Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study.

Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.

Chronic wound assessment: Cultural and linguistic adaptation for European Portuguese of RESVECH-2 scale.

INTRODUCTION: In order to assess and to follow up the evolution of chronic wounds, it is advisable to apply measurement scales. This procedure allows clinicians to verify the appropriateness of their activities and whether the healing process is evolving as expected. AIM: To conduct a cross-cultural adaptation and psychometric analysis of Portuguese version of RESVECH 2.0. METHODS: A quantitative and correlational study was designed and, to perform the cross-cultural adaptation of RESVECH 2.0, we followed the classic sequential approach for linguistic equivalence to European Portuguese. The study occurred at a Portuguese oncology hospital and the sample encompassed 281 patients with multiple chronic wounds. RESULTS: RESVECH 2.0 is a practical measurement instrument, easy to use, and well accepted by nurses to know all kinds of wounds' etiologies. The reliability test revealed an acceptable internal consistency and high proportion of agreement between two raters assessing the same patient. Construct validity was considered average/good and the principal component factor analysis with varimax rotation obtained six factors corresponding to 59.5% of explained variance. When comparing the domains from RESVECH 2.0 with those from BWAT we found statistically significant correlations. CONCLUSION: The adapted version of RESVECH 2.0 scale presents a good internal consistency and is valid for the Portuguese language and culture, being useful and effective in clinical practice.

Prevention of pressure injury in the operating room: Heels operating room pressure injury trial.

The objective was to evaluate the efficacy of multi-layered silicone foam (intervention) compared with transparent polyurethane film (control) in preventing heel pressure injuries caused by surgical positioning of individuals undergoing elective surgery. It was designed an intra-patient, open, parallel, randomised controlled trial was conducted in a university hospital in southern Brazil, from March 2019 to February 2020, with patients undergoing elective surgeries of cardiac and gastrointestinal specialties. The patients who met the selection criteria constituted, simultaneously, a single group receiving the intervention and active control, through paired analysis of the cutaneous sites (right heel and left heel). The outcome was the occurrence of PI, within the follow-up period was 72 hours. Brazilian Registry of Clinical Trials: RBR-5GKNG5. There was analysis of 135 patients/270 heels, with an overall incidence of 36.7%. The pressure injury incidence was significantly lower in the intervention group (26.7%), compared with the control group (P = .001); relative risk of 0.57. In the intervention group, the estimated pressure injury-free time (survival) was 57.5 hours and in the control group, 43.9 hours. It was concluded that Multi-layered silicone foam (intervention) is more efficacious than transparent polyurethane film (control) in the prevention of pressure injuries caused by surgical positioning of individuals undergoing elective surgery.

Thromboembolic events in people with cancer during the COVID-19 pandemic: case-control study.

OBJECTIVE: to analyze the association between coronavirus disease infection and thromboembolic events in people with cancer in the first year of the pandemic. METHOD: case-control study carried out by collecting medical records. The selected cases were adults with cancer, diagnosed with a thromboembolic event, treated in the selected service units during the first year of the pandemic. The control group included adults with cancer without a diagnosis of a thromboembolic event. Pearson's chi-square test was applied to verify the association between risk factors and the outcome and logistic regression techniques were applied to identify the odds ratio for the occurrence of a thromboembolic event. RESULTS: there were 388 cases and 440 control cases included in the study (ratio 1/1). Females predominated, who were white, with mean age of 58.2 (±14.8) years. Antineoplastic chemotherapy was the most used treatment and coronavirus disease was identified in 11.59% of participants. In the case group, deep vein thrombosis was more prevalent. CONCLUSION: the study confirmed the hypothesis that coronavirus disease infection did not increase the chance of thromboembolic events in people with cancer. For the population studied, the factors that were associated with these events were those related to cancer and its treatment. HIGHLIGHTS: (1) Deep vein thrombosis was what prevailed in the studied population. (2) Chemotherapy increased the chance of thromboembolic events by 65%. (3) Thromboembolic events showed a significant association with a higher death rate as the outcome. (4) COVID-19 did not increase the risk of thromboembolic events in people with cancer.

Validation of the "international consultation on incontinence questionnaire urinary incontinence quality of life".

