[Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. / Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro.

OBJECTIVE: This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. METHOD: A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. RESULTS: The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. CONCLUSIONS: Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro / Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future

Objetivo:Este estudio pretende explorar la percepción de los especialistas sobre el desempeño de las residencias de ancianos durante la COVID-19.Método:Este es un estudio desarrollado en 2 fases: 1) un grupo focal, con el que se trabajó en mayo 2020, con 5 especialistas y 2) un Delphi modificado, implementado en septiembre 2020 con 22 especialistas, ambos en el área de asistencia en residencias de ancianos del norte y centro de Portugal.Resultados:Los resultados permitieron identificar 3 áreas principales que influenciaron el desempeño de las residencias de ancianos desde el inicio del brote de la COVID-19: modelos de organización y recursos; salud física y mental de los residentes y; la familia como apoyo.Conclusiones:Las personas mayores que residen en residencias para ancianos quedan particularmente vulnerables a la COVID-19, pues esta enfermedad puede tener para ellos consecuencias muy graves o incluso conducirle a la muerte. Es importante que las residencias prevengan la fragilidad física y mental de los ancianos, así como la soledad que muy probablemente les asola debido a las circunstancias pandémicas. Los responsables por las residencias de ancianos deben percibir que las personas mayores que viven en ellas tienen. por lo general. problemas de salud, lo que debería determinar la implementación de nuevas estrategias, entre ellas el aumento del número de profesionales debidamente capacitados.

Objective:This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak.Method:A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal.Results:The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support.Conclusions:Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

"Living Together with Dementia"-A psychoeducational group programme for family caregivers.

PURPOSE: To evaluate the effectiveness of the psychoeducational programme "Living together with dementia" applied to a group of family caregivers of people with dementia. DESIGN AND METHODS: A quasi-experimental study with pretest and posttest and a 4-month follow-up. Fifteen family caregivers of people with dementia were recruited in a community care unit in northern Portugal. RESULTS: A positive and statistically significant impact on these caregivers' burden was found. PRACTICE IMPLICATIONS: The programme could be an important mechanism to train family caregivers of home-dwelling people with dementia.

[Nursing homes in Portugal during the COVID-19 outbreak: Challenges for the future]. / Residencias de ancianos en Portugal durante la COVID-19: desafíos para el futuro.

Objective: This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak. Method: A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal. Results: The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support. Conclusions: Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills.

Avaliação da cognição de um grupo de idosos institucionalizados de uma região do norte de Portugal / Cognition assessment of a group of institutionalized aged from a northern region of Portugal / Evaluación cognitiva de un grupo de ancianos institucionalizados de una región del norte de Portugal

Resumo Contexto: Envelhecer compreende um conjunto de alterações, nomeadamente cognitivas; existindo uma linha muito ténue entre as mudanças esperadas para esta etapa da vida e as alterações de cariz patológico. Cerca de 80% das pessoas com défice cognitivo desenvolvem demência, pelo que, é fundamental intervir para retardar o aparecimento desta síndrome. O primeiro passo para a intervenção é a avaliação do perfil cognitivo destas pessoas. Objetivos: Identificar o perfil cognitivo de um grupo de idosos de uma região do Norte de Portugal; e identificar a relação entre as variáveis sociodemográficas e o perfil cognitivo de um grupo de idosos de uma região do Norte de Portugal. Métodos: Estudo quantitativo, transversal, descritivo-correlacional de corte. A amostra foram idosos institucionalizados (n = 37) com capacidade para responder a um questionário composto por questões sociodemográficas e pelo Montreal Cognitive Assessment (MoCA), versão portuguesa. A colheita de dados decorreu entre Novembro de 2017 e Fevereiro de 2018, sendo cumpridos todos os pressupostos éticos da investigação com humanos. Resultados: Os participantes eram maioritariamente mulheres (67,6%), com média de idade de 82 anos, viúvas e com mais de 4 anos de escolaridade. A pontuação obtida no MOCA variou entre 6 e 24 pontos, verificando-se correlação entre o score global e as variáveis sexo e idade. Todos os participantes apresentaram défices maioritariamente na linguagem e na abstração. Conclusões: Evidenciou-se uma maior prevalência de défices cognitivos na população mais velha, sendo clara a importância de avaliar e intervir na cognição destas pessoas, objetivando a manutenção/regressão dos défices e prevenindo a evolução para quadros demenciais. Pela proximidade a esta população, os enfermeiros, nomeadamente os especialistas em saúde mental e psiquiatria, são agentes privilegiados para a intervenção nesta área, através da implementação de programas de estimulação geral da cognição.

