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BACKGROUND: The goal of this article was to research the psychometric properties of the WHOQOL-BREF(PT) instrument in a sample of elderly citizens residing in a rural area in their own homes or at family members' or friends' homes and to compare the results: (i) to those reported by the team of Portuguese researchers that undertaken the instrument's translation/validation to the Portuguese language and (ii) to those reported internationally by the World Health Organization Quality of Life group. An overall quality of life scoring (QOL24-all facets) is also proposed in this article as novelty. The correlation level between QOL24 and the instrument's general facet was also investigated. METHODS: This was a cross-sectional study with a sample of 351 elderly citizens (46.4% males and 53.6% females) randomly selected from the official dataset of the Local Health Unit of Baixo Alentejo. All the data were collected by health professionals at the participants' homes following the structured interview methodology and using the WHOQOL-BREF(PT) instrument. Three different structural equation models were developed: (i) a first-order confirmatory factor analysis, to assess the instrument's psychometric properties; (ii) a hierarchical second-order confirmatory factor analysis model, to allow determining the QOL24 scoring; and (iii) a more generic structural equation model, to investigate the correlation level between QOL24 and the instrument's general facet. RESULTS: The WHOQOL-BREF(PT) showed an "almost very good" goodness of fit (comparative fit index of 0.949 and Tucker-Lewis index of 0.943), an adequate internal consistency (Cronbach's alpha: from 0.64 to 0.90; composite reliability: from 0.59 to 0.88) and tolerable convergent validity (average variance extracted: from 0.374 to 0.614). However, discriminant validity was not reached because strong correlations between the first-order factors (four QOL domains) were obtained, together with low values of the average variance extracted. The scoring of QOL domains and QOL24, determined as weighted averages (proposed in this article as novelty) were significantly different than those determined as unweighted averages. The standardized correlation coefficient between QOL24 and the instrument's general facet was of 0.89 (statistically highly significant). CONCLUSIONS: The WHOQOL-BREF(PT) is a psychometrically sound instrument to assess the QOL of the considered population sample. However, the QOL domains were found strongly intertwined. More studies are necessary to validate the weighted average scoring strategy of QOL domains and QOL24. Concurrent validity between QOL24 and the instrument's general facet was considered as "strong".
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Anciano Frágil/psicología , Anciano Frágil/estadística & datos numéricos , Vida Independiente/psicología , Vida Independiente/estadística & datos numéricos , Psicometría/normas , Calidad de Vida/psicología , Encuestas y Cuestionarios/normas , Anciano , Anciano de 80 o más Años , Estudios Transversales , Etnicidad/psicología , Etnicidad/estadística & datos numéricos , Análisis Factorial , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Portugal , Reproducibilidad de los Resultados , Población Rural/estadística & datos numéricos , Traducciones , Organización Mundial de la SaludRESUMEN
OBJECTIVES: To evaluate and compare nurses' depression, anxiety and stress symptoms at the beginning of the COVID-19 pandemic and after six months; to evaluate and compare the frequency of use of mental health promotion strategies during the same period; and to identify the relationship between the frequency of use of mental health promotion strategies, during the same period, with nurses' depression, anxiety and stress symptoms. METHODS: Data collection was carried out in two moments: at baseline and after six months. An online questionnaire was applied to nurses to assess the frequency of use of some mental health promotion strategies and their depression, anxiety, and stress symptoms (through the Depression Anxiety Stress Scales - short version (DASS-21)). RESULTS: The anxiety and stress symptoms significantly decreased over time. The physical activity increased, and a decrease was observed in the remote social contacts after six months. The stress, anxiety and depression scores were significantly lower in nurses who frequently or always used all strategies compared to participants who never or rarely used them, except for one strategy (rejecting information about COVID-19 from unreliable sources). CONCLUSIONS: Mental health promotion strategies, such as physical activity, relaxation activity, recreational activity, healthy diet, adequate water intake, breaks between work shifts, maintenance of remote social contacts, and verbalization of feelings/emotions, are crucial to reduce nurses' stress, anxiety and depression symptoms during the COVID-19 outbreak.
