ERS International Congress 2023: highlights from the Allied Respiratory Professionals Assembly.

This article summarises some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2023 European Respiratory Society International Congress. Two sessions from each Assembly group are outlined, covering the following topics: Group 9.01 focuses on respiratory physiology techniques, specifically on predicted values and reference equations, device development and novel applications of cardiopulmonary exercise tests; Group 9.02 presents an overview of the talks given at the mini-symposium on exercise training, physical activity and self-management at home and outlines some of the best abstracts in respiratory physiotherapy; Group 9.03 highlights the nursing role in global respiratory health and presents nursing interventions and outcomes; and Group 9.04 provides an overview of the best abstracts and recent advances in behavioural science and health psychology. This Highlights article provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.

Clinical virtual simulation: predictors of user acceptance in nursing education.

BACKGROUND: Using virtual patients integrated in simulators expands students' training opportunities in healthcare. However, little is known about the usability perceived by students and the factors/determinants that predict the acceptance and use of clinical virtual simulation in nursing education. OBJECTIVES: To identify the factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing education. METHODS: Observational, cross-sectional, analytical study of the use of clinical virtual simulation in nursing to answer the research question: What factors/determinants predict the acceptance and use of a clinical virtual simulator in nursing education? We used a non-probabilistic sampling, more specifically a convenience sample of nursing degree students. The data were collected through a questionnaire adapted from the Technology Acceptance Model 3. In technology and education, the Technology Acceptance Model is a theoretical model that predicts the acceptance of the use of technology by users. RESULTS: The sample comprised 619 nursing students, who revealed mean values of perceived usefulness (M = 5.34; SD = 1.19), ease of use (M = 4.74; SD = 1.07), and intention to use the CVS (M = 5.21; SD = 1.18), in a Likert scale of seven points (1-the worst and 7 the best possible opinion). This study validated the use of Technology Acceptance Model 3 adapted and tested the related hypotheses, showing that the model explains 62% of perceived utility, 32% of ease of use, and 54% of intention to use the clinical virtual simulation in nursing by nursing students. The adequacy of the model was tested by analysis of the direct effects of the relationships between the internal constructs (PU-BI, ß = 0.11, p = 0.012; PEOU-BI, ß = -0.11, p = 0.002) and the direct relations between some of the constructs internal to the Technology Acceptance Model 3 and the external determinants Relevance for learning and Enjoyability. In the proposed model, the external constructs that best predicted perceived usefulness, ease of use, and behaviour intention to use the clinical virtual simulation in nursing were Relevance for learning and Enjoyability. CONCLUSIONS: These study results allowed us to identify relevance for learning and enjoyability as the main factors/determinants that predict the acceptance and use of clinical virtual simulation in learning in nursing.

Aerobic and resistance exercise in heart failure inpatients: a scoping review.

Exercise performance is an essential tool for managing heart failure. Although the benefits of exercise are well documented for people with chronic and stable heart failure, there is still no consensus on their prescription in patients hospitalized with acute heart failure undergoing clinical stabilization. The aim of this study is to identify the literature on exercise programs encompassing the components of aerobic and resistance training for hospitalized patients admitted for acute heart failure. A scoping review was conducted according to the proposed methodology of the Joanna Briggs Institute. Studies with adults over 18 years old, hospitalized, and diagnosed with acute heart failure who participated in aerobic and resistance exercise training programs during their hospital stay were included. Three studies met the inclusion criteria. One was a retrospective, observational analytical cohort study, in which the main outcome of the exercise program was improvement in the previous disabilities of the participants. The other two were multicenter randomized controlled studies that showed greater improvement in physical function, functional capacity, depression, quality of life, and frailty status in the intervention groups. The exercise prescriptions differed according to the principles of the exercise prescription-frequency of exercise, intensity of exercise, exercise time (duration), type (mode), exercise volume, and progression. It is too early to make recommendations based on evidence of the type structure of an exercise program with aerobic and strength-training components in this population. However, in the exercise programs of the reviewed studies, the predominance of light to moderate intensity and the importance of progressively increase the frequency and duration of the training sessions were demonstrated, with bicycle ergometers and walking being the most common types of aerobic exercises. It is recommended that investment and research in this area should continue with more methodologically robust studies.

