Artificial Intelligence in Wound Care Education: Protocol for a Scoping Review.

As healthcare continues evolving in the age of digital technology, the integration of artificial intelligence has emerged as a powerful force, particularly in wound care. The education of healthcare professionals in wound care is crucial for ensuring they acquire the necessary knowledge and skills, optimizing patient outcomes. This paper outlines the protocol for a scoping review with the goal of mapping and analyzing the current scientific evidence regarding the potential impact of artificial intelligence in wound care education. The current protocol follows the JBI methodological framework. The search was conducted in December 2023 in the following databases: CINAHL Complete (via EBSCOhost), MEDLINE (via PubMed), Cochrane Library, Academic Search Complete, Scientific Electronic Library Online (Scielo), Scopus, and Web of Science. Electronics searches were conducted in the Scientific Open Access Scientific Repositories of Portugal (RCAAP) and ProQuest Dissertations and Theses, OpenAIRE, and Open Dissertations databases to access gray literature. Additionally, searches were performed on Google Scholar and specific journals such as the International Wound Journal, Skin Research and Technology, Journal of Wound Care, and Wound Repair and Regeneration. The initial database searches retrieved a total of 11,323 studies. After removing duplicates, a total of 6450 studies were submitted for screening. Currently, 15 studies are included in this review, and data charting and analysis are underway. The findings of this scoping review will likely provide insights into the application of artificial intelligence in wound care education.

Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study.

Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.

O meu estilo de vida FANTASTICO: Tradução, adaptação e validação do questionário em pré-adolescentes portugueses / The FANTASTIC questionnaire: Translation, adaptation, and validation of the lifestyle assessment instrument in Portuguese preadolescents / Mi estilo de vida FANTASTICO: traducción, adaptación y validación del cuestionario en preadolescentes portugueses

Resumo Enquadramento: Os estilos de vida construídos na pré-adolescência influenciarão todo o desenvolvimento humano ao longo do ciclo vital. O seu diagnóstico constitui uma necessidade efetiva para a prestação dos cuidados de enfermagem ao nível da saúde escolar. Objetivo: Traduzir, adaptar e validar o questionário FANTASTICO para pré-adolescentes portugueses. Metodologia: realizou-se um processo de tradução e de adaptação do questionário com recurso à Técnica de Delphi. Foi criada uma base informática específica. Realizou-se um estudo exploratório para avaliar as propriedades psicométricas do instrumento. O processo desenvolveu-se entre janeiro e julho de 2019. Resultados: A versão traduzida e adaptada em painel de peritos, manteve os 30 itens do instrumento original. O estudo exploratório revelou que o instrumento apresenta um bom alfa de Cronbach total de 0,72. Conclusão: A versão portuguesa O Meu Estilo de Vida FANTASTICO (pré-adolescentes) constitui um bom instrumento de medida para avaliar os estilos de vida dos pré-adolescentes portugueses.

Abstract Background: Lifestyles built in pre-adolescence will influence all human development throughout the life cycle. Its diagnosis constitutes an effective need for the provision of nursing care in terms of school health. Objective: To translate, adapt and validate the FANTASTICO questionnaire for Portuguese pre-adolescents. Methodology: A process of translation and adaptation of the questionnaire was carried out using the Delphi technique. A specific computer base it was created. An exploratory study was carried out to evaluate the instrument's psychometric properties. The process took place between January and July 2019. Results: The translated version and adapted by an expert panel maintained the 30 items of the original instrument. The exploratory study revealed that the instrument has good psychometric properties with a total Cronbach's alpha of 0.72. Conclusion: The Portuguese version O Meu Estilo de Vida FANTASTICO (pre-adolescents) is a good measuring instrument to assess the lifestyles of Portuguese pre-adolescents.

Resumen Marco contextual: Los estilos de vida construidos en la preadolescencia influirán en todo el desarrollo humano a lo largo del ciclo vital. Su diagnóstico es una necesidad efectiva para la prestación de cuidados de enfermería en el ámbito de la salud escolar. Objetivo: Traducir, adaptar y validar el cuestionario FANTASTICO para preadolescentes portugueses. Metodología: Se llevó a cabo un proceso de traducción y adaptación del cuestionario mediante la técnica Delphi. Se creó una base de datos informática específica. Se realizó un estudio exploratorio para evaluar las propiedades psicométricas del instrumento. El proceso se desarrolló entre enero y julio de 2019. Resultados: La versión traducida y adaptada en panel de expertos mantuvo los 30 ítems del instrumento original. El estudio exploratorio mostró que el instrumento tiene un buen alfa de Cronbach total de 0,72. Conclusión: La versión portuguesa Mi Estilo de Vida FANTASTICO (preadolescentes) constituye un buen instrumento de medida para evaluar los estilos de vida de los preadolescentes portugueses.

