Does the Aged Simulation Suit help nursing students provide better care? - A phenomenological study.

BACKGROUND: The use of simulation in the training of nurses has increased in the last decades, allowing the acquisition and development of several competencies. OBJECTIVE: Understand the experiences of nursing students who used the aged simulation suit. METHODOLOGY: Qualitative study of a phenomenological nature. The participants were nursing students, who used the aged simulation suit. Data collection was made through the interview, and the data analysis was performed following the Giorgi phenomenological method. RESULTS: Three themes reflect the essence of the experience: Wear the skin of the elderly; Confrontation with their own ageing process; Skills development. CONCLUSION: If, on the one hand, the students who used the aged simulation suit experienced sensory and motor impairment and consequent confrontation with their own ageing process, on the other hand, they experienced the development of scientific, relational and citizenship skills. It is expected that the results of this work will foster the use of the aged simulation suit as a complementary methodology, with potential impact on the quality of care and health gains.

[Palliative rehabilitation interventions in palliative care: a scoping review]. / Interventi di riabilitazione palliativa in cure palliative: una scoping review.

BACKGROUND: Palliative rehabilitation is defined as the process of helping a person with a progressive, commonly advanced, and/or incurable disease reach their physical, psychological, and social potential consistent with physiological and environmental limitations and life preferences. However, the evidence on this subject is dispersed in the literature. OBJECTIVE: To examine and map interventions of palliative rehabilitation, implemented and evaluated in palliative care. METHODOLOGY: A scoping review, using the Joanna Briggs Institute's guideline, was conducted. Multiple databases were searched: CINAHL Complete; PubMed; Scopus; SciELO; Cochrane Central Register of Controlled Trials; PEDro, as well as grey literature for studies that focus on qualified healthcare professionals caring for patients 18 years of age or older, working in palliative care, that focus on the concepts of palliative rehabilitation interventions. RESULTS: Of the 314 studies retrieved, two were included in this review. Both were conducted with physiotherapists, and none mentioned nursing rehabilitation. One of the studies implemented and evaluated an intervention of exclusively physical domain and another of physical and emotional domain. The interventions still differ in the number of treatments which ranged from 4 to 7 sessions. Both studies were implemented in oncological and non-oncological patients. CONCLUSION: Further research is needed to explore the rehabilitation strategies used by healthcare professionals working in palliative care that help patients. Moreover, since nurses are often the healthcare professionals who are in closest proximity to, and who spend the most time with, the patient, which rehabilitation interventions do these professionals should be focus of intervention.

Comfort experience in palliative care: a phenomenological study.

BACKGROUND: Palliative care aims to provide maximum comfort to the patient. However it is unknown what factors facilitate or hinder the experience of comfort, from the perspective of inpatients of palliative care units. This lack of knowledge hinders the development of comfort interventions adjusted to these patients. The aim of this research is to describe the comfort and discomfort experienced by inpatients at palliative care units. METHODS: A phenomenological descriptive study was undertaken. Ten inpatients were recruited from a Spanish palliative care unit and seven from a Portuguese palliative care unit. Data were collected using individual interviews and analysed following the method of Giorgi. RESULTS: Four themes reflect the essence of the lived experience: The Palliative Care as a response to the patient's needs with advanced disease, attempt to naturalize advanced disease, confrontation with their own vulnerability, openness to the spiritual dimension. CONCLUSIONS: Informants revealed that they experience comfort through humanized care, differentiated environment, symptomatic control, hope and relationships. The discomfort emerges from the losses and powerlessness against their situation. Even if such findings may seem intuitive, documenting them is essential because it invites us to reflect on our convictions about what it means to be comfortable for these patients, and allows incorporating this information in the design of focused interventions to maximize the comfort experience.

Emotional Management Strategies in Prehospital Nurses: A Scoping Review.

BACKGROUND: Prehospital care is intricate and unpredictable. Nurses in this environment encounter psychologically challenging situations and traumatic experiences daily. Nurses respond variably when delivering care in this context. This study aims to map the emotional management strategies used by prehospital nurses. METHODS: Research was conducted in MEDLINE, CINAHL Complete, and the Open Access Scientific Repository of Portugal (RCAAP). The inclusion criteria were studies with prehospital nurses in Portuguese, English, and Spanish languages, covering all study types. RESULTS: From the initial 511 studies identified, four studies were deemed eligible after rigorous screening. The strategies used are individual (pre- and post-event) and collective, varying from formal to informal, with or without institutional support. Notable experiences included a lack of technical/scientific preparation, personal life association, treating acquaintances, pediatric-age patients, childbirth, cardiopulmonary arrests in young individuals, traffic accidents, and suicides. CONCLUSIONS: Nurses need training in basic emotional management tools. This research provides an initial understanding of their emotional well-being's impact on personal and professional performance. This study was prospectively registered with the Open Science Framework (OSF) on 29 June 2023, with the registration number: z638t.