Need and baseline for harmonising nursing education in respiratory care: preliminary results of a global survey.

Background: The COVID-19 pandemic confirmed that respiratory nurses are critical healthcare providers. Limited knowledge is available about appropriate education to prepare nurses to deliver high-quality respiratory care. A survey was developed by the International Coalition for Respiratory Nursing (ICRN) group to identify the need for a respiratory nursing core curriculum. Method: A 39-item survey was distributed to 33 respiratory nursing experts in 27 countries. Questions asked about current roles, perception of need, expectations for a core curriculum project and respiratory content in nursing education in their countries. Results: 30 responses from 25 countries were analysed; participants predominantly worked in academia (53.3%, 16/30) and clinical practice (40%, 12/30). In total, 97% (29/30) confirmed a need for a core respiratory nursing curriculum. Post-registration nursing programmes at bachelor (83.3%, 25/30) and masters (63.3%, 19/30) levels include internal/medical nursing care; less than half identified separate respiratory nursing content. The core educational programme developed should include knowledge (70%, 21/30), skills (60%, 18/30), and competencies (50%, 15/30), with separate paediatric and adult content. Conclusion: Survey results confirm a wide variation in nursing education and respiratory nursing education across the world, with many countries lacking any formal educational programmes to prepare nurses capable of providing enhanced quality respiratory care. These findings support the need for a core respiratory curriculum. To advance this significant work the ICRN group plans to conduct a Delphi study to identify core curriculum requirements for respiratory nursing education at pre-registration and advanced educational levels to flexibly meet each country's specific educational requirements for recognition of respiratory nursing speciality practice.

A meta-analysis on the structure of pulmonary rehabilitation maintenance programmes on COPD patients' functional capacity.

Pulmonary rehabilitation (PR) improves functional capacity, health-related quality of life (HRQoL) in COPD patients, and maintenance programmes are relevant in preserving those improvements. However, little is known about the structure of maintenance programmes after PR. We performed a systematic review and meta-analysis of experimental and quasi-experimental studies evaluating individuals with COPD admitted to a maintenance PR programme, delivered after an initial PR programme. We reported functional capacity evaluation (6-minute-walking-test), HRQoL, dyspnoea and symptom control. Searches were performed on the 11th April 2021 using MEDLINE, Embase, EBSCO, CINAHL, Web of Science and Cochrane Library. We extracted summary-level data from trial publications and used a random-effects model, predicting that severe heterogeneity was detected. The protocol was registered in PROSPERO (CRD42021247724). Fifteen studies were included in the meta-analysis, with 1151 participants. Maintenance programmes were associated with a pooled mean increase of 27.08 meters in 6mWT (CI: 10.39 to 43.77; I2 = 93%; p < 0.0001), being better in supervised, long (>12 month) home-based programmes; and having a potential MD of -4.20 pts in SGRQ (CI: -4.49 to -3.91; I2 = 0%; p = 0.74). Regarding dyspnoea and exacerbations, we found a nonsignificant trend for improvement after maintenance PR programmes. Severe COPD patients showed smaller improvements in programmes up to a year. Overall, the strength of the underlying evidence was moderate. Despite limitations of risk of bias and heterogeneity, our results support that home-based, supervised, long-term maintenance PR programmes may significantly improve functional capacity in COPD patients and HRQoL.

Easiness, usefulness and intention to use a MOOC in nursing.

