Access, access, access: the Three A's of pulmonary rehabilitation - perspectives of patients, loved ones and healthcare professionals.

Efforts need to be made to increase access to pulmonary rehabilitation as early as possible, prioritising those who are more symptomatic and have functional status limitations, and improving communication within and among healthcare services https://bit.ly/3LMcLcU.

Long-Term Maintenance Strategies after Pulmonary Rehabilitation: Perspectives of People with Chronic Respiratory Diseases, Informal Carers, and Healthcare Professionals.

Pulmonary rehabilitation (PR) is an effective intervention for people with chronic respiratory diseases (CRD); however, its effects fade after 6-12 months. Community-based strategies might be valuable to sustain PR benefits, but this has been little explored. People with CRD, informal carers, and healthcare professionals (HCPs) were recruited from pulmonology appointments of two local hospitals, two primary care centres, and one community institutional practice and through snowballing technique. Focus groups were conducted using a semi-structured guide. Data were thematically analysed. Twenty-nine people with CRD (24% female, median 69 years), 5 informal carers (100% female, median 69 years), and 16 HCPs (75% female, median 36 years) were included. Three themes were identified: "Maintaining an independent and active lifestyle" which revealed common strategies adopted by people with "intrinsic motivation and professional and peer support" as key elements to maintain benefits, and that "access to information and partnerships with city councils' physical activities" were necessary future steps to sustain active lifestyles. This study suggests that motivation, and professional and peer support are key elements to maintaining the benefits of PR in people with CRD, and that different physical activity options (independent or group activities) considering peoples' preferences, should be available through partnerships with the community, namely city councils.

An Intervention Program Based on Regular Home Visits for Improving Maternal Breastfeeding Self-efficacy: A Pilot Study in Portugal.

BACKGROUND: In this pilot study, the breastfeed care plus intervention program was implemented to support women and their families in breastfeeding success. Primary interests were women's self-efficacy in breastfeeding and exclusive breastfeeding. METHODS: A pilot study was developed in the region of Aveiro-Portugal in two Family Health Units. The experimental and control groups consisted of sixteen women each, initially. Four home visits with assessment and guidance focused on breastfeeding support aimed at women and families were delivered in the experimental group, while the control group received conventional care. Both groups were followed between the 5th and the 120th day postpartum and were subjected to three evaluation moments. RESULTS: On the 120th day postpartum, eleven women completed the BCP intervention program (three women stopped breastfeeding), and nine women received conventional care (seven women stopped breastfeeding). Both interventions proved to be effective in improving the 'perception of breastfeeding self-efficacy,' with higher scores being found in the experimental group (p < 0.001). The proportion of exclusive breastfeeding was also higher in the experimental group. CONCLUSIONS FOR PRACTICE: The BCP intervention program, during the first 120 days postpartum, showed promissory results in improving 'perception of breastfeeding self-efficacy' compared to conventional care, favoring breastfeeding duration and exclusivity, and cumulative breastfeeding competence of women/families.

Non-technical skills in nursing education: effectiveness of a high-fidelity simulation-based course / Competências não-instrumentais no ensino de estudantes de enfermagem: eficácia de um programa em contexto de simulação de alta-fidelidade

Literature refers that patients are commonly affected by preventable adverse events associated with non-technical skills failures. Non-technical skills training programs address to prepare for, respond to, and mitigate adverse events in healthcare. This study took place at Center for Clinical Simulation of Aveiro University. Third year prelicensure nursing students were included in two groups: control group (N=27), and experimental group (N=20, who participated in the training course developed, focusing on non-technical skills and crisis resource management acting principles). The study was divided in two different moments, before the implementation of the course, and after the implementation of the course. The course was then divided in three sessions: one four-hour theoretical session; and two three-hour practical sessions, each including two high-fidelity simulation-based different scenarios, four in total.Regarding non-technical skills, we found significant differences in the experimental group in eleven items after intervention. As per participants' self-confidence levels, those who participated seem to have significantly increased confidence in their skills. Regarding social-demographic variables, it seems that students from primary healthcare tend to present better non-technical skills than students from maternal health specialty. Overall these results seem to suggest that the course developed was effective in increasing students' knowledge and awareness on non-technical skills. It was demonstrated that the development and application of the structured course is feasible and positive changes in behavior can be measured through the instru-ments developed. Then, consideration must be given in integrating non-technical skills training into nursing education

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The Influence of Presurgical Factors on the Rehabilitation Outcome of Patients Following Hip Arthroplasty.

