Cross-Cultural Validation of the Portuguese Version of the Quality of Oncology Nursing Care Scale.

BACKGROUND: Quality assessment in oncology nursing care has been a growing topic in the literature, gaining relevance as oncological nursing care becomes more complex as the science progresses. However, there are no instruments that assess the perception of the quality of oncology nursing care from the point of view of patients for the Portuguese population. Thus, the cross-cultural translation and validation of the Quality of Oncology Nursing Care Scale (QONCS) was performed for the Portuguese context. This instrument allows nurses to assess patients' self-perception of the quality of nursing care provided in an oncological setting. It also allows researchers to compare the results obtained internationally with the application of this scale. METHODS: This is a methodological study, with two distinct phases: the first corresponded to the translation and cultural adaptation of the scale to the Portuguese context, and the second consisted of the psychometric validation of the QONCS, which included factor analysis and the evaluation of the psychometric properties of the instrument. We obtained responses from 402 patients from a Portuguese oncology hospital. RESULTS: The Portuguese version of the Quality of Oncology Nursing Care Scale (QONCS_PT) consists of 34 items inserted into a tetra-factorial model, which explains a total variance of the instrument of 69.8%. A Cronbach's alpha of 0.93 was obtained for the complete instrument. CONCLUSIONS: QONCS_PT has a competent and reliable structure. The scale's validity was assured and can be used in the Portuguese population, as it is useful for direct care provision but also for researchers and managers.

Translation, Adaptation, and Validation of the Portuguese Version of the Exercise of Self-Care Agency Scale.

Assessing a person's capacity to engage in self-care behaviours is another added value in identifying one's potential to care for oneself in the health domain that contributes to planning person-centred care. This study aimed to translate, adapt, and validate the Exercise of Self-Care Agency (ESCA) Scale by Kearney and Fleischer, revised by Riesch and Hauck for the Portuguese version, using a sample of 625 elderly people living at home in Portugal. A cross-cultural adaptation process follows the stages of translation, synthesis, back-translation, and consensual solution for the translation process and pretesting. Construct validity was tested using exploratory factor analysis, and factor structure was subjected to confirmatory factor analysis. Reliability was determined by analysing internal consistency, resorting to Cronbach's alpha coefficient. This resulted in an instrument formed of 29 items, keeping the factor structure conceptually aligned with the underlying theory. Cronbach's alpha coefficient values were 0.87 for the global scale and varied between 0.65 and 0.84 for the subscales. The final four-factor model showed an acceptable quality of fit. The Portuguese version of the ESCA shows appropriate validity and reliability for use in future research and health contexts.

Nurses' Well-Being at Work in a Hospital Setting: A Scoping Review.

The aim of this review was to analyze the scientific evidence about nurses' well-being at work in the hospital context. Well-being is present in our daily experiences, whether in a personal or professional context. Nurses are frequently put under pressure and stressed at work, which can influence their well-being. Nurses' well-being at work in a hospital setting is crucial due to its relevance to occupational health, the quality of patient care, and the identification of stress and satisfaction factors. Methods: This systematic review followed the methodological guidelines of the Joanna Briggs Institute (JBI). The databases searched included CINAHL, MEDLINE, Scopus, Cochrane Database of Systematic Reviews, LILACS, Scientific Electronic Library Online (SciELO), and the Open Access Scientific Repositories of Portugal (RCAAP). The following inclusion criteria were defined: studies in Portuguese or English; with abstracts or full texts available; with a publication date from 2018 to 2022; and research containing the identified keywords in the title (TI) or abstract (AB). To organize and synthesize the data, we used a table to extract the significant information from each included study. Results: Eight studies were included, all of them emphasizing the assessment of well-being at work and the manager's intervention to promote this well-being. We found that most studies indicate that nurses are satisfied with their work. There are several factors that can influence this positive level of well-being at work, such as interaction with management, culture, and organizational commitment. It can be concluded that nurse managers have a decisive role in promoting well-being at work.

