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Percorrer ESSa - Artigos em Revistas Indexados à WoS/Scopus por Objetivos de Desenvolvimento Sustentável (ODS) "04:Educação de Qualidade"
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- Conhecimento e dificuldades dos enfermeiros sobre as precauções básicas de controlo de infeçãoPublication . Coelho, Juliana; Baptista, GoreteAs Infeções Associadas aos Cuidados de Saúde (IACS) permanecem um desafio significativo, apesar das estratégias nacionais implementadas para o seu controlo. As Precauções Básicas de Controlo de Infeção (PBCI) constituem a primeira linha de defesa na prevenção das IACS, sendo essencial que os enfermeiros detenham conhecimento adequado. Objetivo: Analisar o nível de conhecimento, as perceções e os fatores condicionantes que influenciam a adesão dos enfermeiros às PBCI no Serviço de Urgência de uma Unidade Local de Saúde do Norte de Portugal. Métodos: Estudo quantitativo, descritivo, correlacional e transversal, realizado num serviço de urgência de uma Unidade Local de Saúde do Norte de Portugal. A amostra, por conveniência, integrou 83 enfermeiros. Os dados foram recolhidos por questionário autoaplicado e a suaanálise inferencialincluiutestes de Qui-quadrado e ANOVA(p < 0,05). Resultados: A maioria dos enfermeiros apresentou nível moderado de conhecimento (57,8%). A experiência profissional e o grau académico apenas revelaram uma associação com tendência positiva em relação ao conhecimento geral, enquanto a formação específica em controlo de infeção revelou impacto estatisticamente significativo no nível de conhecimento. A principalbarreira identificada foi o elevado número de doentes (79,5%). A formação contínua (92,8%) foi apontada como estratégia mais eficaz. Conclusão: Os enfermeiros apresentaram conhecimento moderado, mas com persistência de lacunas. Os resultados obtidos destacam a importância da formação contínua nesta área e a presença de dificuldades predominantemente organizacionais.
- Effect of mobility at ICU discharge on mortality and length of post-ICU stay: a retrospective analysisPublication . Mendes, Roberto Gonçalves; Nunes, Manuel Lourenço; Branco, Miguel Castelo; Novo, AndréAdmission to intensive care can be accompanied by significant adverse effects for patients, which last beyond their stay in the unit. Early mobilisation is part of a set of a bundle to minimise these effects and is now unanimously considered to be safe and beneficial. It is therefore important to understand how it is being implemented in practice and what its real benefits are. Aim/Objective To characterise mobility in the ICU and correlate the level of mobility at discharge from the ICU with the results of post-intensive care, namely: length of stay after intensive care and hospital mortality. Methods This was an observational, retrospective study carried out in the Intensive Care Department of a Local Health Unit located in the Portuguese countryside. A quantitative research methodology was used. Results Of the 244 patients included in the sample, 54.5% achieved orthostatism during the ICU stay and 36.5% achieved deambulation. The average length of stay between leaving the ICU and hospital discharge was 8.0 ± 7.5 days. Patients who remained at bed rest at discharge had longer hospital stays than patients who were ambulating (p = 0.014); and patients who performed activities in bed also had longer hospital stays than those who were orthostatic or ambulating (p = 0.026 and 0.002 respectively). Post-ICU mortality was 5.7%, and there was a strong correlation with mobility on discharge from the ICU (p < 0.001), with less mobile patients having a higher mortality rate than expected (odds ratio = 5.13). Conclusions The mobility levels founded in this study are in line with international reality. Patients who achieve higher levels of mobility during their stay in intensive care have shorter hospital stays and lower mortality.