PURPOSE: The aims of this study were to evaluate the relationship between sociodemographic information, anthropometric values, clinical and presurgery factors, and length of stay (LOS) in older adult patients undergoing total hip arthroplasty (THA) and to predict which factors can delay the start of the rehabilitation program and increase the corresponding LOS. METHODS: A prospective cohort study was conducted in an orthopedic inpatient unit with 40 patients undergoing THA. FINDINGS: The Morse Fall Scale scores and pain intensity scores delayed the commencement of the rehabilitation program. Gender and social support were important determinants of LOS and rehabilitation outcome following THA. The weight of the lower limb without osteoarthritis followed by pain intensity and overweight patients also influenced LOS. CONCLUSIONS/CLINICAL RELEVANCE: Functional outcomes after THA are variable, and the rehabilitation process is an important factor to regain their normal level of physical functioning. This factor can have an impact in the discharge of patients, in resource allocation and in health care of older adult patients.

Pressure ulcer (risk) assessment: recommendations to improve nursing practice

Pressure ulcer (risk) assessment is complex and multifactorial. National and inter-national guidelines give orientations about pressure ulcer (PU) management and provide important recommendations. However, it's necessary to know our reality in order to improve Evidence-Based Nursing. The main aim of this study was to pro-vide some recommendations to improve clinical practice, clinical research, clinical management and continuous education on PU domain. The study was designed as a retrospective cohort analysis of electronic health record database from adult patients admitted to general wards in a Portuguese hospital during one year. The study had a sample of 8147 participants where 34.4% had "high risk" of PU deve-lopment at the first PU risk assessment, 7.9% had (at least) one PU at the first skin and tissue assessment and 3.4% developed (at least) one PU during the length of inpatient stay. (Im)"mobility" was the major risk factor assessed through Braden Scale for PU development. The systematic PU risk assessment: is sensitive to patient clinical changes; should be performed since the hospital admission; and should be used in combination with nursing clinical judgement. The systematic skin and tissue assessment: identifies early changes in skin and tissue condition; should be performed since the hospital admission; and should identify wounds of different aetiologies. The PU assessment could be improved with the implementation of a validated tool in order to standardised data record, to monitor PU/wounds charac-teristics and their evolution

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Non-technical skills assessment scale in nursing: construction, development and validation1.

OBJECTIVES: The introduction of non-technical skills during nursing education is crucial to prepare nurses for the clinical context and increase patient safety. We found no instrument developed for this purpose. to construct, develop and validate a non-technical skills assessment scale in nursing. METHOD: methodological research. Based on the literature review and experience of researchers on non-technical skills in healthcare and the knowledge of the principles of crisis resource management, a list of 63 items with a five-point Likert scale was constructed. The scale was applied to 177 nursing undergraduate students. Descriptive statistics, correlations, internal consistency analysis and exploratory factor analysis were performed to evaluate the psychometric properties of the scale. RESULTS: scale items presented similar values for mean and median. The maximum and the minimum values presented a good distribution amongst all response options. Most items presented a significant and positive relationship. Cronbach alpha presented a good value (0.94), and most correlations were significant and positive. Exploratory factor analysis using the Kaiser-Meyer-Olkin test showed a value of 0.849, and the Bartlett's test showed adequate sphericity values (χ2=6483.998; p=0.000). One-factor model explained 26% of the total variance. CONCLUSION: non-technical skills training and its measurement could be included in undergraduate or postgraduate courses in healthcare professions, or even be used to ascertain needs and improvements in healthcare contexts.

Pressure ulcer incidence and Braden subscales: Retrospective cohort analysis in general wards of a Portuguese hospital.

