Transitional care for older persons with need of geriatric rehabilitation nursing interventions.

BACKGROUND: The literature review notes that people in need of care from Rehabilitation Programs do not always see their continuity ensured. OBJECTIVE: This study aim to analyze the perspective of Specialists Nurse in Rehabilitation Nursing in relation to the organization and specialized intervention of transitional care for older people in need of rehabilitation programs. METHODS: This is a qualitative study within the interpretivist paradigm. A focus group with 8 nurses and 13 interviews with Portuguese nurses were carried out between April 2022 and February 2023. Content analysis was carried out. RESULTS: The triangulation of the data made it possible to identify 3 categories: Coordination of a transitional care program; Empowering the person to self-manage the transitional care process and Empowering the Informal Caregiver. CONCLUSIONS: It is imperative to promote the coordination of transitional care, increase the functional capacity of the person and empower the informal caregiver.

The effectiveness of nursing interventions in adherence to self-care for preventing venous ulcer recurrence: A systematic literature review.

Venous ulcers affect up to 3% of the global population, with a high impact on economies and quality of life. This is exacerbated by its recurrence rates, which reach 70% at 12 months after healing. The perpetuation of these cycles of healing and recurrence is not interrupted or even attenuated by the self-care activities recommended and directed toward their prevention. In this context, we sought to identify the effectiveness of interventions that promote adherence to self-care to prevent venous ulcer recurrence. In August 2022, we conducted a literature search via EBSCO in the following databases: CINAHL Complete, MEDLINE Complete, Cochrane Database of Systematic Reviews, Scopus, and Web of Science. The inclusion criteria were researched in the form of randomised controlled trials or systematic literature reviews, and 99 studies were identified. During the different times of selection, four studies met the defined inclusion criteria and were included. As the main conclusions, the emphasis goes to the importance of the use of compression and the greater effectiveness of higher compression classes for the prevention of recurrence. Different educational methodologies seem to be important to increase knowledge about prevention, specifically regarding the aetiology of recurrence and the implementation of prevention measures.

The art and learning patterns of knowing in nursing.

Objective To identify the perception of the students about the use of art as a pedagogical strategy in learning the patterns of knowing in nursing; to identify the dimensions of each pattern valued in the analysis of pieces of art. Method Descriptive mixed study. Data collection used a questionnaire applied to 31 nursing students. Results In the analysis of the students' discourse, it was explicit that empirical knowledge includes scientific knowledge, tradition and nature of care. The aesthetic knowledge implies expressiveness, subjectivity and sensitivity. Self-knowledge, experience, reflective attitude and relationships with others are the subcategories of personal knowledge and the moral and ethics support ethical knowledge. Conclusion It is possible to learn patterns of knowledge through art, especially the aesthetic, ethical and personal. It is necessary to investigate further pedagogical strategies that contribute to the learning patterns of nursing knowledge.

Telerehabilitation in Children and Adolescents with Cystic Fibrosis: A Scoping Review.

Cystic fibrosis requires regular monitoring and intervention by healthcare teams; despite that, adherence to therapeutic measures is less than desired. The evolution of technology has allowed much of the care provided in person to be replaced by a telehealth delivery model, but studies on telerehabilitation are scarce and dispersed. This scoping review aimed to identify which domains of rehabilitation intervention are mediated by information and communication technologies and how they are developed in the provision of care to children and adolescents with cystic fibrosis. The data collection was conducted in February and June 2023, following the three steps recommended by the JBI for this type of review: (1) the search was conducted in MEDLINE, CINAHL, Scopus, JBI, and Web of Science; (2) the bibliographic references obtained from the included articles were analysed; and (3) the grey literature was checked. The eligibility criteria were children and adolescents and rehabilitation interventions mediated by information and communication technologies. The five studies included in this review were subjected to analysis, and a narrative synthesis of the results was carried out. The interventions identified included physical exercise programs (60%), management of the therapeutic regimen (40%), and symptom control (40%). The information and communication technologies were web-based platforms, video games, and telephones. The use of telerehabilitation included face-to-face meetings to ensure participants performed the exercises correctly, monitor their response to exercise, and teach them how to avoid risky situations during home workouts. In all studies, exercise sessions were supervised by the participants' parents or caregivers.