Abstract Background: Aging comprises a set of changes, namely cognitive. There is a very thin line between the expected changes for this stage of life and the pathological changes. About 80% of people with cognitive impairment develop dementia, so it is essential to intervene to delay the onset of this syndrome. The first step for the intervention is the assessment of the cognitive profile of these people. Aim: To identify the cognitive features of a group of aged from a region of northern Portugal; and to identify the relationship between sociodemographic variables and cognitive features of a group of elderly people from a northern region of Portugal. Methods: Quantitative, cross-sectional and descriptive-correlational study. The sample consisted of institutionalized aged (n = 37) capable of answering a questionnaire composed of sociodemographic questions and the Montreal Cognitive Assessment (MoCA), Portuguese version. Data collection took place between November 2017 and February 2018, and all ethical assumptions for human research were met. Results: The participants were mostly women (67.6%), with an average age of 82 years, widows and with more than 4 years of schooling. The MOCA score ranged from 6 to 24 points, with a correlation between the overall score and the gender and age variables. All participants presented deficits mostly in language and abstraction. Conclusions: The results confirm the higher prevalence of cognitive deficits in the older population, being clear the importance of evaluating and intervening in the cognition of these people, aiming at the maintenance / regression of the deficits and preventing the evolution to dementia. Due to the proximity to this population, nurses, namely specialists in mental health and psychiatry, are privileged agents for intervention in this area, through the implementation of general cognition stimulation programs.

Resumen Contexto: El envejecimiento comprende un conjunto de cambios, a saber, cognitivos; Hay una línea muy delgada entre los cambios esperados en esta fase de la vida y los cambios patológicos. Alrededor del 80% de las personas con deterioro cognitivo desarrollan demencia, por lo que es esencial intervenir para retrasar la aparición de este síndrome. El primer paso para la intervención es la evaluación del perfil cognitivo de estas personas. Objetivo(s): Identificar las características cognitivas de un grupo de ancianos de una región del norte de Portugal; e identificar la relación entre las variables sociodemográficas y las características cognitivas de un grupo de ancianos de una región del norte de Portugal. Metodología: Estudio cuantitativo, transversal y descriptivo-correlacional de corte. La muestra consistió en ancianos institucionalizados (n = 37), capaces de responder un cuestionario compuesto por preguntas sociodemográficas y la Evaluación Cognitiva de Montreal (MoCA), versión portuguesa. La recopilación de datos tuvo lugar entre noviembre de 2017 y febrero de 2018, y se cumplieron todos los supuestos éticos para la investigación en humanos. Resultados: Los participantes eran en su mayoría mujeres (67,6%), con una edad promedio de 82 años, viudas y con más de 4 años de estudio. El puntaje MOCA varió de 6 a 24 puntos, con una correlación entre el puntaje general y las variables de género y edad. Todos los participantes presentaron déficits principalmente en lenguaje y abstracción. Conclusiones: Los resultados confirman la mayor prevalencia de déficits cognitivos en la población de edad avanzada, dejando en claro la importancia de evaluar e intervenir en la cognición de estas personas, apuntando al mantenimiento / regresión de los déficits y evitando la evolución a la demencia. Debido a la proximidad a esta población, las enfermeras, es decir, especialistas en salud mental y psiquiatría, son agentes privilegiados para la intervención en esta área, a través de la implementación de programas generales de estimulación cognitiva.

'Living Together With Dementia': preliminary results of a training programme for family caregivers.