FANTASTIC lifestyle questionnaire from 1983 until 2022: A review.

Background: Studying lifestyles has always been important; quantifying them has become more complex. However, a questionnaire produced in 1983 has shown that its simple form of evaluation can be an added value in understanding lifestyles. Our aim is a systematic review of the scientific literature about the use of the FANTASTIC Lifestyle questionnaire (FLQ). Methods: The reflective systematic literature review on PubMed, Medline, Science Direct, and SCIELO databases with the descriptors "FANTASTIC Lifestyle questionnaire" OR "FANTASTICO questionnaire" OR "FANTASTIC questionnaire" OR "FANTASTIC survey" OR "FANTASTIC checklist". PRISMA criteria reporting of systematic reviews and meta-analyses were applied. The inclusion criteria were the use of FLQ instrument to measure lifestyles, presenting quantitative or qualitative results, and psychometric studies. It excluded other lifestyle instruments, incomplete articles, and non-English, Brazilian, Spanish, and Portuguese language articles. Results: Findings reveal 41 scientific articles included in the study. It analyzed the results and most studies use the instrument to assess all dimensions. However, some studies reported assessing specific dimensions such as nutrition, sleep, stress, tobacco, alcohol, and drugs. The questionnaire has been applied to a wide range of ages and literacy levels. Conclusion: This literature review allowed us to conclude that this questionnaire is still in use today and is applied in several contexts and populations. It is also possible to verify the relevance of its use and to design intervention strategies and programs for a healthy society. It is essential to draw attention to this issue and promote health literacy (HL) on this topic.

Prognostic factors for delayed healing of complex wounds in adults: A scoping review.

Complex or hard-to-heal wounds continue to be a challenge because of the negative impact they have on patients, caregivers, and all the associated costs. This study aimed to identify prognostic factors for the delayed healing of complex wounds. Five databases and grey literature were the sources used to research adults with pressure ulcers/injuries, venous leg ulcers, critical limb-threatening ischaemia, or diabetic foot ulcers and report the prognostic factors for delayed healing in all care settings. In the last 5 years, a total of 42 original peer-reviewed articles were deemed eligible for this scoping review that followed the JBI recommendations and checklist PRISMA-ScR. The most frequent prognostic factors found with statistical significance coinciding with various wound aetiologies were: gender (male), renal disease, diabetes, peripheral arterial disease, the decline in activities of daily life, wound duration, wound area, wound location, high-stage WIfI classification, gangrene, infection, previous ulcers, and low ankle brachial index. It will be essential to apply critical appraisal tools and assessment risk of bias to the included studies, making it possible to make recommendations for clinical practice and build prognostic models. Future studies are recommended because the potential for healing through identification of prognostic factors can be determined, thus allowing an appropriate therapeutic plan to be developed.

O estigma como fonte da construção social do conceito de tuberculose pulmonar: perspectiva dos enfermeiros / El estigma como fuente de la construcción social del concepto de tuberculosis pulmonar: perspectiva de las enfermeras / Stigma as a source of the social construction of the concept of pulmonary tuberculosis: perspective of nurses

Objetivos: descrever a construção social do conceito social da tuberculose pulmonar que, na pesrpetiva de enfermeiros, emerge de conceitos alicerçados no estigma. Método: estudo descritivo, de abordagem qualitativa, com 12 enfermeiros de centros de diagnóstico pneumológico do Norte de Portugal. Dados colhidos nos meses de novembro de 2020 e janeiro de 2021 por entrevista semiestruturada, posteriormente analisados pela metodologia de análise de conteúdo. Resultados: dos discursos dos participantes emerge o conceito da tuberculose pulmonar. O entendimento da doença está envolto de mitos e tabus, com prognóstico sombrio, causa medo de contágio, de morte, pavor, vergonha, afastamento, isolamento social e negação da doença. Entre enfermeiros, falar de tuberculose é tema a evitar, é área que causa confusão e medo. Considerações finais: a conceção da palavra tuberculose persiste enraizada em conceitos e preconceitos. O estigma social permanece na sua essência e faz perpetuar o seu conceito negativo, até à atualidade.

Objetivos: describir la construcción social del concepto social de la tuberculosis pulmonar que, desde la perspectiva de enfermeros, emerge de conceptos basados en el estigma. Método: estudio descriptivo, de abordaje cualitativo, con 12 enfermeros de centros de diagnóstico pneumológico del Norte de Portugal. Datos recogidos en los meses de noviembre de 2020 y enero de 2021 por entrevista semiestructurada, posteriormente analizados por la metodología de análisis de contenido. Resultados: de los discursos de los participantes emerge el concepto de la tuberculosis pulmonar. El entendimiento de la enfermedad está envuelto de mitos y tabúes, con pronóstico sombrío, causa miedo de contagio, de muerte, pavor, vergüenza, alejamiento, aislamiento social y negación de la enfermedad. Entre enfermeras, hablar de tuberculosis es tema a evitar, es área que causa confusión y miedo. Consideraciones finales: la concepción de la palabra tuberculosis persiste enraizada en conceptos y prejuicios. El estigma social permanece en su esencia y hace perpetuar su concepto negativo, hasta la actualidad.

