“A beautiful mind” – Promoção da literacia em saúde mental / “A beautiful mind” - Promotion of mental health literacy

Introdução: Associado à iliteracia do que fazer para prevenir, retardar e quando procurar ajuda, perante a esquizofrenia, requer-se ao enfermeiro especialista em saúde mental um agir ético, alicerçado no conhecimento empírico, técnico-científico, envolvendo os deveres profissionais: dignidade, individualidade e autonomia. Objetivo: Promover a literacia em saúde mental, através da análise do adoecer de uma pessoa com esquizofrenia e das questões éticas associadas ao cuidar em enfermagem de saúde mental. Metodologia: Estudo de caso – filme “Uma Mente Brilhante”, de natureza qualitativa, exploratória-descritiva. Resultados e Discussão: A esquizofrenia transforma a forma de pensar, de sentir e de relação com as pessoas, conduzindo à estigmatização associada a mitos conectivos entre a doença mental e a violência, contribuindo para a dificuldade/exclusão no emprego, apoio social e procura de ajuda. Conclusão: Salienta-se a promoção da literacia do agir perante uma pessoa com esquizofrenia, e do cuidado ético em enfermagem inerente. (AU)

Introduction: Associated with the illiteracy of what to do to prevent, delay, and when to seek help, in the face of schizophrenia, the nurse specialist in mental health is required to act ethically, based on empirical, technical-scientific knowledge, involving professional duties: dignity, individuality and autonomy. Objective: To promote mental health literacy by analysing the illness of a person with schizophrenia and the ethical issues associated with mental health nursing care. Methodology: Case study – film “A Brilliant Mind”, of a qualitative, exploratory-descriptive nature. Results and Discussion: Schizophrenia transforms the way of thinking, feeling, and relating to people, leading to stigmatisation associated with connecting myths between mental illness and violence, contributing to difficulty/exclusion in employment, social support and seeking help. Conclusion: The promotion of literacy on how to act towards a person with schizophrenia, and the inherent ethical care in nursing, are highlighted. (AU)

Psychoeducation Programs to Reduce Preoperative Anxiety in Adults: A Scoping Review.

BACKGROUND: Surgical procedure is a critical event that causes anxiety for patients. One of the possible intervention strategies to reduce anxiety in the preoperative period is psychoeducation. METHODS: A scoping review was conducted according to the JBI methodology and PRISMA-ScR to map knowledge about psychoeducation programs to reduce preoperative anxiety in adults. The data were extracted by the researchers, according to the objective of the study. Finally, the data synthesis was presented in narrative format and tables. RESULTS: four studies were included in the review with different characteristics of psychoeducation programs. The approach of these programs consisted of teaching about anxiety, instruction and training in anxiety control techniques. The contents referred to included the surgical process and intervention techniques to reduce anxiety. Program sessions lasted from 45 to 150 min, with a frequency of 1 to 6. The assessment instrument used was the State-Trait Anxiety Inventory. The dynamisers were nurses, psychotherapists and clinical psychologists. CONCLUSIONS: Psychoeducation programs can be useful and effective in reducing anxiety. More studies are needed to confirm these results.

Nonpharmacological Clinical Effective Interventions in Constipation: A Systematic Review.

PURPOSE: To identify nonpharmacological clinically effective interventions for constipation in adults. METHODS: A systematic review of experimental studies of nonpharmacological interventions addressing participants' management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693. RESULTS: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant's modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage. CONCLUSIONS: Specific nonpharmacological interventions are crucial for nurses' clinical practice and of major importance for clients and families. Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice. CLINICAL RELEVANCE: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.

A eficácia da terapia por pressão negativa para o tratamento da ferida no pé diabético: uma revisão de revisões / The effectiveness of negative pressure therapy for the treatment of diabetic foot wound: an umbrella study

Introduction and objectives: Diabetic foot is one of the disabling complications of diabetes affecting more than one million people in Portugal. Negative pressure therapy is relatively recent, describing itself as facilitating wound bed preparation and inducing granulation and angiogenesis. It is our goal to provide an overview of available evidence on the clinical efficacy of negative pressure in the treatment of diabetic foot in adults. Methodology: This is an umbrella review, with research in Scopus, Web of Science and Ebsco (Cinahl Complete and Medline), with the time limit (2014-2019), English and Spanish language, after defining the PICO review question, descriptors and inclusion and exclusion criteria. Two investigators performed methodological quality assessment, independently using JBI Critical Assessment Instrument. Results and discussion: 14 systematic reviews were identified, 3 were duplicated, 9 were eliminated after application of the inclusion criteria. Two articles were included, one with meta-analysis. The reviews included 23 studies indicating that negative pressure therapy is effective and safe, generally reflecting greater amounts of granulation tissue and shorter healing time. The existence of few randomized controlled trials and small samples are some of the limitations mentioned. Conclusions: The availability of evidence synthesized with this review may support clinical decision-making leading to an improvement in the quality of health care provided to people with diabetic foot injury