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COVID-19 , Pandemias , Ansiedad/epidemiología , Estudios Transversales , Depresión/epidemiología , Depresión/prevención & control , Brotes de Enfermedades , Promoción de la Salud , Humanos , Salud Mental , Estudios Prospectivos , SARS-CoV-2RESUMEN
BACKGROUND: The aging population and its associated health needs require specific nursing care. The aim of this study was to draw an epidemiological profile of Portuguese elderly adults attending in residential homes and day centers and to evaluate the association between the functioning and cognition of these older adults and their sociodemographic characteristics and presence of multimorbidity. METHODS: This was a cross-sectional study of 613 older adults. Functioning was assessed using the Elderly Nursing Core Set, and cognition was assessed using the Mini Mental State Examination. Descriptive and inferential analyses were performed. RESULTS: The mean age was 85.73 years; the majority of the participants were female (69.3 %), widowed (67.0 %) and over 85 years old (60.4 %). A total of 68.2 % of the sample presented multimorbidity. A total of 54.5 % had cognitive impairment, and the average functional profile was classified as "moderate difficulty". Institutionalized older adults had more diseases than those who attended the day center. Women, those who were illiterate, those who were institutionalized and older adults who had diseases of the nervous system had a worse functional profile and greater cognitive impairment. Those with multimorbidity had a worse functional profile, and those without a spouse had greater cognitive impairment. CONCLUSIONS: Given the functional and cognitive profile of older adults, it is necessary to adopt care practices focused on the rehabilitation/maintenance of self-care and affective relationships. This care must be provided by highly qualified professionals. Therefore, it is necessary to increase the ratio of nurses per older adult in these institutions.
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In order to include appropriate informed decisions on dental therapeutic or preventive procedures in children, Pediatric Dentists should apply the fundamentals of "Evidence-Based Dentistry" (EBD). This oral health approach assists clinicians in understanding and applying the most relevant research published on evidence in the clinical setting when treating their patients. One of the crucial steps of EBD is to critically appraise and use the primary articles about therapy or prevention, namely, Randomized Clinical Trials (RCT), the study design that best addresses the questions related with these clinical areas. The aim of the present paper was to provide the basic concepts and an example of how to critically read and understand articles on RCT studies in Pediatric Dentistry employing the CONSORT statement, a process that involves assessing the reliability of results, risk of bias (internal validity), and applicability of reported clinical findings (external validity).
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Odontología Basada en la Evidencia , Odontología Pediátrica , Niño , Humanos , Salud Bucal , Ensayos Clínicos Controlados Aleatorios como Asunto , Reproducibilidad de los ResultadosRESUMEN
Post-Market Research Clinical evidence supports the use of dexketoprofen trometamol (DEX) to manage acute postoperative pain. However, controversies surround the impact of the use of this drug in preoperative analgesic protocols. The aim of the present meta-analysis was to evaluate the effectiveness of the preoperative administration of DEX under postoperative pain conditions. Electronic and manual searches were conducted through diverse electronic databases. A systematic review and meta-analysis to evaluate the analgesic efficacy of the preoperative administration of DEX was performed including Randomized Clinical Trials (RCTs) published between 2002 and 2017. Suitable individual studies were evaluated through a quality system, and the data were extracted and analyzed. Fourteen RTCs were included (12 parallel trials and 2 cross-over trials), published in the English and Turkish languages. Follow-up periods ranged from 4, 6, 8, 24, and 48 hr. All trials measured the outcome result as Acute Pain Level (APL) (VAS, NRS, VRS), time to requiring a second dose of DEX or analgesic emergency and consumption of opioids via patient-controlled analgesia. When the comparators were other drugs - paracetamol, Lornoxicam or placebo during the preoperative time, preoperative administration of DEX was superior. When the comparison comprised preoperative and postoperative DEX, both alternatives exhibited comparable analgesic effects. The analgesic efficacy of the preoperative administration of DEX when compared to placebo, lornoxicam, and paracetamol on postoperative pain was evident. Preoperative administration of DEX compared to its immediate postoperative administration showed a similar analgesic effect.
