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This scoping review was conducted under the Joanna Briggs Institute (JBI) framework. It included primary studies published until 30 April 2023, obtained through a systematic search across PubMed, Web of Science, CINAHL, and MEDLINE databases. The review focused on primary studies that used the Delphi technique in nursing competence research, especially those related to defining core competency frameworks and developing instruments to assess professional competence. The goal was to analyze the different methodological approaches used by authors, synthesize them, and propose recommendations to enhance methodological rigor, reliability, and validity in the application of the Delphi technique. For this purpose, the following review question was established: "What is the available evidence on the use of the Delphi technique in the study of professional competence in nursing?". The extracted textual elements underwent a content analysis, resulting in dimensions established through an inductive approach. Twenty studies were included, yielding insights into diverse methodological options for conducting Delphi studies, organised around a set of dimensions: (1) preparatory procedures; (2) procedures for accessing and selecting experts; (3) acquisition of expert input; (4) data analysis and consensus; and (5) ethical and legal procedures and guarantees. The study's limitations include the inability to include certain studies due to a lack of response to requests for clarification from corresponding authors. Additionally, the primary studies' methodological quality was not assessed, which is another relevant aspect. The study's results offer valuable insights for researchers intending to utilise the Delphi technique within the context of the research referenced in the included studies. This information encompasses important methodological choices, highlighting their potential benefits and associated risks. The review was prospectively registered on the Open Science Framework (Registration No: osf.io/kp2vw).
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Background: Homeless people are continuously facing adverse living conditions as poor access to basic nutrition, hygiene conditions and healthcare services, being at increased risk of severe infectious diseases as HIV and hepatitis as well as cardiovascular diseases and mental disorders. The characterization of homeless people's health is fundamental to identify their health care needs. Considering that the aforementioned diseases are associated with chronic inflammatory processes, the main goal of this study was to characterize the inflammatory profile of a homeless population through quantification in saliva of a panel of inflammatory cytokines. Methods: The inflammatory profile was assessed in 114 individuals residing in two temporary shelters located in Lisbon and that accepted to participated in the study. Inflammatory proteins were quantified using a Multiplex Immunoassay approach. Data analysis was performed using the GraphPad Prism software and statistical significance among the groups was assessed using the nonparametric Mann-Whitney test. Results: Even though some protein levels might be masked by drug treatment, data analysis showed high levels of INF-Ï, IL-10 and TNF-α in the infectious disease group, critical cytokines for the immune response against viruses and bacteria. Also, cytokines like IL-1ß and IL-6 were detected at statistically significant levels in the cardiovascular disease group and all cytokines included in this study were quantified in the mental disorders group. Conclusion: These findings may help the healthcare services in the evaluation of treatment efficacy and disease monitoring, and in the development of effective public healthcare strategies and policy interventions to improve quality of life of the homeless population.
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Citocinas , Personas con Mala Vivienda , Inflamación , Humanos , Personas con Mala Vivienda/estadística & datos numéricos , Masculino , Femenino , Adulto , Portugal , Persona de Mediana Edad , Saliva/químicaRESUMEN
OBJECTIVES: to map the benefits of Augmentative and Alternative Communication in ventilated adults in Intensive Care Unit and identify strategies used. METHODS: a Scoping Review was carried out according to the Joanna Brigs Institute Protocol. The research question was: "In adult patients ventilated in Intensive Care Units, what are the benefits of Augmentative and Alternative Communication?". An article research was carried out at PubMed, EBSCOhost and B-On databases. It was held between October and November 2018, from 2013 to 2018, in Portuguese and in English. RESULTS: 61 references were obtained. After selection according to the inclusion criteria, 7 articles were analyzed. CONCLUSIONS: studies enunciate Augmentative and Alternative Communication as a strategy to enhance communication, describing methods and tools. There is no agreement on the most effective tool.
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Comunicación , Intubación Intratraqueal/efectos adversos , Respiración Artificial/efectos adversos , Humanos , Intubación Intratraqueal/métodos , Relaciones Profesional-Paciente , Respiración Artificial/métodosRESUMEN
OBJECTIVES: to characterize the homeless families who use a Public Shower Room; identify significant life events/phenomena for the family's transition to homelessness; understand the relationship between significant life events; identify future expectations of respondents. METHODS: an exploratory, descriptive study using the interview and thematic content analysis. Sample consisted of public shower room users. RESULTS: mental illness, social, personal and family factors justify the transition of subjects to homelessness. The total absence of hopelessness alternates with expectations for the future based on resilience and hope. Final Considerations: we highlight in the study the self-determination expressed in small expressions of the narrative, on the one hand, as well as aspects related to the evolution of family relationships, on the other.
