Fundamental care and knowledge interests: Implications for nursing science.

AIMS AND OBJECTIVES: To characterise the intratheoretical interests of knowledge in nursing science as an epistemological framework for fundamental care. BACKGROUND: For Jürgen Habermas, theory does not separate knowledge interests from life. All knowledge, understanding and human research is always interested. Habermas formulated the knowledge interests in empirical-analytical, historical-hermeneutic and critical social sciences; but said nothing about health sciences and nursing science. DESIGN: Discursive paper. RESULTS: The article is organised into five sections that develop our argument about the implications of the Habermasian intratheoretical interests in nursing science and fundamental care: the persistence of a technical interest, the predominance of a practical interest, the importance of an emancipatory interest, "being there" to understand individuals' experience and an "existential crisis" that uncovers the individual's subjectivity. CONCLUSIONS: The nursing discipline can take on practical and emancipatory interests (together with a technical interest) as its fundamental knowledge interests. Nurses' privileged position in the delivery of fundamental care gives them the opportunity to gain a deep understanding of the patient's experience and illness process through physical contact and empathic communication. RELEVANCE TO CLINICAL PRACTICE AND NURSING RESEARCH: In clinical, academic and research environments, nurses should highlight the importance of fundamental care, showcasing the value of practical and emancipatory knowledge. This process could help to improve nursing science's leadership, social visibility and idiosyncrasy.

Experiences of Patients with Breast Cancer Participating in a Prehabilitation Program: A Qualitative Study.

Background: Breast cancer (BC) is the most prevalent cancer diagnosis among women worldwide. Several randomized controlled trials and systematic reviews have shown the benefits of exercise before, during, and after cancer treatment to manage side effects related to cancer and its therapies. However, these are poorly implemented across the disease-span, specifically, during the preoperative setting. Methods: Patients diagnosed with BC and participating in a randomized controlled trial on the effects of a prehabilitation program based on Nordic walking, muscle strengthening, and therapeutic education were invited to participate in this qualitative substudy. Two groups of eight patients each were recorded, transcript and analyzed using a specialized software (Atlas-Ti®, version 24). Results: During the axial codification phase, 22 unique codes and 6 main themes were identified related to their experience with the program, namely, (1) information received prior to participating; (2) motivation to participate; (3) barriers; (4) facilitators; (5) perceived degree of support from healthcare workers as well as peers; and (6) satisfaction with the characteristics of the prehabilitation program. Conclusions: Patients interviewed showed great interest in prehabilitation as a way to prepare both physically and mentally for surgery. In order to implement these interventions, healthcare systems need to acknowledge barriers and facilitators as well as the need for these programs to be supervised and monitored to avoid adverse events.

Adherence to Supervised and Unsupervised Exercise Programmes in Ageing Population with Intermittent Claudication: A Randomized Controlled Trial.

Background: Intermittent Claudication symptomatic peripheral arterial disease (ICSPAD) is associated with reduced mobility, functional capacity, and quality of life. Physical exercise is an effective non-pharmacological intervention for the management of ICSPAD. Adherence to exercise programs is challenging, due to the nature of the disease and the complex comorbidities associated with it. This study aimed to determine adherence to three supervised physical exercise programs (a walking intervention, strength intervention, and concurrent intervention) and an unsupervised exercise program (standard advice) in individuals with ICSPAD. Methods: In this clinical trial, 122 patients were divided into four groups based on the type of exercise program they followed: standard advice, walking intervention, strength intervention, and concurrent intervention. Results: The results revealed that while the demographic characteristics were similar, the strength intervention group had a younger mean age, and the walking group had a higher prevalence of hypertension and increased usage of anti-hypertensive drugs. Adherence to physical exercise and pedometer wearing was highest in the standard advice group. Logistic regression analysis showed lower odds of adherence to exercise and pedometer wearing in the intervention groups compared to the standard advice group. Adherence did not significantly vary across ankle-brachial index categories. Furthermore, there was no significant difference in adherence between the severity levels of intermittent claudication, though mild cases tended to exhibit higher adherence. Conclusions: The results show that the standard advice from healthcare professionals positively influences treatment adherence.

Frailty, body composition and nutritional status in non-institutionalised elderly. / Fragilidad, composición corporal y estado nutricional en ancianos no institucionalizados.

OBJECTIVE: Frailty is a clinical syndrome characterized, among other signs, by involuntary weight loss and decreased muscle strength. The aim of this study was to analyse associations between frailty, body composition and nutritional status in non-institutionalised elderly people in the municipality of Alfândega (Braganza-Portugal). METHOD: Observational, prevalence and association study involving 220 elderly (mean 75.8±6.8 years of age; 68.8% women). Frailty was assessedt according to Fried criteria, body composition by bioelectrical impedance analysis and nutritional status using the Mini Nutritional Assessment Short-Form. RESULTS: The prevalence of frailty was 23.6%. Frail participants had, on average, lower total muscle mass and lower segmental muscle mass (arms and legs) than pre-frail and non-frail (p <.001). From the elderly at risk of malnutrition or undernourished (n=24), the majority (n=13) had frailty syndrome. It was observed that 41.2% of the elderly with low weight were frail. This syndrome prevailed only in 17.1% of the eutrophic persons, increasing again to 22.4% in the overweight group (p <.001). CONCLUSION: The phenotypic profile of frail elderly was characterised by lower muscle mass. The results of our study suggest that both underweight and overweight may be associated with frailty. There is the need to prevent and manage frailty, not only taking into account possible treatable medical causes, but also by intervening in important pillars, such as physical activity, dietary and nutritional problems.