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Analgésicos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Cetoprofeno/análogos & derivados , Dolor Postoperatorio/tratamiento farmacológico , Trometamina/uso terapéutico , Humanos , Cetoprofeno/uso terapéutico , Periodo Preoperatorio , Resultado del TratamientoRESUMEN
Two yeast isolates producing asci-containing elongate ascospores with curved ends typical of the genus Spathaspora were isolated from rotting wood samples collected in an Atlantic rainforest ecosystem in Brazil. Phylogenetic analysis of the LSU rRNA gene D1/D2 domain sequences demonstrated that the strains represent a new species and placed it next to Candida blackwellae, in a clade that also contains Candida albicans and Candida dubliniensis. Other sequences of the ribosomal gene cluster supported same placementin the same clade, and a phylogenomic analysis placed this new species in an early emerging position relative to the larger C. albicans/Lodderomyces clade. One interpretation is that the genus Spathaspora is, in fact, paraphyletic. In conformity with this view, we propose the novel species Spathaspora boniae sp. nov. to accommodate the isolates. The type strain of Spathaspora boniae sp. nov. is UFMG-CM-Y306T (=CBS 13262T). The MycoBank number is MB 821297. A detailed analysis of xylose metabolism was conducted for the new species.
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Filogenia , Saccharomycetales/clasificación , Madera/microbiología , Xilosa/metabolismo , Brasil , ADN de Hongos/genética , Fermentación , Genes de ARNr , Técnicas de Tipificación Micológica , ARN Ribosómico 16S/genética , Saccharomycetales/genética , Saccharomycetales/aislamiento & purificación , Análisis de Secuencia de ADN , Esporas FúngicasRESUMEN
Three novel D-xylose-fermenting yeast species of Spathaspora clade were recovered from rotting wood in regions of the Atlantic Rainforest ecosystem in Brazil. Differentiation of new species was based on analyses of the gene encoding the D1/D2 sequences of large subunit of rRNA and on 642 conserved, single-copy, orthologous genes from genome sequence assemblies from the newly described species and 15 closely-related Debaryomycetaceae/Metschnikowiaceae species. Spathaspora girioi sp. nov. produced unconjugated asci with a single elongated ascospore with curved ends; ascospore formation was not observed for the other two species. The three novel species ferment D-xylose with different efficiencies. Spathaspora hagerdaliae sp. nov. and Sp. girioi sp. nov. showed xylose reductase (XR) activity strictly dependent on NADPH, whereas Sp. gorwiae sp. nov. had XR activity that used both NADH and NADPH as co-factors. The genes that encode enzymes involved in D-xylose metabolism (XR, xylitol dehydrogenase and xylulokinase) were also identified for these novel species. The type strains are Sp. girioi sp. nov. UFMG-CM-Y302(T) (=CBS 13476), Sp. hagerdaliae f.a., sp. nov. UFMG-CM-Y303(T) (=CBS 13475) and Sp. gorwiae f.a., sp. nov. UFMG-CM-Y312(T) (=CBS 13472).
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Fermentación , Genoma Fúngico , Genómica , Saccharomycetales/clasificación , Saccharomycetales/metabolismo , Xilosa/metabolismo , Brasil , Análisis por Conglomerados , Coenzimas/metabolismo , ADN de Hongos/química , ADN de Hongos/genética , ADN Ribosómico/química , ADN Ribosómico/genética , NAD/metabolismo , NADP/metabolismo , Filogenia , ARN Ribosómico/genética , Saccharomycetales/genética , Saccharomycetales/aislamiento & purificación , Análisis de Secuencia de ADN , Esporas Fúngicas/citología , Madera/microbiologíaRESUMEN
This study assessed the efficiency of Scheffersomyces amazonensis UFMG-CM-Y493T, cultured in xylose-supplemented medium (YPX) and rice hull hydrolysate (RHH), to convert xylose to xylitol under moderate and severe oxygen limitation. The highest xylitol yields of 0.75 and 1.04 g g-1 in YPX and RHH, respectively, were obtained under severe oxygen limitation. However, volumetric productivity in RHH was ninefold decrease than that in YPX medium. The xylose reductase (XR) and xylitol dehydrogenase (XDH) activities in the YPX cultures were strictly dependent on NADPH and NAD+ respectively, and were approximately 10% higher under severe oxygen limitation than under moderate oxygen limitation. This higher xylitol production observed under severe oxygen limitation can be attributed to the higher XR activity and shortage of the NAD+ needed by XDH. These results suggest that Sc. amazonensis UFMG-CM-Y493T is one of the greatest xylitol producers described to date and reveal its potential use in the biotechnological production of xylitol.