- Interrater reliability of a manual diagnostic protocol for pancreatic functional visceral dysfunctionPublication . Faria, Miguel; Machado, Nuno; Sousa, Marcos; Pires, Patrícia; Pires, TelmaA reliable manual examination has not been validated as a diagnostic tool for nociplastic visceral pain. Aims: To establish the interrater reliability of a manual examination protocol for functional pancreatic visceral dysfunction and the clinical criteria for a manual palpatory diagnosis based on the clinical features of the noci- plastic visceral pain. Methods: This double-blind cross-sectional study involved 60 participants assessed by three raters using a manual protocol for diagnosing functional pancreatic visceral dysfunction. Five palpation-based criteria were evaluated: (1) local pain, (2) referred pain, (3) neurovegetative symptoms, (4) hyperalgesia or allodynia, and (5) tissue resistance/density. Interrater agreement was measured using percentage agreement and Fleiss’ kappa. The reliability of the Verbal Numerical Rating Scale (vNRS) was assessed using the intraclass correlation coef - cient (ICC). Repeated measures analysis of variance and Cochran’s Q test (with Bonferroni correction) were used to analyze vNRS scores and categorical outcomes, respectively. Signi cance was set at p < 0.05. Results: Criteria 1, 3, and 4 showed particularly high levels of agreement, with overall agreement percentages of 93.3%, 95.6%, and 95.6%, respectively. The corresponding Fleiss’ kappa values were 0.863, 0.880, and 0.908, indicating almost perfect agreement. In contrast, Criteria 2 and 5 demonstrated substantial, but compara- tively lower, agreement, with overall percentages of 86.7% and 87.8% and Fleiss’ kappa values of 0.679 and 0.755. The vNRS demonstrated excellent reliability across all three pancreas regions, with ICC values well >0.90: head (ICC= 0.943, 95% con dence interval [CI]= 0.913–0.964), body (ICC= 0.950, 95% CI= 0.923– 0.968), and tail (ICC= 0.963, 95% CI= 0.944–0.977). Conclusions: Three blinded raters reached an almost perfect pair-wise interrater agreement on the presence or absence of functional visceral dysfunction in the topographic projection of the pancreas. This study provides pre- liminary evidence that a manual diagnostic protocol is a reliable and potentially useful diagnostic tool in diagnos- ing nociplastic pain in the topographic projection of the pancreas. Future research should prioritize evaluating the validity of the nociplastic visceral pain diagnosis.
- Maternal longevity is associated with reduced risk but an earlier onset of alzheimer’s disease in offspringPublication . Tábuas-Pereira, Miguel; Mano, Francisco; Bernardes, Catarina; Durães, João; Lima, Marisa; DenHaan, Kaitlyn; Paquette, Kimberly; Kun-Rodrigues, Célia; Carmona, Susana; Tábuas, Teresa; Faustino, Pedro; Coelho, Mariana Ruth; Silva-Spínola, Anuschka; Duro, Diana; Almeida, Maria Rosário; Malva, João; Baldeiras, Inês; Brás, José; Guerreiro, Rita; Santana, IsabelWhile human longevity has increased significantly over the last 2 centuries, the time spent in good physical and cognitive health has not risen proportionately. The incidence of Alzheimer’s disease (AD) increases with age, but parental longevity is often associated with better offspring health and lower AD risk. This study aimed to investigate the relationship between parental longevity and AD. We included patients with AD and cognitively healthy subjects (over 75 years), collecting family history data, namely maternal and paternal age at death. We performed a logistic regression to evaluate the association of parental longevity and AD risk and linear regression models for the association with age of onset and CSF biomarkers, adjusting for confounders. We analyzed 3069 participants from a Portuguese cohort, including 893 AD patients and 2176 cognitively healthy controls. Maternal longevity was inversely associated with AD risk (OR: 0.989, 95%CI = [0.982, 0.997], P = 0.005). In AD patients, higher maternal age of death was associated with an earlier disease onset (β = −0.081, 95%CI = [−0.148, −0.013], P = 0.019). No associations were found between parental longevity and CSF biomarkers. Maternal longevity appears protective against AD risk but is linked to an earlier onset in patients. This may indicate that protective factors for AD could become detrimental once AD is triggered. These findings highlight the complex interplay of genetic, environmental, and potentially epigenetic influences on AD.
- Nursing degree curriculum: differences and similarities between 15 european countriesPublication . Antão, Celeste; Santos, Bruna; Santos, Nelson; Fernandes, Hélder; Barroso, Bárbara; Mǎrginean, Cristina Oana; Pimentel, Maria HelenaThis study explores the curriculum of Nursing Bachelor’s degrees across 15 European countries, aiming to describe nursing course curricula and admission requirements and to identify differences and similarities in the implementation of the Bologna Process. The research employs a qualitative and documentary methodology, analyzing curricula from selected higher education institutions involved in the Erasmus+ “Innovative Skills for Nurses” project. The findings reveal variations in the duration of training, with some countries adopting 3-year (180 ECTS) programs, while others require 4-year (240 ECTS) programs. Furthermore, discrepancies were found in the balance between theoretical and clinical education, as well as the availability of optional subjects. Countries with longer training programs tend to offer more consolidated practices and greater alignment with Bologna’s principles, fostering better professional outcomes. The study highlights the challenges posed by non-standardized training durations and their impact on mobility and employability of nursing professionals. These findings may inform future discussions on harmonizing nursing education across Europe to ensure consistency in quality and professional competencies.