Objective: to describe the social construction of the social concept of pulmonary tuberculosis that, from the perspective of nurses, emerges from concepts based on stigma. Method: descriptive study, qualitative approach, with 12 nurses from centers of pneumological diagnosis in northern Portugal. Data collected in November 2020 and January 2021 by semi-structured interview, subsequently analyzed by content analysis methodology. Results: from the participants' discourses, the concept of pulmonary tuberculosis emerges. The understanding of the disease is surrounded by myths and taboos, with a bleak prognosis, causes fear of contagion, death, fear, shame, estrangement, social isolation and denial of the disease. Among nurses, talking about tuberculosis is a topic to avoid, it is an area that causes confusion and fear. Final considerations: the concept of the word tuberculosis persists rooted in concepts and prejudices. Social stigma remains at its core and perpetuates its negative concept to the present day.

Application of the FANTASTIC Lifestyle Questionnaire in the Academic Context.

Studying citizens' lifestyles is extremely important for understanding society and the social conditions of the personal lifestyle. Understanding the lifestyles of university students is especially important because they will be the future citizens and professionals who will shape society's future. The aim of this study was a systematic review of the scientific literature about the use of the FANTASTIC Lifestyle questionnaire in an academic context. The reflective systematic literature review was carried out on PubMed, MEDLINE, Science Direct, and SCIELO databases with the keywords ("FANTASTIC Lifestyle questionnaire" OR "FANTASTICO questionnaire" OR "FANTASTIC questionnaire" OR "FANTASTIC survey" OR "FANTASTIC checklist") AND ("university students"). The PRISMA criteria for reporting systematic reviews and meta-analyses were applied. The inclusion criteria were the use of the "FANTASTIC Lifestyle questionnaire" instrument for measuring lifestyles, the presentation of quantitative or qualitative results, and psychometric studies. The exclusion criteria were no use of FANTASTIC Lifestyle Questionnaire; other population, no quantitative or qualitative analysis, incomplete articles. The 15 scientific articles included in the study were analyzed. This literature review allowed us to conclude the importance and usefulness/actuality of this questionnaire. Furthermore, the importance of diagnosis should be emphasized, as should the development of strategies and intervention programs for the maintenance or creation of healthy societies.

Prognostic Factors for Delayed Healing of Complex Wounds in Adults: A Scoping Review Protocol.

(1) Background: The high prevalence of persons with wounds and its consequences for a person's quality of life makes the issue a relevant focus of attention for healthcare professionals. Through prognostic factors for healing, the individual risk of complications can be predicted, is possible to predict imminent delays and guide decision-making, thus helping healthcare professionals. (2) Methods: A scoping review performed according to JBI methodology and guided by the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews (PRISMA-ScR) checklist will aim to identify the studies that meet predefined eligibility criteria. Five databases and gray literature will be the sources used to research adults with pressure ulcers, venous leg ulcers, arterial ulcers, or diabetic foot ulcers and report the prognostic factors for delayed healing in any care setting. (3) Results: This review will consider all quantitative and mixed studies in the last five years. The selection of articles will be carried out by two reviewers independently, using EndNoteWeb and Rayyan. Prognostic factors will be presented by design study, sampling, setting, outcome, wound type, and statistical methods. (4) Conclusions: Mapping prognostic factors for delayed healing could also be a starting point for a systematic review and meta-analyses to quantify the value of each factor.

Adaptation and Validation of the Tuberculosis Related Stigma Scale in Portuguese / Adaptação e validação da Tuberculosis Related Stigma Scale para português / Adaptación y validación de la Tuberculosis Related Stigma Scale en portugués

Objective: To adapt and validate the Tuberculosis Related Stigma Scale (TRSS) in European Portuguese. Materials and method: A methodological study in a sample of 204 individuals being treated for pulmonary tuberculosis in Portuguese Pulmonary Diagnostic Centers, with at least one month of treatment or in follow-up. The evaluation process of linguistic and conceptual equivalence involved translation, the consensus among judges, back-translation, semantic validation, and pre-testing of the TRSS. The scale's psychometric properties were assessed by verifying the reliability and validity of the results and calculating Cronbach's alpha coefficient and the exploratory factor analysis of principal components, with Varimax rotation of the scale items. Results: The Portuguese version of the TRSS has a Cronbach's alpha coefficient of 0.94 and has 23 items distributed in two dimensions: "Community's perspectives on tuberculosis" (11 items) and "Person's perspectives on tuberculosis" (12 items). Its psychometric characteristics ensure adequate reliability and validity for the Portuguese population. Conclusions: The TRSS is a valid and reliable instrument to assess stigma in people with pulmonary tuberculosis and, to date, the only scale validated in this domain for the Portuguese population, which allows nurses to make an integrated intervention.