The aim of this article was to present the preliminary results of a training programme for family caregivers of people with dementia at an early to moderate stage living at home - 'Living Together With Dementia'. In this randomised controlled trial, 27 family caregivers who met the inclusion criteria were recruited from the neurology outpatient consultation clinic of a hospital in the north of Portugal and randomised into two groups (control and experimental) between October 2015 and March 2016. The programme 'Living Together With Dementia' was applied to the participants of the experimental group. The strategies used, overload, difficulties and satisfaction of the caregivers were assessed at three different stages (at the beginning and end of the intervention, as well as at follow-up). For the data analysis, quantitative parametric measures were applied. The Health Ethical Commission of the Hospital Centre approved the study, and its protocol and Helsinki Declaration ethical principles were considered throughout the process. In the final assessment, an improvement in the overload and difficulties was confirmed, as was an increase in the caregivers' satisfaction level and an improvement in coping/problem-solving strategies. In the follow-up stage, the results tended to revert towards those of the initial assessment. The programme 'Living Together With Dementia' appeared to be a major contribution enabling family caregivers of people with dementia, although there is a need to develop an efficacy study using a more substantial sample. The programme contributed to a reduction in the overload and difficulties borne by the family caregivers of people with dementia at an early to moderate stage living at home and to increased caregiver satisfaction.

Automedicação: comportamento de um grupo de estudantes de saúde no ensino superior / Self-medication: behavior of a group of health students in higher education

Introduction: In developed countries, self-medication has become a common practice, especially where over-the-counter medication is possible. Self-medication is considered one of the main public health problems. Aim: To characterize the profile of a group of students in health higher education, in relation to self-medication during their academic career. Methods: Cross-sectional descriptive exploratory study, framed in the quantitative paradigm. 285 students from the Nursing Degree and Physiotherapy Degree courses, a stratified sample, from a private Higher School of Health in northern Portugal, participated. A structured questionnaire was used to gather the necessary information for the study, the data collection period was from October to December 2017. Data analysis was performed using the Statistical Package for Social Sciences (SPSS - version 24), using descriptive statistics techniques (univariate and bivariate). Results and Discussion: Participated predominantly female students, with an average age of 21 years. They resort to self-medication, and on their own initiative. The most commonly used drugs were analgesics and anti-inflammatory drugs, which were consumed for short periods. The results obtained with the study are in line with others developed in the area. Conclusions: Students self-medicate and base their decision making with knowledge in pharmacology. These results are important for the population where the study was conducted. It is suggested to approach non-pharmacological interventions to treat pain cause that stood out for self-medication

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Literacia em saúde e adesão terapêutica em doentes renais crónicos em programa regular de hemodiálise / Health literacy and therapeutic adhesion in chronic kidney patients on a regular hemodialysis program

Health literacy can be understood as the set of cognitive and social skills that determine individuals' motivation and ability to make judgments and make decisions about health care, disease prevention, and health promotion. Therapeutic adherence may be related to a set of behaviors that coincide with the prescribed therapeutic regimen. The different capabilities of individuals to use and process health information, as well as to adhere to the proposed therapy, are of special importance in relation to chronic diseases, such as chronic kidney disease. Taking into account the relationship of this triad of concepts, it was important to know the level of literacy and therapeutic adherence in chronic kidney patients in a regular hemodialysis program. The methodology used followed a quantitative paradigm, in a cross-sectional descriptive correlational study. The sample consisted of 100 chronic kidney patients in a regular hemodialysis program at a clinic in the northern region of Portugal. The interview was used to gather information. The results obtained evidenced the existence of low levels of health literacy in 69% of the individuals that correlated with age and level of schooling. Regarding therapeutic adherence, the majority of the sample adhered to the therapy (78%), showing no relation between this and health literacy. As this is a national problem and leads to a deficiency in the sustainability of the health economy and the quality of life of our population, it is considered fundamental to provide the patient with the skills to deal with their health-disease process

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Nível de e-literacia em saúde em alunos do ensino secundário privado / Level of e-literacy in health in private secondary school students

Introduction: e-literacy in health is related to the use of Internet or other electronic means related to the dissemination or visualization of information about health and / or health services. Objectives: To describe the level of e-literacy in health, in a group of students of a private high school, in the North of Portugal; to relate the level of e-literacy in health with sociodemographic data; to relate the level of e-literacy in health with the contextual variables of the students. Method: Descriptive, correlational and transversal quantitative study. 102 students from the science and technology course of a private high school in the north of Portugal participated. A questionnaire was applied consisting of 3 groups: group I sociodemographic variables; group II consisted of contextual variables and group III constituted by the "eHEALS - eHealth Literacy Scale" scale. Results: Students presented positive levels of e-Literacy in health. They know how to use the Internet to find health information and recognize its usefulness and importance, but did not have confidence in the information obtained when making deci-sions on health. Conclusion: Students present positive levels of e-literacy in health but need guidance to the sources of consultation in order to rely on the information accessed for health project management