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Relaciones Familiares/psicología , Personas con Mala Vivienda/psicología , Adulto , Anciano , Femenino , Personas con Mala Vivienda/estadística & datos numéricos , Humanos , Entrevistas como Asunto/métodos , Masculino , Persona de Mediana Edad , Narración , Investigación CualitativaRESUMEN
OBJECTIVE: Ventilator associated pneumonia is the most frequent health-care-associated infection in Intensive Care Units, causing increased antibiotic consumption and resistance, length of stay, plus multiple health and economic costs. The aim of the study was to assess whether a customised guideline implementation would improve ventilator-associated pneumonia incidence and associated intensive care outcomes. DESIGN: This was a quasi-experimental, before-after study consisting of pre-intervention, intervention and post-intervention periods. SETTING: Three intensive care units at a well-known Portuguese hospital centre. INTERVENTION: A set of eight recommendations was implemented after a guideline adaptation process. PATIENTS: Adult patients admitted to the intensive care units over the study periods, aged 18â¯years or older and under invasive ventilation through an endotracheal tube or tracheostomy cannula. MEASUREMENTS AND MAIN RESULTS: Data related to patient characterisation, guideline compliance and health outcomes were analysed. From a population of 1970 patients, a study sample of 828 was studied. Compliance with the recommendations was high. We identified a significant reduction in the incidence of ventilator-associated pneumonia in two of the units (pâ¯=â¯0.020 and pâ¯=â¯0.001) and a reduction in duration of invasive ventilation, intensive care unit length of stay and mortality in all the three units. We found associations between some recommendations and the implementation of the set of recommendations and intensive care unit length of stay, duration of invasive ventilation and mortality. CONCLUSION: The implementation of an evidence-based, locally customised guideline may improve ventilator associated pneumonia incidence and several outcomes.
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Guías como Asunto/normas , Neumonía Asociada al Ventilador/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Control de Infecciones/métodos , Control de Infecciones/normas , Unidades de Cuidados Intensivos/organización & administración , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Neumonía Asociada al Ventilador/mortalidad , Portugal , Resultado del TratamientoRESUMEN
OBJECTIVE: This article aims to characterise intubation-associated pneumonia regarding its diagnosis, causes, risk factors, consequences and incidence. RESEARCH METHODOLOGY: Integrative literature review using database Pubmed and B-on and webpages of organisations dedicated to this area of study. SETTING: The research took place between May and July 2015. After selection of the articles, according to established criteria, their quality was assessed and 17 documents were included. RESULTS: Evidence has demonstrated that intubation associated pneumonia has a multifactorial aetiology and one of its main causes is micro-aspiration of gastric and oropharynx contents. Risk factors can be internal or external. The diagnostic criteria are based on clinical, radiological and microbiological data, established by several organisations, including the European Centres for Disease Control and Prevention, which are, however, still not accurate. In recent years, there has been a downward trend in the incidence in Europe. Nevertheless, it continues to have significant economic impact, as well as affecting health and human lives. CONCLUSIONS: Several European countries are committed to addressing this phenomenon through infection control and microbial resistance programmes; however there is a much to be done in order to minimise its effects. The lack of consensus in the literature regarding diagnosis criteria, risk factors and incidence rates is a limitation of this study.
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Intubación Intratraqueal/efectos adversos , Neumonía Asociada al Ventilador/prevención & control , Respiración Artificial/efectos adversos , Humanos , Incidencia , Control de Infecciones/métodos , Control de Infecciones/normas , Neumonía Asociada al Ventilador/epidemiología , Portugal , Literatura de Revisión como Asunto , Factores de RiesgoRESUMEN
OBJECTIVE: To identify the Nursing interventions, described in literature, in the ERAS® program. METHOD: We defined a scoping review based on the recommendations of The Institute Joanna Brigs (JBI) and on research in electronic databases. We chose the studies through flow diagrams "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" and presented them in a chart. RESULTS: We found 306 articles published between 2010 and 2018 and included 14 of them. The main results were: the crucial role nurses play throughout the surgical process, which begins at the preoperative nursing consultation; goes to post-operative care, such as early giving food to patients, effective management of pain or early mobilization; and ends in telephone follow-up. CONCLUSION: The introduction of the surgical program ERAS® may be an opportunity for nurses to play a more influential role in the surgical path, directly involving with their clients' results.
