Validation and Screening Capacity of the European Portuguese Version of the SUNFRAIL Tool for Community-Dwelling Older Adults.

Early detection of frailty may prevent or delay adverse health outcomes in community-dwelling older adults. In Portugal, there are currently no valid multidimensional frailty screening tools. SUNFRAIL is a user-friendly multidimensional tool for frailty screening that can be used in primary care. AIMS: (i) to determine the validity and reliability of the European Portuguese version of the SUNFRAIL tool for use in community-dwelling older adults; (ii) to assess the screening capacity of this version of SUNFRAIL using Fried's phenotypic model criteria for frailty as a reference test. METHODS: Cross-sectional pilot study in a convenience sample of 128 community-dwelling older adults. Objective and subjective data were collected. Internal consistency, concurrent validity, sensitivity, and specificity (ROC curve analysis) were examined. RESULTS: Internal consistency was low. Significant moderate to strong correlations were found between different domains and the total score. The differences between robust, pre-frail, and frail older adults were significant. SUNFRAIL was also correlated with multimorbidity. Sensitivity and specificity were satisfactory. CONCLUSIONS: The European Portuguese version of the SUNFRAIL tool is a promising frailty screening tool for community-dwelling older adults to be routinely used in clinical practice. However, more consistent results on its validity and reliability are needed to be used nationwide.

Fresno test to measure evidence-based practice knowledge and skills for Portuguese undergraduate nursing students: A translation and adaptation study.

BACKGROUND: The Fresno Test was originally identified as an instrument to assess evidence-based practice knowledge and skills through cognitive testing and performance assessment in medical students. Further studies have been recommended to establish the measurement properties of the Fresno Test in different learner populations. OBJECTIVES: To perform a cross-cultural adaptation of the Fresno Test for Portuguese undergraduate nursing students and to analyze the interrater reliability. DESIGN: Cross-cultural adaptation study with interrater reliability assessment carried out in two phases during 2017-2018. SETTINGS: One of the main nursing schools, Portugal. PARTICIPANTS: Fourth year undergraduate nursing students. METHODS: The study was performed in two phases, firstly the cross-cultural adaptation (performed in five stages) and secondly the analysis of interrater reliability. RESULTS: Stages I, II, III and IV of the cross-cultural adaptation proceeded smoothly and the expert panel produced and agreed upon the pre-final version of Adapted Fresno Test. In stage V (the pre-test stage), students reported a general understanding of the items, but they reported a lack of knowledge to answer the test. An expert panel subsequently agreed that modifications were needed to ensure the test was within the student's competency level and to decrease risk of assessment bias. For phase II, 50 complete questionnaires were randomly selected to be rated by three independent nurses using the modified rubric to score the test. The overall interrater reliability was 0.826 with a range from 0.271 to 1.000 for each item. CONCLUSIONS: The Adapted Fresno Test presented in this paper is the first instrument translated for European Portuguese and adapted specially for undergraduate nursing students. Despite good interrater reliability, further validation studies with more robust samples are suggested to definitively establish psychometric properties beyond the interrater reliability.

The Effectiveness of an Evidence-Based Practice (EBP) Educational Program on Undergraduate Nursing Students' EBP Knowledge and Skills: A Cluster Randomized Control Trial.

Evidence-based practice (EBP) prevents unsafe/inefficient practices and improves healthcare quality, but its implementation is challenging due to research and practice gaps. A focused educational program can assist future nurses to minimize these gaps. This study aims to assess the effectiveness of an EBP educational program on undergraduate nursing students' EBP knowledge and skills. A cluster randomized controlled trial was undertaken. Six optional courses in the Bachelor of Nursing final year were randomly assigned to the experimental (EBP educational program) or control group. Nursing students' EBP knowledge and skills were measured at baseline and post-intervention. A qualitative analysis of 18 students' final written work was also performed. Results show a statistically significant interaction between the intervention and time on EBP knowledge and skills (p = 0.002). From pre- to post-intervention, students' knowledge and skills on EBP improved in both groups (intervention group: p < 0.001; control group: p < 0.001). At the post-intervention, there was a statistically significant difference in EBP knowledge and skills between intervention and control groups (p = 0.011). Students in the intervention group presented monographs with clearer review questions, inclusion/exclusion criteria, and methodology compared to students in the control group. The EBP educational program showed a potential to promote the EBP knowledge and skills of future nurses.

