Portuguese translation, cultural adaptation, and validation of the Person-Centred Practice Inventory - Staff (PCPI-S).

Aiming to translate, culturally adapt, and psychometrically evaluate the Person-centred Practice Inventory - Staff (PCPI-S) for Portuguese healthcare professionals, this methodological study was conducted sequentially in two phases. Phase I followed the 10-steps recommendations from the ISPOR taskforce for translation and cultural adaptation of patient reported outcome measures. Phase II comprised a quantitative cross-sectional virtual survey of the translated PCPI-S with healthcare professionals, who were reached through snowball sampling from both primary and specialized care settings. The psychometric properties of the PCPI-S were determined by assessing reliability and construct validity. A sample of 304 healthcare professionals participated in Phase II. Ceiling effects were found. The overall internal consistency was excellent (> 0.9). The confirmatory factor analysis showed a good model fit after minor modifications, revealing construct validity, and supporting the theoretical framework. In conclusion, the three-factorial model of PCPI-S adjusted to the studied sample is a valid and reliable instrument to assess the perceptions of healthcare professionals on person-centred practice in various Portuguese clinical contexts. Considering the ceiling effects, the effect of social desirability should be explored.

Portuguese translation, cultural adaptation, and validation of the Person-Centred Practice Inventory - Staff (PCPI-S) / Tradução, adaptação cultural e validação do Inventário da Prática Centrada na Pessoa, profissionais de saúde (PCPI-S)

Abstract Aiming to translate, culturally adapt, and psychometrically evaluate the Person-centred Practice Inventory - Staff (PCPI-S) for Portuguese healthcare professionals, this methodological study was conducted sequentially in two phases. Phase I followed the 10-steps recommendations from the ISPOR taskforce for translation and cultural adaptation of patient reported outcome measures. Phase II comprised a quantitative cross-sectional virtual survey of the translated PCPI-S with healthcare professionals, who were reached through snowball sampling from both primary and specialized care settings. The psychometric properties of the PCPI-S were determined by assessing reliability and construct validity. A sample of 304 healthcare professionals participated in Phase II. Ceiling effects were found. The overall internal consistency was excellent (> 0.9). The confirmatory factor analysis showed a good model fit after minor modifications, revealing construct validity, and supporting the theoretical framework. In conclusion, the three-factorial model of PCPI-S adjusted to the studied sample is a valid and reliable instrument to assess the perceptions of healthcare professionals on person-centred practice in various Portuguese clinical contexts. Considering the ceiling effects, the effect of social desirability should be explored.

Resumo Com o objetivo de traduzir, adaptar culturalmente e avaliar psicometricamente o Inventário para a Prática Centrada na Pessoa para profissionais de saúde (PCPI-S) em diversos contextos de prestação de cuidados, este estudo metodológico realizou-se em duas fases sequenciais. A Fase I seguiu as recomendações de dez etapas da taskforce da ISPOR para tradução e adaptação cultural de medidas de resultados auto reportados. A Fase II incluiu um estudo cross-sectional do PCPI-S traduzido com profissionais de saúde, que foram alcançados por meio de amostragem snowball em contextos de cuidados primários e diferenciados. A psicometria do PCPI-S foi analisada pela avaliação da confiabilidade e validade de construto. Uma amostra de 304 profissionais de saúde participou da Fase II. Efeitos de teto foram encontrados. A consistência interna geral foi excelente (> 0,9). A análise fatorial confirmatória mostrou um bom ajuste do modelo e validade de construto, refletindo o referencial teórico. Concluindo, o modelo tri-fatorial do PCPI-S ajustado à amostra estudada é um instrumento válido e fiável para avaliar as percepções dos profissionais de saúde sobre a prática centrada na pessoa em vários contextos de cuidados portugueses. Considerando os efeitos teto, a desejabilidade social deve ser explorada.

Design of Innovative Clothing for Pressure Injury Prevention: End-User Evaluation in a Mixed-Methods Study.

The global relevance of pressure injury (PI) prevention technologies arise from their impact on the quality of life of people with limited mobility and the costs associated with treating these preventable injuries. The purpose of this mixed methods study is to evaluate the design of a prototype integrating Smart Health Textiles for PI prevention based on feedback from specialist nurses who care for individuals who are prone to or have PIs. This is a mixed methods study. A structured questionnaire was conducted as part of an evaluation of a prototype garment for the prevention of PIs. This questionnaire was applied during the evaluation of the prototype and afterwards focus group discussions were held with experts. Descriptive statistics techniques were used to analyze the data and thematic and integrated content analysis was conducted through concomitant triangulation. Nineteen nurses took part, aged 30 to 39 years (52.6%) and with 12.31 ± 8.96 years of experience. Participants showed that the prototype required more manipulation and physical effort, which interfered its usefulness, in addition to presenting difficulties with the openings and the material of the closure system, which interfered with the ease of use and learning. Overall satisfaction with the product was moderate, with some areas for improvement found, such as satisfaction, recommendations to colleagues, and pleasantness of use. It is concluded that areas for improvement have been found in all dimensions, including in the design of openings and the choice of materials. These findings supply significant insights for improving clothing to meet the needs of healthcare professionals and patients.