Habilidades sociais na especialidade da enfermagem em oncologia: estudo qualitativo / Social skills in the nursing specialty in oncology: qualitative study / Habilidades sociales en la especialidad de enfermería en oncología: estudio cualitativo

Objetivo: compreender o significado das habilidades sociais atribuído por enfermeiros especialistas em enfermagem em oncologia. Método: estudo qualitativo, exploratório, que aplicou a Teoria Fundamentada nos Dados e o Interacionismo Simbólico. Participaram 14 enfermeiros de um dos grupos amostrais, especialistas em oncologia, de hospital oncológico. Aplicamos a entrevista semiestruturada, on-line, de maio de 2021 a dezembro de 2022. A análise seguiu a codificação aberta, axial e integração, e aplicamos o paradigma da codificação. Resultados: a categoria paradigmática 'condição do fenômeno' é apresentada face o aspecto semântico e de reconhecimento da aplicação das habilidades sociais. A categoria Percepções e significados das habilidades sociais para enfermeiros oncologistas alicerçou-se nas subcategorias: reagindo ao termo, e atribuindo significados e valores às habilidades sociais na especialidade da enfermagem em oncologia. Conclusão: os enfermeiros reconhecem as habilidades sociais e sua importância na oncologia. Desse modo, reitera-se a importância da articulação teórico-prático para qualificar a prática na oncologia.

Objective: to understand the meaning of social skills attributed by specialist nurses in oncology nursing. Method: a qualitative, exploratory study, which applied Grounded Theory and Symbolic Interactionism. The participants were 14 nurses from one of the sample groups, specialists in oncology, from an oncological hospital. We applied semi-structured interviews, online, from May 2021 to December 2022. The analysis followed open, axial, and integration coding, and the coding paradigm. Results: we present the paradigm condition category, given the semantic aspect and recognition of the application of social skills. The category Perceptions and meanings of social skills for oncology nurses was based on the subcategories: reacting to the term, and attributing meanings and values to social skills in the specialty of nursing in oncology. Conclusion: nurses recognize social skills and their importance in oncology. We reinforce the importance of theoretical-practical articulation to qualify the practice in oncology.

Objetivo: comprender el significado de las habilidades sociales atribuido por enfermeros especialistas en enfermería oncológica. Método: estudio cualitativo, exploratorio, que aplicó la Teoría Fundamentada y el Interaccionismo Simbólico. 14 enfermeros, expertos en oncología, participaron en uno de los grupos de muestreo de un hospital oncológico. Aplicamos entrevistas semiestructuradas, en línea, de mayo de 2021 a diciembre de 2022. El análisis siguió la codificación abierta, axial y de integración, y aplicamos el paradigma de la codificación. Resultados: se presentó la categoría paradigmática 'condición del fenómeno' ante el aspecto semántico y de reconocimiento de la aplicación de habilidades sociales. La categoría 'Percepciones y significados de las habilidades sociales para enfermeros de oncología' se basó en las subcategorías: reaccionando al término y atribuyendo significados y valores a las habilidades sociales en la especialidad de enfermería en oncología. Conclusión: los enfermeros reconocen las habilidades sociales y su importancia en la oncología. Siendo así, reforzamos la importancia de la articulación teórico-práctica para cualificar la práctica en oncología.

Relationship of the nursing practice environment with the quality of care and patients' safety in primary health care.

BACKGROUND: Nursing practice environment has impact on the quality of nursing care and on patients' and nurses' outcomes, namely better performances of these healthcare workers. Improving the nursing practice environment is a low-cost organizational strategy to achieve better patients' outcomes and retain qualified nurses, thus improving nursing care of units, healthcare organizations and healthcare system. This study aims to analyse the relationship between nursing practice environment and the nurses` perception of quality of care, patient safety, and safety culture in Primary Health Care in Portugal. METHODS: We conducted a descriptive, analytical, and cross-sectional study using data from RN4CAST Portugal. The sample was composed of 1059 nurses from 55 Health Center Groups of the mainland Portugal, 15 Health Centers of the Autonomous Region of Madeira and 6 Health Centers of the Autonomous Region of the Azores. Multivariate analysis and correlation analysis methods were used for data processing. RESULTS: Nurses consider that, in the Portuguese Primary Health Care, there is a mixed and unfavourable nursing practice environment, with a perception of a good quality of care, and both acceptable patients' safety and safety culture. The Collegial Nurse-Physician Relations and Nursing Foundations for Quality of Care dimensions to have the best ratings. The perception of Primary Health Care nurses on the dimension Nurse Participation in Organization Affairs was the one that showed the lowest score, followed by Staffing and Resource Adequacy and Nurse Manager Ability, Leadership, and Support of Nurses. Based on perception of nurses, the relationship between the nursing practice environment and the safety culture is higher, followed by the quality of care and patients' safety. CONCLUSIONS: The perception of Primary Health Care nurses is that there is an unfavourable and mixed nursing practice environment, with good quality of care, and acceptable patient safety and safety culture. The quality of the nursing practice environments is associated to better quality and safety of care. Thus, improving the nursing practice environments in healthcare organizations is a low-cost organizational strategy to achieve greater patients and nurses' outcomes, improving the quality of nursing care to patients in the Primary Health Care units.