Mild cognitive impairment in older adults: Analysis of some factors.

Mild cognitive decline is a feared aspect of aging associated with frailty experienced by individuals. OBJECTIVE: To determine the number of elderly people with mild cognitive impairment (MCI); to determine the relationship of sociodemographic and clinical variables by group of individuals with or without MCI and to determine the relationship between MCI assessed by 6CIT and the cognitive domains assessed by the MoCA. METHODS: A correlational study was conducted of 44 elderly individuals attending a day-care center or residing in a care home, with an average age of 88.9 ± 8.8 years who answered a structured interview collecting sociodemographic and clinical data. RESULTS: The elderly living at home had higher average body mass index and number of pathologies than those living in an institution for the elderly (p < 0.01). 63.6% of the elderly did not have MCI, and no differences were found between residential settings. The comparison between 6CIT and MoCA yielded differences in the general domain and in visual, attention, abstraction and, orientation subdomains. CONCLUSION: Cognitive stimulation interventions should be optimized according to the residential setting at the level of comorbidities and nutrition.

O declínio cognitivo leve é um aspecto temido do envelhecimento associado à fragilidade vivenciada pelos indivíduos. OBJETIVO: Determinar o número de idosos com comprometimento neurocognitivo leve; determinar a relação das variáveis sociodemográficas e clínicas por grupo de indivíduos com ou sem comprometimento neurocognitivo leve e determinar a relação entre o comprometimento neurocognitivo leve avaliado pelo 6CIT e os domínios cognitivos avaliados pelo MoCA. MÉTODOS: Estudo correlacional realizado em 44 idosos de instituições de creche e residência permanente, com idade média de 88,9 ± 8,8 anos, que responderam a uma entrevista estruturada composta por dados sociodemográficos e clínicos. RESULTADOS: Os idosos que residem em casa apresentam maior índice de massa corporal médio e número de patologias que os idosos que vivem em uma instituição para idosos (p < 0,01). 63,6% dos idosos não apresentam comprometimento neurocognitivo leve e não são encontradas diferenças ao atravessar o contexto da residência. Na comparação entre 6CIT e MoCA produz diferenças no domínio geral e subdomínios visuais, de atenção, abstração e orientação. CONCLUSÃO: É necessário otimizar as intervenções de estimulação cognitiva de acordo com o contexto de residência no nível de comorbidades e nutrição.

Development and validation of a complex intervention: A physical exercise programme aimed at delaying the functional decline in frail older adults.

Aim: To develop and validate a physical exercise programme aimed at delaying the functional decline in frail older adults. Design: The revised guideline of Criteria for Reporting the Development and Evaluation of Complex Interventions in health care was followed. Methods: The physical exercise programme was designed and validated by exercise specialists to be implemented by healthcare professionals. The physical exercise programme underwent three stages of development, piloting and evaluation. It includes a portfolio of exercises in different support materials (posters, e-book and website). A testing intervention was delivered to the target population. Results: The Criteria for Reporting the Development and Evaluation of Complex Interventions in health care process has the potential to help practitioners in developing and planning complex interventions, such as an exercise programme. Its components can be adjusted to the context and to the characteristics of the target population. A study protocol and a pilot study will be developed to test the effectiveness of the physical exercise programme on delaying the functional decline of frail older adults.

Effects of caregiver-provided individual cognitive interventions on cognition, social functioning and quality of life in older adults with major neurocognitive disorders: a systematic review.

