Toque terapêutico no cuidado da enfermagem: uma análise conceitual / Tacto terapéutico en el cuidado de enfermería: un análisis conceptual / Therapeutic touch in nursing care: a conceptual analysis

Resumo Objetivo Analisar o conceito de toque terapêutico no cuidado de enfermagem, especificando seus atributos, antecedentes e consequentes. Métodos Trata-se de uma análise conceitual na visão evolutiva de Rodgers (2000), sobre o conceito de toque terapêutico na assistência de enfermagem, juntamente com a revisão integrativa da bibliografia baseada na questão da pesquisa: Qual é o conceito de toque terapêutico no cuidado de enfermagem? Quais são os atributos, antecedentes e consequentes do toque terapêutico no cuidado com a enfermagem? A pesquisa foi realizada nas bases de dados eletrônicas CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, na Biblioteca do Conhecimento Online b-on, através da conjugação dos descritores DeCS/MESH "therapeutic touch", "nursing" e "nursing care" e do operador booleano AND no período temporal de 2000 a 2020. Resultados A amostra foi formada por oito estudos que identificaram três pilares temáticos: (i) atributos: método complementar e eficaz, técnica, ferramenta, intervenção de enfermagem, uso de mãos, intenção de ajudar ou curar, tratamento complementar, toque intencional e transferência de energia; (ii) antecedentes: dor, ansiedade, fadiga, demência, doença de Alzheimer, cefaleia de tensão, síndrome de fibromialgia e problemas cardiovasculares; (iii) consequentes: promove um efeito calmante; aumenta a empatia, satisfação, interação, respeito, senso de valor e vida; promove bem-estar, conforto, tranquilidade e paz, esperança, segurança, motivação, humor e qualidade do sono; reduz o estresse e comportamentos perturbadores; promove melhor estado funcional e qualidade de vida. Conclusão O toque terapêutico está implícito na prática profissional dos enfermeiros, exigindo um ajuste concreto e singular às circunstâncias e necessidades reais da pessoa, em favor de uma prática que promova o conforto.

Resumen Objetivo Analizar el concepto de tacto terapéutico en el cuidado de enfermería y especificar sus atributos, antecedentes y consecuentes. Métodos Se trata de un análisis conceptual en la visión evolutiva de Rodgers (2000), sobre el concepto de tacto terapéutico en la atención de enfermería, junto con la revisión integradora de la bibliografía basada en la pregunta de investigación: ¿Cuál es el concepto de tacto terapéutico en el cuidado de enfermería? ¿Cuáles son los atributos, antecedentes y consecuentes del tacto terapéutico en el cuidado de enfermería? El estudio fue realizado en las bases de datos electrónicas CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, en la Biblioteca do Conhecimento Online b-on, a través de la unión de los descriptores DeCS/MESH "therapeutic touch", "nursing" y "nursing care" y del operador booleano AND en el período temporal de 2000 a 2020. Resultados La muestra fue formada por ocho estudios que identificaron tres pilares temáticos: (i) atributos: método complementario y eficaz, técnica, herramienta, intervención de enfermería, uso de manos, intención de ayudar o curar, tratamiento complementario, tacto intencional y transferencia de energía; (ii) antecedentes: dolor, ansiedad, fatiga, demencia, enfermedad de Alzheimer, cefalea tensional, síndrome de fibromialgia y problemas cardiovasculares; (iii) consecuentes: promueve un efecto calmante; aumenta la empatía, satisfacción, interacción, respeto, sentido de valor y vida; promueve bienestar, consuelo, tranquilidad y paz, esperanza, seguridad, motivación, humor y calidad de sueño; reduce el estrés y comportamientos perturbadores; promueve mejor estado funcional y calidad de vida. Conclusión El tacto terapéutico está implícito en la práctica profesional de los enfermeros y exige una adaptación concreta y singular a las circunstancias y necesidades reales de la persona, a favor de una práctica que promueva el bienestar.

Abstract Objective To analyze the concept of therapeutic touch in nursing care, specifying its attributes, antecedents, and consequents. Methods This is a conceptual analysis of the evolutive view of Rodgers (2000), about the concept of therapeutic touch in nursing care, together with an integrative literature review based on the research question: What is the concept of therapeutic touch in nursing care? What are the attributes, antecedents, and consequents of therapeutic touch in nursing care? The search was conducted in the electronic databases CINAHL Complete, MEDLINE Complete, Nursing & Allied Health Collection: Comprehensive, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Library, Information Science & Technology Abstracts, MedicLatina, in the b-on Online Knowledge Library, by combining the descriptors DeCS/MESH "therapeutic touch", "nursing" e "nursing care" and the Boolean operator AND over the period from 2000 to 2020. Results The sample was composed of eight studies that identified three thematic pillars: (i) attributes: complementary and effective method, technique, tool, nursing intervention, use of hands, intention to help or heal, complementary treatment, intentional touch, and energy transfer; (ii) antecedents: pain, anxiety, fatigue, dementia, Alzheimer's disease, tension headache, fibromyalgia syndrome, and cardiovascular problems; (iii) consequents: promotes a calming effect; increases empathy, satisfaction, interaction, respect, sense of worth and life; promotes well-being, comfort, tranquility and peace, hope, security, motivation, mood and sleep quality; reduces stress and disruptive behaviors; promotes better functional status and quality of life. Conclusion Therapeutic touch is implicit in the professional practice of nurses, requiring concrete and unique adjustment to the real circumstances and needs of the person, towards a practice that promotes comfort.

A new interministerial strategy for the promotion of healthy eating in Portugal: implementation and initial results.

OBJECTIVE: To describe the implementation, main intervention areas and initial results of the Integrated Strategy for the Promotion of Healthy Eating (EIPAS) in Portugal. METHODS: EIPAS was published as a Law, in December of 2017, as a result of a collaboration between several ministries, including the Finance, Internal Affairs, Education, Health, Economy, Agriculture, and Sea Ministries, aiming at improving the dietary habits of the Portuguese population. The working group, led by the Ministry of Health, developed this strategy for over a year. The framework produced was based on WHO and European Commission recommendations as well as on relevant data from the last Portuguese dietary intake survey (2015/2016). EIPAS also reflects the results of a public hearing, including the food industry, among others, and the experience gathered, since 2012, through the National Programme for the Promotion of Healthy Eating. It considers the 'health in all policies' challenge set by WHO and has four different strategic areas, namely (1) creation of healthier food environments, (2) improvement of the quality and accessibility of healthy food choices for consumers, (3) promotion and development of literacy, in order to encourage healthy food choices, and (4) promotion of innovation and entrepreneurship. In order to achieve these goals, a set of 51 actions was established and assigned to the seven ministries involved. RESULTS: Under the scope of this strategy, Portugal has already implemented several actions, including (1) definition of standards for food availability at all public healthcare institutions; (2) implementation of a sugar tax on sweetened beverages; (3) implementation of a voluntary agreement with the food industry sector for food reformulation (work in progress); (4) design of a proposal for an interpretative model of front-of-pack food labelling; (5) improvement of the nutritional quality of food aid programmes for low-income groups; and (6) regulation of marketing of unhealthy foods to children. CONCLUSIONS: For the first time, Portugal has a nutrition policy based on the WHO concept of 'health in all policies' and on the national data on food intake. The implementing process of all 51 actions and the inherent complexities and difficulties found so far have made this process be an authentic political and social laboratory that deserves to be followed.