Safety-promoting interventions for the older person with hip fracture on returning home: A systematic review.

BACKGROUND: Older adults with a prior history of falls that results in hip fractures have difficulties in regaining pre-fracture functional capacity. Scientific evidence has shown benefits of the implementation of multidimensional rehabilitation programs, but this evidence is not systematized with regard to continuity of care after hospital discharge. OBJECTIVE: To identify interventions that promote safety and functional recovery of older adults with hip fractures after hospital discharge. METHOD: A systematic review was carried out according to Cochrane methodology. The research strategy was predefined for the MEDLINE and CINAHL databases. The identified articles were screened according to the eligibility criteria by two independent reviewers. The articles included in the bibliographic sample were evaluated for risk of bias. RESULTS: Of the 10,036 articles found, 10 were included in this systematic review. The safety-promoting interventions identified were: exercise training, occupational therapy/activities of daily living training, transfer and gait training, strengthening exercises, education on assistive device use, fall prevention education, nutritional assessment, environmental modifications/adjustments at home, use of an app, medication, self-care education, and support and counseling. CONCLUSIONS: In eight studies analyzed, exercise training emerged as the most effective intervention for promoting the safety of older adults after hip fractures on returning home. Three studies associated two or more interventions, which focused on exercise training, occupational therapy/training of activities of daily living, and conventional postoperative rehabilitation with transfer and gait training, strengthening exercises, education on assistive device use and discharge planning, aiming to achieve muscle strengthening and safe gait, associated with the performance of activities of daily living.

Nursing Intervention to Prevent and Manage Delirium in Critically Ill Patients: A Scoping Review.

Delirium is an acute neuropsychiatric syndrome of multifactorial etiology with a high incidence in people admitted to intensive care units. In addition to reversible impairment of cognitive processes, it may be associated with changes in thinking and perception. If, in the past, it was considered an expected complication of severe disease, nowadays, delirium is associated with a poor short-term and long-term prognosis. Knowing that its prevention and early identification can reduce morbidity, mortality, and health costs, it is vital to investigate nursing interventions focused on delirium in critically ill patients. This study aimed to identify nursing interventions in the prevention and management of delirium in critically ill adults. The method used to answer the research question was a scoping review. The literature search was performed in the Medline (via PubMed), CINAHL (via EBSCOhost), Scopus, Web of Science, and JBI databases. The final sample included 15 articles. Several categories of non-pharmacological interventions were identified, addressing the modifiable risk factors that contribute to the development of delirium, and for which nurses have a privileged position in their minimization. No drug agent can, by itself, prevent or treat delirium. However, psychoactive drugs are justified to control hyperactive behaviors through cautious use. Early diagnosis, prevention, or treatment can reduce symptoms and improve the individual's quality of life. Therefore, nursing professionals must ensure harmonious coordination between non-pharmacological and pharmacological strategies.

Nursing Interventions for Client and Family Training in the Proper Use of Noninvasive Ventilation in the Transition from Hospital to Community: A Scoping Review.

Noninvasive ventilation is an increasingly disseminated therapeutic option, which is explained by increases in the prevalence of chronic respiratory diseases, life expectancy, and the effectiveness of this type of respiratory support. This literature review observes that upon returning home after hospital discharge, there are difficulties in adhering to and maintaining this therapy. The aim of this study is to identify nursing interventions for client and family training in the proper use of noninvasive ventilation in the transition from hospital to community. A scoping review was carried out by searching MEDLINE, CINAHL, Scopus, and Web of Science. The articles were selected by two independent reviewers by applying the predefined eligibility criteria. Regarding transitional care, the authors opted to include studies about interventions to train clients and families during hospital stay, hospital discharge, transition from hospital to home, and the first 30 days after returning home. The eight included publications allowed for identification of interventions related to masks or interfaces, prevention of complications associated with noninvasive ventilation, leakage control, maintenance and cleaning of ventilators and accessories, respiratory training, ventilator monitoring, communication, and behavioral strategies as transitional care priority interventions to guarantee proper training in the transition from hospital to community.

The Effect of Interventions on Preventing Musculoskeletal Injuries Related to Nurses Work: Systematic Review.