AIM: To study the influence of Braden subscales scores (at the first pressure ulcer risk assessment) on pressure ulcer incidence using a univariate and a multivariate time to event analysis. MATERIALS AND METHODS: Retrospective cohort analysis of electronic health record database from adult patients admitted without pressure ulcer(s) to medical and surgical wards of a Portuguese hospital during 2012. The hazard ratio of developing a pressure ulcer during the length of inpatient stay was calculated by univariate Cox regression for each variable of interest and by multivariate Cox regression for the Braden subscales that were statistically significant. RESULTS: This study included a sample of 6552 participants. During the length of stay, 153 participants developed (at least) one pressure ulcer, giving a pressure ulcer incidence of 2.3%. The univariate time to event analysis showed that all Braden subscales, except "nutrition", were associated with the development of pressure ulcer. By multivariate analysis the scores for "mobility" and "activity" were independently predictive of the development of pressure ulcer(s) for all participants. CONCLUSION: (Im)"mobility" (the lack of ability to change and control body position) and (in)"activity" (the limited degree of physical activity) were the major risk factors assessed by Braden Scale for pressure ulcer development during the length of inpatient stay. Thus, the greatest efforts in managing pressure ulcer risk should be on "mobility" and "activity", independently of the total Braden Scale score.

Non-technical skills assessment scale in nursing: construction, development and validation / Escala de avaliação de habilidades não técnicas em enfermagem: construção, desenvolvimento e validação / Escala de evaluación de habilidades no técnicas en enfermería: construcción, desarrollo y validación

ABSTRACT The introduction of non-technical skills during nursing education is crucial to prepare nurses for the clinical context and increase patient safety. We found no instrument developed for this purpose. Objectives: to construct, develop and validate a non-technical skills assessment scale in nursing. Method: methodological research. Based on the literature review and experience of researchers on non-technical skills in healthcare and the knowledge of the principles of crisis resource management, a list of 63 items with a five-point Likert scale was constructed. The scale was applied to 177 nursing undergraduate students. Descriptive statistics, correlations, internal consistency analysis and exploratory factor analysis were performed to evaluate the psychometric properties of the scale. Results: scale items presented similar values for mean and median. The maximum and the minimum values presented a good distribution amongst all response options. Most items presented a significant and positive relationship. Cronbach alpha presented a good value (0.94), and most correlations were significant and positive. Exploratory factor analysis using the Kaiser-Meyer-Olkin test showed a value of 0.849, and the Bartlett's test showed adequate sphericity values (χ2=6483.998; p=0.000). One-factor model explained 26% of the total variance. Conclusion: non-technical skills training and its measurement could be included in undergraduate or postgraduate courses in healthcare professions, or even be used to ascertain needs and improvements in healthcare contexts.

RESUMO A introdução de habilidades não técnicas durante o ensino de enfermagem é fundamental para preparar os enfermeiros para o contexto clínico e aumentar a segurança do paciente. Não foram encontrados quaisquer instrumentos desenvolvidos para essa finalidade. Objetivos: construir, desenvolver e validar uma escala de avaliação de habilidades não técnicas em enfermagem. Método: pesquisa metodológica. Com base na revisão da literatura e na experiência dos pesquisadores em habilidades não técnicas em saúde, e no conhecimento dos princípios do gerenciamento de recursos em crises, foi construída uma lista de 63 itens e com uma escala Likert de cinco pontos. A escala foi aplicada em 177 estudantes de graduação em enfermagem. Estatística descritiva, correlações, análises de consistência interna e análise fatorial exploratória foram realizadas para avaliar as propriedades psicométricas da escala. Resultados: os itens da escala apresentaram valores semelhantes para média e mediana. Os valores máximo e mínimo mostraram uma boa distribuição em todas as opções de resposta. A maioria dos itens apresentou uma relação significativa e positiva. O alfa de Cronbach apresentou um bom valor (0,94) e a maioria das correlações foi significativa e positiva. A análise fatorial exploratória através do teste de Kaiser-Meyer-Olkin apresentou um valor de 0,849, e o teste de Bartlett apresentou valores de esfericidade adequados (χ2=6483.998; p=0.000). O modelo de um fator explicou 26% da variância total. Conclusão: a formação em habilidades não técnicas e sua mensuração poderiam ser incluídos nos programas de graduação ou pós-graduação de profissões da saúde, ou até mesmo serem utilizadas para avaliar as necessidades e melhorias nos contextos de cuidados de saúde.