Evaluating the Methodological Approaches of Cross-Cultural Adaptation of the Bedside Handover Attitudes and Behaviours Questionnaire into Portuguese.

Nurse managers need culturally adapted assessment instruments to support the implementation of change to Nursing Bedside Handover (NBH) in healthcare institutions. This study aimed to cross-culturally adapt the Bedside Handover Attitudes and Behaviours (BHAB) questionnaire to the Portuguese context and evaluate the methodological approaches used for this purpose. To guide this study, we followed a guideline for cross-cultural translation and adaptation measurement instruments in healthcare. The results of the content validity testing suggested that the BHAB questionnaire is a valid instrument for use in the Portuguese context. To obtain these results we showed 1) using of a new methodological approach, the dual focus, to resolve the divergences and ambiguities in the translators' committee and the multi-professional committee; 2) the lack of a conceptual definition of the construct of the instrument as a requirement to retain items with I-CVI <0.70 after validity relevance pretesting and 3) the cognitive debriefing and relevance pretesting as methodological approaches which can be used alone or together to reinforce the evaluation of cultural relevance of the items. We concluded there is a need for guidelines to support the decision-making process of healthcare researchers with comprehensive information about the different methodological approaches they can follow.

The Nursing Practice Environment and Patients' Satisfaction with Nursing Care in a Hospital Context.

Nursing, being a profession in health, aims to improve the quality of the response to patients' demands, which have repercussions on the attitudes, behaviors and performance of nurses. BACKGROUND: The aim of the study was to evaluate the relationships among the nursing practice environment, nurse-patient interactions and patients' satisfaction with nursing care in a hospital context. METHODS: The study applied a descriptive analysis. Based on the initial exploration of the data, we decided to perform a simple linear regression of the dimensions of the scales. RESULTS: The latent variables and interactions between the different dimensions of the three constructs (the nursing practice environment (PES-NWI), nurse-patient interactions (NPIS-22-PT) and patients' satisfaction in the hospital context (SAPSNC-18)) were submitted to confirmatory analysis. The model was statistically significant, with a good fit with the data (χ2/gl = 128.6/41 (0.000); GFI = 0.900; AGFI = 0.831; TLI = 0.910; CFI = 0.907; RMSEA = 0.102). CONCLUSIONS: The study showed favorable rates of overall satisfaction on the part of patients, such as the nurses' skills in dealing with their illness/health situation, ability to solve problems in a timely manner, responsiveness to patients' needs and technical competence.

The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal's Long-Term Care Units.

BACKGROUND: The morbidity associated with ageing has contributed to an increase in the prevalence of Pressure Ulcers (PUs) in all care settings. The impact of these on people's quality of life and the extent of the associated economic and social burden constitutes today, by their importance, a serious public health problem. This study aims to describe the nursing work environment in Portuguese long-term care (LTC) units and to assess how this environment relates to the quality of PU care. METHODS: A longitudinal study among inpatients with PUs was conducted in LTC units. The Nursing Work Index-Revised Scale (NWI-R) was sent to all nurses in these units. Cox proportional hazard models were used to relate the satisfaction degree with the service (measured by the NWI-R-PT items) to the healing time of the PUs, adjusting for confounders. RESULTS: A total of 165 of 451 invited nurses completed the NWI-R-PT. Most were women (74.6%) and had 1 to 5 years of professional experience. Less than half (38.4%) had education in wound care. Of the 88 patients identified with PUs, only 63 had their PU documented, highlighting the difficulties in updating electronic records. The results showed that the level of concordance with Q28 "Floating so that staffing is equalised among units" is strongly associated with a shorter PU healing time. CONCLUSION: A good distribution of nursing staff over the units will likely improve the quality of wound care. We found no evidence for possible associations with the questions on participation in policy decisions, salary level, or staffing educational development and their relationship with PUs healing times.