Objetivo: adaptar e validar a Tuberculosis Related Stigma Scale (TRSS) para o português de Portugal. Materiais e método: estudo metodológico, numa amostra de 204 pessoas em tratamento de tuberculose pulmonar, em Centros de Diagnóstico Pneumológico portugueses, com pelo menos um mês de tratamento, ou em follow-up. O processo de avaliação da equivalência linguística e conceptual envolveu tradução, consenso entre juízes, retrotradução, validação semântica e pré-teste da TRSS. As propriedades psicométricas da escala foram avaliadas através da verificação da confiabilidade e validade dos resultados, recorrendo ao cálculo do coeficiente alfa de Cronbach e da análise fatorial exploratória de componentes principais, com rotação Varimax dos itens da escala. Resultados: a versão portuguesa da TRSS tem um coeficiente alfa de Cronbach de 0,94 e ficou com 23 itens distribuídos por duas dimensões: "Perspetivas da comunidade em relação à tuberculose" (11 itens) e "Perspetivas da pessoa em relação à tuberculose" (12 itens). As características psicométricas garantem-lhe confiabilidade e validade adequadas para a população portuguesa. Conclusões: a TRSS constitui um instrumento válido e confiável para avaliar o estigma na pessoa com tuberculose pulmonar sendo, até ao momento, a única escala validada nesse domínio para a população portuguesa, o que permite ao enfermeiro uma intervenção integrada.

Objetivo: adaptar y validar la Tuberculosis Related Stigma Scale (TRSS) en el portugués de Portugal. Materiales y método: estudio metodológico, en una muestra de 204 personas en tratamiento de tuberculosis pulmonar, en Centros de Diagnóstico Neumológico portugueses, con por lo menos un mes de tratamiento o en seguimiento. El proceso de evaluación de la equivalencia lingüística y conceptual implicó traducción, consenso entre expertos, retrotraducción, validación semántica y preprueba de la TRSS. Las propiedades psicométricas de la escala se evaluaron a partir de la verificación de la fiabilidad y validez de los resultados, mediante el cálculo del coeficiente alfa de Cronbach y el análisis factorial exploratorio de componentes principales, con rotación Varimax de los ítems de la escala. Resultados: la versión portuguesa de la TRSS tiene un coeficiente alfa de Cronbach de 0,94 y quedó con 23 ítems distribuidos en dos dimensiones: "Perspectivas de la comunidad en relación con la tuberculosis" (11 ítems) y "Perspectivas de la persona en relación con la tuberculosis" (12 ítems). Las características psicométricas le garantizan confiabilidad y validez adecuadas para la población portuguesa. Conclusiones: la TRSS constituye un instrumento válido y fiable para medir el estigma en la persona con tuberculosis pulmonar y es, hasta ahora, la única escala validada en este dominio para la población portuguesa, lo que le permite al profesional de enfermería una intervención integrada.

Shifting the distribution curve for healthcare resource use through topical oxygen therapy for wound healing.

The clinical and economic burden associated with hard-to-heal wounds is high and evidence suggests that it continues to increase. Healthcare resources consumed during the provision of wound care can be saved by implementing strategies and actions aimed at promoting wound healing. When these are successful, the frequency distribution curve for time to healing and for the consumption of healthcare resources should 'move to the left' and the extent to which it is 'skewed to the right' would be reduced, resulting in a reduction in the population mean for time to wound healing, and correspondingly, healthcare resources. Not only would this release healthcare resources in the short term, but, if these changes are maintained, would render savings sustainable, thereby contributing to lowering the overall burden of wounds and wound care. In this article, we present evidence that suggests that the adoption of adjunct topical haemoglobin spray can effect these desired changes in the wound healing curve and, due to the nature of the technology, it can be easily and sustainably implemented within relevant whole populations requiring wound care. The ease of adoption and impact is further illustrated by a patient case study.

