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- Virtual escapes: a pedagogical strategy for developing emotional competence in nursing studentsPublication . Gomes, Lisa; Cassar, Maria; Bugeja, Roderick; Oliveira, Inês; Cainé, João; Pereira, Rui; Chircop, Daren; Veiga-Branco, AugustaEmotional competence, the ability to manage interpersonal relationships through understanding one's and others' emotions, encompasses two dimensions: cognitive and behavioral. In nursing practice, the combination of these dimensions allows for better performance in highly complex clinical situations. Nursing education does not always emphasize these competences. This pilot study explored the potential of an escape room, a Serious Games (SGs) prototype with virtual reality (VR), as a pedagogical strategy for eliciting emotions in a safe learning environment. Participants' immersion in the game provided an opportunity to identify, manage, and process emotions. Data were gathered by a questionnaire and by observation of performance. The findings revealed that participants felt various emotions (n = 51) while playing the game. The least frequent reported emotions were hope, shame, and contempt. Admiration, pride, satisfaction, and fear were the most frequently reported emotions. These findings suggest that using a SGs prototype with VR as a pedagogical tool holds significant potential in emotion elicitation in a safe learning environment, implying its value as a construct of emotional competence. Further research to verify educational value is recommended.
- “Sit-to-stand test to assess muscle strength after intradialytic exercises in chronic kidney disease patients: A systematic review with meta-analysis”Publication . Almeida, Klebson da Silva; Costa, Natália Silva; Lima, Bráulio Nascimento; Neves, José Leonardo Dos Reis; Barreto, Luiz Gustavo Pereira; Freitas, Luana de Jesus; Silva, Monique Mesquita; Maneschy, Mariela de Santana; Novo, André; Chiavegato, Luciana DiasChronic kidney patients undergoing hemodialysis (HD) experience a decline in muscle strength and functionality, as musculoskeletal disorders affect both strength and functional capacity. This study aims to evaluate the influence of intradialytic (ID) exercise on the strength and functionality of chronic kidney patients, as assessed by sit-to-stand test, and to identify the most commonly used sit-to-stand protocol. Methods: A search was conducted across eight databases to identify relevant studies published before March 29, 2024. Clinical trials investigating intradialytic exercises and utilizing the sit-to-stand test as an assessment tool were eligible. The risk of bias in individual studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Mean differences (MD) and 95 % confidence intervals were calculated and pooled in metaanalyses. The quality of meta-analyses was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach. Results: A total of 6717 studies were initially identified. After screening,17 articles involving 870 participants, met the inclusion criteria demonstrating acceptable methodological quality, with a mean PEDro scale of 5,23 (+/- 1,56). Despite the lack of robust evidence, this review suggests that the ID exercise improves strength and functionality. Among the various sit-to-stand test subtypes, the 10-repetition sit-to-stand test was found to be the most effective. Conclusion: Despite the low quality of studies, the 10-repetition sit-to-stand test (10-STS) seems to be the most effective for evaluating muscle strength of lower limbs and functionality. ID exercise seems to positively impact muscle strength and, consequently, the functionality of chronic kidney disease patients undergoing HD.
- O efeito da COVID-19 na mortalidade: causas subjacentes no excedente de óbitos em Portugal ContinentalPublication . Pires, Cláudia Sofia martins; Pimentel, Maria Helena; Teixeira, Cristina; BarrosoO excedente de mortalidade durante a pandemia COVID-19 não é totalmente explicado pela infeção. Objetivos: Avaliar causas subjacentes ao excedente de mortes, durante a pandemia, em Portugal Continental (PC). Metodologia: Óbitos por causa subjacente e população, por género e idade (< 60, 60-69, 70-79 e =80), para 2015-2019 e 2020-2021 obtidos do INE. Avaliação de diferenças entre períodos através da razão padronizada de mortalidade (RPM) e respetivo intervalo de confiança a 95% (IC95%). Resultados: A mortalidade por “doenças mentais e do comportamento” foi superior ao esperado em todos os grupos, particularmente em mulheres mais jovens (RPM = 168%; IC95%:127-217) e mais velhas (RPM = 140%; IC95%:137-144). Mortalidade por “doenças do sistema genito-urinário” é superior ao expectável em idade mais avançada, com valores de RPM entre 110% (IC95%:105-114) e 113% (IC95%:104-122). Mortalidade por “doenças do aparelho circulatório”, é inferior ao expectável em grupos etários até aos 80 anos. Conclusão: Os “transtornos mentais e do comportamento”, e as “doenças do sistema genito-urinário” associam-se a vulnerabilidade no contexto de COVID-19.