Flushing in Intravenous Catheters: Observational Study of Nursing Practice in Intensive Care in Brazil.

An observational study was developed with 108 nursing professionals who managed vascular access devices in 4 intensive care units of a university hospital in Rio de Janeiro, Brazil. The objective was to analyze the practice of the nursing staff in performing flushing for the maintenance of vascular access devices in critically ill patients. Data were collected by observing the flushing procedure using a structured checklist and analyzed using descriptive and inferential statistics. In 23% of the 404 observations, there was no flushing. When performed at some point during catheter management (77%), flushing was predominant after drug administration with 1 or 2 drugs administered. There were flaws in the flushing technique applied in terms of volume and method of preparation. Time of professional experience >5 years, knowledge about recommendations, and training on flushing were variables associated with technique performance. It was concluded that the flushing procedure did not meet the recommendations of good practices, with failures that constituted medication errors.

Repercussions of sickle cell disease and sickle cell ulcers for men inserted in the world of work.

OBJECTIVE: To analyze the repercussions of sickle cell disease and sickle cell ulcer for men in the world of work and discuss the challenges faced to remain in the work environment. METHOD: A qualitative study, developed at the dressing clinic and at a stomatherapy clinic. Twenty men with sickle cell disease and sickle cell ulcer participated, applying a semi-structured interview script. The software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires was used for treatment and lexical data analysis. RESULTS: The Descending Hierarchical Classification enabled the creation of classes: Man with sickle cell disease and sickle cell ulcer: experiences and repercussions; and Coping measures adopted by men with sickle cell disease and sickle cell ulcer to stay at work. CONCLUSION: Disease and injury repercussions involve biopsychosocial dimensions, highlighting the need for professional training to assist with competence and humanity. Strategies adopted to maintain work are breaks in the working day, use of analgesics to relieve pain, allocating time during work to apply dressings.

Development of Smart Clothing to Prevent Pressure Injuries in Bedridden Persons and/or with Severely Impaired Mobility: 4NoPressure Research Protocol.

Pressure injuries (PIs) are a major public health problem and can be used as quality-of-care indicators. An incipient development in the field of medical devices takes the form of Smart Health Textiles, which can possess innovative properties such as thermoregulation, sensing, and antibacterial control. This protocol aims to describe the process for the development of a new type of smart clothing for individuals with reduced mobility and/or who are bedridden in order to prevent PIs. This paper's main purpose is to present the eight phases of the project, each consisting of tasks in specific phases: (i) product and process requirements and specifications; (ii and iii) study of the fibrous structure technology, textiles, and design; (iv and v) investigation of the sensor technology with respect to pressure, temperature, humidity, and bioactive properties; (vi and vii) production layout and adaptations in the manufacturing process; (viii) clinical trial. This project will introduce a new structural system and design for smart clothing to prevent PIs. New materials and architectures will be studied that provide better pressure relief, thermo-physiological control of the cutaneous microclimate, and personalisation of care.

Nursing Practices and Sensitive Outcomes Related to Peripheral Intravenous Catheterization in Portugal: A Scoping Review.

Implementation of evidence-based practice (EBP) is essential for ensuring high-quality nursing care. In Portugal, nurses are responsible for care delivery to patients who require peripheral intravenous access. However, recent authors emphasized the predominance of a culture based on outdated professional vascular access practices in Portuguese clinical settings. Thus, the aim of this study was to map the studies conducted in Portugal on peripheral intravenous catheterization. A scoping review was conducted based on the Joanna Briggs Institute recommendations, with a strategy adapted to different scientific databases/registers. Independent reviewers selected, extracted, and synthesized the data. Of the 2128 studies found, 26 were included in this review, published between 2010 and 2022. Previous research shows that Portuguese nurses' implementation of EBP was found to be relatively low overall, while most studies did not attempt to embed EBP change into routine care. Although nurses are responsible for implementing EBP at an individual patient level, the studies conducted in Portugal report nonstandardized practices among professionals, with significant deviations from recent evidence. This reality, combined with Portugal's absence of government-endorsed evidence-based standards for peripheral intravenous catheter (PIVC) insertion and treatment and vascular access teams, may explain the country's unacceptably high incidence of PIVC-related complications reported over the last decade.

Short Peripheral Venous Catheters Contamination and the Dangers of Bloodstream Infection in Portugal: An Analytic Study.