BACKGROUND: The growing ageing population and the increasing prevalence of non-communicable diseases call for innovation and healthcare mastered professional skills. Emerging digital learning contents envisioning to complement education, lifelong learning and in-service training. The use of digital platforms allows nurses to access contents in several formats, enabling the required pedagogical autonomy and personal time management. This allows nurses to enrol in education wherever accessible, reducing personal and professional costs and ensuring high-quality standards. OBJECTIVES: To assess students and nurses' easiness, usefulness and intention to use a Massive Open Online Course (MOOC) as an educational resource to enhance self-management intervention skills in COPD patients. METHODS: An exploratory, descriptive and transversal study was conducted. Participants were nursing students, registered nurses and rehabilitation nurses. A questionnaire supported by Davis Technology Acceptance Model and on the determinants of the ease-of-use perception of Venkatesh was applied. An EFA was performed and two dimensions were obtained (perceived easiness and global quality of the course and perceived usefulness and intention to use the MOOC) and groups were compared in these dimensions. RESULTS: From the total participants (n = 93), 65.6% were nursing students, 15.1% were Portuguese nurses and 19.4% were Portuguese rehabilitation nurses. The perceived easiness and global quality score of the course were 4.70 (SD = 0.314) and the perceived usefulness and intention to use the MOOC was 4.73 (SD = 0.346). Rehabilitation nurses, who are older, scored higher than nurses and students (χ2(2, n = 93) = 8.43, p = .015, ε2 = 0.092). The dropout rate was 25%. CONCLUSIONS: The MOOC showed usefulness and nurses' intention to use this educational resource in future education and yielded high average rates of perceived easiness and global quality. These massive courses unlock new opportunities for nursing education and to lifelong learning in nursing, enhancing safety and quality of the healthcare services in supporting patients to achieve a better quality of life.

Do we need tailored training and development plans for European Union respiratory nurses?

Nurses are critical players in healthcare and should be the next profession to standardise levels of education, preparing them for an active partnership with other healthcare professionals prepared to tackle the chronic disease problem in Europe https://bit.ly/3bMR76b.

Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review.

PURPOSE: To identify nonpharmacological clinically effective interventions for constipation in adults. METHODS: A systematic review of experimental studies of nonpharmacological interventions addressing participants' management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693. RESULTS: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant's modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage. CONCLUSIONS: Specific nonpharmacological interventions are crucial for nurses' clinical practice and of major importance for clients and families. Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice. CLINICAL RELEVANCE: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.

Correction: Clinical Virtual Simulation in Nursing Education: Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/11529.].

Clinical Virtual Simulation in Nursing Education: Randomized Controlled Trial.

BACKGROUND: In the field of health care, knowledge and clinical reasoning are key with regard to quality and confidence in decision making. The development of knowledge and clinical reasoning is influenced not only by students' intrinsic factors but also by extrinsic factors such as satisfaction with taught content, pedagogic resources and pedagogic methods, and the nature of the objectives and challenges proposed. Nowadays, professors play the role of learning facilitators rather than simple "lecturers" and face students as active learners who are capable of attributing individual meanings to their personal goals, challenges, and experiences to build their own knowledge over time. Innovations in health simulation technologies have led to clinical virtual simulation. Clinical virtual simulation is the recreation of reality depicted on a computer screen and involves real people operating simulated systems. It is a type of simulation that places people in a central role through their exercising of motor control skills, decision skills, and communication skills using virtual patients in a variety of clinical settings. Clinical virtual simulation can provide a pedagogical strategy and can act as a facilitator of knowledge retention, clinical reasoning, improved satisfaction with learning, and finally, improved self-efficacy. However, little is known about its effectiveness with regard to satisfaction, self-efficacy, knowledge retention, and clinical reasoning. OBJECTIVE: This study aimed to evaluate the effect of clinical virtual simulation with regard to knowledge retention, clinical reasoning, self-efficacy, and satisfaction with the learning experience among nursing students. METHODS: A randomized controlled trial with a pretest and 2 posttests was carried out with Portuguese nursing students (N=42). The participants, split into 2 groups, had a lesson with the same objectives and timing. The experimental group (n=21) used a case-based learning approach, with clinical virtual simulator as a resource, whereas the control group (n=21) used the same case-based learning approach, with recourse to a low-fidelity simulator and a realistic environment. The classes were conducted by the usual course lecturers. We assessed knowledge and clinical reasoning before the intervention, after the intervention, and 2 months later, with a true or false and multiple-choice knowledge test. The students' levels of learning satisfaction and self-efficacy were assessed with a Likert scale after the intervention. RESULTS: The experimental group made more significant improvements in knowledge after the intervention (P=.001; d=1.13) and 2 months later (P=.02; d=0.75), and it also showed higher levels of learning satisfaction (P<.001; d=1.33). We did not find statistical differences in self-efficacy perceptions (P=.9; d=0.054). CONCLUSIONS: The introduction of clinical virtual simulation in nursing education has the potential to improve knowledge retention and clinical reasoning in an initial stage and over time, and it increases the satisfaction with the learning experience among nursing students.