RESUMEN La introducción de habilidades no técnicas durante la educación de enfermería es fundamental para preparar a los enfermeros para el contexto clínico y aumentar la seguridad del paciente. No se encontraron instrumentos desarrollados para este propósito. Objetivos: construir, desarrollar y validar una escala de evaluación de habilidades no técnicas en enfermería. Método: investigación metodológica. Con base en la revisión de la literatura y la experiencia de los investigadores en habilidades no técnicas en el cuidado de la salud y el conocimiento de los principios del manejo de recursos en crisis, se construyó una lista de 63 ítems y con una escala Likert de cinco puntos. Se aplicó la escala a 177 estudiantes de pregrado en enfermería. Se realizaron estadísticas descriptivas, correlaciones, análisis de consistencia interna y análisis factorial exploratorio para evaluar las propiedades psicométricas de la escala. Resultados: los ítems de la escala presentaron valores similares para la media y la mediana. Los valores máximo y mínimo mostraron una buena distribución en todas las opciones de respuesta. La mayoría de los ítems presentaron una relación significativa y positiva. El alfa de Cronbach presentó un buen valor (0,94), y la mayoría de las correlaciones fueron significativas y positivas. El análisis factorial exploratorio mediante la prueba Kaiser-Meyer-Olkin mostró un valor de 0,849, y la prueba de Bartlett mostró valores de esfericidad adecuados (χ2=6483.998; p=0,000). El modelo de un factor explicó el 26% de la varianza total. Conclusión: la capacitación en habilidades no técnicas y su medición podrían incluirse en programas de grado y posgrado en profesiones de la salud, o incluso utilizarse para evaluar las necesidades y mejoras en los contextos de atención médica.

Effects of resistance exercise on endothelial progenitor cell mobilization in women.

This study aimed to determine the effect of a single bout of resistance exercise at different intensities on the mobilization of circulating EPCs over 24 hours in women. In addition, the angiogenic factors stromal cell-derived factor 1 (SDF-1α), vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1-alpha (HIF-1α) and erythropoietin (EPO) were measured as potential mechanisms for exercise-induced EPCs mobilization. Thirty-eight women performed a resistance exercise session at an intensity of 60% (n = 13), 70% (n = 12) or 80% (n = 13) of one repetition maximum. Each session was comprised of three sets of 12 repetitions of four exercises: bench press, dumbbell curl, dumbbell squat, and standing dumbbell upright row. Blood was sampled at baseline and immediately, 6 hours, and 24 hours post-exercise. Circulating EPC and levels of VEGF, HIF-1α and EPO were significantly higher after exercise (P < 0.05). The change in EPCs from baseline was greatest in the 80% group (P < 0.05), reaching the highest at 6 hours post-exercise. The change in EPCs from baseline to 6 hours post-exercise was correlated with the change in VEGF (r = 0.492, P = 0.002) and HIF-1α (r = 0.388, P = 0.016). In general, a dose-response relationship was observed, with the highest exercise intensities promoting the highest increases in EPCs and angiogenic factors.

Vivência do professor no cotidiano da criança com estomia: abordagem da Fenomenologia Social / Experience of teachers in the daily life of a child with stoma: a Social Phenomenology approach

Este estudo procurou compreender a vivência de professores no processo de inclusão de crianças com estomia, tendo como referencial a Fenomenologia Sociológica. Foram realizadas entrevistas, com cinco professores, no período entre dezembro de 2015 e janeiro de 2016. A coleta de dados foi efetuada por narração do professor, posterior transcrição e análise dos dados. Emergiram quatro categorias temáticas: sentimentos vividos pelos professores; fatores que interferem nos cuidados; estratégias eficazes para o cuidado; estratégias para melhoria dos cuidados. Os professores, valorizaram a integração da criança com estomia na escola; consideram que esta ocorre com a modificação da formação pedagógica; e apontaram a necessidade da presença do enfermeiro nas escolas. Os resultados mostram a importância do desenvolvimento de ações e estratégias de apoio aos professores e aos alunos com estomia no contexto de uma escola inclusiva, considerando que o enfermeiro escolar é determinante para a promoção em saúde destas crianças.