Peripheral venous catheters (PVCs) are the most used vascular access devices in the world. However, failure rates remain considerably high, with complications such as PVC-related infections posing significant threats to patients' well-being. In Portugal, studies evaluating the contamination of these vascular medical devices and characterizing the associated microorganisms are scarce and lack insight into potential virulence factors. To address this gap, we analyzed 110 PVC tips collected in a large tertiary hospital in Portugal. Experiments followed Maki et al.'s semi-quantitative method for microbiological diagnosis. Staphylococcus spp. were subsequently studied for the antimicrobial susceptibility profile by disc diffusion method and based on the cefoxitin phenotype, were further classified into strains resistant to methicillin. Screening for the mecA gene was also done by a polymerase chain reaction and minimum inhibitory concentration (MIC)-vancomycin as determined by E-test, proteolytic and hemolytic activity on skimmed milk 1% plate and blood agar, respectively. The biofilm formation was evaluated on microplate reading through iodonitrotetrazolium chloride 95% (INT). Overall, 30% of PVCs were contaminated, and the most prevalent genus was Staphylococcus spp., 48.8%. This genus presented resistance to penicillin (91%), erythromycin (82%), ciprofloxacin (64%), and cefoxitin (59%). Thus, 59% of strains were considered resistant to methicillin; however, we detected the mecA gene in 82% of the isolates tested. Regarding the virulence factors, 36.4% presented α-hemolysis and 22.7% ß-hemolysis, 63.6% presented a positive result for the production of proteases, and 63.6% presented a biofilm formation capacity. Nearly 36.4% were simultaneously resistant to methicillin and showed expression of proteases and/or hemolysins, biofilm formation, and the MIC to vancomycin were greater than 2 µg/mL. Conclusion: PVCs were mainly contaminated with Staphylococcus spp., with high pathogenicity and resistance to antibiotics. The production of virulence factors strengthens the attachment and the permanence to the catheter's lumen. Quality improvement initiatives are needed to mitigate such results and enhance the quality and safety of the care provided in this field.

End-User Assessment of an Innovative Clothing-Based Sensor Developed for Pressure Injury Prevention: A Mixed-Method Study.

This study aimed to evaluate a clothing prototype that incorporates sensors for the evaluation of pressure, temperature, and humidity for the prevention of pressure injuries, namely regarding physical and comfort requirements. A mixed-method approach was used with concurrent quantitative and qualitative data triangulation. A structured questionnaire was applied before a focus group of experts to evaluate the sensor prototypes. Data were analyzed using descriptive and inferential statistics and the discourse of the collective subject, followed by method integration and meta-inferences. Nine nurses, experts in this topic, aged 32.66 ± 6.28 years and with a time of profession of 10.88 ± 6.19 years, participated in the study. Prototype A presented low evaluation in stiffness (1.56 ± 1.01) and roughness (2.11 ± 1.17). Prototype B showed smaller values in dimension (2.77 ± 0.83) and stiffness (3.00 ± 1.22). Embroidery was assessed as inadequate in terms of stiffness (1.88 ± 1.05) and roughness (2.44 ± 1.01). The results from the questionnaires and focus groups' show low adequacy as to stiffness, roughness, and comfort. The participants highlighted the need for improvements regarding stiffness and comfort, suggesting new proposals for the development of sensors for clothing. The main conclusions are that Prototype A presented the lowest average scores relative to rigidity (1.56 ± 1.01), considered inadequate. This dimension of Prototype B was evaluated as slightly adequate (2.77 ± 0.83). The rigidity (1.88 ± 1.05) of Prototype A + B + embroidery was evaluated as inadequate. The prototype revealed clothing sensors with low adequacy regarding the physical requirements, such as stiffness or roughness. Improvements are needed regarding the stiffness and roughness for the safety and comfort characteristics of the device evaluated.

A three step protocol for the development of an innovative footwear (shoe and sensor based insole) to prevent diabetic foot ulceration.

Background: The incidence of diabetic foot ulceration (DFU) is increasing worldwide. Therapeutic footwear is usually recommended in clinical practice for preventing foot ulcers in persons with diabetes. The project Science DiabetICC Footwear aims to develop innovative footwear to prevent DFU, specifically a shoe and sensor-based insole, which will allow for monitoring pressure, temperature, and humidity parameters. Method: This study presents a three-step protocol for the development and evaluation of this therapeutic footwear, specifically: (i) a first observational study will specify the user requirements and contexts of use; (ii) after the design solutions were developed for shoe and insole, the semi-functional prototypes will be evaluated against the initial requirements; (iii) and a pre-clinical study protocol will enable the evaluation of the final functional prototype. The eligible diabetic participants will be involved in each stage of product development. The data will be collected using interviews, clinical evaluation of the foot, 3D foot parameters and plantar pressure evaluation. This three-step protocol was defined according to the national and international legal requirements, ISO norms for medical devices development, and was also reviewed and approved by the Ethics Committee of the Health Sciences Research Unit: Nursing (UICISA: E) of the Nursing School of Coimbra (ESEnfC). Results: The involvement of end-users (diabetic patients) will enable the definition of user requirements and contexts of use to develop design solutions for the footwear. Those design solutions will be prototyped and evaluated by end-users to achieve the final design for therapeutic footwear. The final functional prototype will be evaluated in pre-clinical studies to ensure that the footwear meets all the requirements to move forward to clinical studies. Discussion: The three-step study outlined in this protocol will provide the necessary insights during the product development, ensuring this new therapeutic footwear's main functional and ergonomic features for DFU prevention.