- Volume of exercise performed by heart failure inpatients undergoing cardiac rehabilitation – a quasi-experimental studyPublication . Delgado, Bruno; Lopes, Ivo; Rodrigues, Fátima; Neto, Célia; Pereira, Ana; Novo, AndréHeart Failure inpatients have a significant functional dependence, impairment of performance in activities of daily living and low exercise tolerance... The amount of Exercise is directly related to its benefits and the volume of exercise performed must be adjusted to safety issues. The aim of this study is to evaluate the volume of exercise performed and it’s relation with functional capacity and find a baseline volume level safe and effective. METHODS: Quasi-experimental study involving 72 inpatients who performed an aerobic exercise training program. Volume of exercise was registered in terms of number of cycloergometer turns, meters walked, steps climbed and the total time exercising. Subjective perception of exertion was evaluated in every training session at beginning and in the end. Patients performed two 6-minute walking tests (6MWT). RESULTS: 987 exercise sessions were performed. The majority of the patients were significant impaired: 81.9% are NYHA III and 73.6% present HFrEF. Patients achieved lower levels of perceived exertion throughout the inhospital stay: 6 (±3) (admission) and 2(±2) (discharge). Patients who performed more volume of exercise walked a higher distance in the discharge 6MWT. CONCLUSION: A bigger volume of aerobic exercise is related to a better improvement on functional outcomes. An average of more than 10 minutes per session seems to be more effective in terms of improvement of the functional capacity.
- Satisfação no trabalho e intenção de abandono em enfermagem: a influência do empoderamento profissionalPublication . Gomes, Jacinta; Galvão, Ana Maria; Gomes, Maria José; Moura Ramos, OlgaA satisfação profissional e a intenção de abandono em enfermagem estão fortemente relacionadas com as políticas organizacionais promotoras do empoderamento estrutural e do capital psicológico dos trabalhadores. Avaliar a satisfação no trabalho, a intenção de abandono e o empoderamento profissional em enfermeiros na prática clínica em organizações de saúde; avaliar a associação entre o empoderamento profissional, a satisfação no trabalho e a intenção de abandono dos enfermeiros. Estudo observacional, transversal e correlacional, com abordagem quantitativa. Amostra por conveniência constituída por 308 enfermeiros na prática clínica. Instrumento de recolha de dados constituído por questionário de caraterização sociodemográfica e profissional, Job Satisfaction Survey, Antecipated Turnover Scale, Conditions for Workplace Effectiveness Questionnaire II e Psychological Empowerment Instrument. Participaram no estudo enfermeiros com média de idade de 40,15 anos (±9,38) e que exercem prática clínica há 16,19 anos (±9,30). Aferiu-se uma relação positiva significativa entre a satisfação no trabalho e todas as dimensões do empoderamento profissional (0,2550,088). Para a intenção de abandono, obtiveram-se relações negativas com todas as dimensões do empoderamento estrutural e psicológico (-0,352
- Machine learning classification of consumption habits of creatine supplements in gym goersPublication . Magalhães, Patrícia C.; Encarnação, Samuel; Forte, Pedro; Teixeira, José Eduardo; Monteiro, A. M.; Barbosa, Tiago M.; Pereira, Ana Maria Geraldes Rodrigues; Schneider, AndréThe aim is to identify usage patterns and the main factors that influence creatine supplementation, providing a basis for future educational interventions and recommendations for safe and effective use. The study was applied to gym goers in Bragança, where a QR code for a survey was released. 158 people participated, 65 non-consumers of creatine supplementation (37.34% men; 22.78% women) and 95 consumers (15.19% men; 24.68% women). Five machine learning algorithms were implemented to classify creatine consumption in gym goers: Logistic Regression, Gradient Boosting Classifier, Ada Boost Classifier, Xgboost Classifier. K-folds cross-validation was implemented to validate the machine learning performance. There was an increased proportion of females with considered themselves not sufficiently informed about the creatine effects/side effects (22.2%) in comparison to males (8.47%), p=0.03. The AdaBoost classifier exposed the best overall performance (86%) in classifying overuse of creatine in gym goers based on their Smoke habits (r = 0.33), grams of creatine used per day (r = 0.50) and lack information about the side effects of creatine intake (r = -0.33). The K-folds method validates the results with very good performance (86%). In conclusion, the five machine learning methods employed well characterized the overuse of creatine in gym goers based on smoke habits, grams of creatine per day, and lack information about the side effects of creatine intake.
- Influência do estilo de liderança no empoderamento estrutural de enfermeiros: um estudo transversalPublication . Ramos, Olga Moura; Sá, José Alberto Fernandes Traila Monteiro de; Gomes, Jacinta Maria Pisco Alves; Galvão, Ana Maria; Gomes, Maria JoséAvaliar os estilos de liderança em enfermagem, o empoderamento estrutural de enfermeiros na prática clínica e a associação entre os estilos de liderança e o empoderamento estrutural dos enfermeiros. Método: estudo observacional e correlacional, realizado entre dezembro de 2023 e fevereiro de 2024. Trezentos e oito enfermeiros de organizações de saúde de Portugal responderam à Escala de Avaliação do Estilo Gerencial e ao Conditions of Workplace Effectiveness Questionnaire II. Análise de dados com estatística descritiva e inferencial. Resultados: reportado nível moderado de empoderamento estrutural (16,66±3,88). O estilo de liderança mais pontuado foi o direcionado para as relações (32,31±9,24). Há correlações positivas entre os diferentes estilos de liderança e o nível de empoderamento estrutural. A liderança direcionada para as relações é a que apresenta a correlação mais forte (r=0,446; p=0,000). Conclusão: os estilos de liderança em enfermagem são determinantes na construção de ambientes de prática que facilitam o acesso às estruturas de capacitação.