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Principais problemas éticos nos cuidados de saúde primários / Major ethical problems in primary health care

Introduction: Identifying the ethical problems experienced in Primary Health Care leads us to the importance of reflection on them being essential for a humanizing care culture. Aim: To describe the main ethical problems in the daily life of health professionals in Primary Health Care. Methods: Integrative Literature Review, conducted between October / December 2016. The following databases were used: Medline, Scielo, UCP Institutional Repository and RCAAP. Inclusion criteria were: primary studies that met the study objectives and studies under 10 years. We found 200 studies. 97 were excluded for not meeting the study objectives, 24 because they were not from primary sources, 45 because they were not fully presented, and 34 because they were older than 10 years. They incorporated the integrative review 5 articles. Results and Discussion: It was noticed that the main ethical problems identified can be distributed in 3 groups: ethical problems in relations with users and families; ethical problems in team relations and ethical problems in health system relations. It has been noted that as the number of years of experience increases, ethical problems become more supported and sustained. It was found that there are differences in the identification of ethical problems between nurses and doctors working in Primary Health Care. Conclusions: All studies present ethical issues in relationships with clients and family members; interprofessional relations and relations with the health system. In addition, it was found that ethical problems are influenced by length of service and profession

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Construção de um apoio online para o familiar cuidador / Construction of an online support for the family caregiver

The increase in the number of dependent individuals means that more and more families find themselves in the situation of caregivers, with all the consequences that performing this role entails. Based on this reality, we consider it to be completely relevant to systematize knowledge in this area towards the develop of an educational online support tool for caregivers. We conducted a focus group with experts in this field to identify what appropriate content an online caregiver support program should have. Our goal is to build an online tool that works as a complement to the work of professionals and is safe for carers. The main results and conclusions, after we analyze the focus group incomes indicate that the online support tool should contain topics that can be grouped into three main themes: 1) caregiver knowledge and skills, 2) potential resources for the caregiver and 3) caregiver coping strategies and well-being. It was also possible to obtain important complementary information that will be very useful in the construction of the online tool. The relevance of this study to clinical practice is that, although it is still necessary to expand and enhance the scope of research in this area, we consider this information essential for all health professionals seeking to provide effective support to family caregivers, as well as to serve as support for the development of intervention projects and health services

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Marine Spatial Planning in the Benguela Current Large Marine Ecosystem.

The Benguela Current Large Marine Ecosystem (BCLME) in the south-east Atlantic covers the territorial waters and Exclusive Economic Zones (EEZ's) of Angola and Namibia and partly of South Africa. Increasing demands, user-user and user-environment conflicts occur throughout the area. The three countries, which are parties to the Benguela Current Convention (BCC), have begun to implement Marine Spatial Planning (MSP) to support the sustainable development of the area and enhance ocean governance. This makes the region one of the first in a developing economies context and on the African continent to introduce MSP. The article (1) traces the origin of MSP in the region and describes the reasons for its development, (2) reviews the status of MSP processes to date at the regional and national level, and (3) reflects on the regional and individual country processes in terms of differences and similarities in approach and process governance, shared opportunities and difficulties. The study finds that MSP in the region is introduced because of both strong interests to use it as a means to help grow the blue/ocean economy and as a mechanism to further the implementation of the ecosystem approach. Similar steps have been taken so far and alike approaches to MSP exist across the three countries, with the BCC as regional convention facilitating knowledge sharing and assisting to improve cross-border coherence and consistency on MSP from the outset. Although challenges, such as limited finances and data gaps exist both at national and regional level, the MSP processes to-date have created an enabling environment to develop the first marine spatial plans in each country and to exchange knowledge and experiences within the region and with other regions.

