Development and Validation of the Serious Educational Game in Nursing Appraisal Scale.

OBJECTIVES: This study aims to develop and validate the Serious Educational Game in Nursing Appraisal Scale (SEGiNAS), a tool designed to evaluate the implementation of serious games within nurse education contexts of quantity of process, quality of process, and learning outcomes. METHODS AND MATERIALS: This methodological and psychometric study aimed to develop and validate a scale. The item generation phase was based on the cognitive theory of multimedia learning, resulting in a 20-item scale. The validation phase involved evaluating the psychometric scale by surveying 160 Portuguese nurses. RESULTS: A factor analysis revealed a three-factor structure corresponding to the scale's designed dimensions, explaining a total variance of 64.5%. The scale demonstrated high internal consistency for all factors, including engagement and teaching effectiveness (0.925), learning impact and practical application (0.883), and content relevance and clarity (0.848). The dimensions were engagement and teaching effectiveness, learning impact and practical application, and content relevance and clarity. CONCLUSIONS: The SEGiNAS scale represents a valid and reliable tool for evaluating serious games in nursing education. Its development fills an existing gap in assessing the teaching-learning process with serious games. This study was not registered.

Nurse-Led Approaches to Lowering Alcohol Use among Adolescents: Study Findings.

This study delves into how motivational sessions and brief interventions impact students' alcohol consumption, highlighting the vital role of nurses in fostering positive behavioural changes. The study aims to discern the effects of these interventions, starting with a pre-and post-intervention setup involving 62 students from a private school in northern Portugal. The intervention comprised a session delivered by school and mental health nurses, utilizing the motivational intervention and FRAMES method and a poster offering feedback on alcohol consumption scores. The results indicated that females tended to drink for fewer days and engage in less binge drinking than males. Furthermore, the intervention hinted at a reduction in the number of heavy drinking days. This study underscores the importance of including healthcare professionals, particularly nurses, in delivering brief interventions within school settings. The findings carry weight for crafting evidence-based interventions to cultivate healthier adolescent behaviours and enhance overall well-being.

Game4NurseSupervisor: Development of a board game for nursing mentoring.

AIM: To describe the stages of developing a board game prototype to promote knowledge about nursing mentorship. BACKGROUND: Clinical supervision in nursing is a vital strategy for the quality of care. The use of gamification through a board game can enhance knowledge about mentoring in nursing. DESIGN: We present a pilot study describing the development phases of the board game "Game4NurseSupervisor®." METHODS: The study comprised three phases. The first phase involved a modified e-Delphi study with experts to collect and validate the content to be integrated into the board game. The second phase focused on constructing the prototype of the board game. Finally, the third phase involved testing the prototype in sessions held in two healthcare units, followed by an evaluation through a questionnaire. RESULTS: The e-Delphi study, involving a panel composed of 59 experts, progressed through two rounds, resulting in 61 cards divided into four categories. The second phase involved constructing the board game, incorporating interactive elements such as "Game4NurseSupervisor®." In the third phase, 25 nurses, consisting of clinical practice nurses, participated in the testing phase and expressed satisfaction with the game. Highlighted benefits included reflective, playful, dynamic, interactive and educational aspects. CONCLUSIONS: The conclusions suggest that "Game4NurseSupervisor®" could be a valuable tool for promoting knowledge about nursing mentorship, providing an innovative and interactive approach to skill development. This study makes a valuable contribution by addressing a previously unexplored aspect of nurse mentor training: the potential of board games.

Occurrence, genetic diversity and resistance profiles of Salmonella enterica from Brazilian sausages collected at production facilities.