OBJECTIVE: To Validate the International Consultation on Incontinence Questionnaire Quality of Life for the Portuguese population. Urinary incontinence is a highly prevalent condition with a negative impact on people's quality of life. The International Consultation on Incontinence Questionnaire Quality of Life was adapted in order to have a standardized structure that allows the assessment of the impact of urinary incontinence on quality of life. METHOD: An observational cross-sectional study was carried out with two hundred and twenty participants recruited at the Centro Hospitalar de Vila Nova de Gaia/Espinho and at the Centro Hospitalar Universitário de São João during the period from September 2019 to January 2020. The psychometric properties of the questionnaire were assessed. For internal consistency, the standardized Cronbach's alpha coefficient was calculated. In order to obtain construct validity, an exploratory factor analysis was performed using varimax rotation to extract the main components. RESULTS: The Portuguese version of the questionnaire has 21 items distributed by the three factors found, maintaining the items proposed in the original version. The result of standardized Cronbach's alpha coefficient, α=0.906 overall, confirms the internal consistency of the Portuguese version of the instrument. Pearson's correlation analysis was performed between each item and the item assessing the impact on quality of life in the form of a scale, verifying a positive correlation in all items. CONCLUSIONS: The Portuguese version of the questionnaire proved to be reliable and valid in the study carried out for clinical and research use.

Thromboembolic events in people with cancer during the COVID-19 pandemic: case-control study / Eventos tromboembólicos em pessoas com câncer na pandemia da COVID-19: estudo caso-controle / Eventos tromboembólicos en personas con cáncer durante la pandemia de COVID-19: estudio de caso-control

Abstract Objective: to analyze the association between coronavirus disease infection and thromboembolic events in people with cancer in the first year of the pandemic. Method: case-control study carried out by collecting medical records. The selected cases were adults with cancer, diagnosed with a thromboembolic event, treated in the selected service units during the first year of the pandemic. The control group included adults with cancer without a diagnosis of a thromboembolic event. Pearson's chi-square test was applied to verify the association between risk factors and the outcome and logistic regression techniques were applied to identify the odds ratio for the occurrence of a thromboembolic event. Results: there were 388 cases and 440 control cases included in the study (ratio 1/1). Females predominated, who were white, with mean age of 58.2 (±14.8) years. Antineoplastic chemotherapy was the most used treatment and coronavirus disease was identified in 11.59% of participants. In the case group, deep vein thrombosis was more prevalent. Conclusion: the study confirmed the hypothesis that coronavirus disease infection did not increase the chance of thromboembolic events in people with cancer. For the population studied, the factors that were associated with these events were those related to cancer and its treatment.

Resumo Objetivo: analisar a associação entre a infecção por coronavírus e os eventos tromboembólicos em pessoas com câncer, durante o primeiro ano da pandemia. Método: estudo caso-controle realizado mediante coleta em prontuários. Os casos estudados foram de adultos com câncer, com diagnóstico de evento tromboembólico, atendidos nas unidades do serviço selecionado durante o primeiro ano da pandemia. O grupo controle contou com adultos com câncer sem diagnóstico de evento tromboembólico. Teste qui-quadrado de Pearson foi aplicado para verificar associação entre fatores de risco e o desfecho de técnicas de regressão logística foram aplicadas para identificar a razão de chance de ocorrência de evento tromboembólico. Resultados: 388 casos e 440 controles foram incluídos no estudo (proporção 1/1). Prevaleceu o sexo feminino, raça branca, média de idade de 58,2 (±14,8) anos. A quimioterapia antineoplásica foi o tratamento mais utilizado e a doença por coronavírus foi identificada em 11,59% dos participantes. No grupo caso, trombose venosa profunda foi mais prevalente. Conclusão: o estudo confirmou a hipótese de que a infecção por doença por coronavírus não aumentou a chance de eventos tromboembólicos em pessoas com câncer. Para a população estudada, os fatores que tiveram associação com os eventos foram os relacionados ao câncer e seu tratamento.