Conocimiento e interés: implicaciones metodológicas para la ciencia enfermera / Knowledge and interest: methodological implications for nursing science

Objetivo: caracterizar los intereses cognoscitivos de la ciencia enfermera y sus implicaciones metodológicas. Metodología: ensayo teórico, basado en una revisión bibliográfica narrativa sobre los intereses de conocimiento descritos por Jürgen Habermas. Resultados: La explicitación de los intereses intrateóricos puede contribuir al marco filosófico, epistemológico y metodológico en las ciencias de la salud y la ciencia enfermera en particular. En las distintas áreas de ciencias de la salud confluyen, con distinta preponderancia, los intereses técnico, práctico y emancipatorio. Conclusión: Si bien en la medicina predomina el interés técnico, la enfermería se encuentra en disposición de integrar los intereses práctico y emancipatorio como ejes de conocimiento de sus programas de investigación. Este planteamiento puede reforzar la posición de las enfermeras a nivel profesional, académico e investigador, así como de las metodologías de investigación cualitativa asociadas a ambos intereses

Objective: The aim of this study was to define the knowledge interests of nursing science and their methodological implications. Methods: Theoretical essay based on a narrative literature review about the knowledge interests described by Jürgen Habermas. Results: Setting out the intratheoretical interests of health sciences and nursing science in particular,could add onto their philosophical, epistemological and methodological framework. Technical, practical and emancipatory interests converge with different weightings in different areas of health sciences. Conclusions: Although in medicine there is a predominance of the technical interest, nursing is in an ideal position to integrate practical and emancipatory interests as the axis of its research programmes. This approach could strengthen not only nurses' position at a professional, academic and research level, but also the qualitative research methodologies associated with both interests

Fragilidad, composición corporal y estado nutricional en ancianos no institucionalizados / Frailty, body composition and nutritional status in non-institutionalised elderly

Objetivo: La fragilidad es un síndrome clínico caracterizado, entre otros signos, por la pérdida involuntaria de peso y fuerza muscular disminuida. El objetivo de este estudio fue analizar asociaciones entre fragilidad, composición corporal y estado nutricional en ancianos no institucionalizados del municipio de Alfândega (Braganza-Portugal). Método: Estudio observacional, de prevalencia y asociación cruzada en el que participaron 220 ancianos (edad media de 75,8±6,8 años; 68,8% mujeres). La fragilidad fue evaluada según el fenotipo de Fried, la composición corporal por impedancia bioeléctrica y el estado nutricional mediante el Mini Nutritional Assessment Short-Form. Resultados: La prevalencia de fragilidad fue del 23,6%. Los participantes frágiles presentaban, en promedio, menor masa muscular total y menor masa muscular por segmentos (brazos y piernas) que los prefrágiles y no frágiles (p<0,001). De aquellos ancianos en riesgo de desnutrición o desnutridos (n=24), la mayoría (n=13) presentaban síndrome de fragilidad. Se observó que el 41,2% de los ancianos con bajo peso eran frágiles. Dicho síndrome prevaleció tan solo en el 17,1% de las personas eutróficas, aumentando de nuevo al 22,4% en el grupo con sobrepeso (p<0,001). Conclusión: El perfil fenotípico de los ancianos frágiles se caracterizó por menor masa muscular. Los resultados de nuestro estudio sugieren que tanto el bajo peso como el sobrepeso podrán conducir a situaciones de fragilidad. Es fundamental prevenir y gestionar la fragilidad, no solo teniendo en cuenta las posibles causas médicas tratables, sino también interviniendo en pilares importantes, como la actividad física y los problemas dietéticos y nutricionales (AU)

Objective: Frailty is a clinical syndrome characterized, among other signs, by involuntary weight loss and decreased muscle strength. The aim of this study was to analyse associations between frailty, body composition and nutritional status in non-institutionalised elderly people in the municipality of Alfândega (Braganza-Portugal). Method: Observational, prevalence and association study involving 220 elderly (mean 75.8±6.8 years of age; 68.8% women). Frailty was assessed according to Fried criteria, body composition by bioelectrical impedance analysis and nutritional status using the Mini Nutritional Assessment Short-Form. Results: The prevalence of frailty was 23.6%. Frail participants had, on average, lower total muscle mass and lower segmental muscle mass (arms and legs) than pre-frail and non-frail (p <.001). From the elderly at risk of malnutrition or undernourished (n=24), the majority (n=13) had frailty syndrome. It was observed that 41.2% of the elderly with low weight were frail. This syndrome prevailed only in 17.1% of the eutrophic persons, increasing again to 22.4% in the overweight group (p <.001). Conclusion: The phenotypic profile of frail elderly was characterised by lower muscle mass. The results of our study suggest that both underweight and overweight may be associated with frailty. There is the need to prevent and manage frailty, not only taking into account possible treatable medical causes, but also by intervening in important pillars, such as physical activity, dietary and nutritional problems (AU)