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Atención de Enfermería/métodos , Atención Perioperativa/normas , Humanos , Atención de Enfermería/normas , Atención de Enfermería/tendencias , Atención Perioperativa/métodosRESUMEN
ABSTRACT Objectives: to map the benefits of Augmentative and Alternative Communication in ventilated adults in Intensive Care Unit and identify strategies used. Methods: a Scoping Review was carried out according to the Joanna Brigs Institute Protocol. The research question was: "In adult patients ventilated in Intensive Care Units, what are the benefits of Augmentative and Alternative Communication?". An article research was carried out at PubMed, EBSCOhost and B-On databases. It was held between October and November 2018, from 2013 to 2018, in Portuguese and in English. Results: 61 references were obtained. After selection according to the inclusion criteria, 7 articles were analyzed. Conclusions: studies enunciate Augmentative and Alternative Communication as a strategy to enhance communication, describing methods and tools. There is no agreement on the most effective tool.
RESUMEN Objetivos: mapear los beneficios de la Comunicación Aumentativa y Alternativa en adultos ventilados en Unidades de Terapia Intensiva e identificar las estrategias utilizadas. Métodos: fue realizada una Scoping Review según el Protocolo Joanna Brigs Institute. La cuestión de investigación fue: "En enfermos adultos ventilados en Unidades de Terapia Intensiva: ¿cuáles los beneficios de la Comunicación Aumentativa y Alternativa?". Una investigación de artículos fue realizada en las bases de datos PubMed, EBSCOhost y B-On, entre octubre y noviembre de 2018, referente al periodo de 2013-2018, en los idiomas portugués e inglés. Resultados: tras la selección según los criterios de inclusión, se obtuvieron 7 referencias. Conclusiones: los diferentes estudios enuncian a Comunicación Aumentativa y Alternativa como estrategia que potencia la comunicación, describiendo los métodos e instrumentos. No existe consenso relativamente al instrumento más eficaz.
RESUMO Objetivos: mapear os benefícios da Comunicação Alternativa e Aumentativa em adultos ventilados em Unidade de Terapia Intensiva e identificar estratégias utilizadas. Métodos: realizada uma Scoping Review segundo o Protocolo Joanna Brigs Institute. A questão de pesquisa foi: "Em doentes adultos ventilados em Unidades de Cuidados Intensivos, quais os benefícios da Comunicação Alternativa e Aumentativa?". Realizada pesquisa de artigos nas bases de dados PubMed, EBSCOhost e B-On, entre outubro e novembro de 2018, referente ao período de 2013 e 2018, nos idiomas português e inglês. Resultados: foram obtidas 61 referências. Após seleção de acordo com os critérios de inclusão, foram analisados 7 artigos. Conclusões: os diversos estudos enunciam a Comunicação Alternativa e Aumentativa enquanto estratégia potenciadora da comunicação, descrevendo métodos e instrumentos. Não existe consenso relativamente ao instrumento mais eficaz.
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ABSTRACT Objectives: to characterize the homeless families who use a Public Shower Room; identify significant life events/phenomena for the family's transition to homelessness; understand the relationship between significant life events; identify future expectations of respondents. Methods: an exploratory, descriptive study using the interview and thematic content analysis. Sample consisted of public shower room users. Results: mental illness, social, personal and family factors justify the transition of subjects to homelessness. The total absence of hopelessness alternates with expectations for the future based on resilience and hope. Final Considerations: we highlight in the study the self-determination expressed in small expressions of the narrative, on the one hand, as well as aspects related to the evolution of family relationships, on the other.