Resumen Objetivo: analizar la asociación entre la infección por enfermedad por coronavirus y eventos tromboembólicos en personas con cáncer durante el primer año de la pandemia. Método: estudio caso-control realizado mediante la recolección de datos en historiales médicos. Los casos fueron adultos con cáncer, diagnosticados con evento tromboembólico, atendidos en las unidades del servicio seleccionado durante el primer año de la pandemia. El grupo control estuvo compuesto por adultos con cáncer sin diagnóstico de evento tromboembólico. Se aplicó la prueba de chi-cuadrado de Pearson para verificar la asociación entre factores de riesgo y el resultado, y se utilizaron técnicas de regresión logística para identificar la razón de posibilidades de ocurrencia de evento tromboembólico. Resultados: se incluyeron en el estudio 388 casos y 440 controles (proporción 1/1). Prevaleció el género femenino, raza blanca, con una edad media de 58,2 (±14,8) años. La quimioterapia antineoplásica fue el tratamiento más utilizado y la enfermedad por coronavirus fue identificada en el 11,59% de los participantes. En el grupo de casos, la trombosis venosa profunda fue más prevalente. Conclusión: el estudio confirmó la hipótesis de que la infección por enfermedad por coronavirus no aumentó la probabilidad de eventos tromboembólicos en personas con cáncer. Para la población estudiada, los factores que tuvieron asociación con estos eventos fueron los relacionados con el cáncer y su tratamiento.

Validation of the "international consultation on incontinence questionnaire urinary incontinence quality of life" / Validación de la "consulta internacional sobre incontinenciacuestionario de incontinencia urinaria módulo de calidad de vida" / Validação do "international consultation on incontinence questionnaire urinary incontinence quality of life module"

ABSTRACT Objective: To Validate the International Consultation on Incontinence Questionnaire Quality of Life for the Portuguese population. Urinary incontinence is a highly prevalent condition with a negative impact on people's quality of life. The International Consultation on Incontinence Questionnaire Quality of Life was adapted in order to have a standardized structure that allows the assessment of the impact of urinary incontinence on quality of life. Method: An observational cross-sectional study was carried out with two hundred and twenty participants recruited at the Centro Hospitalar de Vila Nova de Gaia/Espinho and at the Centro Hospitalar Universitário de São João during the period from September 2019 to January 2020. The psychometric properties of the questionnaire were assessed. For internal consistency, the standardized Cronbach's alpha coefficient was calculated. In order to obtain construct validity, an exploratory factor analysis was performed using varimax rotation to extract the main components. Results: The Portuguese version of the questionnaire has 21 items distributed by the three factors found, maintaining the items proposed in the original version. The result of standardized Cronbach's alpha coefficient, α=0.906 overall, confirms the internal consistency of the Portuguese version of the instrument. Pearson's correlation analysis was performed between each item and the item assessing the impact on quality of life in the form of a scale, verifying a positive correlation in all items. Conclusions: The Portuguese version of the questionnaire proved to be reliable and valid in the study carried out for clinical and research use.

RESUMEN Objetivo: Validar la Consulta Internacional sobre Incontinencia Cuestionario de Calidad de Vida para la población portuguesa. La incontinencia urinaria es una condición altamente prevalente conun impacto negativo en la calidad de vida de las personas. Se adaptó el International Consultationon Incontinence Questionnaire Quality of Life para tener una estructura estandarizada que permita evaluar el impacto de la incontinencia urinaria en la calidad de vida. Método: Se realizóunestudio transversal observacional condoscientosveinte participantes reclutados en el Centro Hospitalar de Vila Nova de Gaia/Espinho y en el Centro Hospitalar Universitário de São João durante el período de septiembre de 2019 a enero de 2020. Las propiedades psicométricas delcuestionario. Para la consistencia interna se calculó el coeficiente alfa de Cronbach estandarizado. Para obtener la validez de constructo se realizó una nálisis factorial exploratorio mediante rotación varimax para extraer los componentes principales. Resultados: La versión portuguesa del cuestionario tiene 21 ítems distribuidos por los tres factores encontrados, manteniendo los ítems propuestos en la versión original. El resultado del coeficiente alfa de Cronbach estandarizado, α=0,906 global, confirma la consistencia interna de la versión portuguesa del instrumento. Se realizó el análisis de correlación de Pearson entre cada ítem y el ítem que evalúa el impacto en la calidad de vida en forma de escala, verificándose una correlación positiva en todos los ítems. Conclusiones: La versión portuguesa delcuestionario demostró ser confiable y válida en el estudio realizado para uso clínico y de investigación.