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Debaryomyces/crecimiento & desarrollo , Xilitol/biosíntesis , Aldehído Reductasa/metabolismo , Medios de Cultivo/química , D-Xilulosa Reductasa/metabolismo , Debaryomyces/clasificación , Debaryomyces/enzimología , Fermentación , Proteínas Fúngicas/metabolismo , Microbiología Industrial , NAD/metabolismo , NADP/metabolismo , Xilitol/metabolismo , Xilosa/metabolismoRESUMEN
Countries of Southern Europe are currently suffering from severe socio-economic pain resulting from high debt levels and austerity measures which constrain investment in innovation-based recovery strategies that are essential for entry into a long-term sustainable period of increasing employment and wealth creation. Young university-educated people are particularly innovative, and hence vital to the development of such strategies, but employment opportunities are poor and many are forced to seek employment that neither profits from their training nor satisfies their justified career expectations, or to emigrate. They are the 'lost generation'. A strategy is proposed here for the creation of Pipelines for New Chemicals, national centre-network partnerships for the discovery-synthesis of new chemicals obtained though harvesting new biological diversity, and their exploitation to develop new medicines, agrochemicals, materials, and other products and applications. The goal is to create new regional motors of economic growth and development, by harnessing the knowledge, motivation and innovation potential of the excellently educated young people of Europe to catalyse the development of new small, medium and large enterprises centred around novel chemicals, and the value chains that will evolve with them, and thereby develop a powerful sector of sustainable growth in employment and social and economic prosperity in Southern Europe.
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Productos Biológicos/economía , Biotecnología/economía , Emigración e Inmigración , Empleo/economía , Europa (Continente) , Recursos HumanosRESUMEN
BACKGROUND: Mannosylerythritol lipids (MEL) are glycolipids with unique biosurfactant properties and are produced by Pseudozyma spp. from different substrates, preferably vegetable oils, but also sugars, glycerol or hydrocarbons. However, solvent intensive downstream processing and the relatively high prices of raw materials currently used for MEL production are drawbacks in its sustainable commercial deployment. The present work aims to demonstrate MEL production from cellulosic materials and investigate the requirements and consequences of combining commercial cellulolytic enzymes and Pseudozyma spp. under separate hydrolysis and fermentation (SHF) and simultaneous saccharification and fermentation (SSF) processes. RESULTS: MEL was produced from cellulosic substrates, Avicel® as reference (>99% cellulose) and hydrothermally pretreated wheat straw, using commercial cellulolytic enzymes (Celluclast 1.5 L® and Novozyme 188®) and Pseudozyma antarctica PYCC 5048(T) or Pseudozyma aphidis PYCC 5535(T). The strategies included SHF, SSF and fed-batch SSF with pre-hydrolysis. While SSF was isothermal at 28°C, in SHF and fed-batch SSF, yeast fermentation was preceded by an enzymatic (pre-)hydrolysis step at 50°C for 48 h. Pseudozyma antarctica showed the highest MEL yields from both cellulosic substrates, reaching titres of 4.0 and 1.4 g/l by SHF of Avicel® and wheat straw (40 g/l glucan), respectively, using enzymes at low dosage (3.6 and 8.5 FPU/gglucan at 28°C and 50°C, respectively) with prior dialysis. Higher MEL titres were obtained by fed-batch SSF with pre-hydrolysis, reaching 4.5 and 2.5 g/l from Avicel® and wheat straw (80 g/l glucan), respectively. CONCLUSIONS: This work reports for the first time MEL production from cellulosic materials. The process was successfully performed through SHF, SSF or Fed-batch SSF, requiring, for maximal performance, dialysed commercial cellulolytic enzymes. The use of inexpensive lignocellulosic substrates associated to straightforward downstream processing from sugary broths is expected to have a great impact in the economy of MEL production for the biosurfactant market, inasmuch as low enzyme dosage is sufficient for good systems performance.