RESUMEN Objetivos: caracterizar las familias sin-hogar, usuarias de un Balneario Publico; identificar los fenómenos/acontecimientos de vida significativos por la transición de la familia para sin-hogar; comprehender la relación entre los acontecimientos de vida significativos; identificar las expectativas por el futuro de los inquiridos. Métodos: estudio exploratorio, descriptivo, con recurso a la entrevista y la análisis temática de contenido. La muestra fue constituida por usuarios de un Balneario Publico. Resultados: la enfermedad y los factores de orden social, personal y familiar justifican la transición de los sujetos para sin-hogar. La ausencia total de expectativas, marcadas por la desesperanza, alterna con las expectativas futuras asientes en la resiliencia y en la esperanza. Consideraciones Finales: relevamos en el estudio la autodeterminación asiente en pequeñas expresiones de la narrativa, así como los aspectos ligados a la evolución de la unidad familiar.
RESUMO Objetivos: caracterizar as famílias sem-teto utilizadoras de um Balneário Público; identificar os fenômenos/acontecimentos de vida significativos para a transição da família para a condição de sem-teto; compreender a relação entre os acontecimentos de vida significativos; identificar as expectativas para o futuro dos inquiridos. Métodos: estudo exploratório, descritivo utilizando a entrevista e a análise temática de conteúdo. A amostra foi constituída pelos usuários de um Balneário Públic. Resultados: a doença mental, os fatores de ordem social, pessoal e familiar justificam a transição dos sujeitos para a condição de sem-teto. A ausência total de expectativas, marcadas pela desesperança, alterna com as expectativas futuras assentes na resiliência e na esperança. Considerações Finais: relevamos no estudo a autodeterminação expressa em pequenas expressões da narrativa, por um lado, bem como os aspetos ligados à evolução das relações familiares, por outro.
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Relaciones Familiares/psicología , Personas con Mala Vivienda/psicología , Entrevistas como Asunto/métodos , Narración , Investigación Cualitativa , Personas con Mala Vivienda/estadística & datos numéricosRESUMEN
ABSTRACT Objective: To identify the Nursing interventions, described in literature, in the ERAS® program. Method: We defined a scoping review based on the recommendations of The Institute Joanna Brigs (JBI) and on research in electronic databases. We chose the studies through flow diagrams "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)" and presented them in a chart. Results: We found 306 articles published between 2010 and 2018 and included 14 of them. The main results were: the crucial role nurses play throughout the surgical process, which begins at the preoperative nursing consultation; goes to post-operative care, such as early giving food to patients, effective management of pain or early mobilization; and ends in telephone follow-up. Conclusion: The introduction of the surgical program ERAS® may be an opportunity for nurses to play a more influential role in the surgical path, directly involving with their clients' results.
RESUMEN Objetivo: Identificar las intervenciones de Enfermería en el programa ERAS® descriptas en la literatura. Método: Se elaboró una Scoping Review basada en las recomendaciones del Institute Joanna Brigs (JBI) y con investigación en bases de datos electrónicas. Los estudios fueron seleccionados a través de los diagramas de flujo de los Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) y presentados en un marco. Resultados: Se han encontrado 306 artículos publicados entre 2010 y 2018, habiéndose incluido 14 de ellos. Los principales resultados son: el papel crucial que el enfermero desempeña a lo largo de todo el proceso quirúrgico, empezando en la consulta de enfermería preoperatoria, pasando por los cuidados post-operativos como la introducción temprana de la alimentación, la gestión eficaz del dolor o la movilización precoz y, terminando con el seguimiento telefónico. Conclusión: La implementación del programa quirúrgico ERAS® puede ser una oportunidad para que los enfermeros desempeñen un papel más influyente en el recorrido quirúrgico, involucrándose directamente en los resultados del cliente.
RESUMO Objetivo: Identificar as intervenções de Enfermagem no programa ERAS® descritas na literatura. Método: Foi elaborada uma scoping review com base nas recomendações do The Institute Joanna Brigs (JBI) e na pesquisa em bases de dados eletrônicas. Os estudos foram selecionados através de diagramas de fluxo Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e apresentados em um quadro. Resultados: Foram encontrados 306 artigos publicados entre 2010 e 2018, tendo-se incluído 14 deles. Os principais resultados são: o papel crucial que o enfermeiro desempenha ao longo de todo o processo cirúrgico, começando na consulta de Enfermagem pré-operatória, passando pelos cuidados pós-operatórios como a introdução precoce da alimentação, gestão eficaz da dor ou mobilização precoce e terminando com o follow-up telefônico. Conclusão: A implementação do programa cirúrgico ERAS® pode ser uma oportunidade para o enfermeiro desempenhar um papel mais influente no percurso cirúrgico, envolvendo-se diretamente nos resultados do cliente.