This study has sought to understand the experience of teachers in the process of inclusion of children with stoma, being Sociological Phenomenology the reference. Interviews were conducted with five teachers between December 2015 and January 2016. Data collection was carried out from the narration of teachers, with later transcription and data analysis. Four thematic categories emerged: feelings experienced by teachers, factors that interfere with care, effective strategies for care, and strategies to improve care. The teachers valued the integration of the child with stoma in the school; they consider that this happens with the modification of the pedagogical formation, and they also pointed out the need for the presence of nurses in schools. The results show the importance of the development of actions and strategies to support teachers and students with stoma in the context of an inclusive school, considering that the school nurse is a determining factor for the health promotion of these children.

Non-technical skills assessment for prelicensure nursing students: An integrative review.

BACKGROUND: In nursing, non-technical skills are recognized as playing an important role to increase patient safety and successful clinical outcomes (Pearson and McLafferty, 2011). Non-technical skills are cognitive and social resource skills that complement technical skills and contribute to safe and efficient task performance (Flin et al., 2008). In order to effectively provide non-technical skills training, it is essential to have an instrument to measure these skills. METHODOLOGY: An online search was conducted. Articles were selected if they referred to and/or described instruments assessing non-technical skills for nurses and/or prelicensure nursing students in educational, clinical and/or simulated settings with validation evidence (inclusion criteria). RESULTS: Of the 53 articles located, 26 met the inclusion criteria. Those referred to and/or described 16 instruments with validation evidence developed to assess non-technical skills in multidisciplinary teams including nurses. CONCLUSION: Although articles have shown 16 valid and reliable instruments, to our knowledge, no instrument has been published or developed and validated for the assessment of non-technical skills of only nurses in general, relevant for use in high-fidelity simulation-based training for prelicensure nursing students. Therefore, there is a need for the development of such an instrument.

Analyses of pressure ulcer incidence in inpatient setting in a Portuguese hospital.

AIM: To gain more insight into the magnitude of the problem of pressure ulcer incidence in general wards of a Portuguese hospital. MATERIAL AND METHODS: Retrospective cohort analysis of electronic health record database from 7132 adult patients admitted to medical and surgical wards of Aveiro Hospital during 2012. The development of (at least) one pressure ulcer during the length of stay was associated with age, gender, type of admission, specialty units, first Braden Scale score, length of stay, patient discharge outcome and ICD-9 diagnosis. RESULTS: An incidence of 3.4% participants with pressure ulcer category I-IV in inpatient setting during 2012. During the length of stay, 320 new pressure ulcers were developed, most of them category/stage II. The sacrum/coccyx and the trochanters were the most problematic areas. CONCLUSIONS: The major risk factor for the development of a new pressure ulcer during the length of stay was the presence of (at least) one pressure ulcer at the first skin assessment. The length of stay itself, age and lower Braden Scale scores of our participants also played an important role in the odds of developing a pressure ulcer. Infectious diseases, traumatism and fractures and respiratory diseases were the ICD-9 diagnoses with higher frequency of participants that developed (at least) one pressure ulcer during the length of stay. It's important to standardize procedures and documentation in all care settings. The documentation of nursing interventions is vital to evaluate the impact of evidence-based nursing.

Fall risk assessment: retrospective analysis of Morse Fall Scale scores in Portuguese hospitalized adult patients.

PURPOSE: The Morse Fall Scale is used in several care settings for fall risk assessment and supports the implementation of preventive nursing interventions. Our work aims to analyze the Morse Fall Scale scores of Portuguese hospitalized adult patients in association with their characteristics, diagnoses and length of stay. METHODS: Retrospective cohort analysis of Morse Fall Scale scores of 8356 patients hospitalized during 2012. Data were associated to age, gender, type of admission, specialty units, length of stay, patient discharge, and ICD-9 diagnosis. RESULTS: Elderly patients, female, with emergency service admission, at medical units and/or with longer length of stays were more frequently included in the risk group for falls. ICD-9 diagnosis may also be an important risk factor. CONCLUSIONS: More than a half of hospitalized patients had "medium" to "high" risk of falling during the length of stay, which determines the implementation and maintenance of protocoled preventive nursing interventions throughout hospitalization. There are several fall risk factors not assessed by Morse Fall Scale. There were no statistical differences in Morse Fall Scale score between the first and the last assessment.