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Práticas educativas em enfermagem de saúde familiar: contributo para o desenvolvimento das competências clínicas dos enfermeiros / Educational practices in family health nursing: contribution to the development of nurses' clinical skills

Introduction: Internationally, research on educational practices in family health nursing has been limited, especially on their impact on clinical practice. This research is part of the project on the Dynamic Model of Family Assessment and Intervention integrated in the Center for Health Technology and Services Research. Objective: to describe the perception of family nurses about the contribution of teaching-learning strategies in the development of skills in family health nursing. Methods: quantitative, exploratory-descriptive study. A questionnaire was designed to evaluate the perception of the contribution of teaching-learning strategies based on a Portuguese classification. Perception was assessed on a Likert scale. The convenience sample consisted of 112 nurses who trained on the Dynamic Model of Family Assessment and Intervention after informed consent. Descriptive statistics was used for data treatment and analysis. Results and discussion: On average, mostly all strategies were perceived as having a moderate to high contribution (3.58, SD: 0.6), with a slight emphasis on the "reality simulation" teaching-learning strategies group. The "Case Study" stood out as the strategy perceived with the highest average contribution. It is suggestive that there is greater importance given to experiential learning as a promoter of knowledge and competence development, based on reflexivity about action. Conclusion: The identification of the contribution of the teaching-learning strategies is relevant for the improvement of the training design on the nursing model, as an intentional action promoting a competent acting knowledge, aiming the articulation of the theory with the clinical practice

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A mudança nas perceções dos enfermeiros de família sobre os pressupostos da intervenção familiar após o processo formativo MDAIF / Change in perceptions of family nurses about the assumptions of family intervention after the MDAIF formative process

The Dynamic Model of Family Assessment and Intervention (MDAIF) aims to constitute itself as a reference that promotes clinical decision processes based on systemic proposition. This study aimed to evaluate the changes in nurses' perceptions about the assumptions of family intervention after the training process centered on this referential. This is an exploratory and quantitative study with a sample of 553 family nurses who participated in the "MDAIF" training, organized by the Northern Regional Health Administration, until 2017. A 10 item Likert scale was used with responses between 1 "totally incompetent and 7" "fully compe-tent", based on MDAIF and applied in the pre and post training periods. T-test was performed for paired samples using SPSS version 23.0. There were very significant statistical changes regarding the perception of competence in all items evaluated, and participants after training perceived with higher competence on the assumptions of family intervention. The results confirm the importance of formative processes based on family health nursing theoretical references. May contribute to the development of family-centered practices as a client, as well as to investigate the health returns resulted from them

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Dynamic model for assessment and family intervention - impact on families health gains

The current Primary Health Care reform is focused on effectiveness patterns, tar-geted at ensuring the best possible health gains for its users. In regard to this ap-proach the aim is to assess health gains as a result of the implementation of the Dynamic Model for Assessment and Family Intervention. For this quantitative study, the focus of attention areas described in the opera-tive dimensions of this Nursing Model. Data collection was performed based on the information produced by Primary Health Care Nurses, through the Information System in use. The family health gains indexes computed into the Microsoft Office Excel 2007 were used for data processing and analysis. In the structural dimension, the major health gains were found in the residential house (50%). In the development dimension, the interventions targeted at family planning were found effective for 85.19% of the families, with the adaptation to pregnancy showing the lowest rates in health gains (50%). As to the functional di-mension, the highest rates in health gains were found for an adequate caregiver role in 33% of the families, whilst in the family process, health gains rates were at 5.56%. The implementation of the MDAIF had a positive impact on health gains outco-mes for families, fostering the development of assessment and family intervention competencies as well as the identification of training needs in specific intervention areas

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The impact on training of the dynamic model for assessment and family intervention