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Celulosa/metabolismo , Glucolípidos/biosíntesis , Tensoactivos/metabolismo , Ustilaginales/crecimiento & desarrolloRESUMEN
In this study, yeasts associated with lignocellulosic materials in Brazil, including decaying wood and sugarcane bagasse, were isolated, and their ability to produce xylanolytic enzymes was investigated. A total of 358 yeast isolates were obtained, with 198 strains isolated from decaying wood and 160 strains isolated from decaying sugarcane bagasse samples. Seventy-five isolates possessed xylanase activity in solid medium and were identified as belonging to nine species: Candida intermedia, C. tropicalis, Meyerozyma guilliermondii, Scheffersomyces shehatae, Sugiyamaella smithiae, Cryptococcus diffluens, Cr. heveanensis, Cr. laurentii and Trichosporon mycotoxinivorans. Twenty-one isolates were further screened for total xylanase activity in liquid medium with xylan, and five xylanolytic yeasts were selected for further characterization, which included quantitative analysis of growth in xylan and xylose and xylanase and ß-D-xylosidase activities. The yeasts showing the highest growth rate and cell density in xylan, Cr. laurentii UFMG-HB-48, Su. smithiae UFMG-HM-80.1 and Sc. shehatae UFMG-HM-9.1a, were, simultaneously, those exhibiting higher xylanase activity. Xylan induced the highest level of (extracellular) xylanase activity in Cr. laurentii UFMG-HB-48 and the highest level of (intracellular, extracellular and membrane-associated) ß-D-xylosidase activity in Su. smithiae UFMG-HM-80.1. Also, significant ß-D-xylosidase levels were detected in xylan-induced cultures of Cr. laurentii UFMG-HB-48 and Sc. shehatae UFMG-HM-9.1a, mainly in extracellular and intracellular spaces, respectively. Under xylose induction, Cr. laurentii UFMG-HB-48 showed the highest intracellular ß-D-xylosidase activity among all the yeast tested. C. tropicalis UFMG-HB 93a showed its higher (intracellular) ß-D-xylosidase activity under xylose induction and higher at 30 °C than at 50 °C. This study revealed different xylanolytic abilities and strategies in yeasts to metabolise xylan and/or its hydrolysis products (xylo-oligosaccharides and xylose). Xylanolytic yeasts are able to secrete xylanolytic enzymes mainly when induced by xylan and present different strategies (intra- and/or extracellular hydrolysis) for the metabolism of xylo-oligosaccharides. Some of the unique xylanolytic traits identified here should be further explored for their applicability in specific biotechnological processes.
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Biodiversidad , Saccharum/microbiología , Madera/microbiología , Xilanos/metabolismo , Xilosidasas/metabolismo , Levaduras/enzimología , Levaduras/crecimiento & desarrollo , Brasil , Celulosa , Medios de Cultivo/química , Hidrólisis , Temperatura , Levaduras/clasificación , Levaduras/aislamiento & purificaciónRESUMEN
BACKGROUND: Addressing informal caregivers' needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge about programmes aimed at meeting the needs of informal caregivers of adults who are dependent on others for daily life activities. METHODS: Following the PRISMA guidelines, the electronic databases EBSCOhost Research Platform, MEDLINE, CINAHL, Scopus, Web of Science and The Virtual Health Library were searched for randomized experimental studies published between 2012 and 2022 that implemented programmes addressing informal caregivers' needs to improve their experiences, health, and well-being. Quality was assessed using the standardized critical evaluation tools from the Joanna Briggs Institute. Two independent investigators performed the eligibility assessment and data extraction. Quantitative data on the effectiveness of interventions were collected, and the content of each intervention was synthesized and aggregated into categories, through narrative synthesis. RESULTS: The majority of the included studies (n = 16) were conducted in European countries and implemented a structured intervention programme compared to the provision of usual care. The studies were of fair to high methodological quality, with a higher risk of bias related to blinding. The results supported the achievement of favourable health outcomes among informal caregivers, namely improvements in mental health (n = 3) and quality of life (n = 3) and a decrease in psychological symptomatology (n = 5) and burden (n = 3). None of the interventions reported adverse outcomes; however, five studies did not describe significant differences in the outcomes assessed after the implementation of the programmes. Interventions focusing on training and educating caregivers (n = 14) and cognitive-behavioural strategies (n = 7) were the most common, while programmes focusing on emotional and psychological support as a resource to improve caregivers' psychological outcomes were scarce. CONCLUSIONS: This systematic review adds to the growing body of evidence and insight showing that programmes that address informal caregivers' needs seem to contribute to better physical and psychological health outcomes through the promotion of caregivers' educational support and the implementation of cognitive-behavioural strategies. Future research should implement methodologically robust cross-country programmes tailored to informal caregivers' physical, emotional, psychosocial, societal, and educational needs throughout the care trajectory.