Influencing Factors of Nurses' Practice during the Bedside Handover: A Qualitative Evidence Synthesis Protocol.

Nursing Bedside Handover (NBH) is acknowledged as a nursing practice implemented at the patient's bedside to improve communication safety during the shift change, but it is vulnerable due to inconsistent application among nurses. This synthesis of qualitative evidence aims to review and synthesize the perceptions and experiences of nurses regarding the factors that, in their perspective, influence NBH practice. We will follow the thematic synthesis methodology of Thomas and Harden and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) Statement guidelines. A search will be conducted through the databases of MEDLINE, CINAHL, Web of Science, and Scopus, and we will follow the three-step search process to identify primary studies with qualitative or mixed-method research designs and projects of quality improvement. The screening and selection of the studies will be carried out by two independent reviewers. We will use the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to report the screening, search, and selection of studies. To assess its methodological quality, two reviewers will independently use the CASM Tool. The extracted data will be reviewed, categorized, and summarized in tabular and narrative formats. The findings obtained will allow us to inform future research and change management led by nurse managers.

Turnover Intention and Organizational Commitment of Primary Healthcare Nurses.

Turnover intention is a predictor of the decision to leave an organization, which, if carried out, affects the quality of care provided. There is an association between turnover intention and organizational commitment. The more committed nurses are to the unit in which they work, the more committed they become to the unit's organizational goals; thus, they tend to continue working for the organization. Aiming to assess the turnover intention and the organizational commitment of nurses in primary healthcare, we conducted a quantitative, observational, descriptive, and cross-sectional study. The Intention of Turnover Scale and the Organizational Commitment Scale were applied in a sample of 297 nurses. Data were analyzed based on descriptive statistics. About 92.8% of the nurses intend to stay at their current workplace and only 7.3% plan to leave soon, suggesting low turnover intention; 84.5% of the nurses are willing to make an effort beyond what is normal to help their organization succeed, and 88.7% feel really interested in the destiny of the organization, which shows high organizational commitment. Pearson's Coefficient revealed the existence of a significant negative correlation between the factors "Intention to leave" and "Committed to the organization" (r = -0.51, p < 0.01). These findings suggest that, when nurses are more committed to their work and to the organization, they display less intention to leave, keeping the teams committed and motivated towards the organizational goals Our findings may guide nurse managers and policy-makers to develop strategies that retain nurses in organizations, keeping them motivated and engaged, and focusing on higher organizational commitment due to the influence it may have on the turnover intention.

Does Regular Exercise Impact the Lung Function of Healthy Children and Adolescents? A Systematic Review and Meta-Analysis.

PURPOSE: To assess the quality of the available evidence on the effect of exercise for the improvement of lung function in healthy children and adolescents. METHOD: We performed a systematic review and meta-analysis of intervention studies examining the effects of regular exercise on spirometric parameters of healthy children and adolescents aged ≤18 years. RESULTS: Within the exercise groups, there were significant improvements in forced vital capacity (mean difference: 0.17 L; 95% confidence interval, 0.07 to 0.26; P < .05) and forced expiratory volume in the first second (mean difference: 0.14 L; 95% confidence interval, 0.06 to 0.22; P < .05). Results were consistent across different age groups and duration of interventions. In the between-group analysis, forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow were higher in the exercise group compared with the nonexercise group, but the differences did not reach statistical relevance. There was significant statistical heterogeneity between studies. CONCLUSION: Regular exercise has the potential to improve lung function parameters in healthy children and adolescents; however, the small number of studies and the heterogeneity between them raise concern about the quality of the currently available evidence. These findings bring to attention the need for well-designed trials addressing this important public health issue.

Sociocultural differences in the development of obesity in adolescents in Murcia.