OBJECTIVE: The objective of this review was to investigate the effectiveness of caregiver-provided individual cognitive interventions for improving cognition, social functioning and quality of life in older adults with major neurocognitive disorders. INTRODUCTION: A large number of people with major neurocognitive disorders live in their homes, requiring ongoing community care. Different individual cognitive intervention programs have been explored as a potential approach for implementation by caregivers on a one-to-one basis. These programs have the advantage of being implemented in a home setting and in the real-life context of the older adult, in a society that is increasingly aging and where aging in place is being fostered. INCLUSION CRITERIA: This review considered experimental studies that included older adults aged 60 years and over with major neurocognitive disorders who were receiving individual cognitive interventions (e.g. cognitive stimulation, cognitive training or cognitive rehabilitation) provided by their caregivers. The comparator was usual care, wait-list control or alternative therapeutic intervention. The primary outcomes of interest included cognition, social functioning and quality of life. Additionally, behavior, mood and activities of daily living were considered. METHODS: A comprehensive search strategy was used to identify relevant published and unpublished studies from January 1995 to March 2018, written in English, Spanish and Portuguese. Studies meeting the inclusion criteria were retrieved and their methodological quality was assessed by two independent reviewers using the JBI critical appraisal checklists for randomized controlled trials and quasi-experimental studies. Quantitative data were extracted using the standardized data extraction tool from the JBI System for the Unified Management, Assessment and Review of Information. Due to the clinical and methodological heterogeneity in the included studies, statistical pooling was not possible. Therefore, findings are presented in a narrative format. RESULTS: Eight randomized controlled trials and two quasi-experimental studies were included, with a total sample of 844 dyads (older adults and caregivers). The number of dyads included in the studies ranged from 16 to 356. Beneficial effects of the caregiver-provided individual cognitive interventions were observed in various cognitive domains, including memory, attention, verbal fluency and problem-solving. Two studies additionally reported the positive impact of the intervention of interest on general cognitive functioning. None of the reviewed studies revealed significant changes in quality of life. Social functioning was not analyzed in any of the included studies. Beneficial effects were also reported in relation to behavior and activities of daily living, despite the low level of evidence. CONCLUSIONS: This review responds to a gap in current international literature on the synthesis of evidence on the use of caregiver-provided individual cognitive interventions. The intervention of interest is associated with improvement in cognitive performance, revealing some benefits for the stabilization of neuropsychiatric symptoms and an increase in autonomy in activities of daily living. Further research on the impact of sociodemographic and clinical factors on the intervention effects is needed, as these factors seem to interfere with successful intervention implementation. To reinforce current evidence, the methodological quality of future studies should be improved.

Feasibility, appropriateness and meaningfulness analysis of the Sunfrail Tool to the European Portuguese population during cross-cultural adaptation process.

Frailty is an age-related condition characterized by increased vulnerability to negative outcomes. To enable informed decision-making and implementation of individually tailored practices for frailty management, it is necessary to develop screening tools that cover different domains of individual functioning, reliably predict future adverse outcomes and are generalizable to healthcare settings other than primary care. The Sunfrail Tool, an easy-to-use nine-item instrument, seems to meet all these requirements. The current study aimed to perform a cross-cultural adaptation of the Sunfrail Tool for the European Portuguese population and to perform the feasibility, appropriateness and meaningfulness analyses of the Sunfrail Tool Portuguese version. METHODS: The process of cross-cultural adaptation was conducted in four-phases (translation, synthesis, back translation and creation of consensual version). To reinforce the content validity, the additional analysis on feasibility, appropriateness and meaningfulness were conducted with end-users (older adults, informal caregivers and health and social care professionals). RESULTS: The frailty concept was considered suitable for the European Portuguese population. A consensus version was reached by an expert panel after considering the results of two forward and two back-translations. This prefinal version was endorsed to the first author of the original version of the instrument, as recommended by international guidelines. The content validation performed by healthcare professionals (n = 7), patients (n = 18) and informal caregivers (n = 3) showed that the Sunfrail Tool was moderately comprehensible and ambiguous. Five items required changes for cultural adaptation. CONCLUSION: The Sunfrail Tool seems to be a promising instrument for the early identification of frailty to be used in the European Portuguese context to inform clinical decisions on preventive responses. However, to enable identification of frail and nonfrail individuals with this tool and ensure effectiveness on pathways activation for frailty management, there is a need to define cut-off points. Guidelines supporting the interview process are also desirable.