Estudo psicométrico da escala de satisfação com o suporte social em pessoas com tuberculose pulmonar / Psychometric study of the social support satisfaction scale in people with pulmonary tuberculosis / Estudio psicométrico de la escala de satisfacción con el apoyo social en personas con tuberculosis pulmonar

RESUMO Objetivo: avaliar as propriedades psicométricas da Escala de Satisfação com o Suporte Social em pessoas com tuberculose pulmonar. Método: estudo metodológico desenvolvido em duas etapas: validação de conteúdo dos itens; e avaliação das propriedades psicométricas da Escala. A colheita dos dados decorreu entre o período de outubro de 2020 e janeiro de 2021 numa amostra de 204 pessoas com tuberculose pulmonar, em Centros de Diagnóstico Pneumológico no Norte de Portugal. Resultados: a Escala validada apresenta um coeficiente α-Cronbach de 0,91, mantendo os 15 itens. Verificou-se uma distribuição diferente dos itens dentro das subescalas, designada como: "Satisfação com a família" (α-Cronbach=0,94) passa a integrar sete itens; "Satisfação com os amigos" (α-Cronbach=0,85) integra somente quatro itens; "Atividades Sociais" (α-Cronbach=0,86) e "Intimidade" (α-Cronbach=0,77) passam de três e quatro itens da escala original, para dois itens cada uma. Conclusão: a versão da Escala de Satisfação com o Suporte Social pode constituir-se em um recurso para o planejamento dos cuidados de Enfermagem à pessoa com tuberculose pulmonar.

ABSTRACT Objective: to evaluate the psychometric properties of the Satisfaction with Social Support Scale in people with pulmonary tuberculosis. Method: methodological study developed in two stages: content validation of the items; and assessment of the psychometric properties of the Scale. Data were collected between October 2020 and January 2021 in a sample of 204 individuals with pulmonary tuberculosis in Pulmonary Diagnostic Centers in Northern Portugal. Results: The validated scale has α-Cronbach's coefficient of 0.91, keeping the 15 items. There was a different distribution of items within the subscales, designated as: "Satisfaction with family" (α-Cronbach=0.94) now includes seven items; "Satisfaction with friends" α-Cronbach =0.85) includes only four items; "Social activities" (α-Cronbach=0.86) and "Intimacy" (α-Cronbach =0.77) go from three and four items of the original scale to two items each. Conclusion: the version of the Satisfaction with Social Support Scale can be a resource for planning nursing care for people with pulmonary tuberculosis.

RESUMEN Objetivo: evaluar las propiedades psicométricas de la Escala de Satisfacción con el Apoyo Social en personas con tuberculosis pulmonar. Método: estudio metodológico desarrollado en dos etapas: validación del contenido de los ítems; y evaluación de las propiedades psicométricas de la Escala. Los datos se recogieron entre octubre de 2020 y enero de 2021 en una muestra de 204 individuos con tuberculosis pulmonar en centros de diagnóstico pulmonar del norte de Portugal. Resultados: La escala validada tiene un coeficiente de α-Cronbach de 0,91, manteniendo los 15 ítems. Se encontró una distribución diferente de los ítems dentro de las subescalas, a saber: "Satisfacción con la familia" (α--Cronbach=0,94) incluye ahora siete ítems; "Satisfacción con los amigos" (α--Cronbach=0,85) incluye sólo cuatro ítems; "Actividades sociales" (α-Cronbach=0,86) e "Intimidad" (α--Cronbach=0,77) pasan de tres y cuatro ítems de la escala original a dos ítems cada uno. Conclusión: la versión de la Escala de Satisfacción con el Apoyo Social puede constituirse en un recurso para la planificación de los cuidados de Enfermería a personas con tuberculosis pulmonar.

O tratamento diretamente observado na estratégia de controlo da tuberculose em Portugal / Directly observed therapy in the tuberculosis control strategy in Portugal / El tratamiento observado directamente en la estrategia de control de la tuberculosis en PortugalMaria Isabel

Resumo Enquadramento: A tuberculose, como problema de saúde à escala global, requer um tratamento eficaz. A World Health Organization recomenda a toma da medicação de forma supervisionada e personalizada. Portugal aderiu a esta estratégia, não se tendo identificado estudos desta problemática. Objetivo: descrever as implicações do tratamento diretamente observado (TDO) no controlo da tuberculose, em Portugal. Metodologia: Estudo exploratório e descritivo, numa amostra de 303 pessoas com tuberculose pulmonar, em centros de diagnóstico pneumológico da região Norte de Portugal, entre março de 2019 e janeiro de 2020. Resultados: A TDO é a modalidade de tratamento em 88,1% da amostra. A maioria dos participantes (75,9% das mulheres e 66,3% dos homens) fazem o tratamento sob supervisão do enfermeiro, nas unidades de saúde. As suas expectativas individuais não parecem ser priorizadas. A tomada de decisão sobre a estratégia aplicada surge centrada nos profissionais de saúde e não aparenta privilegiar a participação da pessoa doente. Conclusão: A modalidade TDO, apresenta-se como fonte de insatisfação, potencia o agravamento dos recursos económicos da pessoa doente e do estigma social.