BACKGROUND: Childhood obesity presents alarming numbers in our country, being even higher in the population of immigrant origin. The main objective was to analyse the excess weight numbers both in native adolescents and in those children of immigrants and to determine the ethnic influence on lifestyle habits that could condition these differences in weight overload. METHODS: Adolescents from 1st year of Obligatory Secondary Education (E.S.O.) participated; somatometry was determined and classified according to BMI (with WHO references) and parental origin. Parents completed the survey on healthy habits (ENHASA). An analysis of variance was performed for each of the 4 dimensions of the questionnaire. RESULTS: A total of 416 adolescents participated (12.8±0.62 years). Excess weight was detected in 41.2% of the participants, with significant differences between groups (p 0.018): 36.7% in Spanish, 42.9% in North Africa and 58.2% in South America. The ANOVA analysis showed differences in the section "physical activity" (p 0.003), highlighting the maximum disparity in the performance of extracurricular sports activities, with a lower score in both non-native groups. CONCLUSION: We found significant differences according to ethnic origin in the number of overweight children and the amount of physical activity they do; South American adolescents are the most sedentary. We must design interventions that guarantee the access of all adolescents to sports activities to prevent the development of obesity.

Transcultural nursing leadership: A concept analysis.

Background: Globalisation, wars, competitiveness, and technological innovation have increased workplace diversity, requiring leaders to conduct multinational projects, lead people from different cultural backgrounds, and deliver appropriate services that meet the needs of clients from different cultures. Several concepts are interchangeably used to define and describe leadership in culturally-diverse work environments; one such concept is transcultural leadership. Because of nurses' global migration and care delivery to patients from different cultural backgrounds, this concept is of interest in the nursing field. While some nurses have been identified as transcultural leaders, no definition of transcultural nursing leadership has been found in the literature. Objective: This study aimed to develop an operational definition of transcultural nursing leadership. Design: A concept analysis was performed using Walker and Avant's method. Methods: A literature search was conducted using electronic databases, including CINAHL and MEDLINE, books, and encyclopaedias. Quantitative, qualitative, mixed- design studies and literature reviews; master's and doctoral theses; interviews; and text and opinion papers published in English, Spanish, or Portuguese that focused on leadership in multicultural work environments overall and in nursing in particular were included. To identify differences and similarities between the concepts, a Correspondence Factor Analysis with the support of the software IRaMuTeQ was undertaken. Results: A total of 45 documents with definitions or descriptions of the concepts was included, of which five were in the nursing area and 40 in other areas of study. The defining attribute of transcultural nursing leadership is guiding the delivery of culturally-congruent care. Its antecedents were culturally-diverse populations, multicultural nursing teams, and the need to prepare healthcare workers, administrators, academics, professors, researchers, and minorities for transcultural nursing. The consequences identified included culturally-congruent care for patients and optimal health outcomes for all populations. The identified attributes, antecedents, and consequences did not cover the complexity of a culturally-diverse nursing work environment. Thus, the antecedents, attributes, and consequences of transcultural leadership identified in the literature were considered and added. Conclusions: Transcultural nursing leadership is a concept grounded in nursing theory that has significant implications for nursing management, education, research, and policy. This holds great promise for advancing culturally-congruent care, addressing health disparities, and building highly inclusive and productive nursing teams in an increasingly diverse world.

Translation and Validation of the Individual Workload Perception Scale-Revised for Portuguese Nurses.

(1) Background: In Portugal, there is no scale to assess nurses' satisfaction with their workload. Therefore, this study aimed to culturally/linguistically adapt and validate the IWPS-R scale, with 29 items, to produce a Portuguese version. (2) Methods: A quantitative, descriptive and cross-sectional study was conducted in two phases: translation and adaptation of the IWPS-R into Portuguese, following the steps recommended by Beaton; and evaluation of its psychometric properties in a non-probability sample of 323 nurses working in a hospital centre of reference in Portugal. (3) Results: The final scale obtained a total explained variance of 62.3% and a KMO of 0.88. The reliability was assured through the determination of an internal consistency of 0.88. The construct validity was determined through confirmatory factor analysis. The factorial model presented a good quality fit (X2/df = 2.118; CFI = 0.925; GFI = 0.900; RMSEA = 0.059; p (RMSEA ≤ 0.05) = 0.041; RMR = 0.078; MECVI = 1.525; SRMR = 0.0631) with five factors. (4) Conclusions: The Individual Workload Perception Scale-Revised-Portuguese version (IWPS-R-PT) is a 21-item tool with five dimensions: Nurse Manager Support, Team Support, Workload, Organizational Resources and Intent to Stay. The IWPS-R-PT was found suitable for hospital-based nurses and may be useful in other settings where nurses work.