Analysis of use of technological support and information content by patients with chronic obstructive pulmonary disease

OBJECTIVE: To identify types of technological support and information content utilized to promote therapeutic regimen management for patients with chronic obstructive pulmonary disease (COPD). METHODS: In this study, which had a quantitative, exploratory, descriptive, and transversal approach, the authors used a questionnaire organized on the basis of a literature review and two models: One of acceptance of the technology and a theoretical one of the determinants for patients' perceived ease of its use. RESULTS: The patients with COPD reported need for more information related to their daily activities and breathing exercises. Patients who had higher literacy and higher technological literacy reported that web-based technologies were more useful. Those who had lower literacy and lower technological literacy reported higher usefulness, intention and ease of use of mobile phone books, and videos in the access to information. CONCLUSION: Information resources may use any technological support, provided information is available according to the literacy and technological literacy of the patients and tailored to their needs.

OBJETIVO: Identificar tipos de suportes tecnológicos e conteúdos informacionais utilizados na promoção da gestão do regime terapêutico em pacientes com DPOC. MÉTODOS: Estudo de abordagem quantitativa, exploratório transversal e descritivo, tendo como recurso um questionário baseado no modelo de aceitação da tecnologia, no modelo teórico dos determinantes da percepção da facilidade de utilização da mesma e na revisão da literatura. RESULTADOS: Os pacientes com DPOC referiram maior necessidade de informação relacionada com as atividades do dia-a-dia e com os exercícios respiratórios. Pacientes com maior literacia e maior literacia tecnológica referem maior utilidade das tecnologias Web-based; pacientes com menor literacia e menor literacia tecnológica referem maior utilidade, intenção e facilidade para a utilização do telemóvel, livros e vídeos no acesso à informação. CONCLUSÃO: Os recursos informacionais podem adotar diferentes suportes tecnológicos, desde que disponibilizados em função da literacia e literacia tecnológica e adequados às necessidades informacionais dos pacientes.

OBJETIVO: Identificar tipos de soportes tecnológicos y contenidos informacionales utilizados en la promoción de la gestión del régimen terapéutico en pacientes con DPOC. MÉTODOS: Estudio de abordaje cuantitativo, exploratorio transversal y descriptivo, teniendo como recurso a un cuestionario basado en el modelo de aceptación de la tecnología, en el modelo teórico de los determinantes de la percepción de la facilidad de utilización del mismo y en la revisión de la literatura. RESULTADOS: Los pacientes con DPOC refirieron mayor necesidad de información relacionada con las actividades del dia a dia y con los ejercicios respiratorios. Pacientes con mayor literacia y mayor literacia tecnológica refieren mayor utilidad de las tecnología Web-based; pacientes con menor literacia y menor literacia tecnológica refieren mayor utilidad, intención y facilidad para la utilización del telemóvil, libros y videos en el acceso a la información. CONCLUSIÓN: Los recursos informacionales pueden adoptar diferentes soportes tecnológicos, siempre y cuando estén disponibles en función de la literacia y literacia tecnológica y adecuados a las necesidades informacionales de los pacientes.

Revisão integrativa da literatura sobre gestão do regime terapêutico em pacientes com doença pulmonar obstrutiva crônica / Integrative literature review on treatment management in patients with chronic obstructive pulmonary disease / Revisión integradora de la literatura sobre el manejo del régimen terapéutico en pacientes con enfermedad pulmonar obstructiva crónica

Com este estudo pretende-se identificar qual a melhor estratégia de intervenção de enfermagem na promoção da gestão do regime terapêutico em pacientes com Doença Pulmonar Obstrutiva Crônica no ambiente hospitalar. Realizamos uma revisão integrativa da literatura dos anos 2006 a 2009. A partir da análise dos dados, constatamos que os estudos utilizam diferentes elementos e diferentes indicadores de efetividade para avaliarem as estratégias de intervenção utilizadas. Baseando-se nas evidências disponíveis, não é possível identificar qual a melhor estratégia. Desta revisão emerge a definição dos indicadores de resultado mais consensuais na avaliação da efetividade das estratégias de intervenção. Torna-se agora necessário desenvolver, implementar e avaliar a efetividade das estratégias de intervenção de enfermagem, recorrendo a estes indicadores, para definir qual a melhor estratégia de intervenção, baseada na evidência.