Abstract Background: Tuberculosis is a global health problem that requires effective treatment. The World Health Organization (WHO) recommends that treatment should be tailored and supervised. Portugal has adhered to this strategy, but no studies on this issue were identified. Objective: To describe the implications of Directly Observed Therapy (DOT) for tuberculosis control in Portugal. Methodology: Exploratory and descriptive study with a sample of 303 people suffering from pulmonary tuberculosis, in Pulmonary Diagnostic Centers, in Northern Portugal, between March 2019 and January 2020. Results: DOT was the treatment modality used in 88.1% of the sample. Most participants (75.9% of women and 66.3% of men) received treatment under the supervision of a nurse in the health care units. Patients' expectations do not seem to be a priority. Decision-making regarding the adopted strategy is left to the health professionals and does not seem to prioritize the patient's participation. Conclusion: The DOT modality is a source of dissatisfaction, aggravates patients' financial burden, and promotes social stigma.

Resumen Marco contextual: La tuberculosis, como problema de salud mundial, requiere un tratamiento eficaz. La Organización Mundial de la Salud recomienda tomar la medicación de forma supervisada y personalizada. Portugal se ha adherido a esta estrategia, aunque no se ha identificado ningún estudio al respecto. Objetivo: Describir las implicaciones del tratamiento observado directamente (TDO) para el control de la tuberculosis en Portugal. Metodología: Estudio exploratorio y descriptivo, en una muestra de 303 personas con tuberculosis pulmonar, en centros de diagnóstico neumológico de la región norte de Portugal, entre marzo de 2019 y enero de 2020. Resultados: El TDO es la modalidad de tratamiento en el 88,1% de la muestra. La mayoría de los participantes (el 75,9% de las mujeres y el 66,3% de los hombres) realizan el tratamiento con la supervisión del enfermero, en las unidades sanitarias. No parece que se prioricen sus expectativas individuales. La toma de decisiones sobre la estrategia aplicada parece centrada en los profesionales sanitarios y no parece priorizar la participación de la persona enferma. Conclusión: La modalidad de TDO se presenta como una fuente de insatisfacción, potencia el empeoramiento de los recursos económicos de la persona enferma y el estigma social.

Quality of life and therapeutic regimen management in onychomycosis patients and in vitro study of antiseptic solutions.

Onychomycosis or tinea unguium (EE12.1) and Onychomycosis due to non-dermatophyte moulds (1F2D.5) (OM) is a fungal infection of the nail plates with a high prevalence that often affects vulnerable people with co-existing health problems. Gold standard pharmacological treatments for onychomycosis have been associated with low success rates and increasing antifungal resistance, suggesting that treatment outcome is dependent on multiple variables. Here, the prevalence of OM and quality of life were characterized in two vulnerable populations-Hospital patients and Homeless people. Comparing both groups, the most prevalent fungal species were identified in Hospital patients. Then, the in vitro fungicidal properties of the antiseptics povidone-iodine, polyhexamethylene biguanide-betaine, octenidine dihydrochloride, and a super-oxidized solution against two ATCC strains (Candida albicans and Aspergillus niger) and three clinical fungal isolates from Hospital patients (Candida parapsilosis, Trichophyton interdigitale, and Trichophyton rubrum) were tested. OM prevalence was high in both patient groups studied, who also reported a reduction in quality of life and concerns about the state of their feet. In addition, Hospital patients had a non-negligent therapeutic regimen management style. Antiseptics tested in vitro revealed antifungal properties. As antiseptics are low-cost and easy to apply and have few iatrogenic effects, the demonstration of fungicidal properties of these solutions suggests that they may constitute potential supportive therapeutics for OM.

Referral to the national network of integrated care: the nurses' perception.

OBJECTIVE: to understand the referral to the National Network of Integrated Continuous Care, from the perspective of nurses who work in this care context. METHOD: an exploratory and descriptive study with a qualitative approach, with data collection between July and September 2019 through interviews with 12 nurses who work in Integrated Continuous Care Teams, in Northern Portugal. The content analysis technique was used to analyze the statements. RESULTS: the professionals revealed that there are difficulties and constraints in the process of referring users to the National Network of Integrated Continuous Care. The process is bureaucratic, complex, and time-consuming, conditioning user accessibility to timely care. CONCLUSION: the referral process is a very bureaucratic and time-consuming procedure, which not only conditions and delays users' access to the National Network of Integrated Continuous Care network, contributing to the worsening of the clinical status of some patients. The number of professionals is insufficient, inducing the demand for services through urgency. The focus on primary care should seek to improve inequalities in access, compete for more equitable and accessible care, generating more quality in health care.

Assessing Community Empowerment for an Innovative Epidemiologic Approach.