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

(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.

The Burnout of Nurses in Intensive Care Units and the Impact of the SARS-CoV-2 Pandemic: A Scoping Review.

BACKGROUND: The world's population changed with the emergence of the SARS-CoV-2 pandemic. Burnout arises due to overwork, prolonged work periods, a lack of human and material resources, etc. Several studies have reported the incidence of burnout syndrome in nurses that work in intensive care units (ICUs). The aim was to map the scientific evidence related to nurses' burnout in the ICU, namely the repercussions of SARS-CoV-2 in terms of burnout among nurses. METHODS: A scoping review followed the Joanna Briggs Institute methodology guidelines to search for and synthesise studies published between 2019 and 2022. The databases searched were MEDLINE, CINAHL, LILACS, SCOPUS, PsycINFO and OPEN GREY. A total of fourteen articles were eligible to be included. RESULTS: A content analysis of the selected articles was carried out, and three categories emerged that corresponded to the dimensions of burnout according to Maslach and Leiter: emotional exhaustion, depersonalisation dimension and a lack of personal accomplishment. It was evident that nurses who worked in the ICU during the pandemic showed high levels of burnout. CONCLUSIONS: It is recommended that hospital administrations hire health professionals, namely nurses, as a strategic and operational management strategy to reduce the risk of increased burnout during pandemic outbreaks.

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

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.

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

Background: The COVID-19 pandemic has had consequences for social, economic, cultural and educational life, affecting nursing training and practice. To date, no previous scoping reviews addressing this objective have been found. This study aims to map the literature related to changes in clinical training for nursing students during the COVID-19 pandemic. Methods: A scoping review will be carried out according to the Joanna Briggs Institute's latest guidance regarding methodology. A set of relevant electronic databases and grey literature will be searched using terms such as clinical practice, nursing students, COVID-19. Results: This scoping review will consider any type of quantitative, qualitative, and mixed-methods study and systematic review designs for inclusion, focusing on changes in clinical training for nursing students during the COVID-19 pandemic. Conclusion: Pedagogical criteria had to be changed due to the COVID-19 pandemic, especially face-to-face clinical training for nursing students. Identifying the changes in clinical training for nursing students during the COVID-19 pandemic will help educators to understand the potential impact of this specific context and trace possible gaps. This protocol is registered at Open Science Framework.

Burnout and Nursing Care: A Concept Paper.

Burnout comprises a series of undetermined physical and psychosocial symptoms caused by an excessive energy requirement at work-it is a crisis in relationships with work itself and not necessarily a concern with underlying clinical disorders related to workers. Professions involving human interactions commonly involve emotional engagement, especially when the cared-for person needs assistance and support, as is the primary concern in the nursing profession. To some extent, the acknowledgment of the phenomena of burnout and how it affects people is sometimes addressed from a biomedical perspective. This concept paper aims to describe the burnout concept and reflect on the impact on nurses. Our intention with this reflection, considering the burnout impact on nurses, is to support a paradigm change in the prevention and management of burnout in healthcare contexts, promoting and fostering the well-being of nurses.

The Burnout of Nurses in Intensive Care Units and the Impact of the Pandemic of SARS-CoV-2: Protocol of a Scoping Review.

Background: The SARS-CoV-2 pandemic has brought multiple challenges for health institutions and their professionals. The requirement of this disease forced nurses to confront organizational and clinical challenges to maintain the quality standards of care they provide. These requirements may have contributed to increased burnout symptoms. This study aims to map the scientific evidence related to nurses' burnout in intensive care units. Methods: A scoping review will be conducted according to the Joanna Briggs Institute methodology. Relevant databases will be used as well as grey literature, where the following words will be used: burnout, nurses, intensive care units and SARS-CoV-2. Results: This scoping review will include all types of studies-quantitative, qualitative and mixed-and all types of reviews that focus on the objective of this review. Conclusions: It is vital to determine the impact of the burnout caused by the pandemic of SARS-CoV-2 to assess amending measures of risk and protection factors. This will help in the implementation of guidelines according to the available evidence. Additionally, this will help to improve the skills of these professionals as well as to reduce their emotional and physical exhaustion. This protocol is registered with the Open Science Framework.