Introduction: The Dynamic Model for Assessment and Family Intervention (MDAIF), as an operative theoretical referential underlying the assessment and family inter-vention practices, was adopted for the family nursing specialty, in Portugal. Objective: To assess the impact of the professional practice of MDAIF on the as-sessment and family intervention practices of Primary Healthcare Nurses. Methods: A study descriptive case. Forty-nine nurses were invited to participate in the pre-training moment and forty-three in the post-training. Participants were as-ked to sign a written informed consent and were delivered an open-question form applied in the two moments. The data retrieved were submitted to content analysis with a posteriori categorization. Results and discussion: In the pre-training moment, the most common family as-sessment practices were: "Areas of attention MDAIF", "Evaluative data of the MDAIF"; "Attention Individual areas"; and for the most common family intervention practices", "action"; "client"; "health programmes"; "prevention levels".After the training: "MDAIF dimensions"; and "individual areas of attention", with occasional incidence. In the family intervention, the categories identified were: "MDAIF areas of attention" and "action". It is well known that knowledge transfer into practice in family health nursing is a challenge and that only a relatively small percentage of the training is effectively applied, however, in this study it is possible to observe that training had a positive impact in practice changes. The actions focused on care provided to each member of the family changed to care targeted at the family as a client. Conclusion: Training has enabled knowledge transfer to professional performance

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Atitudes dos enfermeiros face à família: validação da escala Families' Importance in Nursing Care - Nurses Attitudes / Attitudes of nurses towards families: validation of the scale Families' Importance in Nursing Care - Nurses Attitudes / Actitudes de los enfermeros frente a la familia: validación de la escala Families Importance in Nursing Care - Nurses Attitudes

As atitudes que os enfermeiros adotam em relação à família condicionam o processo de cuidar. Nosso propósito com este estudo foi nesse sentido: dispor de um instrumento que nos permitisse conhecer esta variável. Assim, nossa proposta foi efetuar a adaptação transcultural e avaliar as propriedades psicométricas da versão portuguesa do instrumento Families' Importance in Nursing Care - Nurses Attitudes (FINC-NA), que visa avaliar as atitudes dos enfermeiros acerca da importância de envolver a família nos cuidados de enfermagem. Foi seguido o método preconizado pela literatura. A amostra foi constituída por 136 enfermeiros dos Cuidados de Saúde Primários. Os resultados obtidos nos testes de confiabilidade revelam uma boa consistência interna para o total dos itens (Alpha de Cronbach = 0,87). O estudo psicométrico permite-nos afirmar que a versão em português da FINC-NA, que denominamos A importância das famílias nos cuidados de enfermagem - atitudes dos enfermeiros (IFCE-AE), é um instrumento fidedigno e válido.

The attitudes of nurses towards families determine the care process. With this study, we aimed to obtain an instrument that would allow us to learn about this variable. Hence, our purpose was to perform the cross-cultural adaptation and evaluate the psychometric features of the Portuguese version of the instrument Families' Importance in Nursing Care - Nurses Attitudes (FINC-NA), which aims to evaluate the attitudes of nurses towards the importance of involving the patient's family in the nursing care. The method recommended by the literature was followed. The sample consisted of 136 nurses working in primary health care. The results obtained in the reliability tests showed good internal consistency (Cronbach's Alpha=0.87). The psychometric study permits us to state that the Portuguese version of the FINC-NA, which in Portuguese is referred to as A importância das famílias nos cuidados de enfermagem - atitudes dos enfermeiros (IFCE-AE), is a reliable and valid tool.

Las actitudes adoptadas por enfermeros en relación a la familia condicionan el proceso de cuidar. En tal sentido, nos propusimos con este estudio, disponer de un instrumento que nos permita conocer esta variable. Así, nos propusimos efectuar la adaptación transcultural y evaluar las propiedades psicométricas de la versión portuguesa del instrumento Families Importance in Nursing Care - Nurses Attitudes (FINC-NA), que apunta a evaluar actitudes de enfermeros acerca de involucrar a la familia en los cuidados de enfermería. Se siguió el método sugerido por la literatura. Muestra constituida por 136 Enfermeros de Atención Primaria de Salud. Los resultados obtenidos en pruebas de fiabilidad revelan buena consistencia interna para el total de ítems (Alpha de Cronbach=0,87). El estudio psicométrico nos permite afirmar que la versión en Portugués del FINC-NA, que denominamos La importancia de las familias en el cuidado de enfermería - actitudes de los enfermeros (IFCE-AE) es un instrumento fidedigno y válido.