BACKGROUND: The 12-month prevalence of musculoskeletal disorders related to work (MDRW) in nurses rests between 71.8% to 84%, so it is urgent to develop preventive intervention programs with the purpose of avoiding negative physical, psychological, socioeconomic, and working aspects. There are several intervention programs aimed at preventing musculoskeletal disorders related to work for nurses, but few have successfully proven results. Despite the evidence pointing to the benefits of multidimensional intervention programs, it is essential to determine which interventions have positive effects on the prevention of this kind of disorder to create an effective intervention plan. AIM: This review intends to identify the different interventions adopted in the prevention of musculoskeletal disorders related to work in nurses and to compare the effectiveness of these interventions, providing the appropriate and scientific basis for building an intervention to prevent musculoskeletal disorders in nurses. METHOD: This Systematic Review was guided by the research question, "What are the effects of musculoskeletal disorders preventive interventions on nursing practice?" and carried out in different databases (MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials, SCOPUS, and Science Direct). Later, the results were submitted to the eligibility criteria, the appraisal quality of the papers, and the data synthesis was performed. RESULTS: 13 articles were identified for analysis. The interventions implemented to control the risk were: training patient-handling devices; ergonomics education; involving the management chain; handling protocol/algorithms; acquiring ergonomics equipment; and no-manual lifting. CONCLUSIONS: The studies associated two or more interventions, the majority of which (11 studies) were training-handling devices and ergonomics education, therefore emerging as the most effective instruments in the prevention of MDRW. The studies did not associate interventions that cover all risk factors (individual, associated with the nature of the work, organizational, and psychological aspects). This systematic review can help with making recommendations for other studies that should associate organizational measures and prevention policies with physical exercise and other measures aimed at individual and psychosocial risk factors.

Nursing Interventions in the Perioperative Pathway of the Patient with Breast Cancer: A Scoping Review.

The decrease in average hospitalisation time and the increase in outpatient surgery in some types of breast cancer represent gains for the reduction of the negative impact of hospitalisation in women with breast cancer but are also a challenge for the organisation of nursing care to prepare women for surgery, reduce anxiety about the interventions, and ensure continuity of care in the postoperative period. The aim of this study is to identify nursing interventions present in the care provided to patients with breast cancer during the perioperative period. A scoping review was the method chosen to answer the research question: What are the specialised nursing interventions in the perioperative pathway of the patient with breast cancer? Inclusion and exclusion criteria were defined for the articles that were identified in the CINAHL and MEDLINE databases; later, additional sources were identified from the list of bibliographic references for each selected study. The final bibliographical sample consisted of seven articles, which allowed the identification of three key moments of nursing interventions in the perioperative period of patients with breast cancer: the preoperative consultation, the reception of the patient in the operating room, and the postoperative consultation. Factors such as psychological, emotional, and spiritual support, communication and patient-centred care, health education and surgical safety, and the definition of a perioperative pathway for these patients contribute significantly to patients' satisfaction and the improvement of their quality of life. The results of this study make it possible to establish recommendations for practise and for research, increasing the range of nurses' actions.

The Organization of Home Palliative Cancer Care by Primary Health Care: A Systematic Review Protocol.

Greater longevity and chronic diseases, such as cancer, require (re)organization of care for the sustainability of health systems and better quality of life. Palliative care organized by primary health care has positive outcomes, changing standards of care at the end of life, reducing hospitalizations and health costs and contributing to people's autonomy to stay at home with controlled symptoms. However, in many countries, this is not possible because the provision of palliative cancer care is isolated or generalized, concentrated in the hospital, and without the strategic participation of primary care. In many developed countries, where palliative care is offered in an integrated way, home care has increased the people's chances of receiving dignified care at the end of life. The aim of this review is to evaluate the organization of home palliative cancer care by primary care to improve the use of health resources and the quality of life of such patients. This systematic review protocol follows the Cochrane methodology to provide a narrative synthesis, with the resulting report guided by the Preferred Reporting Items for Systematic Reviews (PRISMA).

Documenting fall episodes: a scoping review.