What Is the Relationship between Lifestyle and Frailty Status? Data from the Portuguese Multicentre Descriptive Study.

This observational and descriptive study attempted, within the scope of the ModulEn Research Project, to determine associations between lifestyle-related variables and frailty involving 160 community-dwelling older adults aged between 65 and 80 years living in the Central Region of Portugal. Forty-three percent of the study participants were pre-frail and 18% were frail. More than 50% of the frail people had slight cognitive decline, and the frailty condition was more frequently observed in women. As the literature highlights, there is potential for greater reversibility in the pre-frailty condition. To contribute to this reversibility, it is necessary to resort to interventions that promote physical activity and cognitive stimulation, apply adequate eating habits, and/or encourage the adoption of an active and socially integrated lifestyle. A healthy lifestyle implies good sleep and eating habits, and correct metabolic control that allows for effective surveillance of dyslipidemia, diabetes, and blood pressure.

Helmet-Noninvasive Ventilation for Hospitalized Critically Ill COVID-19 Patients: Has Vaccination and the New Variants Changed Evidence?

Noninvasive ventilation (NIV) is a technique for breathing support that significantly improves gas exchange and vital signs, reducing intubation and mortality rates. Helmets, unlike facemasks, allow for longer-term treatment and better ventilation, also being more cost-effective. As of today, we have found no reviews addressing this topic. This review aims to identify, map, and describe the characteristics of the use of noninvasive ventilation through helmet interface in critically ill COVID-19 adult patients hospitalized in acute care settings throughout the multiple moments that defined the COVID-19 pandemic. This scoping review will follow the methodology for scoping reviews proposed by JBI. A set of relevant electronic databases will be searched using terms such as COVID-19, helmet, and noninvasive ventilation. Two reviewers will independently perform the study selection regarding their eligibility. Data extraction will be accomplished using a researcher's developed tool considering the review questions. Findings will be presented in tables and a narrative description that aligns with the review's objective. This scoping review will consider any quantitative, qualitative, mixed-methods studies and systematic review designs for inclusion, focusing on the use of helmet on critically ill adult patients with COVID-19 hospitalized in acute care settings.

Nursing focuses and interventions that promote the autonomy of the elderly.

OBJECTIVES: To describe the meaning attributed to the experiences of the clinical experience of specialist nurses in the implementation of nursing care focuses and respective interventions that promote the autonomy of the elderly. METHOD: Qualitative study based on Giorgi's method. Eighteen specialist nurses were interviewed, recruited for convenience in two hospitals in the northern region of Portugal, between March and December 2018. RESULTS: In the clinical experience of specialist nurses, regarding the nursing process, three themes emerged: focuses of nursing care; implementation of nursing interventions and hindering factors. CONCLUSIONS: The specialist nurses, most of whom are rehabilitation specialists, essentially promote the physical capacity of the elderly, within the scope of autonomy, revealing that working conditions, such as lack of time and information systems, are the limiting factor of their promotion.

Concept of older person autonomy: phenomenological study of the opinion of specialist nurses.

Background: The concept of autonomy is composed of several components, making it a multidimensional concept. This includes cognitive ability, intellectual ability, emotional intelligence, social situation, and physical ability skills. This study aimed to describe the experiences attributed to the meaning of the concept of autonomy, by specialist nurses. Methods: A descriptive phenomenological study was carried out, according to the Giorgi method. Eighteen nurses were recruited at a hospital in Portugal. Data were collected through individual interviews. Results: The 18 specialist nurses work on average as nurses for 16years and are specialist nurses; for an average of 5.9years, most are specialist nurses in rehabilitation nursing. From the data analysis, six themes emerged: ability to do, ability to resolve, decision ability, cognitive ability, social integration, and emotional intelligence. Conclusions: Most professionals perceive the concept as the ability to perform activities of daily living and the ability to make decisions, especially concerning informed consent. It is necessary to raise awareness of the breadth of this concept since the quality of life and dignity of the elderly person depends on autonomy.

Avoidant Coping of the Decision-Making Process on the Location of Care in Old Age: A Possible Conspiracy of Silence?