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Four strains of a novel yeast species were isolated from rotting-wood samples in an Atlantic rainforest site in the state of Minas Gerais, Brazil. These yeasts were obtained from enrichments using yeast nitrogen base (YNB)-d-xylose or YNB-xylan media. The novel yeast species produces bacilliform ascospores typical of the genus Sugiyamaella, and its closest described relative in terms of sequence similarity is Candida (iter. nom. Sugiyamaella) marionensis. The yeast is able to grow in medium with xylan as sole carbon source and produces extracellular enzymes with xylanolytic activities. The novel species Sugiyamaella xylanicola sp. nov. is proposed to accommodate these isolates. The type strain is UFMG-CA-32.1(T) (=CBS 12683(T) =CBMAI 1467(T)).
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Filogenia , Saccharomycetales/clasificación , Madera/microbiología , Xilanos/metabolismo , Brasil , ADN de Hongos/genética , Datos de Secuencia Molecular , Técnicas de Tipificación Micológica , Saccharomycetales/genética , Saccharomycetales/aislamiento & purificación , Análisis de Secuencia de ADNRESUMEN
Patient-centered care reflects the quality of personal, professional, and organizational relationships [...].
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The quality and safety of health care is a priority, a requirement and a demand of health organizations and social institutions with concrete purposes of progressively providing people with a higher level of health and well-being. It is in the development of this path that home care currently represents an area of gradual investment and where health care services and the scientific community have shown interest in building circuits and instruments that can respond to needs. It is essencial that care must be centered and in close proximity to the person and their family, their context. On the other hand, in Portugal, there are already quality and safety models for the institutionalization context however it is non-existent for home care. In this sense, our objective is to identify, through a systematic review of the literature, particularly from the last 5 years, areas of quality and safety in home care.
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Servicios de Atención de Salud a Domicilio , Revisiones Sistemáticas como Asunto , Humanos , Atención a la Salud , Institucionalización , Portugal , Literatura de Revisión como AsuntoRESUMEN
Background: This research work aimed to summarize the rehabilitation nursing interventions published in the scientific literature that most contribute to effective adherence to self-care in older adults with respiratory diseases. Methods: A systematic literature review with meta-analysis was conducted by searching the EBSCOhost platform (CINAHL Complete, MEDLINE Complete, Cochrane, and MedicLatina) using the PRISMA methodology. Five articles were selected for final analysis. Meta-analysis was carried out using Comprehensive Meta-Analysis (CMA) software, and the results were presented in a forest plot. Results: Thirty-one self-promoting rehabilitation nursing interventions were identified, with the most effective being those related to the assessment of progress in physical capacity/activity tolerance (functional status category/domain) and the assessment of the increase in health-related quality of life (health-related quality of life category/domain). Conclusions: Rehabilitation nursing interventions such as self-management programs led by nurses, community-based and home-based rehabilitation programs, and inspiratory muscle training can effectively reduce and enable the effective control of symptoms associated with respiratory disorders, boosting older adults' empowerment to engage in self-care.
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Enfermería en Rehabilitación , Trastornos Respiratorios , Enfermedades Respiratorias , Humanos , Anciano , Autocuidado , Calidad de Vida , Ejercicio FísicoRESUMEN
As a novelty, this article proposes the empirical operationalization of an indicator sensitive to nursing care called patient satisfaction based on functional capacity and quality of life assessments. This was a descriptive cross-sectional study with a sample of 351 individuals aged 65 and older residing in the community. Data acquisition was performed using the structured interview method, employing a core set of 25 codes taken from the International Classification of Functioning, Disability, and Health and the WHOQOL-BREF instrument of the World Health Organization. Confirmatory factor analysis was used to infer the reliability and construct validity of the proposed model, involving three latent factors: functional capacity, quality of life, and patient satisfaction with nursing care received. The proposed model showed good reliability and construct validity, although it failed regarding discriminant validity between latent factors. The greatest statistically significant predictor of the patient satisfaction latent factor was the quality of life latent factor ([Formula: see text]), followed by the functional capacity latent factor ([Formula: see text]). The findings seem to suggest that patient satisfaction is an indicator that may be quantitatively measurable, with functional capacity and quality of life considered very significant predictors of patient satisfaction with the nursing care experience.