Documentation is an important measure for the management of fall risk because it concentrates the attention of professionals, raises awareness of the existence of fall risk factors, and promotes action to eliminate or minimize them. This study aimed to map the evidence on information to document episodes of falls in older adults. We opted for a scoping review, which followed the Joanna Briggs Institute protocol for this kind of study. The research question that guided the research strategy was "What recommendations emerge from the research on the documentation of falls of the older person?" The inclusion criteria defined were older adults who had at least one fall; nursing documentation after a fall has occurred; and nursing homes, hospitals, community, and long-term care. The search was performed on the following platforms: MEDLINE, CINAHL, Scopus, and Cochrane Database of Systematic Reviews in January 2022 and allowed the identification of 854 articles, which after analysis resulted in a final sample of six articles. The documentation of fall episodes should answer the following questions: Who? What? When? Where? How? Doing what? What was said? What were the consequences? and What has been done? Despite the recommendations for the documentation of fall episodes as a preventive measure for their recurrence, there are no studies evaluating the cost-effectiveness of this measure. Future studies should explore the association between fall documentation, fall recurrence prevention programs, and their impact on the prevalence rate of the second and subsequent falls, as well as the severity of injuries and fear of falling.

Telerehabilitation Intervention in Transitional Care for People with COVID-19: Pre-Post Study with a Non-Equivalent Control Group.

SARS-CoV-2 infection and its resulting sequelae have increased the prevalence of people with respiratory symptoms, with impacts on functional capacity, quality of life, anxiety, depression, and mental health. To mitigate this problem, one challenge has been the design and implementation of interventions that simultaneously allow for education, rehabilitation, and monitoring of people with long COVID, at a time when health services were on the verge of rupture due to the volume of people with active COVID and in need of intensive care. Telerehabilitation emerged as a mode for providing rehabilitative care that brought professionals closer to patients and enabled continuity of care. The present study aimed to evaluate the results of a telerehabilitation intervention for people with injuries associated with SARS-CoV-2 infection in hospital-community transitions, considering their degree of dependence in performing activities of daily living, respiratory symptoms, fatigue, gait capacity, muscle strength, and experience with anxiety and depression. A pre-post study with a non-equivalent control group was carried out with a total of 49 participants (intervention group n = 24; control group n = 25). The post-intervention results showed an increase in saturation, a decrease in heart rate, an improvement in the impact of post-COVID functionality, a decrease in fatigue, a decrease in perceived effort, and a decrease in depressive and anxiety symptoms. The telerehabilitation intervention, which combined educational strategies with respiratory and motor rehabilitation, helped improve global functionality and self-care, with clinical and functional impacts.

The Perspective of Rehabilitation Nurses on Physical Exercise in the Rehabilitation of Older People in the Community: A Qualitative Study.

In the face of an increasingly aging population, nurses have to design and implement programs aimed at the elderly in order to keep them healthy and maintain their quality of life. Structured physical exercise and overall physical activity play a major role in maintaining an active lifestyle, improving health, preventing disease, and helping to maintain older people's quality of life. To investigate the importance of implementing physical exercise programs for the older person in the community, taking into account the perspective of the rehabilitation nurse specialist, this is a qualitative, exploratory, and descriptive study with nine rehabilitation nurses from various regions of Portugal who have experience of implementing physical exercise programs with the elderly. This study used semi-structured interviews, one of the most common data collection procedures in social and health research. Content analysis was used to analyze the data. The study received a positive opinion from the Ethics Committee. The participants' perspectives focused on the following subjects: "Physical exercise program for the elderly in the community", "Importance of physical exercise in the rehabilitation of the elderly in the community", "People's adherence to the programs", "Gains in health resulting from the implementation of these strategies" and "Gains from group activities". A set of indicators emerged from the analysis. Nurses recognize the importance of using structured physical exercise programs adjusted to the rehabilitation of the older person, with gains in promoting active and healthy aging.

Nurses' Motivations, Barriers, and Facilitators to Engage in a Peer Review Process: A Qualitative Study Protocol.

