Verificaram-se diferenças estatisticamente significativas nos conhecimentos e competências em Suporte Básico de Vida. Implicações para a prática: implementação de estratégias que promovam a formação em Suporte Básico de Vida a todos cidadãos, quer ao nível da transmissão de conhecimentos, quer da formação prática.

Abstract Introduction Training citizens to help victims in life-threatening situations is fundamental in any society. Objective to evaluate the knowledge on Basic Life Support by workers in a Municipal Council of the north of Portugal, before and after implementing the intervention program "Train to Save" and assess the skills shown after participating in the intervention program. Materials and Methods This was a quasi-experimental longitudinal study, using a questionnaire, which comprised two parts (sociodemographic characterization and evaluation of knowledge) and a skills-assessment grid. In the first moment, knowledge on Basic Life Support was evaluated and an intervention program was implemented; the second moment evaluated the knowledge and skills on Basic Life Support. Results The study had the participation of 97 workers. The results revealed that the workers had insufficient knowledge and skills in Basic Life Support. Discussion and Conclusions Statistically significant differences were verified of knowledge and skills in Basic Life Support. Implications for the practice: implementation of strategies that promote training in Basic Life Support for all citizens at knowledge transmission level and in practical formation.

Resumen Introducción La capacitación de los ciudadanos en la ayuda a las víctimas en riesgo de vida es fundamental en cualquier sociedad. Objetivo evaluar los conocimientos sobre Soporte Básico de Vida de los trabajadores de una Cámara Municipal del Norte de Portugal, antes y después de la implementación del programa de intervención "Capacitar para Salvar" y evaluar las competencias demostradas, después de la participación en el programa de intervención. Materiales y Métodos Se trata de un estudio de tipo cuasi-experimental y longitudinal, donde se utilizó un cuestionario, constituido por 2 partes (caracterización sociodemográfica y evaluación de conocimientos) y una plantilla de evaluación de competencias. En el 1° momento fueron evaluados los conocimientos sobre Soporte Básico de Vida e implementado un programa de intervención, siendo que en el 2º momento fueron evaluados los conocimientos y competencias sobre Soporte Básico de Vida. Resultados Participaron en el estudio 97 trabajadores. Los resultados mostraron que los trabajadores poseen conocimientos y competencias insuficientes en Soporte Básico de Vida. Discusión y Conclusiones Se verificaron diferencias estadísticamente significativas en los conocimientos y competencias en Soporte Básico de Vida. Implicaciones para la práctica: implementación de estrategias que promuevan la formación en Soporte Básico de Vida a todos los ciudadanos, tanto en el nivel de la transmisión de conocimientos como en la formación práctica.