El proceso de transición y capacitación de la persona trasplantada al corazón y familia: ensayo teórico / The process of transition and training of the person transplanted to the heart and family: theoretical essay

La persona trasplantada de corazón y la familia experimentan diferentes tipos de transición, y un acompañante facilitador de su formación para una transición saludable es fundamental.La Enfermería de Rehabilitación (ER), debido a sus habilidades, puede ayudar a las personas a recuperar la estabilidad y el bienestar, sin embargo, existe poca difusión de su fundamento en lasteorías de enfermería. Objetivo: Analizar el aporte de la Teoría de las Transiciones en la práctica dela enfermería rehabilitadora orientada al empoderamiento de la persona trasplantada al corazón ya la familia. Metodología: Estudio crítico-reflexivo guiado por la Teoría de las Transiciones de AfafMeleis y por la legislación reguladora para la práctica del enfermero rehabilitador. Resultado: Sepercibe que la teoría de las Transiciones sustenta la intervención de Enfermería de Rehabilitaciónen las áreas de conocimiento y aprendizaje de habilidades de la persona trasplantada cardíaca y sufamilia, conduciendo a su empoderamiento, toma de decisiones y acción, haciendo que la personase sienta empoderada para superar los retos diarios derivados de su proceso de transición. Conclusión: Es fundamental demostrar la conceptualización en la práctica de enfermería, siendo la transición un foco significativo para la Enfermería de Rehabilitación.(AU)

COVID-19 infection: Positive mental health, psychological vulnerability and sex: Cross-sectional study.

Since mid-March 2020, a state of emergency was decreed in Portugal due to the COVID-19 pandemic and, consequently, measures were implemented to protect public health, such as social isolation, which will certainly have a notable impact on the mental health of the population, especially in the most vulnerable groups. Positive Mental Health (PMH) is essential to deal with adversity, in this case with the pandemic, and to live better and with greater satisfaction. We consider it relevant to investigate how PMH was used as a resource to deal with the pandemic, depending on the level of vulnerability and sex. A, cross-sectional study was carried out whose the aim was to evaluate the levels of PMH and psychological vulnerability in people with COVOD-19 infection and analyze the association between PMH and psychological vulnerability among men and women. METHODS: The instruments used were a sociodemographic characterization questionnaire, the Positive Mental Health Questionnaire, and the Psychological Vulnerability Scale (PVS), that were sent and filled out online. A quantitative, cross-sectional, descriptive, and correlational study was carried out. RESULTS: After analyzing the results, it was found that approximately 50.4% of the respondents (n = 387) had global PMH values that place them in quartile 50. There was also a statistically significant difference between female and male PMH, with women showing greater psychological vulnerability and lower overall PMH. CONCLUSIONS: We conclude that the women present a greater psychological vulnerability and a lower level of PMH when compared to men. RELEVANCE TO CLINICAL PRACTICE: Considering the study's statistically significant results, when we talk about mental health, we should always consider the sex variable as a vulnerability factor, in a pandemic or non-pandemic phase.

The COVID-19 Pandemic and Professional Nursing Practice in the Context of Hospitals.

The COVID-19 pandemic has imposed challenges to health systems and institutions, which had to quickly create conditions to meet the growing health needs of the population. Thus, this study aimed to assess the impact of COVID-19 on professional nursing practice environments and to identify the variables that affected their quality. Quantitative, observational study, conducted in 16 Portuguese hospitals, with 1575 nurses. Data were collected using a questionnaire and participants responded to two different moments in time: the pre-pandemic period and after the fourth critical period of COVID-19. The pandemic had a positive impact on the Structure and Outcome components, and a negative trend in the Process component. The variables associated with the qualification of the components and their dimensions were predominantly: work context, the exercise of functions in areas of assistance to COVID-19 patients, length of professional experience and length of experience in the service. The investment in professional practice environments impacted the improvement of organizational factors, supporting the development of nurses' work towards the quality of care. However, it is necessary to invest in nurses' participation, involvement and professional qualifications, which are aspects strongly dependent on the institutions' management strategies.

Eficácia da técnica de breath stacking na função respiratória em mulheres submetidas a cirurgia bariátrica / Effectiveness of the breath-stacking technique in the respiratory function of women undergoing bariatric surgery / Eficacia de la técnica de breath stacking sobre la función respiratoria en mujeres sometidas a cirugía bariátrica

Enquadramento: A cirurgia abdominal alta está associada a alta incidência de complicações pulmonares. A técnica breath stacking (BS) perspetiva-se como recurso com potencial terapêutico para a enfermagem de reabilitação. Objetivo: Avaliar a eficácia da técnica BS na melhoria da função respiratória. Metodologia: Estudo quasi-experimental com 36 mulheres submetidas a cirurgia bariátrica, distribuídas pelos grupos de controlo (GC) e intervenção (GI). Foram avaliadas no pré e pós-operatório as medidas capacidade vital forçada (CVF), volume expiratório forçado no primeiro segundo (VEF1), pressão inspiratória máxima (PIm), pressão expiratória máxima (PEm), saturação periférica de oxigénio (SpO2) e frequência respiratória (FR). Foi aplicada a técnica BS no GI no pré e pós-operatório. Recorreu-se à análise estatística descritiva e inferencial. Resultados: Observaram-se diferenças estatisticamente significativas pós-operatórias, entre o GC e o GI, na CVF ( -20,29 vs. -13,60), VEF1 (-23,05 vs. -13,38), PIm (-22,96 vs. -14,93), PEm (-14,10 vs -10,32) e FR (12,29 vs 6,45). Conclusão: A técnica de BS permitiu melhorar a função respiratória do GI e reverter as alterações previsíveis no pós-operatório de cirurgia bariátrica.