Peer review supports the integrity and quality of scientific publishing. However, although it is a fundamental part of the publishing process, peer review can also be challenging for reviewers, editors, and other stakeholders. The present study aims to explore the nurses' motivations, barriers, and facilitators in engaging in a peer review process. This qualitative, descriptive exploratory study will be developed in partnerships with three research centers. Researchers followed the consolidated criteria for reporting qualitative research (COREQ) checklist to ensure the quality of this study protocol. According to the selection criteria, the purposive sampling will be used to recruit nurse researchers that act as peer reviewers for several scientific journals in various fields of knowledge. Interviews will be conducted until data have been sufficiently consistent with meeting the initial objectives. Researchers will develop a guide comprising a set of open-ended questions to collect participants' characteristics, descriptive review behavior, and perceptions regarding their motivations, barriers, and facilitators. Researchers will analyze data using an inductive process of content analysis with the help of the QDA Miner Lite database. Findings from this study will generate knowledge that may help stakeholders identify facilitating factors and barriers and guide the development of strategies to remove or minimize these barriers.

Safety-Promoting Interventions for the Older Person with Hip Fracture on Returning Home: A Protocol for a Systematic Review.

Ageing and physical frailty associated with decrease in muscle and bone mass lead to the older persons' vulnerability and increased risk of falling. It is estimated that one in every ten falls in this age group results in a fracture, leading to a downward spiral in their health status, causing greater dependence, with a progressive functional decline that makes it difficult to return to their functional and social status prior to the fracture. The aim of this study is to identify the available evidence on the interventions that promote the safety of older people with hip fracture after hospital discharge. A search will be performed in MEDLINE and CINAHL databases. Randomised and controlled studies that focus on functional assessment, performance in activities of daily living, level of concern about falls, risk and prevalence of falls, injuries secondary to falls, re-fracture rate and health-related quality of life in hip fracture patients will be included. Two authors will perform the study selection, data extraction, and quality assessment independently. Any disagreements will be resolved through discussion with a third researcher. Methodological quality of the included trials will be evaluated by the Cochrane risk-of-bias criteria, and the Standards for Reporting Interventions in Controlled Trials.

Rehabilitation Nurse's Perspective on Transitional Care: An Online Focus Group.

The increasing incidence of chronic and dependence leads to the need for hospitalization and adaptation in the process of returning home, as well as transition between care levels to ensure continuity of care. The World Health Organization has been warning about this problem since 2016, and consider reorganizing the care model as one of the solutions. The present study aimed to analyse the nurses' perspective on transitional care for dependent people with rehabilitation care needs after hospital discharge. METHODS: A focus group was developed with the participation of Rehabilitation Nurses from the hospital and community context, and content analysis was defined a posteriori. RESULTS: From the content analysis emerged four related categories: promotion of continuity of care, nurse of advanced practice as a care manager, capacitation of the person and caregiver, and promotion of the care coordination. CONCLUSIONS: The present study allowed the strategies identification that minimize fragmentation risk of care and promote the person participation in transitional care. Ensuring transitional care is imperative to increase the quality of care, the satisfaction of professionals, clients, and the development of a system of sustainable health.

From Evidence Synthesis to Transfer: Results from a Qualitative Case Study with the Perspectives of Participants.

The increase in health research brings challenges to the production, synthesis, and use of research findings in clinical practice. In the case of undergraduate training in nursing, it is necessary to think about the curricular contents and create opportunities to develop skills for learning evidence-based practice. The objective of this study was to analyze nurses' perspectives regarding the effects of their participation in a project of translation of knowledge into clinical practice during undergraduate nursing education, specifically involving knowledge, attitudes, and competencies related to the use of evidence. This is a qualitative case study grounded in the knowledge-to-action theoretical framework. The participants were 13 nurses who were involved in a project about the translation of knowledge into clinical practice during the last term of their undergraduate course. The data were collected by applying interviews between December 2020 and April 2021. Content analysis was carried out by using the qualitative data analysis software tool webQDA®. The following categories emerged from the content analysis carried out on the material gathered during the interviews: understanding evidence; learning how to use evidence; transferring evidence; adjusting to the context; and observing the advantages of evidence-based practice. Extracurricular activities were perceived as an opportunity to understand what evidence is and observe in loco the advantages of health care for clients, teams, and services. During the project, the participants developed cross-sectional competencies and envisaged changes to their professional activity as a result of changes in their attitude regarding evidence and its use. We concluded that the opportunity to develop evidence-related activities allows for the development of skills and influences the attitude towards evidence-based practice and knowledge use.