This study aimed to investigate the occurrence and the genetic diversity of Salmonella enterica subsp. enterica in sausages from Southern Brazil, evaluate virulence genes and determine the phenotypic and genotypic basis of antimicrobial and sanitizer resistance. Salmonella was detected in sausage samples with an overall prevalence of 5.5%. The prevalent serovars were S. Infantis and S. Rissen. Pulsed-field gel electrophoresis (PFGE) analysis yielded nine distinct PFGE profiles, and some of them were recurrently recovered in the same establishment on different dates. Among tested isolates, 28.5% showed resistance to at least one antimicrobial agent and a multidrug-resistance (MDR) profile was observed in 21.4%. Resistance occurred most frequently to ampicillin, sulfonamide, trimethoprim/sulfamethoxazole, and trimethoprim. Regarding the genotypic antimicrobial resistance profile, S. Schwarzengrund carried tet(B), strA, strB, and sul2 genes. Benzalkonium chloride and chlorhexidine were more effective than peracetic acid and sodium hypochlorite, showing lower minimum inhibitory concentration values. Six Salmonella serovars were found, demonstrating a potential risk of salmonellosis associated with consuming this food. Salmonella carrying virulence genes, MDR profile, and tolerance to sanitizers is a public health concern and a challenge for the food industry, suggesting that new strategies should be developed to control this pathogen. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05809-w.

Adapting lean management to prevent healthcare-associated infections: a low-cost strategy involving Kamishibai cards to sustain bundles' compliance.

Lean healthcare visual management has been successfully integrated into infection control programs, leading to lower healthcare-associated infection (HAI) rates and greater provider compliance with evidence-based prevention practices; however, its implementation during quality improvement (QI) initiatives in limited-resource settings has not yet been well exploited. We aimed to describe a low-cost strategy involving Kamishibai cards to sustain bundles' adherence to prevent HAIs in a middle-income country. This descriptive case study evaluated the implementation of a lean healthcare visual management tool-Kamishibai board (K-board)-during a nationwide QI collaborative preventing three critical HAIs in 189 adult and pediatric/neonatal intensive care units (ICUs) from September 2021 to January 2023. Considering a limited-resource setting, our team adapted a K-board using simple, cheap, and easy-to-handle materials for routine monitoring of QI procedures, including safety bundles' compliance. After test prototypes, the final K-board version was implemented. The chart materials and assembly cost BRL 80.00 (USD 15.48). Before launching, expert working group meetings were held to shape the contents, refine technical issues, and prepare the ICU teams for implementation. After starting, plan-do-study-act cycles were conducted according to the Breakthrough Series model. Participating ICU teams, including leaders and front-line health workers, performed bedside audits following a weekly chronogram. Two indicators were calculated: the percentage of ICUs in which K-boards were being implemented and whether bundles' compliance was addressed in the K-board. Audit data were recorded in 'SimpleQI'. After 17 months of this initiative, 177 (93.7%) participating ICUs had included this visual management tool in their daily care routines. When more than 94 (>50%) ICUs posted K-board data, the mean compliance for the bundles for each HAI was sustained above 85%. A lean healthcare visual management tool can be adapted to local settings, including healthcare facilities with limited resources. K-board seems to be a feasible method for auditing evidence-based practices in medical care, including safety bundles to simultaneously prevent three types of HAIs.

The potential of games for vulnerable groups like refugees: a scoping review.

OBJECTIVE: To map existing studies on the development of games for refugees, identifying the developed games, characteristics and possible application to health care. METHOD: A scoping review study, carried out in July 2022, using the MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, Scopus, SciELO (Scientific Electronic Library Online), Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials databases. RESULTS: 8 studies were identified, with 8 different types of games published between 2016 and 2022. The characteristics of the games found essentially fall on their use to increase empathy towards refugees. CONCLUSION: This study identifies opportunities to strengthen the current body of knowledge in nursing, using games as ways of welcoming, training and integrating populations in situations of social vulnerability in which refugees find themselves.

Contributions of a Rehabilitation Nursing Program in the Self-Care of Women Undergoing Breast Surgery.

