A formação em enfermagem de reabilitação em Portugal desde 2006 / Education/training in rehabilitation nursing in Portugal since 2006 / La formación en enfermería de rehabilitación en Portugal desde 2006

Resumo Enquadramento: Desde o início do século que se verifica uma diminuição da natalidade e maior envelhecimento populacional, existindo mais pessoas com incapacidade e dependência, exigindo cuidados de enfermagem mais especializados. Objetivo: Descrever a evolução na formação da especialidade em enfermagem de reabilitação. Metodologia: Recolha documental no Diário da República, com análise e interpretação hermenêutica das fontes com referência à especialidade de enfermagem de reabilitação, publicadas desde 2006. Resultados: Foram aprovados vários planos de estudo de pós-licenciatura de especialização e mestrado em enfermagem de reabilitação. Progressivamente, houve inclusão de unidades curriculares como Epidemiologia Estatística e Demografia, Aspetos Psicossociais da Incapacidade, Políticas e Modelos de Cuidados de Saúde e Estágios de Cuidados de Enfermagem de Reabilitação à Pessoa com Problemas Oncológicos e em Fim de Vida. Conclusão: A formação em enfermagem de reabilitação desenvolveu-se com influência das alterações políticas e sociodemográficas. Com os avanços tecnológicos, científicos e a evolução dos sistemas de saúde, os cuidados de enfermagem de reabilitação têm evoluído na inovação e formação, com enquadramento legal e nas competências específicas.

Abstract Background: Since the beginning of the 21st century, fertility rates have decreased and life expectancy has increased, with more people with disabilities and dependent on others requiring more specialized nursing care. Objective: To describe the evolution of education/training in rehabilitation nursing. Methodology: Documental search conducted in the Portuguese official journal (Diário da República), with hermeneutic analysis and interpretation of the sources on the specialty of rehabilitation nursing since 2006. Results: Several curricula of postgraduate specialization and master's degrees in rehabilitation nursing have been approved since 2006. Several course units were gradually integrated into the curricula, such as Statistical Epidemiology and Demography, Psychosocial Aspects of Disability, Health Care Policies and Models, and Internships in Rehabilitation Nursing Care for People with Cancer and at the End of Life. Conclusion: Education/training in rehabilitation nursing evolved under the influence of political and socio-demographic changes. With the technological and scientific advances and the evolution of health systems, rehabilitation nursing care has evolved in terms of innovation and education/training within a legal framework and based on specific competencies.

Resumen Marco contextual: Desde principios de siglo se ha producido un descenso de la natalidad y un mayor envejecimiento de la población, con más personas con discapacidad y dependencia, que requieren más cuidados especializados de enfermería. Objetivo: Describir la evolución en la formación de la especialidad en enfermería de rehabilitación. Metodología: Recopilación documental en el Diario de la República, con análisis e interpretación hermenéutica de las fuentes con referencia a la especialidad de enfermería de rehabilitación, publicadas desde 2006. Resultados: Se aprobaron varios planes de estudio de posgrado de especialización y máster en enfermería de rehabilitación. Progresivamente, se incluyeron unidades curriculares, como Epidemiología Estadística y Demografía, Aspectos Psicosociales de la Discapacidad, Políticas y Modelos de Atención Sanitaria y Prácticas de Atención de Enfermería de Rehabilitación a la Persona con Problemas Oncológicos y al Final de la Vida. Conclusión: La formación en enfermería de rehabilitación ha evolucionado con la influencia de los cambios políticos y sociodemográficos. Con los avances tecnológicos y científicos, así como con la evolución de los sistemas sanitarios, los cuidados de enfermería de rehabilitación han evolucionado en innovación y formación, con marcos legales y competencias específicas.

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

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

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

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

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

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

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

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

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

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

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

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

Percepção de enfermeiros frente à promoção da autonomia dos idosos no contexto da covid-19: estudo descritivo correlacional / La percepción de los enfermeros ante la promoción de la autonomía del anciano en covid-19: un estudio correlacional descriptivo / Nurses' perception regarding the promotion of older people's autonomy at covid-19: a descriptive correlational study

RESUMO Objetivo identificar e comparar a percepção dos enfermeiros de cuidados gerais e enfermeiros especialistas sobre o desenvolvimento de intervenções promotoras da autonomia dos idosos Método estudo descritivo-correlacional, transversal. Foi aplicada aos enfermeiros portugueses a Escala de Autoavaliação da Promoção da Autonomia dos Idosos, em setembro e outubro de 2020 Resultados a amostra foi composta por 356 enfermeiros, especialistas e generalistas. Todos tiveram a percepção de promover a autonomia dos idosos, com menos visibilidade no desenvolvimento de intervenções de atividades instrumentais de vida diária. Os enfermeiros especialistas percebem promover mais a autonomia dos idosos, através do desenvolvimento de intervenções físicas e cognitivas (p<0,01), de intervenções de atividades instrumentais de vida diárias (p<0,05) e da capacitação do cuidador (p<0,05) Conclusão este estudo permitiu enfatizar a potencial relevância do desenvolvimento de intervenções promotoras da autonomia dos idosos, assim como a importância da consciencialização dos enfermeiros para a sua realização

RESUMEN Objetivo identificar y comparar la percepción de enfermeros de cuidados generales y enfermeros especializados sobre el desarrollo de intervenciones que promuevan la autonomía de los ancianos Método estudio descriptivo-correlacional, transversal. La Escala de Autoevaluación para la Promoción de la Autonomía de las Personas Mayores se aplicó a enfermeros portugueses en septiembre/octubre de 2020 Resultados la muestra estuvo conformada por 356 enfermeros, especialistas y generales. Todos los enfermeros tuvieron la percepción de promover la autonomía de los ancianos, con menor visibilidad en el desarrollo de intervenciones que involucren actividades instrumentales de la vida diaria. Los enfermeros especialistas perciben promover más autonomía para los ancianos, a través del desarrollo de intervenciones físicas y cognitivas (p <0.01), intervenciones en actividades instrumentales de la vida diaria (p <0.05) y en la formación del cuidador (p <0.05). 0,05) Conclusión este estudio permitió enfatizar la potencial relevancia de desarrollar intervenciones que promuevan la autonomía de los ancianos, así como la importancia de sensibilizar a los enfermeros para que las lleven a cabo

ABSTRACT Objective to identify and compare the perception of general care nurses and specialist nurses about the development of interventions promoting older people's autonomy Method descriptive-correlational, cross-sectional study. The Self-Assessment Scale for the Promotion of Older People's Autonomy was applied to Portuguese nurses in September/October 2020 Results the sample consisted of 356 nurses, specialists and general practitioners. All nurses had the perception of promoting older people's autonomy, with less visibility in the development of interventions involving instrumental activities of daily living. Specialist nurses have a perception of more promotion of autonomy to older people through the development of physical and cognitive interventions (p<0.01), of interventions of instrumental activities of daily living (p<0.05), and in the training of the caregiver (p<0.05) Conclusion this study allowed emphasizing the potential relevance of developing interventions that promote older people's autonomy, as well as the importance of raising nurses' awareness to carry them out