Analyses of pressure ulcer point prevalence at the first skin assessment in a Portuguese hospital.

AIM: To analyze the first pressure ulcer risk and skin assessment records of hospitalized adult patients in medical and surgical areas of Aveiro Hospital during 2012 in association with their demographic and clinical characteristics. MATERIAL AND METHODS: Retrospective cohort analysis of electronic health record database from 7132 adult patients admitted to medical and surgical areas in a Portuguese hospital during 2012. The presence of (at least) one pressure ulcer at the first skin assessment in inpatient setting was associated with age, gender, type of admission, specialty units, length of stay, patient discharge and ICD-9 diagnosis. RESULTS: Point prevalence of participants with pressure ulcer category/stage I-IV of 7.9% at the first skin assessment in inpatient setting. A total of 1455 pressure ulcers were documented, most of them category/stage I. The heels and the sacrum/coccyx were the most problematic areas. Participants with pressure ulcer commonly had two or more pressure ulcers. CONCLUSIONS: The point prevalence of participants with pressure ulcer of our study was similar international literature. The presence of a pressure ulcer at the first skin assessment could be an important measure of frailty and the participants with pressure ulcer commonly had more than one documented pressure ulcer. Advanced age or lower Braden Scale scores or Emergency Service admission were relevant variables for the presence of (at least) one pressure ulcer at the first skin assessment in inpatient setting as well as respiratory, infectious or genitourinary system diseases.

Pressure ulcer risk assessment: retrospective analysis of Braden Scale scores in Portuguese hospitalised adult patients.

AIMS AND OBJECTIVES: To analyse the Braden Scale scores and sub-scores assessed in Portuguese hospitalised adult patients in association with their characteristics, diagnoses and length of stay. BACKGROUND: The Braden Scale is used worldwide for pressure ulcer risk assessment and supports nurses in the implementation of preventive interventions. DESIGN: Retrospective cohort analysis of electronic health record database from adult patients admitted to medical and surgical areas during 2012. METHODS: Braden Scale scores and sub-scores of 8147 patients were associated with age, gender, type of admission (emergency service or programmed), specialty units (medical or surgical), length of stay, patient discharge (discharge, decease or transference to other hospital) and ICD-9 diagnosis. RESULTS: The participants with significantly lower Braden Scale scores were women, older people, hospitalised in medical units, with emergency service admission, longer hospitalisation stays and/or with vascular, traumatisms, respiratory, infection or cardiac diseases. Mobility, friction/shear forces and activity had higher contributions to the Braden Scale score, while nutrition had the lowest contribution. CONCLUSIONS: Approximately one-third of all participants had high risk of pressure ulcer development at admission, which led to the application of nursing preventive care. Our study demonstrated that nurses should pay special attention to patients over 50 years of age, who had significantly lower Braden Scale scores. The Braden Scale scores significantly increased in the last assessments showing that Braden Scale is sensitive to the clinical improvement of the patient. Braden Scale correlations with length of stay reveal its importance as predictor of length of stay. RELEVANCE TO CLINICAL PRACTICE: Nurses should use Braden Scale assessment and consider patients' characteristics and diagnoses to plan more focused preventive interventions and improve nursing care. This study could be the first step to create a preventive protocol based on institutional reality, patients' characteristics, level of risk and affected sub-scales.