An Innovative Concept for a Walker with a Self-Locking Mechanism Using a Single Mechanical Approach.

Background: The ageing process involves a natural degeneration of physiological function and can imply life constraints, namely during activities of daily life (ADL). Walking can be strongly affected by strength, gait, and balance changes, which affect quality of life. The quality of life of the older adult is associated with available solutions that contribute to an active and safe ageing process. Most of these solutions involve technical aids that should be adapted to older adults' conditions. Aim: To identify the advantages and disadvantages of two-wheeled walkers and of two different self-locking systems designed and developed by the authors. Methods: Two studies were performed based on the possible walker combinations used, using a walker with no wheels (classic fixed walker), a two-wheeled walker with self-locking mechanism made of gears and a spring (Approach 1), and a two-wheeled walker with a self-locking mechanism which uses a single spring (Approach 2). These combinations were tested in two quasi-experimental studies with pre-post test design. Results: No significant differences in duration, gait speed, and Expanded Timed Get Up and Go (ETGUG) were found between the walkers, but there was a marginally significant difference in Physiological Cost Index (PCIs), which means that the energetic cost with Approach 1 was greater than that with Approach 2. Users reported a feeling of insecurity and more weight, although no significant differences were observed and they were found to be equivalent in terms of safety. Study 2 found an improvement in duration and gait speed in the ETGUG between the different types of self-locking systems. Conclusions: The PCI is higher in the two-wheeled walker models and with the self-locking mechanism. Approach 2 did not show better conditions of use than the other two walkers, and participants did not highlight its braking system. Although safety is similar among the three walkers, further studies are needed, and the braking system of the two-wheeled walker needs to be improved (Approach 2).

Effectiveness of a Combined Intervention on Psychological and Physical Capacities of Frail Older Adults: A Cluster Randomized Controlled Trial.

BACKGROUND: Older adults experience physical and psychological declines affecting independency. Adapted and structured combined interventions composed of cognitive stimulation and physical exercise contribute to comorbidities' reduction. Methods: Multicenter single-blinded two-arm cluster randomized controlled trial conducted to assess effectiveness of a combined intervention (CI), composed of a cognitive stimulation program (CSP) and a physical exercise program (PEP), on psychological and physical capacities of frail older adults as to on their activities of daily living. Were recruited 50 subjects from two elderly end-user organizations. Of these, 44 (65.9% females, mean age of 80.5 ± 8.47 years) were considered eligible, being randomly allocated in experimental (EG) or control group (CG). Data collected at baseline and post-intervention. EG received CI three times a week during 12 weeks. CG received standard care. Non-parametric measures were considered. Results: At baseline, groups were equivalent for study outcomes. The comparison of pre- and post-intervention data revealed that subjects receiving CI reduced depressive symptomatology and risk of fall based on gait and balance, and improved gait speed. Simultaneously, in the CG a significant decline on activities of daily living was observed. Significant results were found among biomechanical parameters of gait (BPG). EG' effect size revealed to be small (0.2 ≤ r < 0.5). CG' effect size was also small; but for activities of daily living there was an evident decrease. Conclusion: The CI is effective on managing older adults' psychological and physical capacities.

Effectiveness of multisensory stimulation in managing neuropsychiatric symptoms in older adults with major neurocognitive disorder: a systematic review.