Learning to use evidence at nursing undergraduation: a contribution to collective health. / Aprender a usar evidência na graduação em enfermagem: um contributo para a saúde coletiva.

There is universal agreement that health professionals have not implementing evidence-based practice as would be desirable and recommended by science and international institutions with responsibility for the guidelines issued for health contexts. This focus group with eight participants aimed to understand the perspective of students from the undergraduate nursing course on their involvement in a project of knowledge transfer to the clinic. Qualitative analysis followed the coding steps; storage/retrieval and interpretation of the findings and it was carried out by using a software for qualitative data analysis. This study is authorized by an Ethics Committee and respected the principles inherent to the investigation. The four categories that emerged from the content analysis were: Belonging, Using Evidence, Improving Care and Developing Competencies. The analysis of categories, subcategories and verbatim transcripts allowed us to conclude that participation in transference projects for clinics, according to the students, generates learning opportunities about the implementation and communication of evidence, facilitates integration in the service, participation, collaborative work and the development of transversal skills.

É consensual que os profissionais de saúde não estão a implementar a prática baseada na evidência como seria desejável e recomendado pela ciência e organismos internacionais com responsabilidade sobre as diretrizes emanadas para os contextos de saúde. Este focus group com oito participantes teve por objetivo compreender a perspetiva dos estudantes do curso de graduação em enfermagem sobre o seu envolvimento num projeto de transferência de conhecimento para a clínica. A análise qualitativa seguiu as etapas de codificação, armazenamento/recuperação e interpretação dos achados, e foi efetuada com um software de análise de dados qualitativos. Estudo autorizado por uma comissão de ética e que respeitou os princípios inerentes à investigação. As quatro categorias que emergiram da análise de conteúdo foram: "pertencer", "usar evidência", "melhorar cuidados" e "desenvolver competências". A análise das categorias, subcategorias e verbatins permite concluir que a participação em projetos de transferência para a clínica, na voz dos estudantes, gera oportunidades de aprendizagem sobre a implementação e comunicação de evidência, facilita a integração no serviço, a participação, o trabalho colaborativo e o desenvolvimento de competências transversais.

Participation of Nursing Students in Evidence-Based Practice Projects: Results of Two Focus Groups.

The development of true evidence-based practice requires that practitioners have the knowledge and skills to research, analyze, and use evidence. These skills must be acquired in pre-graduate training. The objective of the present study was to analyze the contributions of students' participation in knowledge translation projects to clinical practice for evidence-based learning. This was a qualitative, descriptive, and exploratory study that used focus groups. Scripted interviews were administered. The design of the study included five phases and took place in the partnering institutions of the Safety Transition Project, involving fifteen participants. The study was authorized by the Research Ethics Committee. The data were analyzed following the steps encoding the categories, storage and recovery, and (3) interpretation and using computer software (WebQDA®, Ludomédia, Aveiro, Portugal). Four categories were identified: learning evidence; communicating science; evidence-based practice; and developing skills. The successful implementation of evidence-based practice education resulted in students who understand its importance and use it competently. Further research should explore the skills developed by nurses involved in similar projects and their contribution to an EBP culture.

Falls and Preventive Practices among Institutionalized Older People.

The present study about falls among the older adult population essentially explores bio-physiological factors. In light of the complexity of the factors that cause these accidents, it is important to identify the safety and self-care practices of institutionalized older adults and their relationship with falls in order to introduce prevention measures and personalized cognitive-behavioral strategies. The objective of this study was to: (a) determine the frequency of falls and their recurrence among institutionalized older adults, and (b) to associate the occurrence of falls among institutionalized adults with or without cognitive impairment to communication and safety practices. This was a quantitative, correlational, and longitudinal study with 204 institutionalized older adults living in two long-term care facilities in Portugal. The Scale of Practices and Behaviors for Institutionalized Elderly to Prevent Falls was administered to the sample. The prevalence of falls at a 12-month follow-up was 41.6%, of which 38.3% were recurring episodes. Older adults with cognitive decline showed lower mean scores for safety practices. Further research with larger samples should explore the relationships between communication and safety practices and falls, their recurrence, and fear of new falls.