Necessidades dos pais de crianças hospitalizadas: evidências para o cuidado / The needs of parents of hospitalized children: evidence for care

A hospitalização traz benefícios para o tratamento da criança doente, mas também implica em impactos. Embora essencial e benéfica à criança, a presença dos pais na enfermaria desestabiliza suas rotinas e desencadeia necessidades. O objetivo deste estudo foi buscar evidências na literatura, para identificar, reunir e sintetizar o conhecimento produzido acerca das necessidades dos pais de crianças hospitalizadas, por meio de revisão integrativa da literatura. A busca das referências foi realizada nas bases PubMed, CINAHL, PsycINFO, Scopus, Web of Science e LILACS, entre 2002 a 2014, identificando 17 artigos que se adequaram aos critérios estabelecidos. As necessidades encontradas foram agrupadas em três categorias: necessidades dos próprios pais, necessidades relacionadas às ações da equipe de saúde e necessidades ligadas à estrutura e recursos organizacionais. Estas necessidades estão intimamente interligadas, de modo que o acesso, avaliação e sua satisfação devam ser realizados em conjunto, qualificando a assistência à criança e sua família.

Hospitalization has its benefits when treating sick children, but it can also cause negative impacts. Although it is essential and beneficial to the child, parental presence in the hospital ward destabilizes the family routine and generates new needs. The objective of this study was to search for evidence in the literature and identify, gather, and synthetize the knowledge that has been produced about the needs of parents of hospitalized children via an integrative literature review. The article search was conducted in the PubMed, CINAHL, PsycINFO, Scopus, Web of Science, and LILACS databases between 2002 and 2014 and resulted in 17 articles that met the established criteria. The parental needs found in these studies were grouped into three categories: the needs related to parents themselves, needs related to the health team's actions, and those related to organizational structure and resources. These needs were intimately interconnected, which means that accessing, assessing, and satisfying them must occur simultaneously, thus providing quality care to children and their families.

The involvement of parents in the healthcare provided to hospitalzed children.

OBJECTIVE: to analyze the answers of parents and health care professionals concerning the involvement of parents in the care provided to hospitalized children. METHOD: exploratory study based on the conceptual framework of pediatric healthcare with qualitative data analysis. RESULTS: three dimensions of involvement were highlighted: daily care provided to children, opinions concerning the involvement of parents, and continuity of care with aspects related to the presence and participation of parents, benefits to the child and family, information needs, responsibility, right to healthcare, hospital infrastructure, care delivery, communication between the parents and health services, shared learning, and follow-up after discharge. CONCLUSION: the involvement of parents in the care provided to their children has many meanings for parents, nurses and doctors. Specific strategies need to be developed with and for parents in order to mobilize parental competencies and contribute to increasing their autonomy and decision-making concerning the care provided to children.

The involvement of parents in the healthcare provided to hospitalzed children / Envolvimento dos pais nos cuidados de saúde de crianças hospitalizadas / Participación de los padres en los cuidados de la salud de niños hospitalizados

OBJECTIVE: to analyze the answers of parents and health care professionals concerning the involvement of parents in the care provided to hospitalized children. METHOD: exploratory study based on the conceptual framework of pediatric healthcare with qualitative data analysis. RESULTS: three dimensions of involvement were highlighted: daily care provided to children, opinions concerning the involvement of parents, and continuity of care with aspects related to the presence and participation of parents, benefits to the child and family, information needs, responsibility, right to healthcare, hospital infrastructure, care delivery, communication between the parents and health services, shared learning, and follow-up after discharge. CONCLUSION: the involvement of parents in the care provided to their children has many meanings for parents, nurses and doctors. Specific strategies need to be developed with and for parents in order to mobilize parental competencies and contribute to increasing their autonomy and decision-making concerning the care provided to children. .

OBJETIVO: analisar respostas de pais e profissionais de saúde sobre o envolvimento dos pais no cuidado da criança hospitalizada. MÉTODO: estudo exploratório, com análise qualitativa dos dados, fundamentado no quadro conceitual do cuidado em saúde em pediatria. RESULTADOS: três dimensões do envolvimento foram destacadas: cotidiano dos cuidados com a saúde da criança, perspectivas do envolvimento dos pais e continuidade dos cuidados, com aspectos relacionados à presença e à participação dos pais, benefícios à criança e família, necessidades de informação, responsabilização, direito à saúde, infraestrutura hospitalar, realização de cuidados, comunicação entre pais e serviços de saúde, aprendizagem compartilhada e seguimento após a alta hospitalar. CONCLUSÃO: o envolvimento dos pais nos cuidados de saúde admite múltiplos significados para os pais, enfermeiros e médicos, com desafios para desenvolver com e para os pais estratégias singulares, mobilizando competências parentais e contribuindo para ampliar autonomia e tomadas de decisão nos cuidados com a saúde da criança. .