OBJECTIVE: The objective of the review was to synthesize the effectiveness of multisensory stimulation in managing neuropsychiatric symptoms (NPS) in older adults with major neurocognitive disorder (NCD). INTRODUCTION: Major neurocognitive disorder is characterized by changes in specific cognitive domains with a progressive deterioration in cognitive ability and capacity for independent living. Most older adults with this condition have one or more concomitant symptoms known as NPS. Evidence shows that nonpharmacological therapies have been effective in controlling these symptoms, with multisensory stimulation attracting further investigation. INCLUSION CRITERIA: The review considered studies on older adults aged 65 years or over with major NCD. The intervention of interest was multisensory stimulation, and the comparator was usual care (e.g. no occupational therapy, no cognitive training, and no art therapy, but with possible control of activities such as looking at photographs or doing quizzes), or another intervention (e.g. occupational therapy, cognitive training and art therapy). Primary outcomes were NPS (agitation, aggression, motor disturbances, mood liability, anxiety, apathy, night-time behaviour, eating disorders, delusion and hallucination). Secondary outcomes were quality of life, functional status in activities of daily living, cognitive status and caregiver burden. Experimental study designs were considered. METHODS: A broad range of keywords and a three-step search strategy were used to identify potentially eligible published and unpublished studies from January 1990 to June 2016 in major healthcare-related online databases. Studies in English, Spanish and Portuguese were included. Two independent reviewers assessed the methodological quality of eight included studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists for Randomized Controlled Trials and Quasi-Experimental Studies. Data were extracted using the standardized data extraction tool from the JBI System for the Unified Management, Assessment and Review of Information (JBI SUMARI) and included details about the interventions, populations, study methods and outcomes of interest. Significant differences were found between participants, interventions, outcome measures (clinical heterogeneity), and designs (methodological heterogeneity). For these reasons, a meta-analysis could not be performed. Therefore, the results have been described in a narrative format. RESULTS: Eight studies (seven randomized controlled trials and one quasi-experimental study) were included, with a total sample of 238 participants (pre-intervention). Four studies confirmed the effectiveness of multisensory stimulation in domains such as physically nonaggressive behavior, verbally agitated behavior and agitation. However, these effects did not always persist in the long-term. Six studies showed poorly consistent results on the effects of multisensory stimulation in improving mood, with only one displaying significant effects. Similarly, despite poor results, two studies showed benefits concerning anxiety. Participants reported significantly decreased levels of anxiety over the course of the intervention, and this improvement persisted in the long-term. In regard to functional status in activities of daily living, two studies reported an improvement in the short-term. Moreover, the effectiveness in cognitive domains such as memory and attention to surroundings also showed inconsistent results across the seven studies that analyzed this outcome. Two studies reflected an improvement during the intervention, but also reported a gradual decline in the long-term. Only one study observed significantly better results during the intervention that persisted until the follow-up assessment. Apathy, night-time behavior, eating disorders, delusion and hallucination were NPS that were not explored in the studies that met the criteria to be included in this review. CONCLUSIONS: These findings suggest that multisensory stimulation could be an effective intervention for managing NPS in older adults with major NCD in a mild to severe stage, particularly for managing behavioral symptoms such as agitation. This research provides an indication of the likely effect of the multisensory stimulation on NPS such as agitation and anxiety, as well on cognitive status.

Mild cognitive impairment in older adults: Analysis of some factors / A perturbação neurocognitiva ligeira em idosos: análise de alguns fatores

ABSTRACT Mild cognitive decline is a feared aspect of aging associated with frailty experienced by individuals. Objective: To determine the number of elderly people with mild cognitive impairment (MCI); to determine the relationship of sociodemographic and clinical variables by group of individuals with or without MCI and to determine the relationship between MCI assessed by 6CIT and the cognitive domains assessed by the MoCA. Methods: A correlational study was conducted of 44 elderly individuals attending a day-care center or residing in a care home, with an average age of 88.9 ± 8.8 years who answered a structured interview collecting sociodemographic and clinical data. Results: The elderly living at home had higher average body mass index and number of pathologies than those living in an institution for the elderly (p < 0.01). 63.6% of the elderly did not have MCI, and no differences were found between residential settings. The comparison between 6CIT and MoCA yielded differences in the general domain and in visual, attention, abstraction and, orientation subdomains. Conclusion: Cognitive stimulation interventions should be optimized according to the residential setting at the level of comorbidities and nutrition.