The conspiracy of silence is extremely important due to both its high incidence and its consequences. This process usually occurs in situations of palliative care, or death; however, this concept is also mentioned in the literature linked to other contexts. Therefore, our objective was to study whether the conspiracy of silence may be extrapolated to the context of decision-making on the location of care in old age. To this end, we first analyzed the in-depth semi structured qualitative interviews conducted with older people, caregivers, and professionals, about decision-making on the location of care in old age. Subsequently, a comparative analysis was performed between the basic elements of the conspiracy of silence and this decision-making. Our findings revealed an avoidance process developed by all three groups. Furthermore, this decision-making presents similarities with the conspiracy of silence in the process of avoidance coping and denial that is developed. However, there are significant differences, as information is not withheld from the older person, who has an active attitude in the process of avoidance. Decision-making on the location of care in old age does not exactly match the conspiracy of silence process, but it does seem to correspond to a pact of silence.

Nursing educators' and undergraduate nursing students' beliefs and perceptions on evidence-based practice, evidence implementation, organizational readiness and culture: An exploratory cross-sectional study.

AIMS: To describe the undergraduate nursing students' and nursing educators' evidence-based practice beliefs, their extent of evidence-based practice implementation and their perspectives regarding organizational culture for evidence-based practice. To identify any relationship between the mentioned variables. BACKGROUND: The integration of evidence-based practice in nursing curricula is crucial to educate nursing students to incorporate evidence-based practice in their future clinical practice. Therefore, to promote its integration within nursing education, it is important to deeply understand how prepared academic institutions are for teaching about and supporting evidence-based practice integration. DESIGN: Cross-sectional study. METHODS: Nursing educators and undergraduate nursing students from nine Portuguese nursing schools were invited to participate in this study through an electronic survey comprising socio-demographic questions and the scales. RESULTS: Sixty-eight nursing educators replied to the survey. Most were female, have PhD and have evidence-based practice training. They showed mean scores of 88.92 ± 8.18 for evidence-based practice beliefs, 40.20 ± 18.93 for evidence-based practice implementation and 80.59 ± 17.52 for evidence-based practice organizational culture and readiness. Concerning nursing educator sample, there were moderate and statistically significant relationship between: evidence-based practice beliefs and implementation; and evidence-based practice beliefs and organizational culture and readiness for school-wide integration of evidence-based practice. Between evidence-based practice implementation and organizational culture and readiness for school-wide integration of evidence-based practice, there was a small relationship. One hundred and sixty-seven undergraduate nursing students answered the survey. Mostly, they were female and were in third or fourth year of their nursing degree. Similarly, to educators, students showed mean scores of 58.69 ± 6.92 for evidence-based practice beliefs, 32.37 ± 16.97 for evidence-based practice implementation and 84.20 ± 23.48 for evidence-based practice organizational culture and readiness. Regarding undergraduate nursing student sample, there were moderate and statistically significant relationship between the different variables. CONCLUSIONS: Both nursing educators and undergraduate nursing students had strong evidence-based practice beliefs, but low levels of evidence-based practice implementation. In nursing educators' and undergraduate nursing students' perspectives, there were opportunities in their schools for the development of an evidence-based practice culture. Based on results, support for development and testing of interventions, specifically tailored for promoting evidence-based practice implementation in nursing educational contexts, is recommended.

Fresno test to measure evidence-based practice knowledge and skills for Portuguese undergraduate nursing students: A translation and adaptation study.

BACKGROUND: The Fresno Test was originally identified as an instrument to assess evidence-based practice knowledge and skills through cognitive testing and performance assessment in medical students. Further studies have been recommended to establish the measurement properties of the Fresno Test in different learner populations. OBJECTIVES: To perform a cross-cultural adaptation of the Fresno Test for Portuguese undergraduate nursing students and to analyze the interrater reliability. DESIGN: Cross-cultural adaptation study with interrater reliability assessment carried out in two phases during 2017-2018. SETTINGS: One of the main nursing schools, Portugal. PARTICIPANTS: Fourth year undergraduate nursing students. METHODS: The study was performed in two phases, firstly the cross-cultural adaptation (performed in five stages) and secondly the analysis of interrater reliability. RESULTS: Stages I, II, III and IV of the cross-cultural adaptation proceeded smoothly and the expert panel produced and agreed upon the pre-final version of Adapted Fresno Test. In stage V (the pre-test stage), students reported a general understanding of the items, but they reported a lack of knowledge to answer the test. An expert panel subsequently agreed that modifications were needed to ensure the test was within the student's competency level and to decrease risk of assessment bias. For phase II, 50 complete questionnaires were randomly selected to be rated by three independent nurses using the modified rubric to score the test. The overall interrater reliability was 0.826 with a range from 0.271 to 1.000 for each item. CONCLUSIONS: The Adapted Fresno Test presented in this paper is the first instrument translated for European Portuguese and adapted specially for undergraduate nursing students. Despite good interrater reliability, further validation studies with more robust samples are suggested to definitively establish psychometric properties beyond the interrater reliability.

