Adaptation and validation into Portuguese language of the six-item cognitive impairment test (6CIT).

BACKGROUND: The six-item cognitive impairment test (6CIT) is a brief cognitive screening tool that can be administered to older people in 2-3 min. OBJECTIVE: To adapt the 6CIT for the European Portuguese and determine its psychometric properties based on a sample recruited from several contexts (nursing homes; universities for older people; day centres; primary health care units). METHOD: The original 6CIT was translated into Portuguese and the draft Portuguese version (6CIT-P) was back-translated and piloted. The accuracy of the 6CIT-P was assessed by comparison with the Portuguese Mini-Mental State Examination (MMSE). A convenience sample of 550 older people from various geographical locations in the north and centre of the country was used. RESULTS: The test-retest reliability coefficient was high (r = 0.95). The 6CIT-P also showed good internal consistency (α = 0.88) and corrected item-total correlations ranged between 0.32 and 0.90. Total 6CIT-P and MMSE scores were strongly correlated. The proposed 6CIT-P threshold for cognitive impairment is ≥10 in the Portuguese population, which gives sensitivity of 82.78% and specificity of 84.84%. The accuracy of 6CIT-P, as measured by area under the ROC curve, was 0.91. CONCLUSION: The 6CIT-P has high reliability and validity and is accurate when used to screen for cognitive impairment.

Midwives' interventions for reducing fear of childbirth in pregnant women: a scoping review.

OBJECTIVE: The objective of this review was to map and analyze midwives' interventions for reducing fear of childbirth in pregnant women. INTRODUCTION: Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy. Over the past few decades, there has been growing research interest in interventions for reducing fear of childbirth in pregnant women. One of the challenges in midwifery care is to provide an appropriate model of care for pregnant women with fear of childbirth. Further research efforts are needed to identify midwives' interventions for reducing fear of childbirth in pregnant women and to examine their characteristics. INCLUSION CRITERIA: This scoping review considered studies that included midwives' interventions for reducing fear of childbirth in pregnant women. Specifically, interventions were led and/or implemented by midwives during the antenatal period, and integrating all possible midwifery practice settings. Quantitative, qualitative, and mixed methods studies were included. This review also considered systematic reviews, text and opinion papers, and conference abstracts. METHODS: The JBI methodology for conducting scoping reviews was used. Published and unpublished literature in English, Portuguese, and Spanish from January 1981 to October 2020 was included. MEDLINE (PubMed), CINAHL Complete, APA PsycINFO, Scopus, Embase, Web of Science, SciELO, MedicLatina, Academic Search Complete, ERIC, Psychology and Behavioral Sciences Collection, and the Cochrane Library databases were searched. Searches for gray literature were also undertaken on the Repositório Científico de Acesso Aberto de Portugal, ProQuest Dissertations and Theses, British Library EThOS, OvidSP Resource Center, Banco de Teses da CAPES, and OpenGrey. A three-step search strategy was followed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews checklist was used. Two independent reviewers extracted the data using a data extraction tool developed specifically for this scoping review. RESULTS: A total of 3704 articles were identified and screened, of which 34 articles were included. The majority of studies had been published in the past 10 years (88%) in Scandinavian countries or Australia (79%). Several midwives' antenatal interventions were found, such as midwife-led team models of care. Midwives played a facilitator role that varied across the included studies. In 20 studies (59%), midwives led and implemented the interventions alone ( n   =  13; 38%) or with the participation of other health professionals ( n   =  7; 21%). In the remaining 14 studies (41%), midwives were part of a multidisciplinary team that included different health professionals (mainly obstetricians and psychologists) who had been involved in delivering interventions alongside midwives or with minor participation from midwives. Counseling ( n   =  12; 35%) and psychoeducation ( n   =  8; 24%) were the most common midwife interventions for reducing fear of childbirth in pregnant women. CONCLUSIONS: Midwives working across their full scope of practice play a pivotal role in reducing fear of childbirth, which may explain the variety of midwives' antenatal interventions. Reducing fear of childbirth in pregnant women and promoting normal childbirth as a positive experience are key features of midwives' interventions, which should include women's empowerment measures. Evidence-based midwife-led intervention programs for pregnant women with fear of childbirth should be designed and tested to improve clinical practice as well as women's reproductive outcomes and perinatal experiences.

Citizen involvement in scientific activities and extension of knowledge to society.