Importancia y rendimiento de los hábitos implicados en el desarrollo de exceso de peso según género / Importance and performance of habits involved in the development of excess weight according to gender

Introducción: la obesidad afecta cada vez más a los adolescentes. La clave de la prevención sigue siendo el control de los factores de riesgo modificables. El objetivo fue realizar un análisis mediante mapas de importancia-rendimiento de las principales conductas que condicionan la aparición de exceso de peso en adolescentes en función del género, una técnica estadística que representa gráficamente la importancia y el rendimiento de cada uno de los factores involucrados en el desarrollo del exceso de peso. Material y métodos: se administró un cuestionario sobre hábitos saludables (ENHASA) a padres de adolescentes de 12-14 años de Murcia (España). Posteriormente, fueron clasificados según estado ponderal siguiendo los criterios de la Organización Mundial de la Salud (OMS). Se realizaron un análisis multivariante y mapas de importancia-rendimiento según género. Resultados: participaron 416 adolescentes, detectándose un 40,6% de exceso de peso, sin diferencias significativas por género. El análisis mostró un R2 de 0,123 en adolescentes hombres y de 0,156 en adolescentes mujeres. Se reveló la falta de actividad física como el factor más importante para el desarrollo de exceso de peso en los adolescentes hombres, aunque los hábitos con mayor capacidad de mejora en ellos fueron los relacionados con el uso de televisión y horas de pantalla. En las adolescentes mujeres, lo más condicionante fue el ambiente socioescolar, siendo también los hábitos con menor rendimiento los relacionados con el uso de pantallas. Conclusiones: existen diferencias de género en los hábitos que condicionan el exceso de peso. Se debería tener en cuenta una perspectiva de género a la hora de diseñar nuevas estrategias de prevención (AU)

Introduction: obesity affects more adolescents every day. The key to prevention remains the control of modifiable risk factors. The objective of the work was to carry out an analysis using importance-performance maps of the main behaviors that condition the appearance of excess weight in adolescents according to gender. An statistical technique that draws on a map the importance and performance of each of the risk factors involved in the development of excess weight.Material and methods: we collected information from 416 adolescents between 12 and 14 years of age in Murcia (Spain) using the ENHASA healthy habits questionnaire. Later, we determined their somatometry and they were classified following the criteria of the World Health Organization (WHO). A multivariate analysis and importance-performance maps according to gender were performed.Results: 416 adolescents participated. We obtained 40,6% excess weight without significant differences by sex. The analysis showed an R2 of 0,123 in boys and 0,156 in girls. Lack of physical activity revealed as the most important factor for the development of excess weight in boys, although the habits with the greatest capacity for improvement were those related to the use of television and screen time. In girls, the most determining dimension was the socio-school environment; and the habits with the lowest performance were also those related to the use of screens.Conclusions: there are gender differences in the habits that determine overweight and obesity. It is important to take gender perspective into account when designing new more efficient prevention. (AU)

International Portuguese Nurse Leaders' Insights for Multicultural Nursing.

Cultural diversity among patients and healthcare workers in the Portuguese healthcare organizations will increasingly challenge nurse managers to develop favorable nursing work environments and to improve culturally congruent care. AIM: This study aimed to identify nurse managers' interventions that improve favorable nursing work environments in multicultural nursing teams and culturally congruent care for patients, based on Portuguese nurse leaders' experience in international settings. METHODS: A qualitative and exploratory study was conducted as the first stage of a sequential exploratory mixed study design. A convenience sample of Portuguese nurses with leadership experience of multicultural teams was recruited to participate in one focus group. Qualitative data were recorded and transcribed for content analysis. Text segments were organized into themes and categories with the support of the qualitative software IRaMuTeQ. RESULTS: Nurse managers' interventions, such as adapting the leadership style, thanking nurses for their work, adjusting the unit to attend to patients' worship practices, and supporting foreign nurses in learning the local language, were categorized into three main themes and five categories-transcultural nursing leadership assumptions, capitalizing nurses, improving culturally congruent care, team problems and strategies, and improving effective communication. CONCLUSIONS: These findings corroborate international studies, advocate for capable nurse managers to lead in a globalized world, and are suitable to develop a transcultural nursing leadership questionnaire.

Translation and Validation of the Indicators of Quality Nursing Work Environments in the Portuguese Cultural Context.