RESUMO O declínio cognitivo leve é um aspecto temido do envelhecimento associado à fragilidade vivenciada pelos indivíduos. Objetivo: Determinar o número de idosos com comprometimento neurocognitivo leve; determinar a relação das variáveis sociodemográficas e clínicas por grupo de indivíduos com ou sem comprometimento neurocognitivo leve e determinar a relação entre o comprometimento neurocognitivo leve avaliado pelo 6CIT e os domínios cognitivos avaliados pelo MoCA. Métodos: Estudo correlacional realizado em 44 idosos de instituições de creche e residência permanente, com idade média de 88,9 ± 8,8 anos, que responderam a uma entrevista estruturada composta por dados sociodemográficos e clínicos. Resultados: Os idosos que residem em casa apresentam maior índice de massa corporal médio e número de patologias que os idosos que vivem em uma instituição para idosos (p < 0,01). 63,6% dos idosos não apresentam comprometimento neurocognitivo leve e não são encontradas diferenças ao atravessar o contexto da residência. Na comparação entre 6CIT e MoCA produz diferenças no domínio geral e subdomínios visuais, de atenção, abstração e orientação. Conclusão: É necessário otimizar as intervenções de estimulação cognitiva de acordo com o contexto de residência no nível de comorbidades e nutrição.

Uso de três tipologias de um andarilho: impacto no perfil de desempenho funcional de idosos institucionalizados / Use of three types of walkers: impact on the functional performance profile of institutionalized older adults / Uso de tres tipologías de andador: impacto en el perfil del desempeño funcional de las personas mayores institucionalizadas

Enquadramento: Ao envelhecimento associam-se problemas agudos e crónicos que interferem com a mobilidade da pessoa idosa e a sua independência. Atualmente, existem no mercado diversas tipologias de andarilho com diferentes perfis de desempenho funcional do idoso, que visam compensar limitações físicas e prevenir quedas. Objetivo: Comparar o perfil de desempenho funcional de pessoas idosas institucionalizadas tendo em conta o tempo percorrido, velocidade de marcha, variância frequência cardíaca e custo energético despendido aquando da realização do teste Expanded Timed Get-up-and-Go no uso de três tipologias de um andarilho: fixo, duas rodas e quatro rodas. Metodologia: Estudo quasi-experimental antes e após de grupo único, numa amostra de conveniência de 40 pessoas idosas institucionalizadas. Resultados: Foram identificadas diferenças significativas no tempo percorrido (X² = 15,65; p < 0,001) e na velocidade de marcha (X² = 15,80; p < 0,001). Conclusão: Não existe uma solução ideal única entre as tipologias do andarilho analisadas, sendo, portanto, desejável uma solução personalizada às características e necessidades da pessoa idosa institucionalizada.

Background: Aging is associated with acute and chronic problems that interfere with older adults' mobility and independence. There are several types of walkers available in the market with different functional performance profiles of older people which aim to compensate for physical limitations and prevent falls. Objective: To compare the functional performance profile of institutionalized older adults taking into account the total time, gait speed, heart rate variability, and energy cost during the Expanded Timed Get-up-and-Go test using three types of walkers: fixed, two-wheeled, and four-wheeled walkers. Methodology: One-group pretest and posttest quasi-experimental study in a convenience sample of 40 institutionalized older people. Results: Significant differences were found in the total time (X² = 15.65; p < 0.001) and gait speed (X² = 15.80, p < 0.001). Conclusion: There is no unique ideal solution among the types of walkers analyzed in this study, thus a tailored solution is desirable to meet institutionalized older adults' characteristics and specific needs.

Marco contextual: El envejecimiento está asociado con problemas agudos y crónicos que interfieren en la movilidad de la persona mayor y su independencia. En la actualidad, existen en el mercado varios tipos de andadores con diferentes perfiles de rendimiento funcional de las personas mayores, que tienen como objetivo compensar las limitaciones físicas y prevenir las caídas. Objetivo: Comparar el perfil de rendimiento funcional de las personas mayores institucionalizadas teniendo en cuenta el tiempo recorrido, la velocidad de la marcha, la variancia de la frecuencia cardíaca y el coste energético gastado durante la prueba Expanded Timed Get-up-and-Go en el uso de tres tipologías de andador: fijo, de dos ruedas y de cuatro ruedas. Metodología: Estudio cuasiexperimental antes y después de un solo grupo, en una muestra de conveniencia de 40 personas mayores institucionalizadas. Resultados: Se identificaron diferencias significativas en el tiempo recorrido (X² = 15,65; p < 0,001) y en la velocidad de la marcha (X² = 15,80; p < 0,001). Conclusión: No existe una única solución ideal entre las tipologías de andador analizadas, por lo que lo mejor es una solución personalizada a las características y necesidades de la persona mayor institucionalizada.