OBJETIVO: comprender las experiencias de padres/madres de niños y adolescentes con cáncer, en tratamiento. MÉTODO: investigación cualitativa, basada en la fenomenología existencial de Heidegger, siendo entrevistados 13 padres de ocho pacientes, menores de 19 años, asistidos por una asociación de beneficencia. RESULTADOS: del análisis surgieron tres temáticas: "Experimentando los problemas del tratamiento"; "Temiendo la posibilidad de asustarse" y "Experimentando el descuido del otro". Evidenciamos que durante y después del tratamiento los padres experimentaban el miedo a lo desconocido y la incertidumbre del porvenir de sus hijos, especialmente al observar la muerte de otros niños; también, experimentan la indiferencia de los profesionales de los servicios de salud local, así sintiéndose desamparados e inseguros. CONCLUSIÓN: consideramos indispensable que los profesionales del área de la salud, con destaque para los de enfermería, reflexionen sobre sus acciones de cuidados orientadas a los padres de hijos con cáncer, reconociendo sus necesidades existenciales y objetivando auxiliarlos en su facticidad. .

Validação e análise da precisão da versão em português do Needs of Parents Questionnaire / Validation and reliability analysis of the Portuguese language version of Needs of Parents Questionnaire

OBJETIVO: Descrever os procedimentos para a validação e análise de precisão da versão em português do Needs of Parents Questionnaire em contexto de hospitalização pediátrica em Portugal. MÉTODOS: Estudo descritivo com base em procedimentos para adaptação cultural e linguística de instrumentos de medição em saúde. A validação foi efetuada em uma amostra de 870 acompanhantes de crianças hospitalizadas em serviços de pediatria de quatro hospitais de Portugal, com idades compreendidas entre 2 dias de vida e 18 anos. A validade de conteúdo foi garantida por dois testes de compreensão realizados separadamente com pais de crianças hospitalizadas e com profissionais de saúde. A confiabilidade da versão em português foi avaliada através do teste de reprodutibilidade e determinação da coerência interna. RESULTADOS: Os resultados dos testes de compreensão e de coerência interna, obtidos pelo coeficiente alfa de Cronbach, são idênticos aos do autor original e satisfatórios para três subescalas, o que nos permite afirmar que o questionário tem propriedades psicométricas adequadas para a medição das necessidades dos pais. O questionário foi bem recebido pelos pais das crianças, que valorizam todas as necessidades, destacando a necessidade de confiar nos cuidados de saúde que são prestados à criança quando não estão presentes, a necessidade de ser confiável e as necessidades de informação. CONCLUSÕES: O questionário mostrou ser um instrumento de medição válido e preciso na avaliação das necessidades dos pais durante a hospitalização das crianças. A versão em português do Needs of Parents Questionnaire se encontra validada.

OBJECTIVE: To describe the procedures followed for the validation and reliability analysis of the Portuguese version of the Needs of Parents Questionnaire in the context of pediatric hospitalization in Portugal. METHODS: This is a descriptive study based on procedures for the cultural and linguistic adaptation of health measurement tools. The validation was performed on a sample of 870 parents of hospitalized children in pediatrics departments from four hospitals in Portugal, with ages ranging from 2 days to 18 years. Content validity was assured by two cognitive debriefing meetings, separately organized with parents and staff. The reliability of the Portuguese version was assessed through reproducibility tests and internal consistency computation. RESULTS: Using Cronbach's alpha, results from the cognitive debriefing and internal consistency scores were similar to those obtained by the authors of the original version and good for the three subscales, allowing us to state that the questionnaire has the adequate psychometric properties to measure parents' needs. It was well accepted by parents, who valued all needs, especially the need to trust the care provided to their child when they are not present, as well as the need to be trusted and the need for information. CONCLUSIONS: The questionnaire proved to be a valid and reliable measurement instrument to assess the needs of parents during their pediatric hospitalizations. The Portuguese version of the Needs of Parents Questionnaire has been validated.