The Indicators of Quality Nursing Work Environment scale (IQN-WE) with 65 items, developed by Chiou-Fen Lin, Meei-Shiow Lu, and Hsiu-Ying Huang in 2016, aimed to create a set of quality indicators of the nursing work environment. The translation and validation for the Portuguese cultural context of the IQN-WE scale was performed in this study. OBJECTIVES: culturally and linguistically adapt the IQN-WE scale, originating from the Portuguese version, and evaluate its psychometric characteristics. METHODS: it is a descriptive, cross-sectional, observational and quantitative study. The IQN-WE scale was validated in a sample of 542 nurses belonging to a hospital center in Portugal. The study obtained a response of 21.69%, of whom 78.0% were women and 22% men. The mean age of the sample was 39 years and a standard deviation of 8.1 years. All nurses who work have a bachelor's degree, and 13.5% have a master's degree. RESULTS: the study obtained an instrument with a total explained variance of 52.67% and KMO = 0.843. It found a strong-to-moderate linear correlation matrix between the dimensions. The pre-test and the team of experts ensured the content validity. The determination of internal consistency guaranteed reliability, with 0.95. Confirmatory factor analysis validated the construct. The factorial model presented a goodness of fit index, with five factors. CONCLUSION: the study achieved an instrument with 50 items in five dimensions: Team Support and Professional Development; Team Organization and Management; Safe Nursing Work Environment; Information Systems and Risk Control; Salary and Welfare. The IQN-WE-PT scale proved to be an appropriate instrument to be applied in health organizations in Portugal.

Perfil clínico-epidemiológico dos pacientes em cuidados paliativos atendidos em um serviço de urgência geral / The clinical-epidemiological profile of patients in palliative care treated in an general emergency service

Os pacientes em cuidados paliativos procuram o pronto-socorro para alívio imediato da dor ou de outros sintomas físicos. Os profissionais que atuam em serviços de urgência são treinados para prestar cuidados focados no tratamento direcionado a doenças agudas, mas podem fornecer intervenções paliativas para gerenciar as exacerbações de doenças crônicas ou os cuidados próximos ao fim da vida. Conhecer o perfil dos pacientes em cuidados paliativos atendidos em serviço de urgência e emergência é imprescindível para implementação de medidas que melhorem a qualidade do atendimento deste grupo de pacientes e otimizem o serviço prestado. O objetivo do estudo é descrever o perfil clínico-epidemiológico dos pacientes em cuidados paliativos atendidos no pronto-socorro. Foi realizado um estudo transversal, observacional e retrospectivo, de pacientes adultos de ambos os sexos, em cuidados paliativos atendidos em uma unidade de pronto atendimento ­ UPA, num período de dez meses. O estudo teve aprovação do Comitê de Ética e Pesquisa. Foram analisados 83 pacientes com média de idade de 78,5 (±14,3) anos. Houve predominância do sexo feminino (61,4%). A maioria era procedente do domicílio (87,9%). Havia a presença de cuidador em 91.57% dos casos, predominando o cuidador familiar não-remunerado (76,3%). Sobre atendimento prévio, 44,58% haviam procurado o pronto-socorro no último mês. Quanto à doença de base, 31,3% era oncológica e 68,6% não-oncológica. O câncer de próstata representou a principal causa oncológica (30,7%), seguido de neoplasia hepática e das vias biliares (15,4%). Nos casos não-oncológicos, foi mais frequente a síndrome de fragilidade (42,10%) e sequela grave de acidente vascular cerebral (17,5%). O principal sintoma foi a dispneia em 38 pacientes (45,7%). A dor e a dispneia foram mais frequentes nos casos oncológicos (34,6% e 23,0%, respectivamente), seguidos de dispneia e delirium nos casos não-oncológicos (56,1% e 28,0%, respectivamente). No presente estudo, predominou a faixa etária idosa em cuidados paliativos com cuidador presente com maior frequência de doença de base não-oncológica, dispneia, dor e delirium (AU)