BACKGROUND: Although surgical treatments for breast cancer have exhibited advanced interventions, axillary lymph node dissection can limit functionality and compromise women's self-care. This study aims to assess the effectiveness of a rehabilitation nursing program in improving self-care performance in women undergoing breast surgery with axillary lymph node dissection. METHODS: This quantitative, quasi-experimental study involved 48 women recruited from a main hospital between 2018 and 2019. The participants completed a three-month rehabilitation program at home. The evaluation instrument used was the DASH questionnaire. This study was not registered. RESULTS: The functionality of the upper limb ipsilateral to the surgery improved significantly (p < 0.001) after the implementation of the program, influencing the participants' capacity for self-care, including washing/drying their hair, washing their back, and wearing a shirt. The average DASH total score increased from 54.4 to 8.1 after the program. CONCLUSIONS: The rehabilitation nursing program positively influenced the participants' self-care ability. Incorporating rehabilitation nursing programs into breast cancer treatment can improve self-care performance and the overall quality of patients' lives. This study was not registered.

The Burnout of Nurses in Intensive Care Units and the Impact of the SARS-CoV-2 Pandemic: A Scoping Review.

BACKGROUND: The world's population changed with the emergence of the SARS-CoV-2 pandemic. Burnout arises due to overwork, prolonged work periods, a lack of human and material resources, etc. Several studies have reported the incidence of burnout syndrome in nurses that work in intensive care units (ICUs). The aim was to map the scientific evidence related to nurses' burnout in the ICU, namely the repercussions of SARS-CoV-2 in terms of burnout among nurses. METHODS: A scoping review followed the Joanna Briggs Institute methodology guidelines to search for and synthesise studies published between 2019 and 2022. The databases searched were MEDLINE, CINAHL, LILACS, SCOPUS, PsycINFO and OPEN GREY. A total of fourteen articles were eligible to be included. RESULTS: A content analysis of the selected articles was carried out, and three categories emerged that corresponded to the dimensions of burnout according to Maslach and Leiter: emotional exhaustion, depersonalisation dimension and a lack of personal accomplishment. It was evident that nurses who worked in the ICU during the pandemic showed high levels of burnout. CONCLUSIONS: It is recommended that hospital administrations hire health professionals, namely nurses, as a strategic and operational management strategy to reduce the risk of increased burnout during pandemic outbreaks.

The potential of games for vulnerable groups like refugees: a scoping review / El potencial de los juegos para grupos vulnerables como los refugiados: revisión del alcance / O potencial de jogos para grupos vulneráveis como refugiados: revisão de escopo

ABSTRACT Objective: To map existing studies on the development of games for refugees, identifying the developed games, characteristics and possible application to health care. Method: A scoping review study, carried out in July 2022, using the MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, Scopus, SciELO (Scientific Electronic Library Online), Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials databases. Results: 8 studies were identified, with 8 different types of games published between 2016 and 2022. The characteristics of the games found essentially fall on their use to increase empathy towards refugees. Conclusion: This study identifies opportunities to strengthen the current body of knowledge in nursing, using games as ways of welcoming, training and integrating populations in situations of social vulnerability in which refugees find themselves.

RESUMEN Objetivo: Mapear los estudios existentes sobre el desarrollo de juegos para refugiados, identificando los juegos desarrollados, sus características y su posible aplicación a la atención de salud. Método: Estudio de revisión de alcance, realizado en julio de 2022, utilizando las bases de datos MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, Scopus, SciELO (Scientific Electronic Library Online), Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials. Resultados: Se identificaron 8 estudios, con 8 tipos diferentes de juegos publicados entre 2016 y 2022. Las características de los juegos encontrados recaen esencialmente en su uso para aumentar la empatía hacia los refugiados. Conclusión: Este estudio identifica oportunidades para fortalecer el conocimiento actual en enfermería, utilizando el juego como forma de acoger, capacitar e integrar a poblaciones en situaciones de vulnerabilidad social en las que se encuentran refugiados.