Foot and Ankle Disorders in Nurses Exposed to Prolonged Standing Environments: A Scoping Review.

BACKGROUND: Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses' ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences. METHODS: This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format. FINDINGS: The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future. CONCLUSION/APPLICATIONS TO PRACTICE:: Few studies have focused on nurses' foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses' workplaces.

Escala Portuguesa de Flebite: adaptação transcultural, validade e confiabilidade para uso no Brasil / Portuguese Phlebitis Scale: cross-cultural adaptation, validity and reliability for use in Brazil / Escala Portuguesa de Flebitis: adaptación transcultural, validez y confiabilidad para uso en Brasil

Objetivos: Adaptar a Escala Portuguesa de Flebite para a cultura brasileira e verificar as propriedades psicométricas da versão adaptada. Métodos: Estudo metodológico envolvendo análise da equivalência semântica, cultural e idiomática para adaptação transcultural, cognitive debriefing, verificação da consistência interna e validade de construto. Equivalência foi analisada utilizando percentual de acordos. Validade de construto foi testada utilizando análise fatorial exploratória.A confiabilidade foi avaliada pela consistência interna (α de Cronbach e Ω de McDonald). Resultados: No processo de adaptação transcultural, envolvendo dez especialistas, dois itens não alcançaram concordância ≥ 80% e sofreram ajustes conforme as sugestões recebidas. Doze participantes do cognitive debriefing aprovaram a versão adaptada. Participaram da análise de confiabilidade e de validação do construto 244 adultos em uso de cateter venoso periférico. Análise fatorial exploratória identificou um único fator incluindo todos os itens testados (dor, eritema, edema, rubor no trajeto da veia e cordão venoso palpável) e carga fatorial > 0,743. Consistência interna do conjunto de itens foi alta (α de Cronbach = 0,771 e Ω de McDonald = 0,853). Conclusão: A Escala Portuguesa de Flebite ­ Versão adaptada para o Brasil mostrou-se válida e confiável. Alcançou propriedades que permitem sua utilização na prática clínica, no ensino e pesquisas no país.

Objectives: To adapt the Portuguese Phlebitis Scale to the Brazilian culture and verify the adapted version's psychometric properties. Methods: Methodological study involving analysis of semantic, cultural, and idiomatic equivalence for cross-cultural adaptation, cognitive debriefing, verification of internal consistency, and construct validity. The equivalence was analyzed considering the percentage of agreement among experts. Exploratory factor analysis was used to test construct validity. Reliability was assessed by internal consistency (Cronbach's α and McDonald's Ω). Results: In the cross-cultural adaptation process involving ten experts, two items did not reach an agreement ≥ 80% and underwent adjustments according to the suggestions received. Twelve cognitive debriefing participants approved the adapted version. Adults (n = 244) using a peripheral venous catheter participated in the reliability and construct validation analysis. Exploratory factor analysis identified a single factor, including all tested items (pain, erythema, edema, streak formation along the course of the vein, and palpable venous cord) and factor loading > 0.743. Internal consistency of the set of items was high (Cronbach's α = 0.771 and McDonald's Ω = 0.853). Conclusion: The Portuguese Scale of Phlebitis - Version adapted for Brazil proved valid and reliable. It achieved properties that allow use in Brazil's clinical practice, teaching, and research.

Objetivos: Adaptar la Escala de Flebitis Portuguesa a la cultura brasileña y verificar las propiedades psicométricas de la versión adaptada. Métodos: Estudio metodológico que involucró análisis de equivalencia semántica, cultural e idiomática para adaptación transcultural, debriefing cognitivo, verificación de consistencia interna y validez de constructo. Para el análisis de la concordancia de la equivalencia se utilizó el porcentaje de concordancias. Para probar la validez de constructo, se utilizó el análisis factorial exploratorio. La fiabilidad se evaluó mediante la consistencia interna (α de Cronbach e Ω de McDonald). Resultados: En el proceso de adaptación transcultural, en el que participaron diez expertos, dos ítems no alcanzaron un acuerdo ≥ 80% y se ajustaron de acuerdo con las sugerencias recibidas. Doce participantes en el debriefing cognitivo aprobaron la versión adaptada. Usuarios de catéter venoso periférico (n = 244) participaron en el análisis de confiabilidad y la validación de constructo. El análisis factorial exploratorio identificó un solo factor que incluía todos los ítems probados (dolor, eritema, edema, enrojecimiento en la vena y el cordón venoso palpable) y una carga factorial > 0,743. La consistencia interna de los ítems fue alta (αde Cronbach = 0,771 y Ω de McDonald = 0,853). Conclusión: La Escala Portuguesa de Flebitis ­ Versión adaptada para Brasil demostró ser válida y confiable. Alcanzó propiedades que permiten su uso en la práctica clínica, la docencia e la investigación en Brasil.