Afirmação da mulher na medicina durante o século XV e XVI: um processo religioso e inquisitorial / Afirmación de la mujer en la medicina durante el siglo XV y XVI: un proceso religioso e inquisitorial / Woman's statement in medicine during the fifteenth and sixteenth century: a religious and inquisitorial process

Durante os séculos XV e XVI, num momento de repressão e perseguição religiosa e inquisitorial, as mulheres atuaram como cuidadoras informais com práticas empíricas. Os objetivos deste artigo consiste em destacar o processo de profissionalização dos cuidados da mulher ao longo deste período e conhecer o papel da igreja e dos homens na crítica aos cuidados femininos, assim como apresentar figuras femininas espanholas que se destacaram na medicina neste período. Material e método: O trabalho consiste numa revisão da narrativa realizada a partir de fontes secundárias, relacionadas com o objeto em estudo, bem como uma análise das mesmas desde a história social, tendo em conta as características da época em estudo. Resultados: Durante os séculos XV y XVI, a igreja, junto com a classe médica, conduziu a uma repressão dos cuidados femininos que influenciou a sua aceitação. Assim, os cuidados femininos geraram discordância e conflitos entre a igreja e a sociedade e o cuidar informal da mulher começava a inserir-se na classe médica profissionalizada. Conclusões: As descobertas obtidas neste estudo destacam a aceitação das práticas empíricas femininas, em contraste com os conhecimentos teóricos dos médicos e, posteriormente, a inclusão da mulher nos cuidados profissionais

Durante los siglos XV y XVI, en un momento de represión y persecución religiosa e inquisitorial, las mujeres actuaron como cuidadoras informales con prácticas empíricas. El objetivo del estudio es destacar el proceso de profesionalización de cuidados de la mujer durante dicho periodo; conocer el papel de la iglesia, de los hombres en la crítica hacía las mujeres; presentar figuras femeninas españolas destaca das en la medicina durante este período. Material y método: El trabajo es una revisión narrativa de las fuentes secundarias relacionadas con el objeto de estudio, así como un análisis de las mismas desde la historia social, teniendo en cuenta las características de la época de estudio. Resultados: Durante los siglos XV y XVI, la iglesia, junto con la clase médica, condujo una represión hacía el cuidado femenino que influyó en su aceptación. Así mismo, el cuidado femenino generó desacuerdos y conflictos entre iglesia y sociedad, los cuidados de las mujeres informales, empezaron a formar parte de la clase médica profesionalizada. Conclusiones: Los hallazgos obtenidos refieren como a pesar del predominio del conocimiento teórico médico, las prácticas empíricas de las mujeres consiguieron ser aceptadas en determinadas condiciones y esto constituyó, con posterioridad, el reconocimiento profesional del cuidado

Dring the fifteenth and sixteenth century, at a time of repression and religious and inquisitorial persecution, women have acted as informal caregivers with empirical practices. The objectives of this article is to emphasize the process of professionalization of women's care over that period and to know the role of the church and men in critical care to women, as well as presenting Spanish female figures who have excelled in medicine during this period. Methods: The task is a narrative review of secondary sources related with the object of study, as well as an analysis of the same sources from the social history, keeping in mind the characteristics of the era of study. Results: During the centuries XV and XVI, the church, along with the medical class, led to a suppression of feminine care that influenced their acceptance. Thus, feminine care generated disagreement and conflict between the church and society and the informal women's care began to be part of the professionalized medical profession. Conclusions: The findings from this study highlight the acceptance of female empirical practices, in contrast to the theoretical knowledge of medical and subsequently the inclusion of women in professional care