Patients seek emergency rooms for immediate relief from pain or other physical symptoms. Professionals in emergency rooms are trained to render focused care in the targeted treatment of acute diseases and provide palliative interventions to manage exacerbations of chronic illnesses or end-of-life care to patients under palliative care. Knowing the patient's profile for palliative care in the emergency room can be helpful for implementing targeted measures to provide better patient care. This study aims to describe the clinical-epidemiological profile on patients in palliative care treated in an emergency room. A transversal, observational, and retrospective study was carried out of adult patients of both sexes in palliative care treated at Unidade de Pronto Atendimento -UPA over ten months. Data were collected about admission, type of caregiver, pathology, and outcomes. The study was approved by the Research and Ethics Committee. In total, 83 patients with a mean age of 78.5 (±14.3) were analyzed. There was a predominance of female patients (61.4%), and most came from a residence (87.9%). Further, 91.57% had caregivers, predominantly unpaid family caregivers (76.3%). Regarding previous care, 44.58% had sought palliative care less than one month ago. As the base disease, 68.6% were oncological and 31.3% non-oncological. Prostate cancer constituted the primary oncological cause (30.7%), followed by hepatic neoplasia and bile ducts (15.4%). Fragility syndrome (42.10%) and severe complications after a stroke (17.5%) were more frequent in non-oncological base cases. The main symptom was dyspnea noted in 38 patients (45.7%). Pain and dyspnea were more frequent in oncological cases (34.6% and 23.0%, respectively), followed by dyspnea and delirium in non-oncological cases (56.1% and 28.0%, respectively). In the present study, predominantly older patients with a caregiver demonstrated a more significant frequency of non-oncological base disease, dyspnea, pain, and delirium (AU)

Translation, Adaptation, and Validation of the Self-Efficacy Scale for Clinical Nurse Leaders for the Portuguese Culture.

Studies related to the competencies of clinical nurse leaders as an advanced practice demonstrate that they are an asset to health organizations. However, it is pertinent to use an instrument to measure the self-efficacy of clinical nurse leaders in Portugal to facilitate managers' decision-making. In this study, we aimed to translate, adapt, and validate the Clinical Nurse Leader Self-Efficacy Scale for the Portuguese cultural context. This is a quantitative, observational, and descriptive cross-sectional study. The sample of this study was non-probabilistic and intentional, consisting of 329 nurses responsible for shift and specialist nurses. The translation and validation process followed the internationally recognized guidelines on the psychometric properties of measurement instruments. The factor analysis explained 62.1% of the variance and had a seven-dimensional structure. The seven factors were: Patient-Centred Care; Unit Management; Clinical Leadership; Strategic Leadership; Team Management; Cost Reduction; and Care Planning. The confirmatory analysis showed that the seven-factor model achieved a suitable adjustment in the Portuguese context. The self-efficacy scale for clinical nurse leaders can be considered a valid and reliable instrument for application in Portugal in any care context. This scale allows the assessment of the nurse's perception of their ability to intervene effectively as a clinical leader in their care team.

Validation of Psychometric Properties of the Nursing Work Index-Revised Scale in Portugal.

The use of instruments designed to assess the nursing practice environment is crucial to improve the quality of nursing care, to anticipate problems and difficulties that may arise in organizations, and allow nurse managers to implement changes and improvements in key areas. In this study, we aimed to evaluate the psychometric properties of the Nursing Work Index-Revised Portuguese version (NWI-R-PT) scale. A quantitative, observational, descriptive, and cross-sectional study was conducted. METHODS: The sample consisted of 767 nurses from 4 public Portuguese hospitals. Exploratory and confirmatory factor analysis techniques were used to test the distinct structural models. The scale's accuracy was evaluated through internal consistency, using Cronbach's alpha. RESULTS: NWI-R-PT internal consistency was 0.91. The NWI-R-PT model with six factors, namely "Management Support," "Professional Development," "Fundamentals of Nursing," "Nurse-Physician Relationship," "Endowments," and "Organization of Nursing Care," was supported by exploratory and confirmatory factor analysis. The NWI-R-PT scale presents adequate goodness-of-fit indices concerning the final factorial model and the convergent validity. CONCLUSIONS: The NWI-R-PT scale has a competent and reliable structure. The scale's validity is confirmed; therefore, it may be employed in all contexts in clinical practice, research, and nursing management. The NWI-R-PT is a useful and valid instrument to assess the nursing environment in hospitals, primary care, long-term care, and nursing homes. The scale has significance in improving the quality of nursing care and patient safety, the professional development of nurses, and organizational results.