Care technology prototype for flushing practice in intravenous catheter maintenance / Prototipo de tecnología de cuidado para la práctica de flushing en el mantenimiento de catéteres intravenosos / Protótipo de tecnologia de cuidado para prática do flushing na manutenção de cateteres intravenosos

ABSTRACT Objective: to elaborate, based on the assessment of the nursing team's flushing practice, a care technology prototype aimed at promoting good practices in intravenous catheter maintenance in intensive care. Method: a technology elaboration study, developed in three stages: flushing practice assessment through a questionnaire completed by 108 nursing professionals working in intravenous catheter maintenance in intensive care settings of a public hospital located in the city of Rio de Janeiro, Brazil. Data collection took place from November 2019 to January 2020, with descriptive and inferential data analysis; analysis of this practice regarding the existence of errors according to the main guidelines and scientific evidence, with classification of types of errors in the light of the conceptual framework of patient safety; and technology prototype development. Results: 88% of participants perform flushing in their practice; 49.5% apply the continuous pressure technique on the syringe plunger; 22% perform flushing before, between and after medication administration; predominance of use of volume and syringes with gauges of 5 ml and 10 ml. Variables related to knowledge were associated with not performing flushing. There were active and latent errors that guided the technology prototype construction. Conclusion: a care guide was built that aims to increase nursing team's knowledge about good flushing practices and is configured as a barrier to error recurrence.

RESUMEN Objetivo: elaborar, a partir de la evaluación de la práctica de flushing del equipo de enfermería, un prototipo de tecnología asistencial con el objetivo de promover buenas prácticas en el mantenimiento de catéteres intravenosos en cuidados intensivos. Método: estudio de elaboración de tecnología, desarrollado en tres etapas: evaluación de la práctica de flushing a través de un cuestionario completado por 108 profesionales de enfermería que actúan en el mantenimiento de catéteres intravenosos en Unidades de Cuidados Intensivos de un hospital público ubicado en la ciudad de Río de Janeiro, Brasil. La recolección de datos ocurrió de noviembre de 2019 a enero de 2020, con análisis de datos descriptivo e inferencial; análisis de esta práctica en cuanto a la existencia de errores según las principales guías y evidencias científicas, con clasificación de tipos de errores a la luz del marco conceptual de seguridad del paciente; y desarrollo del prototipo tecnológico. Resultados: el 88% de los participantes realizan flushing en su consulta; el 49,5% aplica la técnica de presión continua sobre el émbolo de la jeringa; el 22% realiza flushing antes, entre y después de la administración de medicamentos; hubo predominio del uso de volumen y jeringas con calibres de 5 ml y 10 ml. Las variables relacionadas con el conocimiento se asociaron con no realizar el flushing. Existieron errores activos y latentes que orientaron la construcción del prototipo tecnológico. Conclusión: se elaboró ​​una guía de atención que tiene como objetivo aumentar el conocimiento del equipo de enfermería sobre las buenas prácticas de flushing y se configura como una barrera para la recurrencia de errores.

RESUMO Objetivo: elaborar, com base na avaliação da prática do flushing da equipe de enfermagem, um protótipo de tecnologia de cuidado voltado a promover as boas práticas na manutenção dos cateteres intravenosos em terapia intensiva. Método: estudo de elaboração de tecnologia, desenvolvido em três etapas: avaliação da prática do flushing através de questionário preenchido por 108 profissionais de enfermagem atuantes na manutenção dos cateteres intravenosos em cenários de terapia intensiva de um hospital público localizado no município do Rio de Janeiro, Brasil. A coleta de dados ocorreu de novembro de 2019 a janeiro de 2020, com análise descritiva e inferencial dos dados; análise dessa prática quanto à existência de erros segundo as principais diretrizes e evidências científicas, com classificação dos tipos de erros à luz do referencial conceitual da segurança do paciente; e elaboração do protótipo da tecnologia. Resultados: 88% dos participantes realizam o flushing na sua prática; 49,5% aplicam a técnica de pressão contínua no êmbolo da seringa; 22% realizam o flushing antes, entre e após a administração de medicamentos; predomínio da utilização do volume e de seringas com calibres de 5 ml e 10 ml. Variáveis relacionadas ao conhecimento associaram-se à não realização do flushing. Houve erros ativos e latentes que orientaram a construção do protótipo da tecnologia. Conclusão: construiu-se um Guia de Cuidado que objetiva ampliar o conhecimento da equipe de enfermagem sobre as boas práticas do flushing e se configura como uma barreira à recorrência dos erros.