RESUMO Objetivo: Mapear os estudos existentes sobre o desenvolvimento de jogos para refugiados, identificando os jogos desenvolvidos, características e possível aplicação aos cuidados de saúde. Método: Estudo de revisão de escopo, realizado em julho de 2022, utilizando as bases de dados MEDLINE® (Medical Literature Analysis and Retrieval System Online), CINAHL® (Cumulative Index to Nursing and Allied Health Literature), SPORTDiscus, Scopus, SciELO (Scientific Electronic Library Online), Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials. Resultados: Foram identificados 8 estudos, com 8 diferentes tipos de jogos publicados entre 2016 e 2022. As características dos jogos encontrados recaem essencialmente sobre a sua utilização para aumentar a empatia para com os refugiados. Conclusão: Este estudo identifica oportunidades para fortalecer o atual corpo de conhecimento em enfermagem, utilizando jogos como formas de acolhimento, formação e integração de populações em situação de vulnerabilidade social em que se encontram os refugiados.

From the challenge of assessing autonomy to the instruments used in practice: A scoping review.

Autonomy is one of the essential components to live a quality life. Monitoring this autonomy is, in effect, essential, to allow the nurses to conceive, implement and evaluate interventions aimed at its promotion or even maintenance. For this reason, this scoping review aims to map the evidence to identify and analyze the instruments used to assess the person's autonomy, which emerges from scientific production. Methods: Scoping review based on the recommended principles by the Joanna Briggs Institute. The research was realized in the databases: Scopus (excluding MEDLINE), CINAHL complete (via EBSCO, Excluding MEDLINE), and MEDLINE (via PubMed). Two independent reviewers evaluated the articles' pertinence for the study's investigation, the extraction, and synthesis of articles. Results: After the analysis, according to the inclusion criteria established, 34 articles were selected, allude to 7 different instruments to assess autonomy. Conclusions: The need for further development at this level is highlighted, namely through the construction and validation of more comprehensive instruments, integrating the different components of the concept of autonomy.

The Burnout of Nurses in Intensive Care Units and the Impact of the Pandemic of SARS-CoV-2: Protocol of a Scoping Review.

Background: The SARS-CoV-2 pandemic has brought multiple challenges for health institutions and their professionals. The requirement of this disease forced nurses to confront organizational and clinical challenges to maintain the quality standards of care they provide. These requirements may have contributed to increased burnout symptoms. This study aims to map the scientific evidence related to nurses' burnout in intensive care units. Methods: A scoping review will be conducted according to the Joanna Briggs Institute methodology. Relevant databases will be used as well as grey literature, where the following words will be used: burnout, nurses, intensive care units and SARS-CoV-2. Results: This scoping review will include all types of studies-quantitative, qualitative and mixed-and all types of reviews that focus on the objective of this review. Conclusions: It is vital to determine the impact of the burnout caused by the pandemic of SARS-CoV-2 to assess amending measures of risk and protection factors. This will help in the implementation of guidelines according to the available evidence. Additionally, this will help to improve the skills of these professionals as well as to reduce their emotional and physical exhaustion. This protocol is registered with the Open Science Framework.

Impact of Exergames on the Mental Health of Older Adults: A Systematic Review and GRADE Evidence Synthesis.

Exergames, which combine digital games and physical exercise, have become a popular alternative to traditional exercise programs and are increasingly used in the health domains. This study aimed to provide a systematic review to synthesize existing studies on the use of exergames for the mental wellbeing of healthy older adults, aggregating the collected data to identify effect size. We performed a Systematic Review and Grading of Recommendations, Assessment, Development, and Assessment (GRADE) evidence synthesis. We performed the search in the following databases: MEDLINE®, CINAHL®, SPORTDiscus, SCOPUS, SciELO, Psychology and Behavioral Sciences Collection, and Cochrane® Central Register of Controlled Trials from the first record until October 2021. Randomized controlled trials using exergames as an intervention were included. A total of 10 articles published between 2009 and 2021 were selected. Most studies used the Nintendo Wii® as the exergame in the intervention program. Interventions ranged from 6 to 12 weeks, with 8-week programs being most frequent. It was possible to observe a positive effect on mood, the reduction of apathy, anxiety and depression, self-esteem, and affection.