Community empowerment can be a process, but also the result of nursing care. To analyze it as a result there is an instrument that allows to quantify its level in nine domains. According to Melo (2020), health centers can be considered communities, becoming the potential target of community and public health nurses care, especially in the public health unit. One of the main functions of a public health unit is the epidemiological surveillance of the population's health state. However, traditional epidemiological surveillance is focused on diseases and Melo (2020) proposes a new approach for epidemiology focused on people in what concerns nursing diagnosis. The aim of this research is to identify the level of empowerment of four Portuguese primary healthcare structures, named as ACeS, so as to improve the epidemiological surveillance of nursing diagnoses. As methodology, we developed four focus group with all nursing leaders from all primary care units of the four ACeS, using the Portuguese version of the empowerment assessment rating scale. The results present the level of community empowerment of each ACeS according to the nine domains of the scale. The needs of intervention to improve the ACeS empowerment were also identified in order to develop the epidemiological surveillance of nursing diagnoses.

Method for positioning and rehabilitation training with the ExoAtlet ® powered exoskeleton.

Exoskeletons for locomotion, support, or other uses are becoming more common. An increasing number of studies are demonstrating relevant results in rehabilitation. Here we describe the steps required to properly place and train patients in ExoAtlet ® powered exoskeletons (Moscow, Russia), for which there is currently limited information available. These steps combine actions related to the hardware, software, as well as safety, rehabilitation, and psycho-emotional state of the subject. Training starts with a general preparation of the environment, the equipment, and the patient. When the actual training program begins, the patient needs to gradually learn to perform the different actions that will be required to control the exoskeleton. Initially, training requires transferring weight between legs to guarantee adequate equilibrium control. Then, actions assisted by computer-controlled motors begin, namely: standing up, walking in place, moving small distances and sitting down. As the patient becomes comfortable with the exoskeleton and the cardiovascular system becomes adjusted to the upright position, training can then include walking over longer distances, inclined planes, opening doors, and climbing stairs.•Powered exoskeletons are becoming a common method in rehabilitation.•The use of ExoAtlet ® powered exoskeletons in clinical research requires manipulation of variables thought to promote rehabilitation, without compromising safety standards.•The phases of training are: transferring weight between legs, walk in place, and walk over longer distances.

Referral to the national network of integrated care: the nurses perception / Referenciação para a rede nacional de cuidados integrados: a percepção dos enfermeiros / Remisión a la red nacional de cuidados integrados: percepciones de los enfermeros

Objective: to understand the referral to the National Network of Integrated Continuous Care, from the perspective of nurses who work in this care context. Method: an exploratory and descriptive study with a qualitative approach, with data collection between July and September 2019 through interviews with 12 nurses who work in Integrated Continuous Care Teams, in Northern Portugal. The content analysis technique was used to analyze the statements. Results: the professionals revealed that there are difficulties and constraints in the process of referring users to the National Network of Integrated Continuous Care. The process is bureaucratic, complex, and time-consuming, conditioning user accessibility to timely care. Conclusion: the referral process is a very bureaucratic and time-consuming procedure, which not only conditions and delays users' access to the National Network of Integrated Continuous Care network, contributing to the worsening of the clinical status of some patients. The number of professionals is insufficient, inducing the demand for services through urgency. The focus on primary care should seek to improve inequalities in access, compete for more equitable and accessible care, generating more quality in health care.

Objetivo: compreender a referenciação para a Rede Nacional de Cuidados Continuados Integrados, a partir da perspetiva de enfermeiros que atuam nesse contexto assistencial. Método: estudo exploratório, descritivo com abordagem qualitativa, cujos dados foram coletados entre julho e setembro de 2019, por meio de entrevistas a 12 enfermeiros que trabalham em Equipes de Cuidados Continuados Integrados, do norte de Portugal. Para analisar as falas, utilizou-se a técnica de análise de conteúdo. Resultados: os profissionais revelaram que existem dificuldades e constrangimentos no processo de referenciação dos usuários para a Rede Nacional de Cuidados Continuados Integrados. O processo é burocrático, complexo e demorado, condicionando a acessibilidade dos usuários aos cuidados em tempo útil. Conclusão: o processo de referenciação é um procedimento muito burocratizado e demorado, que condiciona e atrasa o acesso dos usuários à Rede Nacional de Cuidados Continuados Integrados, contribuindo para o agravamento do estado clínico de alguns pacientes. O número de profissionais é insuficiente, induzindo à procura de serviços pela via da urgência. A aposta na atenção primária deverá procurar melhorar as desigualdades no acesso, concorrer para cuidados mais equitativos e acessíveis gerando mais qualidade nos cuidados de saúde.