Repercussions of sickle cell disease and sickle cell ulcers for men inserted in the world of work / Repercusiones de la anemia de células falciformes y de las úlceras falciformes para los hombres insertados en el mundo del trabajo / Repercussões da anemia falciforme e das úlceras falcêmicas para homens inseridos no mundo do trabalho

ABSTRACT Objective: To analyze the repercussions of sickle cell disease and sickle cell ulcer for men in the world of work and discuss the challenges faced to remain in the work environment. Method: A qualitative study, developed at the dressing clinic and at a stomatherapy clinic. Twenty men with sickle cell disease and sickle cell ulcer participated, applying a semi-structured interview script. The software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires was used for treatment and lexical data analysis. Results: The Descending Hierarchical Classification enabled the creation of classes: Man with sickle cell disease and sickle cell ulcer: experiences and repercussions; and Coping measures adopted by men with sickle cell disease and sickle cell ulcer to stay at work. Conclusion: Disease and injury repercussions involve biopsychosocial dimensions, highlighting the need for professional training to assist with competence and humanity. Strategies adopted to maintain work are breaks in the working day, use of analgesics to relieve pain, allocating time during work to apply dressings.

RESUMEN Objetivo: Analizar las repercusiones de la drepanocitosis y la drepanocitosis para hombres que actúan en el mundo del trabajo y discutir los desafíos enfrentados para permanecer en el ambiente de trabajo. Método: Estudio cualitativo, desarrollado en la clínica de vendajes y en una clínica de estomaterapia. Participaron 20 hombres con drepanocitosis y drepanocitosis, aplicando un guión de entrevista semiestructurada. Para el tratamiento y análisis léxico de los datos se utilizó el software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Resultados: La Clasificación Jerárquica Descendente permitió la creación de clases: Hombre con anemia falciforme y úlcera falciforme: experiencias y repercusiones; y Medidas de afrontamiento adoptadas por el hombre con enfermedad de células falciformes y úlcera falciforme para permanecer en el trabajo. Conclusión: las repercusiones de la enfermedad y lesión involucran las dimensiones biopsicosociales, destacando la necesidad de formación profesional para asistir con competencia y humanidad. Las estrategias adoptadas para mantener el trabajo son pausas en la jornada laboral, uso de analgésicos para aliviar el dolor, asignación de tiempo durante el trabajo para aplicar curas.

RESUMO Objetivo: Analisar as repercussões da doença falciforme e da úlcera falcêmica para homens que atuam no mundo do trabalho e discutir os desafios enfrentados para se manterem no ambiente laboral. Método: Estudo qualitativo, desenvolvido no ambulatório de curativo e em uma clínica de estomaterapia. Participaram 20 homens com doença falciforme e úlcera falcêmica, aplicando-se roteiro de entrevista semiestruturado. Utilizou-se o software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires, para tratamento e análise lexical dos dados. Resultados: A Classificação Hierárquica Descendente possibilitou a criação das classes: Homem com doença falciforme e úlcera falcêmica: vivências e repercussões; e Medidas de enfrentamento adotadas pelo homem com doença falciforme e úlcera falcêmica para manutenção no trabalho. Conclusão: As repercussões da doença e lesão envolvem as dimensões biopsicossociais, evidenciando a necessidade de capacitação dos profissionais para assistir com competência e humanidade. As estratégias adotadas para manutenção no trabalho são pausas na jornada laboral, uso de analgésicos para aplacar a dor, destinação de tempo durante o trabalho para realização dos curativos.

Representações sociais do isolamento de idosos durante a pandemia da COVID-19 / Older people's social representations of their social isolation during the COVID-19 pandemic / Representaciones sociales del aislamiento de los ancianos durante la pandemia COVID-19

Resumo Enquadramento: O isolamento é adotado mundialmente durante as diferentes fases da pandemia na tentativa de achatar a curva de contágio e proteger grupos vulneráveis. Objetivo: Discutir as representações sociais de pessoas idosas sobre o seu isolamento social durante a pandemia da COVID-19. Metodologia: Pesquisa qualitativa alicerçada na abordagem estrutural das representações sociais. Participaram 117 idosos que buscaram imunização para influenza numa unidade básica de saúde Mineira brasileira em 2020. Foram recolhidos dados sociodemográficos e utilizada técnica de evocação. Realizou-se análise prototípica após conciliação lexicográfica, semântica e teste de coocorrência nos softwares EVOC e Iramuteq. Resultados: As representações foram objetivadas no distanciamento e ancoradas nas justificativas necessário-seguro, fazer-possível, ficar-casa, limitar-saída, perigo-doença e prevenção que refletiram o processo de construção das representações sociais. Conclusão: as representações foram objetivadas pelo distanciamento e ancoradas nas justificativas expressas necessário-seguro, fazer-possível, ficar-casa, limitar-saída, perigo-doença e prevenção, que refletiram o processo de construção das representações numa perspetiva cognoscível.

