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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 Published and unpublished literature in English, Portuguese, and Spanish, from 1981 to the present, will be included.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.

Objective: To measure the prevalence of the fear of childbirth (FOC) and determine which factors predict severe FOC among pregnant Portuguese women. Methods: An online cross-sectional study among pregnant Portuguese women aged ≥ 20 years who were recorded using a convenience sampling. Self-administered questionnaires were used for data collection: sociodemographic and obstetric questionnaire and European Portuguese version of Wijma Delivery Expectancy Questionnaire-version A (WDEQ-A). Data of 669 participants were collected successfully from June 9 to October 30, 2019. Predictive factors for severe FOC were investigated using a multivariate logistic regression analysis. Odds ratios (OR) and 95% confidence intervals were calculated. Results: The prevalence of severe FOC (WDEQ-A ≥ 85) among pregnant Portuguese women was 10%. Severe FOC was significantly associated with lower educational level, single/divorced marital status, and negative previous childbirth experience. Multivariate logistic regression analysis indicated that being single or divorced and having a negative previous childbirth experience were predictive variables for severe FOC. Conclusion: Pregnant Portuguese women have FOC, although with varying severity. The data suggest that marital status and women’s perceptions of previous childbirth experience may be useful variables to predict severe FOC. Further research for extending the predictive factors of FOC should be refined. The results are clinically relevant for midwifery care, as they should be used in the sense of early identification of fearful pregnant women to provide adequate support strategies to reduce FOC. info:eu-repo/semantics/publishedVersion

The availability, effectiveness, and access to antenatal care are directly linked with good maternal and neonatal outcomes, making antenatal care an important determinant in health. But to be effective, care must always be appropriate, not excessive, not insufficient. Perinatal outcomes vary within and between countries, raising questions about practices, the use of best evidence in clinical decisions and the existence of clear and updated guidance. Through a scoping review methodology, this study aimed to map the available antenatal care policies for lowrisk pregnant women in high-income countries with a universal health system, financed by the government through tax payments. Following searches on the main databases and grey literature, the authors identified and analysed ten antenatal care policies using a previously piloted datachart: Australia, Denmark, Finland, Iceland, Italy, Norway, Portugal, Spain, Sweden and the United Kingdom. Some policies were over 10 years old, some recommendations did not present a rationale or context, others were outdated, or were simply different approaches in the absence of strong evidence. Whilst some recommendations were ubiquitous, others differed either in the recommendation provided, the timing, or the frequency. Similarly, we found wide variation in the methods/strategy used to support the recommendations provided. These results confirm that best evidence is not always assimilated into policies and clinical guidance. Further research crossing these differences with perinatal outcomes and evaluation of cost could be valuable to optimise guidance on antenatal care. Similarly, some aspects of care need further rigorous studies to obtain evidence of higher quality to inform recommendations. info:eu-repo/semantics/publishedVersion

Wound care specialists are essential to meet the growing need to prevent and treat acute and chronic wounds affecting millions worldwide. Information systems with clinical decision support become essential by collecting, codifying, and storing knowledge, and returning information on-screen to the nurse.Goals: This study aims to identify opportunities for semantic interoperability improvement through the analysis of all diagnoses and interventions used in a public Health Information System related to the integumentary system. Methods: A qualitative descriptive study of nursing diagnoses and interventions data. We selected the Portuguese national Health Information System for data analysis since it was recognized for the progress in terms of information and communications technologies used in the health sector. All nursing diagnoses, interventions, and their relationships available for selection in clinical practice regarding wound healing were analyzed. We performed this research in two phases: (1) Content analysis of nursing diagnoses and interventions, revised by two external experts, and (2) Focus group with Health Information Systems and terminologies experts to discuss and implement contributions to a wound healing clinical model.Results: We matched 66 diagnoses, 171 interventions, and 318 relationships to the integumentary system. Nursing interventions were centered on three action types: performing, determining, and informing. We found unexpected inconsistencies regarding the association between teaching actions and missing knowledge-centered diagnoses. The focus group added an essential perspective on interventions from other domains becoming essential to wound healing. Conclusions: Nurses use standardized language to describe nursing concepts in daily practice. Semantic interoperability is still questionable by persistent changes based on opinions instead of scientific knowledge, with no known public rules or procedures. A qualitative approach allowed for improvements in the concepts used to represent clinical practice and the sentences construction validity.