Influência dos estilos de liderança no burnout dos enfermeiros: uma scoping review / Influence of leadership styles on nurses' burnout: a scoping review / Influencia de los estilos de liderazgo en el agotamiento de las enfermeras: una scoping review

Objetivo: identificar quais os estilos de liderança utilizados por enfermeiros gestores e compreender a sua influência no burnoutdos enfermeiros no contexto de trabalho.Método: scoping review, realizada em abril de 2021, conduzida de acordo com a metodologia de Joanna Briggs Institute. Dois revisores independentes avaliaram a relevância dos artigos, a extração e síntese dos dados. Resultados: foram identificados 3.532 estudos na pesquisa bibliográfica, dos quais sete estudos apresentaram as características de elegibilidade para a inclusão na revisão. Os estilos de liderança identificados na literatura foram a liderança transformacional e liderança autêntica que revelam um impacto positivo na redução do burnout; a liderança laissez-faire que, pelo contrário, promove um ambiente facilitador do desenvolvimento da síndrome em estudo; a liderança transacional, por sua vez, não demonstrou resultados significativos na diminuição e prevenção de burnout, assim como, a liderança autocrática, carismática e situacional cujos resultados não se demonstraram quantificáveis para a sua prevenção. Conclusão: o estilo de liderança transformacional foi aquele que maior relevância demonstrou tanto na prevenção como diminuição do desenvolvimento de burnoutnos enfermeiros.

Objective: identify which leadership styles are used by nurse managers and understand their influence on nurse's burnout nurses in the work context. Method: scoping review, carried out in April 2021, conducted according to the Joanna Briggs Institute methodology. Two independent reviewers assessed the relevance of the articles, the extraction and synthesis of data. Results: 3.532 studies were identified in the literature search, of which seven studies presented the eligibility characteristics for inclusion in the review.The leadership styles identified in the literature were transformational leadership and authentic leadership that reveal a positive impact on reducing burnout; laissez-faire leadership that, on the contrary, promotes an environment that facilitates the development of the syndrome under study; transactional leadership, in turn, did not show significant results in reducing and preventing burnout, as well as autocratic, charismatic and situational leadership whose results were not quantifiable for its prevention.Conclusion: it was concluded that the transformational leadership style was the one that showed the greatest relevance both in preventing and reducing the development of burnoutin nurses.

Objetivo: identificar qué estilos de liderazgo son utilizados por las enfermeras gestoras y comprender su influencia en el agotamiento de las enfermeras en el contexto de trabajo.Método: scoping review, realizado en abril de 2021, según la metodología Joanna Briggs Institute. Dos revisores independientes evaluaron la relevancia de los artículos, la extracción y síntesis de datos. Resultados: se identificaron 3.532 estudios en la búsqueda bibliográfica, de los cuales siete estudios presentaron las características de elegibilidad para su inclusión en la revisión. Los estilos de liderazgo identificados en la literatura fueron el liderazgo transformacional y el liderazgo auténtico que revelan un impacto positivo en la reducción del burnout; liderazgo laissez-faire que, por el contrario, promueve un entorno que facilita el desarrollo del síndrome en estudio; el liderazgo transaccional, por su parte, no mostró resultados significativos enla reducción y prevención del burnout, así como el liderazgo autocrático, carismático y situacional cuyos resultados no fueron cuantificables para su prevención. Conclusión: se concluyó que el estilo de liderazgo transformacional fue el que mostró mayor relevancia tanto en la prevención como en la reducción del desarrollo del burnout en enfermeros.

A construção do caso clínico como recurso no tratamento das urgências subjetivas / The construction of the clinical case as a resource in the treatment of subjective urgencies

Este trabalho discute a metodologia psicanalítica de investigação - construção do caso clínico - como recurso no tratamento das urgências subjetivas. A palavra trazida pelo sujeito que chega à instituição hospitalar psiquiátrica é recolhida como ponto norteador do tratamento, enquanto as narrativas da família e instituição também são convocadas a compor o caso. A partir da construção do caso clínico de João, verificamos a ruptura que se produz no enunciado do sujeito psicótico frente ao Outro absoluto e concreto, fazendo irromper a urgência. A posição de secretariamento adotada pela equipe na figura da analista, entretanto, suscita fragmentos de discurso que aos poucos vão dando sustentação à casa-corpo do sujeito. Essa saída inédita por ele apresentada oferta à prática elementos para pensar possíveis tratamentos ao Outro e passagem ao ato na psicose.