Abstract: Background: Isolation is adopted worldwide during the different phases of the pandemic in an attempt to flatten the contagion curve and protect vulnerable groups. Objective: To discuss the social representations of older people about their social isolation during the COVID-19 pandemic. Methodology: Qualitative research based on the structural approach of social representations. 117 elderly people who sought immunization for influenza in a Brazilian Basic Health Unit in 2020 participated. Sociodemographic data and evocation technique were collected. Prototypical analysis was carried out after lexicographic, semantic reconciliation and co-occurrence testing in the EVOC and Iramuteq software. Results: The representations were aimed at "distancing" and anchored in the justifications "necessary-safe, make-possible, stay-home, limit-exit, danger-disease and prevention" that reflected the process of building social representations. Conclusion: The representations were objectified by distancing and anchored in the expressed justifications necessary-safe, make-possible, stay-at-home, limit-out, danger-disease and prevention, which reflected the process of construction of representations in a knowable perspective.

Resumen: Marco contextual: El aislamiento se adopta en todo el mundo durante las diferentes fases de la pandemia en un intento de aplanar la curva de contagio y proteger a los grupos vulnerables. Objetivo: Discutir las representaciones sociales de las personas mayores sobre su aislamiento social durante la pandemia del COVID-19. Metodología: Investigación cualitativa basada en el enfoque estructural de Representaciones Sociales. Participaron 117 ancianos que solicitaron inmunización contra influenza en una Unidad Básica de Salud de Brasil en 2020. Se recolectaron datos sociodemográficos y técnica de evocación. El análisis prototípico se llevó a cabo después de pruebas lexicográficas, de reconciliación semántica y de co-ocurrencia en el software EVOC e Iramuteq. Resultados: Las representaciones estaban orientadas al "desapego" y ancladas en las justificaciones "necesario-seguro, hacer-posible, quedarse en casa, límite-salida, peligro-enfermedad y prevención" que reflejaban el proceso de construcción de representaciones sociales. Conclusión: Las representaciones fueron objetivadas por el distanciamiento y ancladas en las justificaciones expresadas necesarias -seguro, posibilitar, quedarse en casa, límite fuera, peligro-enfermedad y prevención, que reflejaban el proceso de construcción de representaciones en una perspectiva cognoscible.

Funcionalidade e aprendizagem de um dispositivo de reabilitação para doentes pós-enfarte: Perspetiva de enfermeiros de reabilitação / Functionality and learning of a post-infarction rehabilitation device: The perspective of rehabilitation nurses / Funcionalidad y aprendizaje de un dispositivo de rehabilitación para pacientes que han sufrido un infarto: Perspectiva de los enfermeros de rehabilitación

Resumo Enquadramento: A patologia cardiovascular constitui uma das principais causas de morte e incapacidade em Portugal. Para a promoção da recuperação funcional da pessoa, o desenvolvimento de dispositivos de reabilitação é uma prioridade importante. Objetivos: Descrever dois protótipos do Ablefit a nível da funcionalidade e aprendizagem para doentes pós-enfarte. Metodologia: Investigação qualitativa com recurso a grupos focais. Foram recrutados enfermeiros especialistas em reabilitação por amostragem de conveniência. Resultados: Foram incluídos 16 participantes no estudo. Os protótipos são funcionalmente distintos, possibilitando o beta maior variação de resistência e introdução de progressão a nível do programa de exercícios. A função de biofeedback introduzida posteriormente permite adaptação do programa e facilita o regresso a casa. A cicloergometria para membros inferiores incluída no alfa é uma vantagem significativa e deverá ser melhorada. Conclusão: O protótipo alfa apresenta menos características funcionais e facilidade de aprendizagem que o beta, sendo limitativo na modulação da resistência dos exercícios, bem como na incapacidade de monitorizar os parâmetros fisiológicos. Recomenda-se explorar a funcionalidade de biofeedback em futuros protótipos.

Abstract Background: Cardiovascular diseases are one of the leading causes of death and disability in Portugal. The development of rehabilitation devices is crucial for the promotion of functional recovery. Objectives: To describe the two Ablefit prototypes in terms of functionality and learning for post-infarction patients. Methodology: Qualitative research using focus groups. A convenience was composed of nurse specialists in rehabilitation. Results: The study included 16 participants. The prototypes are distinct in functionality: the beta allows for greater resistance variation and progressive exercise programs. The biofeedback feature allows adapting the program to the user and facilitates returning home. The cycloergometer for the lower limbs included in the alpha is a significant advantage and should be improved. Conclusion: The alpha prototype has fewer functional characteristics and lower ease of use than the beta, limiting the variety of exercise resistance and being incapable of monitoring physiological parameters. The biofeedback feature should be explored in future prototypes.