Objetivo: comprender la derivación a la Red Nacional de Cuidados Continuados Integrados, desde la perspectiva de los enfermeros que actúan en este contexto asistencial. Método: estudio exploratorio, descriptivo, con enfoque cualitativo, cuyos datos fueron recolectados entre julio y septiembre de 2019, a través de entrevistas con 12 enfermeros que trabajan en Equipos de Cuidados Continuados Integrados, del norte de Portugal. Para analizar las declaraciones, se utilizó la técnica de análisis de contenido. Resultados: los profesionales revelaron que existen dificultades y limitaciones en el proceso de derivación de usuarios a la Red Nacional de Cuidados Continuados Integrados. El proceso es burocrático, complejo y demorado, condicionando la accesibilidad del usuario a la atención en tiempo oportuno. Conclusión: el proceso de derivación es un procedimiento muy burocrático y demorado, que no solo condiciona y atrasa el acceso de los usuarios a la Red Nacional de Cuidados Continuados Integrados sino que además contribuye al agravamiento del estado clínico de algunos pacientes. El número de profesionales es insuficiente, lo que induce a la demanda de los servicios de la emergencia. La apuesta en la atención primaria debe orientarse a mejorar las desigualdades en el acceso, competir por una atención más equitativa y accesible y, así, brindar una mayor calidad en la atención de la salud.

Reliability in Mandibular Movement Evaluation Using Photogrammetry in Patients With Temporomandibular Disorders.

OBJECTIVE: The purpose of this study was to propose a quantitative evaluation for mandibular opening-closing movement asymmetries and to verify the intraexaminer and interexaminer reliability using photogrammetry in individuals with and without myogenic temporomandibular disorders. METHODS: Forty-nine female participants between ages 18 and 40 were enrolled in this study. They were assigned to 2 different groups: a temporomandibular disorder group, (n = 25; 28.1 ± 3.6 years) and an asymptomatic group (n = 24; 25.6 ± 5.1 years). Data were collected through photogrammetry using Corel Draw X3 software (Corel Corp, Ottawa, Ontario, Canada) for angle measurements. Reliability analysis was done on the total sample, and the photographs were obtained by a singular examiner on 2 occasions (intraexaminer) 1 month apart and from measurement made by another examiner (interexaminer) on different days. The intraclass correlation coefficient (ICC) was applied with a significance level of 5%. RESULTS: The photogrammetry had excellent intrarater and inter-rater reliability for the evaluation of opening and closing movements of the jaw (intrarater: opening ICC = 0.99; closing ICC = 0.98; inter-rater: opening ICC = 0.89 and closing ICC = 0.82). Photogrammetry also demonstrated excellent intra- and inter-rater reliability in the evaluation of head posture (intra-rater: head deviation ICC = 0.96; head position ICC = 0.75; inter-rater: head deviation ICC = 0.98; head position ICC = 0.98). CONCLUSION: Under these experimental conditions, most angular values presented excellent intra- and interexaminer reliability.

Nursing Consultation in a Public Bathhouse: A Community Resource for the Vulnerable Population in a European Capital.

BACKGROUND: In Portugal's capital, Lisbon, there are 19 public showers (PS) attended by a vulnerable population. AIM: To describe the assessment and interventions performed during nursing consultations. METHOD: This is a quantitative, observational, and cross-sectional study. FINDINGS: In a convenience sample of 77 users, 52% are females, 43% are single, 52% do not possess any economic resources, 87% have mental health issues, and 32% are homeless. The main nursing focuses found were: arterial hypertension, disease management skills, and emotional suffering. The most used nursing intervention is listening, followed by the expression of feelings, valuing the individual and his/her story, analyzing causes, providing support, and comforting. CONCLUSIONS: This study shows that the main focus of the nursing care in these facilities is the human being. The respect for individuality and dignity was the primary concern, in an attempt to empower the individual to better manage his/her health and illness processes.

Nurses' practices in the context of primary healthcare in Portugal.

AIM: The aim of this study was to identify and categorise the nursing practices of Portuguese nurses in the context of primary healthcare services. METHODS: A scoping review was undertaken using the Latin American and Caribbean Health Sciences literature database; Spanish Bibliographic Index of Health Sciences; Medical Literature Analysis and Retrieval System Online; Cochrane Library; Scientific Electronic Library Online; El Banco de Datos de Enfermería nursing database; and Cumulative Index to Nursing and Allied Health Literature databases. The search strategy included articles of original research, which involved nurses or nursing practices in the context of Portugal's primary healthcare, published in Portuguese, Spanish and/or English. The review involved the analysis of 11 studies published in Latin American, Brazilian and Portuguese journals, therefore all were available in Portuguese, published between 2007 and 2013. RESULTS: From the analysis it was possible to establish four categories of primary healthcare nurses' work: technical procedures, health promotion, independent actions, and management and training practices. CONCLUSIONS: Primary healthcare nursing in Portugal is challenged in the context of making more effective use of its own competences, investing more in actions of health promotion and disease prevention and less in technical curative procedures, thus contributing to better performance in the Portuguese National Health System.