Nursing focuses and interventions that promote the autonomy of the elderly.

OBJECTIVES: To describe the meaning attributed to the experiences of the clinical experience of specialist nurses in the implementation of nursing care focuses and respective interventions that promote the autonomy of the elderly. METHOD: Qualitative study based on Giorgi's method. Eighteen specialist nurses were interviewed, recruited for convenience in two hospitals in the northern region of Portugal, between March and December 2018. RESULTS: In the clinical experience of specialist nurses, regarding the nursing process, three themes emerged: focuses of nursing care; implementation of nursing interventions and hindering factors. CONCLUSIONS: The specialist nurses, most of whom are rehabilitation specialists, essentially promote the physical capacity of the elderly, within the scope of autonomy, revealing that working conditions, such as lack of time and information systems, are the limiting factor of their promotion.

Del concepto de independencia al cuestionamiento de su uso en la práctica: scoping review / From the concept of Independence to the questioning of its use in practice: scoping review

Introducción:La independencia es un concepto muy utilizado por las áreas más prácticas del conocimiento en salud, siendo fundamental conocer su significado real para su posterior aplicación.Método:Revisión de alcance basada em los princípios recomendados por el Instituto Joanna Briggs y por el método de análisis conceptual de Walker y Avant. Se realizó uma cuidadosa investigación en las bases de datos: Scopus, CINAHL complete y MEDLINE. Dos revisores independientes evalúan la relevancia de los artículos en estudio, la extracción y síntesis del artículo.Resultados:Se incluyeron ciento y dos de los artículos, luego de la aplicación de los criterios de inclusión. La mayoria de los autores definen la independencia como la capacidad física para el autocuidado y para la realización de las actividades diarias. Otros autores confunden independencia com autonomia, refiriéndose a la independencia como capacidad cognitiva, capacidade financiera, capacidad social y capacidad de decisión.Conclusiones:La independencia incluye la capacidad para realizar actividades de autocuidado y de la vida diaria (AU)

Background:Independence is a widely used concept by the most practical areas of health knowledge, being essential to know its real meaning for subsequent application.Method:Scoping review based on the recommended principles by Joanna Briggs Institute and by the conceptual analysis method from Walker and Avant. Careful research was realized in the databases: Scopus, CINAHL complete, and MEDLINE. Two independent reviewers evaluate the relevance of the articles' understudy, the extraction, and article synthesis.Results:One hundred and two articles were included, after the application of the inclusion criteria. The majority of the authors define independence as the physical capacity for self-care and for the realization of the daily activities. Other authors, confuse independence with autonomy, referring to independence as the cognitive capacity, financial capacity, social capacity, and decision capacity.Conclusions:Independence includes the ability to perform self-care and daily living activities (AU)

Antecedentes:Independência é um conceito amplamente utilizado pelas áreas mais práticas do conhecimento em saúde, sendo essencial conhecer o seu real significado para posterior aplicação.Método:Scoping review baseada nos princípios recomendados pela Joanna Briggs Institute e pelo método de análise conceitual de Walker e Avant. Uma pesquisa cuidados foi realizada nas bases de dados: Scopus, CINAHL complete, and MEDLINE. Dois revisores independentes avaliaram a relevância dos artigos em estudo, a extração e síntese dos artigos.Resultados:Cento e dois artigos foram incluídos, após a aplicação dos critérios de inclusão. A maioria dos autores define independência como a capacidade física para o autocuidado e para a realização das atividades de vida diárias. Outros autores confundem independência com autonomia, referindo-se à independência como a capacidade cognitiva, capacidade financeira, capacidade de sociabilizar e capacidade de decisão.Conclusions:Independência inclui a capacidade para o autocuidado e para as atividades de vida diária (AU)

Concept of older person autonomy: phenomenological study of the opinion of specialist nurses.