- Physical activity during pregnancy: associations between levels and types of physical activity and low back pain–related disability in portuguese pregnant womenPublication . Teixeira, Isabel; Santos, Paula Clara; Festas, Clarinda; Bernardo, DianaLow back pain (LBP) is one of the most prevalent musculoskeletal conditions during pregnancy and frequently impairs daily living activities and quality of life. The association between different levels and types of physical activity (PA) and LBP-related functional disability remains insufficiently explored. This study aimed to examine the association between PA levels and types and functional disability among pregnant women with LBP. A cross-sectional analytical study was conducted involving 192 Portuguese pregnant women. Data were collected through an online questionnaire comprising the Pregnancy Physical Activity Questionnaire and the Oswestry Disability Index (ODI). Most participants engaged predominantly in light-intensity or sedentary activity (69.1%), with minimal participation in vigorous activity (0.8%). Functional disability was generally mild (mean ODI = 11.5 ± 7.35); however, 42.2% of participants reported moderate disability and 11.0% severe disability. Advancing gestational age showed weak associations with increased domestic activity (r = 0.146, p = 0.044), decreased occupational activity (r = −0.295, p = 0.001), and higher functional disability scores (r = 0.142, p = 0.049). Parity was associated with differences in total PA levels (p = 0.005) and domestic activity (p = 0.001). Higher ODI scores were weakly associated with light-intensity and sedentary activity (r = 0.144, p = 0.047), whereas severe disability demonstrated a moderate association with sedentary behavior (r = 0.529, p = 0.014). Overall, lower levels of PA, particularly sedentary behavior, were weakly associated with higher LBP-related disability; however, the observed associations were generally weak and should be interpreted with caution considering the cross-sectional design.
- Physiotherapy education and game-based learning: developing the SPINE frameworkPublication . Bernardo, Diana; Paquete, Manuel Joaquim da Silva P. G; Rosa, Marlene Cristina NevesInnovative pedagogical approaches are increasingly essential in physiotherapy education to foster engagement and competency development. This multicenter cross-sectional study explored physiotherapy students’ perceptions of game-based learning (GBL) across six Portuguese higher education institutions. A total of 208 students completed a structured questionnaire assessing attitudes toward GBL in teaching–learning contexts and competency development. Results indicated generally positive perceptions of GBL, emphasizing its value for motivation, engagement, and integration of theoretical and practical learning. Transversal competencies— such as teamwork, communication, and empathy—were consistently recognized across academic years, while perceived benefits for technical skills increased with clinical exposure. Female students and those with prior health- related experience reported more favorable attitudes. However, students also highlighted limited curricular implementation and the need for clearer alignment between game activities and learning objectives, suggesting barriers at the institutional and pedagogical levels. These insights point to a gap between students’ enthusiasm and current educational practices, underlining the importance of structured guidance for integrating GBL effectively. Building on these findings, the student-perceived integration for novel education (SPINE) framework is proposed as a decision-making model to guide the pedagogically grounded GBL in physiotherapy curricula, emphasizing evidence-informed, context-sensitive, and sustainable implementation.