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Satisfacción del Paciente , Calidad de Vida , Humanos , Anciano , Estudios Transversales , Reproducibilidad de los Resultados , Psicometría/métodos , Encuestas y Cuestionarios , Organización Mundial de la SaludRESUMEN
The quality and safety of health care are a priority for health organizations and social institutions to progressively provide people with a higher level of health and well-being. It is in the development of this path that home care currently represents an area of gradual investment and where health care services and the scientific community have shown interest in building circuits and instruments that can respond to needs. The purpose of this article is to identify areas and criteria for quality and safety in home care. The method used was a systematic review registered in PROSPERO (CRD42022380989). The search was systematically carried out in CINAHL Plus with Full Text, MEDLINE with Full Text and Psychology and Behavioral Sciences Collection, using the following criteria: articles published in Portuguese and English, from January 2017 to November 2022. The results of the analysis of the articles showed areas of quality and safety in home care with their respective dimensions and operational criteria. We concluded that there are three areas: the intervention with the patient, with proximity and patient-centered care, which integrates the individual care plan and the proximity of professionals to the patient and family; the intervention of care and service management, with care management and clinical governance that includes the integrated model of health care, goal management, and context management; and the intervention related to training and professional development, where we have the skills and training of professionals.
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Atención a la Salud , Servicios de Atención de Salud a Domicilio , Humanos , Instituciones de SaludRESUMEN
(1) Background: The pandemic context has limited the social and family contacts of institutionalized older adults, and intervention is urgently needed. The aim of this study is to assess the impact of the implementation of a "Geriatric Proximity" intervention on the functioning, satisfaction with social support, affective experience, and feelings of loneliness of institutionalized older adults in the times of the pandemic. (2) Methods: This is a pilot study. An experimental group (subject to the "Geriatric Proximity" intervention) and a control group were constituted. Four assessment instruments were applied to both groups: the satisfaction with social support scale; the elderly nursing core set; the positive and negative affect schedule; and the UCLA loneliness scale. (3) Results: The control group shows no differences between the three measurement instants, while the experimental group shows between first and third measurements (all p < 0.05). We observed a reduction in the scores of loneliness scale, negative affect, and cognition functioning and an increase in satisfaction with social support and positive affect. (4) Conclusions: The intervention "Geriatric Proximity" showed a positive contribution by decreasing loneliness and increasing affectivity, satisfaction with social support, and cognitive function during the pandemic period.
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Introduction: The strong association between age and the increasing prevalence of chronic diseases, makes it imperative to promote self-care throughout life. Systematic knowledge on the health findings of person-centered care models may contribute to designing effective healthcare strategies to promote empowerment for self-care in long-term care. Objective: To assess the association between the implementation of person-centered care models that promote self-care training in long-term care and health-related outcomes, among adults with chronic illness. Methods: A rapid review of the literature was performed following the Cochrane rapid review methodology. The electronic databases CINAHL, MedicLatina, MEDLINE, and Psychology and Behavioral Sciences Collection were searched for randomized experimental studies, published between 2017 and 2022, that implemented interventions based on person-centered models to promote self-care in adults aged ≥18 years with chronic diseases and needing long-term health care. Verification of the eligibility of the articles and the extraction of data were performed by two independent investigators. Quantitative data on the health-related variables assessed were collected and, through narrative synthesis, health outcomes were grouped into individual, institutional and societal levels. Results: Eight studies, mostly conducted in European countries, were included. All satisfied more than 60% of the methodological quality score. A large variability among studies was found regarding the number of participants, the data collection period and duration of the intervention, the samples selected and the care model implemented. A high number of health-related outcomes (n = 17) were analyzed in the studies, using 52 different instruments. The main health-related outcomes were multidimensional, with implications at the individual, institutional and societal levels. The promotion of overall health and wellbeing (n = 4), the implementation of patient-centered care models (n = 1), the positive and more frequent interactions with health professionals (2), the decrease on staff psychosocial distress (n = 1), and the absence of added costs (n = 1), while improving family caregivers' skills (n = 1) were the main health-related outcomes described. Conclusion: There is a need to develop robust experimental studies focused on the views and experiences of all stakeholders and conducted in different countries and cultures. Short-, medium- and long-term health outcomes should be measured using internationally accepted and validated scales for chronic patients.