Background: The concept of autonomy is composed of several components, making it a multidimensional concept. This includes cognitive ability, intellectual ability, emotional intelligence, social situation, and physical ability skills. This study aimed to describe the experiences attributed to the meaning of the concept of autonomy, by specialist nurses. Methods: A descriptive phenomenological study was carried out, according to the Giorgi method. Eighteen nurses were recruited at a hospital in Portugal. Data were collected through individual interviews. Results: The 18 specialist nurses work on average as nurses for 16years and are specialist nurses; for an average of 5.9years, most are specialist nurses in rehabilitation nursing. From the data analysis, six themes emerged: ability to do, ability to resolve, decision ability, cognitive ability, social integration, and emotional intelligence. Conclusions: Most professionals perceive the concept as the ability to perform activities of daily living and the ability to make decisions, especially concerning informed consent. It is necessary to raise awareness of the breadth of this concept since the quality of life and dignity of the elderly person depends on autonomy.

Nursing focuses and interventions that promote the autonomy of the elderly / Enfoques e intervenciones de enfermería promotoras de la autonomía del anciano / Focos e intervenções de Enfermagem promotoras da autonomia dos idosos

ABSTRACT Objectives: To describe the meaning attributed to the experiences of the clinical experience of specialist nurses in the implementation of nursing care focuses and respective interventions that promote the autonomy of the elderly. Method: Qualitative study based on Giorgi's method. Eighteen specialist nurses were interviewed, recruited for convenience in two hospitals in the northern region of Portugal, between March and December 2018. Results: In the clinical experience of specialist nurses, regarding the nursing process, three themes emerged: focuses of nursing care; implementation of nursing interventions and hindering factors. Conclusions: The specialist nurses, most of whom are rehabilitation specialists, essentially promote the physical capacity of the elderly, within the scope of autonomy, revealing that working conditions, such as lack of time and information systems, are the limiting factor of their promotion.

RESUMEN Objetivos: Describir el significado atribuido a las vivencias de la experiencia clínica de enfermeros especialistas en la implementación de los enfoques de atención de enfermería y las respectivas intervenciones que promueven la autonomía del anciano. Método: Estudio cualitativo basado en el método de Giorgi. Se entrevistaron dieciocho enfermeras especializadas, reclutadas por conveniencia en dos hospitales de la región norte de Portugal, entre marzo y diciembre de 2018. Resultados: En la experiencia clínica de los enfermeros especialistas, en relación con el proceso de enfermería, surgieron tres temas: focos de atención de enfermería; implementación de intervenciones de enfermería y factores obstaculizadores. Conclusiones: Los enfermeros especialistas, en su mayoría especialistas en rehabilitación, promueven fundamentalmente la capacidad física de las personas mayores, en el ámbito de la autonomía, revelando que las condiciones laborales, como la falta de tiempo y sistemas de información, son el fator limitante para su promoción.

RESUMO Objetivos: Descrever o significado atribuído às vivências da experiência clínica dos enfermeiros especialistas na implementação de focos do cuidado de enfermagem e respetivas intervenções promotoras da autonomia dos idosos. Método: Estudo qualitativo com base no método de Giorgi. Foram entrevistados 18 enfermeiros especialistas, recrutados por conveniência em dois hospitais da região a norte de Portugal, entre março e dezembro de 2018. Resultados: Na experiência clínica dos enfermeiros especialistas, quanto ao processo de enfermagem, emergiram três temas: focos do cuidado de enfermagem; implementação de intervenções de enfermagem e fatores dificultadores. Conclusões: Os enfermeiros especialistas, em sua maioria em reabilitação, promovem essencialmente a capacidade física dos idosos, no âmbito da autonomia, revelando que as condições de trabalho, como a falta de tempo e os sistemas de informação, constituem o fator limitador da sua promoção.