- Produção científica em enfermagem de reabilitação e exercício físico em Portugal: revisão bibliométricaPublication . Novo, André; Parola, Vítor; Mendes, Eugénia; Preto, Leonel; Martins, Maria Manuela; Schoeller, Soraia DornellesMapear a enfermagem de reabilitação e o exercício físico. Estudo bibliométrico realizado nas bases SCOPUS, MEDLINE (via PubMed) Web of Science e Repositório Científico de Acesso Aberto de Portugal, com utilização do software VOSviewer. Foram aplicadas técnicas de coocorrência de palavras-chave, títulos, análise de coautoria, agrupamento por modularidade e aplicação de leis para validação. Foram analisadas 96 publicações, com 153 autores e 44 colaborações em coautoria. Autores como André Novo, Bruno Delgado e Eugénia Mendes foram os mais produtivos nessa temática. A produção científica aumentou significativamente após 2020. A Revista Portuguesa de Enfermagem de Reabilitação, a Escola Superior de Enfermagem de Coimbra e o Instituto Politécnico de Bragança concentram a maior parte da produção científica. As palavras-chave evoluíram de enfoques clínicos para abordagens integradas de promoção da funcionalidade e autonomia. Foram identificados quatro clusters temáticos. O exercício físico é uma ferramenta central no cuidado de Enfermagem de Reabilitação. Cada vez mais publicações em Enfermagem de Reabilitação colocam-no como estratégia predominante de cuidado. Contribuição para a prática: valorização da prescrição de exercício baseada em evidências científicas por enfermeiros de reabilitação.
- Proposal of preliminary quality Indicators for long-term care institutions: a study in PortugalPublication . Abrunhosa, Susete Coelho; Fernandes, Hélder; Martin, José IgnácioThis study, based on the Donabedian’s model (JAMA, 260(12), 1743–1748, 1988), indentify professionals who spend the most time in care activities and proposes quality indicators for long-term care institutions in Portugal. The increasing complexity of long-term care in Portugal calls for an evaluation system tailored to the country’s clinical, social organizational context. Existing European indicators, developed for different settings, fail to fully capture national specificities. The indicators proposed in this study, incorporating care time, professional roles, and resident profiles, enable a more accurate assessment, support continuous improvement, and guide evidence-based public policies. Indicators were validated through literature review, Delphi consensus, and analysis of residents’ records using descriptive statistics and multiple linear and logistic regressions models (Stepwise and Forward). Structure, presence of an interdisciplinary team, an Individual Intervention Plan and case manager, Nursing Assistant hours and psychosocial care. Process: rate of dependency, use of anti-infective drugs, for the central nervous and cardiovascular systems, and prevalence of pressure ulcers. Outcome: rate of falls, deaths, hospitalizations, bedridden individuals, incontinence and incidence of pressure ulcers. This preliminary study based on Donabedian's model identifies structure, process and outcome indicators to evaluate long-term integrated care. The time spent caring for dependent users, especially in Long Duration and Maintenance Unit, reveals greater complexity. Despite the broad sample and interdisciplinary approach, methodological limitations require further research to validate and adapt the indicators to the portuguese context
- Relato de caso: incontinência fecalPublication . Pires, Telma; Magalhães, Bruno; Rodrigues, Vítor; Barroso, Isabel; Paulo, Marta; Carvalho, Diana; Marques, Maria Helena; Pires, PatríciaO objetivo do estudo foi avaliar a eficácia de um programa de reabilitação dos Músculos do Pavimento Pélvico (MPP) para superar a Incontinência Fecal (IF). Metodologia: estudo de caso com uma participante de 64 anos, professora, autónoma, com diagnóstico de IF devido a sequela de cirurgia a prolapso retal. Realizou-se um programa de Treino dos Músculos do Pavimento Pélvico (TMPP), de uma sessão/semana, durante 16 semanas, supervisionado por Biofeedback anorretal. Cada sessão demorou 45 minutos, dos quais 20 minutos para TMPP e o restante para o exame físico, terapia manual, massagem e ensinos/registos da doente: diário de sintomas, supervisão da gestão da alimentação, treino intestinal, técnicas/posturas de defecação e suporte emocional. Na primeira sessão (T0) e na última (T1), foi ainda efetuado a anamnese, Índice de Wexner, Bristol Stool Form Scale (BSFS) e Fecal Incontinence Quality of Life (FIQL). Os resultados evidenciaram ganhos na força dos MPP, que evoluíram de grau 2 para 4 na escala de Oxford modificada; na qualidade de vida (QdV), ausência de perdas fecais, as fezes passaram de consistência tipo 2 para 4 na BSFS. Conclusão: o programa de reabilitação uropélvica, mostrou-se eficaz na reeducação dos MPP e melhorou significativamente a QdV da participante. PALAVRAS-CHAVE: incontinência fecal; reabilitação pélvica; treino dos músculos do pavimento pélvico.