High-quality health research must involve the citizen, bringing merit, relevance, and value to research and ensuring the transfer of new knowledge or outputs to the community. This theoretical study aimed to conceptualize and discuss the role of Citizen Involvement and Extension to Society in research processes and outcomes, revealing that both concepts have different purposes. Research units and research funding agencies are promoting Citizen Involvement in all steps of the research process because it adds quality to it. Moreover, universities, research units, and researchers should extend their knowledge to society, the citizens, or the end-users as part of their social responsibility. Citizen Involvement and Extension to Society should be considered strategic areas for the development of research in general and nursing research in particular. More studies are needed to generate new knowledge and useful products to better serve the real needs of society.

Midwifery interventions to reduce fear of childbirth in pregnant women: a scoping review protocol.

OBJECTIVE: The objective of the review is to map and analyze midwifery interventions to reduce fear of childbirth in pregnant women. INTRODUCTION: Fear of childbirth is a phenomenon negatively affecting women's health and well-being before and during pregnancy, as well as after childbirth. During the previous few decades, there has been a growing interest in research into interventions to reduce the fear of childbirth in childbearing women. Currently, providing an appropriate model of care for pregnant women with fear of childbirth is a challenge in midwifery care. Therefore, further efforts are needed to identify and examine the characteristics of different midwifery interventions to reduce fear of childbirth in pregnant women. INCLUSION CRITERIA: This scoping review will consider studies that include interventions to reduce fear of childbirth in pregnant women, led and implemented by midwives, during the antenatal period, in all possible birth scenarios. Quantitative, qualitative, and mixed methods studies will be included. METHODS: The JBI methodology for conducting scoping reviews will be employed. Published and unpublished literature in English, Portuguese, and Spanish, from 1981 to the present, will be included. MEDLINE, CINAHL Complete, Scopus, Web of Science, Embase, and Cochrane Library databases will be searched. Searches for gray literature will be performed. Data will be extracted using a tool developed specifically for the scoping review objectives.

Citizen involvement in scientific activities and extension of knowledge to society / Envolvimento do cidadão nas atividades científicas e extensão do conhecimento à sociedade / Intervención del ciudadano en actividades científicas y extensión del conocimiento a la sociedad

ABSTRACT High-quality health research must involve the citizen, bringing merit, relevance, and value to research and ensuring the transfer of new knowledge or outputs to the community. This theoretical study aimed to conceptualize and discuss the role of Citizen Involvement and Extension to Society in research processes and outcomes, revealing that both concepts have different purposes. Research units and research funding agencies are promoting Citizen Involvement in all steps of the research process because it adds quality to it. Moreover, universities, research units, and researchers should extend their knowledge to society, the citizens, or the end-users as part of their social responsibility. Citizen Involvement and Extension to Society should be considered strategic areas for the development of research in general and nursing research in particular. More studies are needed to generate new knowledge and useful products to better serve the real needs of society.

RESUMO Investigação de alta qualidade em saúde deve envolver o cidadão, pois promove mérito, relevância e valor às atividades de investigação e assegura a transferência de novos conhecimentos ou resultados para a comunidade. Este estudo teórico teve como objetivo conceituar e discutir o Envolvimento do Cidadão nos processos de investigação e Extensão à Sociedade dos seus resultados, revelando que ambos os conceitos têm finalidades distintas. Unidades de investigação e agências de financiamento incentivam o Envolvimento do Cidadão em todas as etapas do processo de pesquisa, acreditando-se que o mesmo adiciona qualidade aos processos de pesquisa. Por outro lado, universidades, unidades de investigação e pesquisadores têm a responsabilidade social de estenderem seus conhecimentos à sociedade, aos cidadãos ou aos usuários finais. O Envolvimento do Cidadão e a Extensão à Sociedade devem ser considerados áreas estratégicas para o desenvolvimento da pesquisa em geral e da enfermagem em particular. Estudos que envolvam o cidadão são necessários para gerar novos conhecimentos e produtos úteis para melhor atender às reais necessidades da sociedade.

RESUMEN La investigación en salud de alta calidad debe involucrar el ciudadano, aportar mérito, relevancia y valor a la investigación y garantizar la transferencia de nuevos conocimientos o resultados para la comunidad. Este estudio teórico tuvo como objetivo conceptuar y debatir el rol de la Intervención Ciudadana y de la Extensión a la Sociedad en los procesos y conclusiones de investigación, revelando que ambos los conceptos tienen finalidades distintas. Unidades de investigación y agencias de fomento a la investigación han promovido la Intervención del Ciudadano en todas las etapas del proceso de investigación una vez que ella aporta calidad a los mismos. Por otro lado, universidades, unidades de investigación e investigadores deben "extender" sus conocimientos a la sociedad, a los ciudadanos o a los usuarios finales como parte de su responsabilidad social. La Intervención del Ciudadano y la Extensión a la Sociedad deben ser consideradas áreas estratégicas para el desarrollo de la investigación en enfermería, específicamente. Más estudios son necesarios para generar nuevos conocimientos y productos útiles con la finalidad de atender mejor a las necesidades de la sociedad.