Background: Upper abdominal surgery is associated with a high incidence of pulmonary complications. The breath-stacking (BS) technique is considered a resource with therapeutic potential for rehabilitation nursing. Objective: To assess the effectiveness of the BS technique in improving the respiratory function. Methodology: Quasi-experimental study with 36 women undergoing bariatric surgery, distributed into a control group (CG) and an intervention group (IG). The forced vital capacity (FVC), the forced expiratory volume in one second (FEV1), the maximal inspiratory pressure (MIP), the maximal expiratory pressure (MEP), the peripheral oxygen saturation (SpO2), and the respiratory rate (RR) were evaluated in the pre and postoperative periods. The BS technique was applied to the IG in the pre and postoperative periods. Both descriptive and inferential statistics were used. Results: Statistically significant postoperative differences were observed between the CG and the IG in FVC (-20.29 vs. -13.60), FEV1 (-23.05 vs. -13.38), MIP (-22.96 vs. -14.93), MEP (-14.10 vs. -10.32), and RF (12.29 vs. 6.45). Conclusion: The BS technique improved the respiratory function of the IG and reversed the predictable changes in the postoperative period of bariatric surgery.

Marco contextual: La cirugía abdominal alta se asocia con una elevada incidencia de complicaciones pulmonares. La técnica de breath stacking (BS) se considera un recurso con potencial terapéutico para la enfermería de rehabilitación. Objetivo: Evaluar la efectividad de la técnica de BS para mejorar la función respiratoria. Metodología: Estudio cuasi-experimental con 36 mujeres sometidas a cirugía bariátrica, distribuidas entre el grupo de control (GC) y el de intervención (GI). Las mediciones de la capacidad vital forzada (CVF), el volumen espiratorio forzado en el primer segundo (VEF1), la presión inspiratoria máxima (PIm), la presión espiratoria máxima (PEm), la saturación periférica de oxigeno (SpO2) y la frecuencia respiratoria (FR) se evaluaron GI que en el GC antes y después de la cirugía. La técnica BS se aplicó en el GI antes y después de la cirugía. Se utilizó un análisis estadístico descriptivo e inferencial. Resultados: Se observaron diferencias posoperatorias estadísticamente significativas entre el GC y el GI en la CVF (-20,29 frente a -13,60), VEF1 (-23,05 frente a -13,38), PIm (-22,96 frente a -14,93), PEm (-14,10 frente a -10,32) y FR (12,29 frente a 6,45). Conclusión: La técnica BS permitió mejorar la función respiratoria del GI y revertir los cambios predecibles en el posoperatorio de cirugía bariátrica.

Análise das variáveis hemodinâmicas em idosos revascularizados após mobilização precoce no leito / Analysis of Hemodynamic Variables among Elderly Revascularized Patients after Early In-Bed Mobilization

Fundamentos: Durante o pós-operatório da cirurgia de revascularização do miocárdio (CRM), o repouso prolongado no leito aumenta a possibilidade de ocorrer complicações sistêmicas decorrentes do imobilismo. Objetivo: Verificar o comportamento das variáveis hemodinâmicas e no pico de fluxo expiratório (peack flow) em pacientes idosos, em pós-operatório de CRM submetidos a três tipos diferentes de intervenção fisioterapêutica. Métodos: Estudados 30 idosos estratificados em três grupos: Grupo A - mobilização com cicloergômetro; Grupo B - mobilização sem uso do cicloergômetro, mas com fisioterapia e Grupo C - sem qualquer mobilização, mas com ventilação não invasiva (VNI), sendo analisados o comportamento da frequência cardíaca (FC), frequência respiratória (FR), pressão arterial (PA), saturação periférica de oxigênio (SpO2) e pico de fluxo expiratório (peack flow). Para a variação dos resultados intragrupos, nas fases pré e pós-teste utilizou-se o teste de Wilcoxon; para a comparação intergrupos nas fases pré e pós-teste utilizou-se o teste de Kruskal-Wallis. Considerou-se significância estatística p<0,05.Resultados: Observou-se aumento significativo para os valores peack flow em todos os grupos (pré e pós-teste); redução significativa da PAS no grupo A, aumento da FC e da FR no grupo B (pré e pós-teste). Na análise intergrupos, observou-se redução da PAD no grupo C, com significado estatístico.

Background: During the post-operative phase after coronary artery bypass (CAB) surgery, prolonged bed rest increases the possibility of systemic complications resulting from immobilization. Objective: To ascertain the behavior of peak expiratory flow and hemodynamic variables among elderly patients during the CAB postoperative period undergoing three types of physiotherapy interventions. Methods: Thirty elderly patients were studied, divided into three groups: Group A - mobilization with an ergometric bicycle; Group B - mobilization without an ergometric bicycle but with physiotherapy; and Group C - no mobilization but with non-invasive ventilation, analyzing the heart rate (HR), respiration rate (RR), blood pressure (BP), peripheral oxygen saturation (SpO2)and expiratory peak flow. The Wilcoxon test was used for variations in the intra-group results for the pre- and post-test phases, using the Kruskal-Wallis test for the inter-group comparison of the pre and post-test phases, with a statistical significance of p<0.05.Results: A significant increase was observed in the peak flow values for the three groups (pre- and post-test);with a significant reduction in the systolic blood pressure for group A and higher heart rates and respiration rates in group B. The inter-group analysis presented a statistically significant reduction in the diastolic blood pressure for group C.