Nursing practice in the promotion of the elderly's autonomy.

OBJECTIVE: To describe the meaning attributed by specialist nurses to the promotion of the elderly's autonomy. METHOD: This is a phenomenological study, according to Giorgi's method, which uses semi-structured interviews. Eighteen specialist nurses participated, recruited using convenience sampling, in two hospitals in the northern region of Portugal, between March and December 2018. RESULTS: Five themes emerged: use of instruments; use of theoretical framework; nursing diagnoses; prescription of interventions; nursing records. CONCLUSION: Specialist nurses use instruments that essentially promote the elderly's physical capacity, within the scope of autonomy. The information systems used to record the diagnoses and prescriptions for interventions do not reflect the intervention for the person's autonomy. Autonomy in a multidimensional way is not very well developed, despite the recognition of its importance for the elderly's quality of life and dignity.

Palliative rehabilitation interventions in palliative care: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to examine and map interventions of palliative rehabilitation that are implemented and evaluated in palliative care. INTRODUCTION: Palliative rehabilitation is defined as the process of helping individuals with a progressive, often advanced or incurable disease reach their physical, psychological, and social potential consistent with physiological and environmental limitations and life preferences. Rehabilitation may prolong functional independence and improve quality of life. Information on palliative rehabilitation interventions, their characteristics, contexts, and population is dispersed throughout the literature, hence the need for a scoping review. INCLUSION CRITERIA: This scoping review will consider all studies that focus on qualified health care professionals working in palliative care who are caring for patients 18 years of age or older, and studies that focus on the concepts of palliative rehabilitation interventions. This scoping review will consider all palliative rehabilitation interventions implemented and evaluated in the context of palliative care. METHODS: The search strategy aims to find published and unpublished studies. The databases to be searched will include CINAHL Complete, PubMed, Scopus, SciELO, Cochrane Central Register of Controlled Trials, and PEDro. The search for unpublished studies will include DART-Europe, OpenGrey, and RCAAP. Studies published in English, Spanish, and Portuguese carried out from 2009 onward will be considered for inclusion. Retrieved papers will be screened for inclusion by two reviewers. Data will be extracted and presented in tabular form and a narrative summary that aligns with the review's objective. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer.

Forgiveness facilitation in palliative care: a scoping review.

OBJECTIVE: The objective of this review is to map the nature and extent of forgiveness facilitation intervention implemented and evaluated in palliative care contexts. INTRODUCTION: Spiritual beliefs often include reconciliation and forgiveness, which are critical to patients and families in palliative care. Forgiveness facilitation can represent a valuable response as a multidisciplinary and non-pharmacological intervention to reduce suffering. INCLUSION CRITERIA: Studies including palliative care patients aged 18 years or over and assisted by palliative care teams, including all healthcare professionals, chaplains, and volunteers, were included in this review. METHODS: This scoping review is based on JBI methodology. The search was conducted in June 2017 and updated in December 2018 using international databases and gray literature in English, Spanish, German, Italian, and Portuguese. RESULTS: A total of 23 articles were included in this review. The results suggest a growing interest in forgiveness facilitation in palliative care in different spiritual and religious traditions. Most studies are based on a psychological perspective. Several activities related to the intervention have been identified, but few details or characteristics are described. Social workers, nurses, doctors, and psychologists were most identified as healthcare staff involved in forgiveness facilitation. The outcomes related to the intervention are mental, physical, and relational well-being; quality of life, decision-making and communication; self-esteem and hope; depression, anger, and anxiety; and inner peace. CONCLUSIONS: Forgiveness facilitation is critical in palliative care and is grounded in a multidisciplinary approach, but further evidence is needed to inform clinical implementation. These results open new perspectives for research and training on palliative healthcare staff.