Prevenção da confusão aguda em doentes adultos internados em cuidados intensivos: Intervenções autónomas do enfermeiro / Prevention of acute confusion in adults hospitalized in intensive care: Autonomous nurse interventions / Prevención de la confusión aguda en adultos hospitalizados en cuidados intensivos: Intervenciones autónomas de enfermeira

Contexto: A confusão aguda é uma situação grave, que engloba alteração da atenção, da consciência e da cognição, desenvolvendo-se num curto período de tempo. Existem um conjunto de intervenções não farmacológicas que ajudam na sua prevenção, nas quais a atuação autónoma do enfermeiro é fundamental. Objetivo: Identificar as intervenções autónomas de enfermagem que previnem a confusão aguda em doentes adultos internados em Unidades de Cuidados Intensivos. Métodos: Revisão integrativa da literatura, através da Pubmed, Repositórios Científicos de Acesso Aberto de Portugal, CINAHL, Medline e Scielo, utilizando os descritores: “Delirium” AND “Critical Care” AND “Nursing” AND “Disease prevention”, durante Fevereiro e Março de 2019. Foram incluídos na revisão os artigos publicados entre 2014-2019; com texto integral de acesso livre; escritos em português; espanhol ou inglês; que dessem resposta ao objetivo do estudo. Resultados: Foram incluídos 8 estudos na revisão, que correspondiam aos critérios de inclusão. Verificou-se que as intervenções não farmacológicas mais utilizadas pelos enfermeiros, para a prevenção da confusão aguda em pessoas adultas internadas em Unidades de Cuidados Intensivos, podem ser distribuídas por sete áreas: promoção da estimulação sensorial; promoção da orientação; envolvimento da família; gestão da dor; gestão ambiental; promoção do sono e mobilização precoce e posicionamento. Face a estas áreas elencou-se um conjunto de intervenções autónomas de enfermagem, com recurso a linguagem classificada, através da Classificação Internacional para a Prática de Enfermagem - CIPE®, versão 2017. Conclusões: Os resultados obtidos permitiram identificar um conjunto de intervenções autónomas de enfermagem, que são eficazes na prevenção da confusão aguda, em doentes adultos internados em Unidades de Cuidados Intensivos, o que se traduz em ganhos em saúde para o utente e ganhos económicos para a instituição.

BACKGROUND: Acute confusion is a serious situation that englobes change in attention, awareness and cognition, which develops over a short period of time. There is a set of non-pharmacological interventions that help in the prevention of acute confusion, in which the autonomous action of the nurse is fundamental. AIM: To identify the autonomous nursing interventions that prevent acute confusion in adult patients hospitalized in Intensive Care Units. METHODS: Integrative literature review through Pubmed, Scientific Open Access Repositories of Portugal, CINAHL, Medline and Scielo, using the descriptors: "Delirium" AND "Critical Care" AND "Nursing" AND "Disease prevention", during February and March 2019. Were included in the review articles published between 2014-2019; with full text of free access; written in Portuguese; Spanish or English; that met the objective of the study. RESULTS: Eight studies were included in the integrative literature review, according to the inclusion criteria. It was verified that the non-pharmacological interventions most used by nurses for the prevention of acute confusion in adults hospitalized in Intensive Care Units can be distributed in seven areas: promotion of sensorial stimulation; promotion of guidance; family involvement; pain management; environmental management; sleep promotion and early mobilization and positioning. According to these areas, a set of autonomous nursing interventions was presented used classified language through the International Classification for Nursing Practice - CIPE®, version 2017. CONCLUSIONS: The results obtained allowed the identification of a set of autonomous nursing interventions that are effective in the prevention of acute confusion in adult patients hospitalized in Intensive Care Units, which translates into health gains for the patient and economic gains for the institution.

CONTEXTO: La confusión aguda es una situación grave, que implica un cambio en la atención, en conciencia y la cognición, que se desarrolla en un corto período de tiempo. Se identifican un conjunto de intervenciones no farmacológicas que ayudan en la prevención de la confusión aguda, en las que la acción autónoma de la enfermera es fundamental. OBJETIVO: Identificar las intervenciones de enfermería que previenen la confusión aguda en pacientes adultos hospitalizados en Unidades de Cuidados Intensivos. METODOLOGIA: Revisión integradora de la literatura, através de Pubmed, Repositorios científicos de acceso abierto de Portugal, CINAHL, Medline y Scielo, utilizando los descriptores: "Delirium" Y "Cuidado crítico" Y "Enfermería" Y "Prevención de enfermedades", durante febrero y marzo 2019. Se incluyeron en la revisión los artículos publicados entre 2014-2019; con texto completo de libre acceso; escrito en portugués; español o inglés; que cumplió con el objetivo del estudio. RESULTADOS: Ocho estudios fueron incluidos en la revisión de literatura, que correspondía a los criterios de inclusión. Se verificó que las intervenciones no farmacológicas más utilizadas por las enfermeras para la prevención de la confusión aguda en adultos hospitalizados en unidades de cuidados intensivos pueden distribuirse en siete áreas: promoción de la estimulación sensorial; promoción de la orientación; implicación familiar manejo del dolor; gestión ambiental; Promoción del sueño y movilización temprana y posicionamiento. En vista de estas áreas, se presentó un conjunto de intervenciones de enfermería autónomas con el uso de lenguaje clasificado a través de la Clasificación Internacional para la Práctica de Enfermería - CIPE®, versión 2017. CONCLUSIONES: Los resultados obtenidos permitieron la identificación de un conjunto de intervenciones de enfermería autónomas que son eficaces en la prevención de la confusión aguda en pacientes adultos hospitalizados en unidades de cuidados intensivos, lo que se traduce en beneficios para la salud del paciente y beneficios económicos para la institución.