- 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.
- Validation of the collett-lester fear of death scale with portuguese studentsPublication . Alves Neto, Alexandra Marisa Maia; Félix, Neto; Patrício, Costa; Gomes, Maria JoséThe Collett-Lester Fear of Death Scale (CL-FODS) is a 28-item multidimensional measure assessing fear of death and dying of self and others. This study evaluated the psychometric properties and dimensionality of the Portuguese version in two phases. Phase 1 (P1; December 2018–February 2019) involved 312 students and used Exploratory Structural Equation Modeling (ESEM) to assess validity. Phase 2 (P2; January–March 2024) tested construct reproducibility with 470 students. Participants completed the Portuguese CL-FODS alongside the Social Desirability Scale, Social Anxiety Scale, Loneliness Assessment, and the Depression, Anxiety, and Stress Scales (DASS-21). An abbreviated version (AB-CLFODS) was developed by removing 12 items across subscales: fear of death of self (Items 1, 2, and 4; e.g., "Short life"), dying of self (Items 1, 5, and 7; e.g., "Physical degradation that occurs"), fear of death of others (Items 1, 2, and 3; e.g., "Loss of a loved one"), and dying of others (Items 1, 2, and 7; e.g., "Having to be with someone who is dying"). The AB-CLFODS demonstrated strong reliability, with Cronbach’s Alpha and McDonald’s ω values of .89 in P1 and .90 in P2. Subscale reliabilities ranged from .75 to .87 in P1 and .79 to .85 in P2. In P1, the scale correlated significantly with social desirability (p = .003), stress (p = .031), and social anxiety (p = .017). P2 confirmed significant correlations with all external measures, including loneliness and DASS-21 scores. Construct validity was further supported in P2 by acceptable fit indices, such as normed chi-square, CFI, and RMSEA values. These findings establish the Portuguese AB-CLFODS as a reliable and valid instrument for assessing fear of death and dying, with consistent psychometric properties and construct validity across time, making it suitable for research and clinical applications.
- Determinants of adolescent pregnancy in the municipality of Malanje, Angola: a case-control studyPublication . Aragão, Kalonesse; Sacomboio, Euclides; Teixeira, Cristina; Van-Dúnem, Joaquim; Campos, PauloAdolescent pregnancy is a global public health problem, with some of the highest rates observed in Sub-Saharan Africa. This phenomenon contributes to maternal and neonatal mortality and may result in diverse economic and psychological consequences. Knowledge of its determinants can help decision-makers to design local policies of sexual and reproductive health. Therefore, the aim of this study was to analyze the determinant factors of adolescent pregnancy in the municipality of Malanje, Angola. Methods: A case-control study was conducted from August to October, 2022. A sample of 411 adolescent women (137 pregnant and 274 non-pregnant) was compared in terms of socio-demographic, behavioral, family, and extra-family factors. Descriptive statistics, binary univariate and multivariate logistic analysis were applied, with p-values ≤ 0.05 indicating statistical significance. Adjusted odds ratio (AOR) and the respective 95% confidence interval (95% CI) were obtained. Results: The multivariable analysis showed that a higher risk of adolescent pregnancy was associated with living in a de facto union or being married (AOR = 10.37; 95% CI = 1.05 - 102.83), having 0 - 4 (AOR = 7.40; 95% CI = 1.25 - 43.77) or 5 - 8 years of schooling (AOR = 5.21; 95% CI = 1.25 - 21.77), and a lower risk was related with having a family history of adolescent pregnancy (AOR = 0.30; 95% CI = 0.11 - 0.80) for women aged 15 - 17. For those aged 18 - 19, a higher risk of pregnancy was associated with early sex initiation (AOR = 3.75; 95% CI = 1.05 - 13.43), having multiple sexual partners (AOR = 3.02; 95% CI = 1.23 - 7.44), while a lower risk was related with peer pressure (AOR = 0.35; 95% CI = 0.15 - 0.82). In both groups, the likelihood of pregnancy was significantly increased for irregular or non-use of contraceptive methods. Conclusion: In Malanje, adolescent pregnancy is a multifactorial phenomenon, and preventive strategies must consider the adolescents’ age. Among adolescents aged 15 - 17, early marriages, should be reduced, through the promotion of education and the creation of specific laws. For older adolescents, preventive strategies should be focused on avoiding risky behaviors such as early initiation of sexual activity and multiple sexual partners. Comprehensive sexual education, including knowledge about contraceptive methods should be promoted.