Analysis of a health team's records and nurses' perceptions concerning signs and symptoms of delirium.

This study investigates the extent of under-diagnosis of acute confusion/delirium by analyzing the records of a health team and the perception of nurses concerning this phenomenon. This quantitative study was developed in a central university hospital in Portugal and used the documentary and interview techniques. The sample obtained through the application of the NeeCham's scale was composed of 111 patients with the diagnosis of acute confusion/delirium hospitalized in the medical and surgical acute care units. A rate of 12.6% of under-diagnosis was identified in the records and a rate of 30.6% was found taking into account the perception of nurses. No indicators of acute confusion/delirium were found in 8.1% of the 111 cases and only 4.5% of the patients were diagnosed with acute confusion/delirium. The results indicate there is difficulty in identifying acute confusion/delirium, with implications for the quality of care, suggesting the need to implement training measures directed to health teams.

Analysis of a health team's records and nurses' perceptions concerning signs and symptoms of delirium / Análise dos registros produzidos pela equipe de saúde e da percepção dos enfermeiros sobre os sinais e sintomas de delirium / Análisis de registros producidos por el equipo de salud y de la percepción de los enfermeros sobre las señales y síntomas de delirio

This study investigates the extent of under-diagnosis of acute confusion/delirium by analyzing the records of a health team and the perception of nurses concerning this phenomenon. This quantitative study was developed in a central university hospital in Portugal and used the documentary and interview techniques. The sample obtained through the application of the NeeCham's scale was composed of 111 patients with the diagnosis of acute confusion/delirium hospitalized in the medical and surgical acute care units. A rate of 12.6 percent of under-diagnosis was identified in the records and a rate of 30.6 percent was found taking into account the perception of nurses. No indicators of acute confusion/delirium were found in 8.1 percent of the 111 cases and only 4.5 percent of the patients were diagnosed with acute confusion/delirium. The results indicate there is difficulty in identifying acute confusion/delirium, with implications for the quality of care, suggesting the need to implement training measures directed to health teams.

Esta pesquisa pretendeu conhecer a dimensão do subdiagnóstico da confusão aguda/delirium, ao analisar os registros produzidos pela equipe de saúde e percepção dos enfermeiros sobre esse fenômeno. Foi desenvolvido em um hospital universitário central, de Portugal, delineada dentro do paradigma quantitativo, utilizando a técnica documental e entrevista. A amostra obtida, pela aplicação da Escala de Confusão NeeCham, foi de 111 doentes com diagnóstico de confusão aguda/delirium, internados em unidades de cuidados agudos médicos e cirúrgicos. Identificou-se taxa de subdiagnóstico do fenômeno de 12,6 por cento nos registros e de 30,6 por cento tendo em conta a percepção dos enfermeiros. Em 8,1 por cento, dos 111 casos, não foi identificado qualquer indicador de confusão aguda/delirium. Somente 4,5 por cento dos doentes tinha o fenômeno diagnosticado. Os resultados apontam dificuldade para se identificar a confusão aguda/delirium, com implicações para a qualidade dos cuidados, sugerindo a necessidade de medidas formativas dirigidas às equipes de saúde.

Esta investigación pretendió conocer la dimensión del subdiagnóstico de la confusión aguda/delirio, al analizar los registros producidos por el equipo de salud y percepción de los enfermeros sobre este fenómeno. Fue desarrollado en un hospital universitario central de Portugal. Delineada dentro del paradigma cuantitativo, utilizando la técnica documental y la entrevista. La muestra obtenida, por la aplicación de la Escala de Confusión NeeCham, fue de 111 enfermos con diagnóstico de confusión aguda/delirio, internados en unidades de cuidados agudos médicos y quirúrgicos. Se identificó una tasa de subdiagnóstico del fenómeno de 12,6 por ciento en los registros y de 30,6 por ciento teniendo en cuenta la percepción de los enfermeros. En 8,1 por ciento de los 111 casos, no fue identificado cualquier indicador de confusión aguda/delirio. Solamente, 4,5 por ciento de los enfermos tenían el fenómeno diagnosticado. Los resultados apuntan para la dificultad en identificar la confusión aguda/delirio, con implicaciones para la calidad de los cuidados, sugiriendo la necesidad de adoptar medidas formativas dirigidas a los equipos de salud.