Features of family caregivers of people with dementia attended at a neurology consultation

Providing care to someone with dementia is a complex task, that requires a set of specific skills and knowledge that family caregivers often lack. Training family caregivers of people with dementia is paramount, and the first step towards such purpose should be the identification of their features and the evaluation of their needs. The main aim of this study is to identify the major characteristics of family caregivers of people with dementia in early or moderate stage living at home, who attend the dementia consultation at a hospital in the north of Portugal, through a quantitative, descriptive and cross-sectional study. This study is a section from a previous randomized controlled trial, performed to assess the short-term efficacy of a training programme for family caregivers of people with dementia (the pro-gramme "Living together with Dementia"). Regarding the findings, we realized that the average age of family caregivers is 52, and these are mostly women, married, with basic education levels and employed. They display intense overload and difficulties levels, but also high degrees of satisfaction. They mostly resort to mixed co-ping/problem resolution strategies and their main needs are expressed as follows: managing emotions and feelings associated with the caring process; developing strategies to preserve physical and mental health; developing knowledge about dementia and its stages and finally, seeking support from formal institutions

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"Living together with dementia": Training programme for family caregivers - A study protocol.

HIGHLIGHTS: The increased incidence of dementia places the family in the role of caregiver.It is important to create, to implement and to validate training programmes for family caregivers of people with dementia living at home.The programme "Living together with dementia" addressed in this protocol seeks to be a response to empower these caregivers. INTRODUCTION: Due the increase incidence of Dementia, the creation, implementation and evaluation of the effectiveness of training programmes for family caregivers of people with dementia living at home should be a goal of health professionals. The aim of this paper is to describe the randomised control trial protocol that will assess the effectiveness of the training programme for family caregivers who care for people with dementia at home "Living together with Dementia". METHODS: Randomised control trial. Family caregivers of people with dementia in early and moderate stages will be recruited through a neurology appointment at the São João Hospital Centre, Porto-Portugal. The inclusion criteria employed will be as follows: to be the main caregiver of the person with dementia; to be literate; the care target has dementia in early or moderate stage; the person with dementia does not suffer from any other severe mental pathology. Caregivers will be randomised and assigned to control and experimental groups. 3 assessment moments will take place: initial, after the intervention and a follow up of 3 to 6 months. The assessment instruments include a survey containing sociodemographic data, Caregiver Burden Scale, Caregiver Assessment Satisfaction Index and Caregiver Assessment Difficulties Index. The participants of the experimental group will be submitted to a 7-week individual psychoeducational programme. The study was approved by the Health Ethics Committee of the São João Hospital Centre in September 2015. DISCUSSION: This programme might prove an asset to family caregivers of people with dementia living at home, since it pinpoints understanding and preparation of their role. It also facilitates the intervention of health professional, as it features as a guideline for their performance with this target population.