Ciclo vital da família e envelhecimento: contextos e desafios / Family life cycle and aging: contexts and challenges

Os focos dos cuidados de enfermagem têm vindo a apresentar configurações diferentes face às mudanças sociais que exigem novas necessidades de saúde. O ciclo vital da família caracteriza-se por padrões de regularidade funcional, associados às funções, estrutura e processos interacionais. Nesta perspectiva a compreensão destes padrões na última etapa do ciclo vital, que se caracteriza pela adaptação ao envelhecimento, permitirá interacções mais ajustadas à promoção da saúde familiar.(AU)

The focus of nursing care has been presenting different configurations due to the social changes that require new health requirements. The family life cycle is characterized by functional regular patterns, associated to the functions, structure and interactional processes. In this perspective, understanding these patterns in the last stage of the lifecycle, which is characterized by the adaptation to aging, allowing interactions more adjusted to the promotion of family health.(AU)

Ciclo vital da família e envelhecimento: contextos e desafios / Family life cycle and aging: contexts and challenges

Os focos dos cuidados de enfermagem têm vindo a apresentar configurações diferentes face às mudanças sociais que exigem novas necessidades de saúde. O ciclo vital da família caracteriza-se por padrões de regularidade funcional, associados às funções, estrutura e processos interacionais. Nesta perspectiva a compreensão destes padrões na última etapa do ciclo vital, que se caracteriza pela adaptação ao envelhecimento, permitirá interacções mais ajustadas à promoção da saúde familiar...

The focus of nursing care has been presenting different configurations due to the social changes that require new health requirements. The family life cycle is characterized by functional regular patterns, associated to the functions, structure and interactional processes. In this perspective, understanding these patterns in the last stage of the lifecycle, which is characterized by the adaptation to aging, allowing interactions more adjusted to the promotion of family health...

[Attitudes of nurses towards families: validation of the scale Families' Importance in Nursing Care--Nurses Attitudes]. / Atitudes dos enfermeiros face à família: validação da escala Families' Importance in Nursing Care--Nurses Attitudes.

The attitudes of nurses towards families determine the care process. With this study, we aimed to obtain an instrument that would allow us to learn about this variable. Hence, our purpose was to perform the cross-cultural adaptation and evaluate the psychometric features of the Portuguese version of the instrument Families' Importance in Nursing Care - Nurses Attitudes (FINC-NA), which aims to evaluate the attitudes of nurses towards the importance of involving the patient's family in the nursing care. The method recommended by the literature was followed. The sample consisted of 136 nurses working in primary health care. The results obtained in the reliability tests showed good internal consistency (Cronbach's Alpha=0.87). The psychometric study permits us to state that the Portuguese version of the FINC-NA, which in Portuguese is referred to as A importância das famílias nos cuidados de enfermagem - atitudes dos enfermeiros (IFCE-AE), is a reliable and valid tool.

Composição química de misturas de farinhas de banana verde com castanha do brasil / Chemical composition of mixtures with green banana and nut Brazil flours

No presente estudo foram preparadas misturas de farinhas de banana verde e de castanha-do-brasil e analisadas suas características e os valores aditivos nutricionais. Diferentes percentuais de farinha de castanha-do-brasil (5%, 10% e 15%) foram misturadas à farinha de banana verde. Determinou-se a composição centesimal da mistura por meio de análises químicas das matérias-primas individuais e das farinhas mistas. Por se tratar de matérias-primas distintas, a composição centesimal da farinha de banana verde e de castanha-do-brasil apresentou diferença significativa para todos os constituintes químicos analisados. As farinhas mistas apresentaram aumento nos teores médios de proteínas, lipídeos, cinzas e decréscimo de carboidratos totais. A mistura de farinha de castanha-do-brasil, em até 15%, na farinha de banana verde, apresentou melhor valor nutricional quando comparada com suas matérias-primas individuais. Sugere-se a realização de mais estudos com as mesmas matérias-primas, com adição de farinhas de castanha-do-brasil, que apresentem baixos teores de lipídeos, com objetivo de aumentar ainda mais a concentração dos teores de fibras totais, proteínas e minerais nas farinhas mistas elaboradas.

The mixtures of green banana and Brazilian nut flours were prepared and characterized on food nutritionaladditive value. Varied percentage of Brazilian nut flour (5%, 10% and 15%) were combined with green banana flour. The centesimal composition of the mixture was determined by means of chemical analyses in the individual raw materials and in the mixed flours. For being distinct raw materials, the centesimal composition of both green banana and Brazilian nut flours showed significant differences in all of theanalyzed chemical constituents. An increase in the average contents of proteins, lipids, and ashes, and adecrease in total carbohydrates were found in the mixed flours. The mixture of Brazilian nut flour in up to 15% in green banana flour demonstrated the best nutritional value when compared with the respective raw materials. It is suggested to perform further studies on the same raw materials and adding Brazilian nut flours containing low lipid contents, for increasing the concentration of the total fibers, proteins and minerals contents in the prepared flours mixtures.