The objective of this study is to identify which is the best nursing intervention strategy to promote treatment management in patients with Obstructive Chronic Pulmonary Disease in the hospital setting. An integrative literature review was performed for the years 2006 to 2009. The data analysis revealed that the studies used different elements and specific effectiveness indicators to evaluate the intervention strategies that were addressed. Based on current evidence, it is not possible to identify the best strategy. The present review points out the need to define more consensual outcome indicators to evaluate the effectiveness of intervention strategies. Hence, it is necessary to develop, implement, and evaluate the effectiveness of nursing intervention strategies, turning to those indicators, to define the best evidenced-based intervention strategy.

Con este estudio, pretendemos identificar cuál es la mejor estrategia de intervención de enfermería en la promoción del manejo del régimen terapéutico en pacientes con Enfermedad Pulmonar Obstructiva Crónica, en el ambiente hospitalario. Realizamos una revisión integradora de la literatura de los años 2006 a 2009. A partir del análisis de los datos, constatamos que los estudios utilizan diferentes elementos y diferentes indicadores de efectividad para evaluar las estrategias de intervención utilizadas, no siendo posible identificar cuál es la mejor estrategia basada en la evidencia disponible. De esta revisión surge la definición de los indicadores de resultado más consensuales en la evaluación de la efectividad de las estrategias de intervención. Se vuelve ahora necesario desarrollar, implementar y evaluar la efectividad de las estrategias de intervención de enfermería, recurriendo a tales indicadores, para definir cuál es la mejor estrategia basada en la evidencia.

[Influence of perception of chronic obstructive pulmonary disease in promotion of self-management of disease]. / Influência da percepção da doença pulmonar obstrutiva crónica na promoção do autocontrolo da doença.

OBJECTIVE: Identify the state of the art about the influence of illness perceptions in the promotion of self -management in patients with COPD. METHOD: We conducted a systematic review of the literature, using the method of PICOS, the systematic literature review includes the years 2004 to 2009 and was conducted between August and September 2009. RESULTS: Four articles met the inclusion criteria, including a review of the literature and three qualitative studies. Clients with higher perception of disease control and greater self -efficacy, with stable emotional situations, have better results in self -control of the disease. The evaluation, discussion and clarification of beliefs, attitudes and their impact on self -confidence and self -control should be integrated into clinical practice. CONCLUSION: The perceived lack of control over the course of the disease contributes to reduced quality of life, creates anxiety, leads to social isolation, can lead to depression, and reduces the motivation to acquire knowledge and skills for self -control disease. The lack of motivation, the inability to recognize the cognitive, instrumental capabilities, social support and support of health professionals, power the low self -control of the disease and non -adherence to therapy.

[Integrative literature review on treatment management in patients with chronic obstructive pulmonary disease]. / Revisão integrativa da literatura sobre gestão do regime terapêutico em pacientes com doença pulmonar obstrutiva crônica.

The objective of this study is to identify which is the best nursing intervention strategy to promote treatment management in patients with Obstructive Chronic Pulmonary Disease in the hospital setting. An integrative literature review was performed for the years 2006 to 2009. The data analysis revealed that the studies used different elements and specific effectiveness indicators to evaluate the intervention strategies that were addressed. Based on current evidence, it is not possible to identify the best strategy. The present review points out the need to define more consensual outcome indicators to evaluate the effectiveness of intervention strategies. Hence, it is necessary to develop, implement, and evaluate the effectiveness of nursing intervention strategies, turning to those indicators, to define the best evidenced-based intervention strategy.