Prevalência de ansiedade em profissionais de enfermagem de urgência e emergência / Prevalence of anxiety in nursing professionals of urgency and emergency / Prevalencia de ansiedad en los profesionales de enfermería de urgencia y emergencia

Objetivo: identificar a prevalência de ansiedade em profissionais de enfermagem. Método: estudo transversal, de abordagem quantitativa, com 90 profissionais da equipe de enfermagem de um hospital de urgência e emergência de Teresina/PI, Brasil. A coleta ocorreu a partir de um formulário semiestruturado e do Inventário de Ansiedade de Beck. Posteriormente os dados foram analisados a partir do programa Statistical Package of Social Science. Resultados: constatou-se que 27,8% dos profissionais possuiam ansiedade leve, 13,3% moderada e 3,3% grave, as quais acometiam principalmente os técnicos de enfermagem. Quanto aos sintomas físicos e psíquicos relacionados à ansiedade destacaram-se a incapacidade de relaxamento e o nervosismo, respectivamente. Conclusão: houve uma quantidade considerável de profissionais da equipe de enfermagem com grau moderado a grave de ansiedade. Assim, faz-se necessário a elaboração de estratégias que eliminem os fatores causadores da ansiedade nesses profissionais.(AU)

Objective: to identify the prevalence of anxiety in nursing professionals. Method: a cross-sectional study with a quantitative approach, with 90 professionals of the nursing staff of an urgency and emergency hospital in Teresina/PI, Brazil. The collection came from a semi-structured form and the Beck Anxiety Inventory. Subsequently the data were analyzed using the program Statistical Package for Social Science. Results: we found that 27.8% had mild anxiety, 13.3% moderate and 3.3% severe, which mainly afflict nursing technicians. Regarding the physical and psychological symptoms related to anxiety highlighted the inability of relaxation and nervousness, respectively. Conclusion: there was a considerable amount of nursing staff professionals with moderate to severe anxiety. Thus, it is necessary to develop strategies to eliminate the factors causing anxiety in these professionals.(AU)

Objetivo: identificar la prevalencia de la ansiedad en los profesionales de enfermería. Método: un estudio transversal con un enfoque cuantitativo, con 90 profesionales del personal de enfermería de un hospital de urgencia y de emergencia en Teresina/PI, Brasil. La recolección de datos sucedió a partir de una forma semiestructurada y el Inventario de Ansiedad de Beck. Posteriormente se analizaron los datos utilizando el paquete estadístico programa de Ciencias Sociales. Resultados: se encontró que el 27,8% de los profesionales poseía ansiedad leve, 13,3% moderada y 3,3% grave, que afectan principalmente a los técnicos de enfermería. En cuanto a los síntomas físicos y psicológicos relacionados con la ansiedad de manifiesto la incapacidad de la relajación y el nerviosismo, respectivamente. Conclusión: había una cantidad considerable de profesionales de enfermería con moderada a severa ansiedad. Por lo tanto, es necesario desarrollar estrategias para eliminar los factores que causan la ansiedad en estos profesionales.(AU)

Training programmes for family caregivers of people with dementia living at home: integrative review.

AIMS AND OBJECTIVES: To establish primary features of training programmes designed to assist family caregivers of people with dementia living at home and to propose a model programme based on literature findings. BACKGROUND: Due to dementia's distinctive progression, there is a widely felt need to train family members who undertake the responsibility of caring for relatives diagnosed with this condition to provide positive care, particularly during the early and middle stages of the disease. DESIGN: Integrative review. METHODS: Literature reviews were carried out in the Pubmed, CINAHL, Mediclatina and Medline databases, using the following describers: training programme, family caregivers, dementia and aged. Such searches encompassed publications between 2004-2014, together with eight articles for review due to their positive identification with the inclusion criteria. Relevant results were extracted, the subsequent analysis performed and the presentation carried out in a descriptive manner. RESULTS: The prevailing length of a training programme for a family caregiver of people with dementia is of six sessions over a six-week period, with one weekly session load, and an average duration of 100 minutes each. Methodologies most commonly used include discussion, problem-solving models as well as skills and strategies training. The themes discussed comprehend caring for the individual with dementia, information about the illness and the use of health and community resources. Regarding the assessment of the family caregiver, the most widely used instruments are demographic assessment questionnaires, self-efficiency and caregiver's burnout scales, as well as depression and quality of life measures. Three assessment instances of family caregivers' needs during the training programme are commonly encountered: initial, final and follow-up. CONCLUSIONS: This review has identified a set of features transversal to training programmes for family members who undertake the care for individuals with dementia living at home, which will bolster the construction and validation of other programmes in the area. More studies about such programmes need to be implemented, particularly engaged in their conceptual and experimental validation. RELEVANCE TO CLINICAL PRACTICE: The results of this review assist nurses by increasing their awareness of the basic assumptions supporting training programmes for family members responsible for individuals with dementia living at home and subsequently enforce them during their interventions with such population.