Validação da Escala de Autoavaliação da Promoção da Autonomia dos Idosos (EAPAI) por parte dos enfermeiros / Validation of the Self-Assessment Scale of Autonomy Promotion in Older Adults (EAPAI) by nurses / Validación de la Escala de Autoevaluación para la Promoción de la Autonomía del Adulto Mayor (EAPAI) por los enfermeiros

Resumo Enquadramento: A promoção da autonomia do idoso assume particular relevo na prestação de cuidados de enfermagem. Contudo, na literatura não foram encontrados instrumentos que permitam efetuar a autoavaliação da promoção da autonomia dos idosos. Objetivo: Avaliar as propriedades psicométricas de uma escala de autoavaliação da promoção da autonomia dos idosos. Metodologia: Estudo metodológico que compreendeu a avaliação das propriedades psicométricas da escala, com recurso de uma amostra de 360 enfermeiros. A fiabilidade foi avaliada através da consistência interna e a validade de constructo através de análise fatorial exploratória (rotação varimax). Resultados: A consistência interna total (Alfa de Cronbach) foi de 0,983, variando de 0,955 a 0,990 nos seis fatores identificados. Conclusão: Esta escala, que apresenta boas propriedades psicométricas, é um instrumento de avaliação da promoção da autonomia dos idosos, na perspetiva dos enfermeiros, potencialmente útil para aumentar a consciencialização destes profissionais neste domínio.

Abstract Background: The promotion of older adults' autonomy is particularly relevant in nursing care. However, no instruments were found in the literature that allowed the self-assessment of autonomy promotion in older adults. Objective: To evaluate the psychometric properties of a self-assessment scale of autonomy promotion in older adults. Methodology: This is a methodological study that included the assessment of the scale's psychometric properties, using a sample of 360 nurses. The scale's reliability was assessed through internal consistency and construct validity using an exploratory factor analysis (varimax rotation). Results: The total internal consistency (Cronbach's alpha) was 0.983, ranging from 0.955 to 0.990 across the six factors identified. Conclusion: The scale presents good psychometric properties and consists of an instrument for nurses to self-assess autonomy promotion in older adults. This instrument can potentially increase nurses' awareness in this area.

Resumen Marco contextual: La promoción de la autonomía de los adultos mayores es especialmente importante en la prestación de cuidados de enfermería. Sin embargo, no se han encontrado en la literatura instrumentos que permitan la autoevaluación de la promoción de la autonomía de los adultos mayores. Objetivo: Evaluar las propiedades psicométricas de una escala de autoevaluación de la promoción de la autonomía de los adultos mayores. Metodología: Estudio metodológico que incluyó la evaluación de las propiedades psicométricas de la escala, para lo cual se utilizó una muestra de 360 enfermeros. La fiabilidad se evaluó mediante la consistencia interna y la validez de constructo mediante el análisis factorial exploratorio (rotación varimax). Resultados: La consistencia interna total (alfa de Cronbach) fue de 0,983, variando de 0,955 a 0,990 en los seis factores identificados. Conclusión: Esta escala, que presenta buenas propiedades psicométricas, es un instrumento para evaluar la promoción de la autonomía en los adultos mayores desde la perspectiva de los enfermeros, lo que resulta potencialmente útil para aumentar la conciencia de estos profesionales en este ámbito.

Nursing practice in the promotion of the elderly's autonomy.

OBJECTIVE: To describe the meaning attributed by specialist nurses to the promotion of the elderly's autonomy. METHOD: This is a phenomenological study, according to Giorgi's method, which uses semi-structured interviews. Eighteen specialist nurses participated, recruited using convenience sampling, in two hospitals in the northern region of Portugal, between March and December 2018. RESULTS: Five themes emerged: use of instruments; use of theoretical framework; nursing diagnoses; prescription of interventions; nursing records. CONCLUSION: Specialist nurses use instruments that essentially promote the elderly's physical capacity, within the scope of autonomy. The information systems used to record the diagnoses and prescriptions for interventions do not reflect the intervention for the person's autonomy. Autonomy in a multidimensional way is not very well developed, despite the recognition of its importance for the elderly's quality of life and dignity.