Resumen Marco contextual: La patología cardiovascular es una de las principales causas de muerte y discapacidad en Portugal. Para promover la recuperación funcional de la persona, el desarrollo de dispositivos de rehabilitación es una prioridad importante. Objetivos: Describir dos prototipos del Ablefit sobre la funcionalidad y el aprendizaje para pacientes que han sufrido un infarto. Metodología: Investigación cualitativa mediante grupos de discusión. Los enfermeros especializados en rehabilitación fueron seleccionados por muestreo de conveniencia. Resultados: Se incluyeron dieciséis participantes en el estudio. Los prototipos son funcionalmente diferentes, lo que permite a beta tener una mayor variación de resistencia e introducir la progresión en el programa de ejercicios. La función de biofeedback introducida posteriormente permite la adaptación del programa y facilita el regreso a casa. La cicloergometría para los miembros inferiores incluida en alfa es una ventaja significativa y debe mejorarse. Conclusión: El prototipo alfa tiene menos características funcionales y facilidad de aprendizaje que el beta, y es limitativo en la modulación de la resistencia a los ejercicios, así como en la incapacidad de monitorizar parámetros fisiológicos. Se recomienda explorar la funcionalidad de biofeedback en futuros prototipos.

Usabilidade teórica de um dispositivo inovador de reabilitação para doentes pós-enfarte: Estudo observacional com enfermeiros de reabilitação / Theoretical usability of an innovative device for post-infarction rehabilitation: Observational study with rehabilitation nurses / Usabilidad teórica de un dispositivo innovador para la rehabilitación posinfarto: Estudio observacional con enfermeros de rehabilitación

Resumo Enquadramento: Os programas de reabilitação cardíaca são fundamentais para a recuperação e manutenção da capacidade funcional em pessoas vítimas de enfarte agudo do miocárdio. Os programas atuais evidenciam taxas de abandono elevadas e requerem mais elementos geradores de motivação nos utilizadores. Objetivos: Avaliar e comparar a usabilidade de dois protótipos de um dispositivo de reabilitação inovador para doentes pós enfarte agudo do miocárdio. Metodologia: Estudo observacional quantitativo, utilizando uma escala do tipo Likert de 5 pontos numa amostra de 16 enfermeiros especialistas em reabilitação, selecionados através da técnica de amostragem "bola de neve". Resultados: A análise quantitativa revelou uma avaliação tridimensional dos protótipos com uma pontuação média de 4 valores, indicando usabilidade e intenção de uso. Ambos os protótipos foram considerados úteis, funcionais e fáceis de aprender e utilizar, observando-se poucas diferenças nas três dimensões. A facilidade de aprendizagem revelou-se mais consensual no protótipo Alfa. Conclusão: Os dois protótipos desenvolvidos alcançaram pontuações de usabilidade elevadas e são muito semelhantes, apresentando um forte potencial de eficácia no contexto desejado.

Abstract Background: Cardiac rehabilitation programs are essential for recovering and maintaining functional capacity in patients with acute myocardial infarction. Current programs have high dropout rates and require more motivational features. Objectives: To assess and compare the usability of two prototypes of an innovative rehabilitation device for post-infarction patients. Methodology: This is a quantitative observational study using a 5-point Likert-type scale with 16 nurse specialists in rehabilitation, selected through snowball sampling. Results: The quantitative analysis showed a three-dimensional assessment of the prototypes with mean scores of 4, indicating usability and intention to use. Both prototypes were considered useful, functional, and easy to learn and use, with few differences reported on the three dimensions. The ease of learning was more consensual in the Alpha prototype. Conclusion: The two developed prototypes present high usability scores and are very similar, demonstrating great potential for effectiveness in the intended context.

Resumen Marco contextual: Los programas de rehabilitación cardíaca son esenciales para la recuperación y el mantenimiento de la capacidad funcional de los pacientes que han sufrido un infarto agudo de miocardio. Los programas actuales tienen altas tasas de abandono y requieren más características de motivación. Objetivos: El estudio pretende cuantificar y comparar la usabilidad de dos prototipos de un dispositivo innovador para la rehabilitación de pacientes que han sufrido un infarto. Metodología: Se realizó un estudio cuantitativo observacional con enfermeros especialistas en rehabilitación, para lo cual se aplicó una escala tipo Likert de 5 puntos. Se reunieron 16 participantes con un método de muestreo por bola de nieve. Resultados: El análisis cuantitativo mostró una evaluación tridimensional de los prototipos con una puntuación media de 4, lo que denota la facilidad de uso y la intención de uso. Ambos prototipos se consideraron útiles, funcionales y fáciles de aprender y utilizar, con pocas diferencias en las tres dimensiones. La facilidad de aprendizaje se consensuó más en el prototipo alfa. Conclusión: Ambos prototipos desarrollados presentan altos valores de usabilidad y son muy similares, con gran potencial para ser efectivos en el contexto deseado.

Nurses' Involvement in the Development and Usability Assessment of an Innovative Peripheral Intravenous Catheterisation Pack: A Mix-Method Study.

Guaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. METHODS: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. RESULTS: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = -2.482, p = 0.013) and avoided omissions while preparing the required material (Z = -1.977, p = 0.048). The participating nurses emphasised the pack's potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. CONCLUSIONS: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.

Evidence-Informed Development of a Bundle for Peripheral Intravenous Catheterization in Portugal: A Delphi Consensus Study.

Contrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses' clinical decision-making in this scope. METHODS: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward's nurses. RESULTS: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter's functionality and performance at each shift. CONCLUSION: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.