RESUMO Objetivo: Validar o International Consultationon Incontinence Questionnaire Quality of Life para a população portuguesa. A incontinência urinária é uma condição com elevada prevalência e com impacto negativo na qualidade de vida das pessoas. O International Consultationon Incontinence Questionnaire Quality of Life foi adaptado de forma a ter uma estrutura estandardizada e que permite avaliar o impacto da incontinência urinária na qualidade de vida. Método: Foi realizado um estudo observacional do tipo transversal com duzentos e vinte participantes recrutados no Centro Hospitalar de Vila Nova de Gaia/Espinho e no Centro Hospitalar Universitário de São João durante o período de setembro de 2019 a janeiro de 2020. Foram avaliadas as propriedades psicométricas do questionário. Para a consistência interna foi calculado o coeficiente alfa de Cronbach padronizado. Para obter a validade do constructo foi realizada uma análise exploratória fatorial por rotação varimax para extração dos principais componentes. Resultados: A versão portuguesa do questionário tem 21 itens distribuídos pelos três fatores encontrados mantendo, no entanto, os itens propostos na versão original.O resultado de coeficiente alfa de Cronbach padronizado, α=0,906 global, confirma a consistência interna da versão portuguesa do instrumento. Foi realizada a análise da correlação de Pearson entre cada item e o item de avaliação do impacto na qualidade de vida em forma de escala verificando-se uma correlação positiva em todos os itens. Conclusões: A versão portuguesa do questionário, mostrou-se confiável e válida no estudo realizado para utilização na clínica e na investigação.

Temperatura da pele de diferentes áreas corporais de idosos sem risco para lesões por pressão / Temperatura de la piel de diferentes áreas corporales de los ancianos sin riesgo de lesiones por presión / Skin temperature of different body areas of the elderly without risk for pressure ulcer

Objetivo: identificar a temperatura da pele de diferentes áreas corporais de idosos hospitalizados em unidade de clínica cirúrgica sem risco de desenvolver lesões por pressão a partir da Escala de Braden. Método: estudo correlacional descritivo, com corte transversal, realizado em unidade de clínica cirúrgica de um hospital universitário de maio a outubro de 2017, com 84 pacientes. Realizada análise estatística descritiva. Resultados: a região sacral apresentou média de temperatura mais alta e o calcâneo direito a mais baixa. Não há diferença na temperatura da pele entre os lados direito e esquerdo nas escápulas, trocânteres e calcâneo; entre os sexos e raças. Quando mensurada das 9:00 às 13:00h, a temperatura dos calcâneos foi menor do que quando mensurada das 13:01 às 17:00h na região dos calcâneos. Conclusão: a região sacral apresenta a média mais alta de temperatura da pele, em relação às áreas mensuradas. Há simetria entre os lados corporais.

Objective: to identify the skin temperature of different body areas of elderly inpatients at a surgical clinic unit without risk of developing pressure injuries from the Braden Scale. Method: descriptive correlational study, with cross-sectional design, conducted at a surgical clinic unit of a university hospital from May to October 2017, with 84 patients. Descriptive statistical analysis was performed. Results: the sacral region presented the highest mean temperature and the right calcaneus, the lowest. There is no difference in skin temperature between the right and left sides in the scapulae, trochanters and calcaneus; between the sexes and races. When measured from 9:00 a.m. to 1:00 p.m., the temperature of the calcaneus was lower than when measured from 1:01 p.m. to 5:00 p.m. in the calcaneus region. Conclusion: the sacral region presents the highest mean skin temperature in relation to the areas measured. There is symmetry between the body sides.

Objetivo: identificar la temperatura de la piel de diferentes áreas corporales de ancianos hospitalizados en una unidad clínica quirúrgica sin riesgo de desarrollar lesiones por presión a partir de la Escala Braden. Método: estudio correlativo descriptivo, con sección transversal, realizado en una unidad clínica quirúrgica de un hospital universitario de mayo a octubre de 2017, con 84 pacientes. Se realizó un análisis estadístico descriptivo. Resultados: la región sacra presentó una temperatura media más alta y el calcáneo derecho tenía la más baja. No hay diferencia en la temperatura de la piel entre los lados derecho e izquierdo en las escápulas, trocánteres y calcáneos; entre los sexos y las razas. Cuando se mide de 9:00 a.m. a 1:00 p.m., la temperatura del calcáneo fue menor que cuando se midió de 1:01 p.m. a 5:00 p.m. en la región del calcáneo. Conclusión: la región sacra presenta la temperatura media más alta de la piel, en relación con las áreas medidas. Hay simetría entre los lados del cuerpo.