Enquadramento: O cancro da próstata é a segunda principal causa de morte por cancro nos homens. O diagnóstico e tratamento podem provocar alterações significativas na vida dos homens e, por consequência, modificar a sua qualidade de vida. Objetivo: Avaliar as alterações na qualidade de vida do doente com patologia oncológica da próstata, desde o momento do diagnóstico da doença até aos 6 meses de tratamento. Metodologia: Foi desenvolvido um estudo descritivo, analítico e longitudinal com a participação de doentes oncológicos, utilizando as escalas HRQoL, SF-12 e EQ-5D em quatro momentos. Resultados: Foram observadas alterações em dimensões da QVRS ao longo de quatro momentos de avaliação, bem como ao nível da funcionalidade e dos sintomas. Conclusão: Este estudo apresenta novas evidências sobre a QVRS dos doentes portadores de patologia oncológica da próstata, nomeadamente em dimensões relacionadas com funções emocionais e sociais, fadiga, náusea e vómito, insónia, sintomas de obstipação e diarreia, atividade sexual, sintomas urinários, intestinais e relacionados com o tratamento hormonal, desde o diagnóstico da doença aos 6 meses de tratamento. Uma intervenção dos profissionais de saúde direcionada para os domínios mais afetados pode proporcionar uma melhor qualidade de vida aos doentes. Background: Prostate cancer is the second leading cause of death from cancer in men. Its diagnosis and treatment can significantly change their life and affect their quality of life. Objective: To assess the changes in the quality of life of patients with prostate cancer, from diagnosis to the 6th month of treatment. Methodology: A descriptive, analytical, and longitudinal study was conducted with prostate cancer patients, using HRQoL, SF-12, and EQ-5D scales in four moments. Results: Changes were found in HRQoL dimensions across the four moments, as well as in functioning and symptoms. Conclusion: is study provides new evidence on dimensions of HRQoL of patients with prostate cancer, namely emotional and social functions, fatigue, nausea and vomiting, insomnia, constipation and diarrhea symptoms, sexual activity, urinary, bowel symptoms, and hormonal treatment-related symptoms, from diagnosis to the 6th month of treatment. Health professionals should intervene in the most affected domains to improve the quality of life of prostate cancer patients. info:eu-repo/semantics/publishedVersion

Objective: The aim of this scoping review is to map the available evidence on the nature, extent, and range of antenatal care policies for low-risk pregnant women in high-income countries with a health system founded on the Beveridge Model. Introduction: Low-risk women in high-income countries have good evolutionary perinatal outcomes but high intervention rates in pregnancy and childbirth, which ultimately leads to high morbidity. This has implications at all levels including families, the health care system, and society. This review aims to inform future policy and identify the viability of the adoption of alternative models to the Portuguese context that can reduce unnecessary interventions. Inclusion criteria: Studies, protocols, guidelines, and policies that provide guidance on antenatal care for low-risk pregnant women in high-income countries with a health system founded on the Beveridge Model (universal health care) will be considered. Documents from 2005 to present will be included, and no language restrictions will be imposed. Methods: An initial search will be conducted in databases including MEDLINE (via PubMed) and CINAHL (via EBSCOhost), followed by a manual search of the reference lists from the documents accepted for inclusion, and a hand search of gray literature. For the countries whose policies are not available through the earlier steps, key persons from health ministries and academia will be contacted. Search results will be exported and data extracted using charting forms. Data will be synthesized using narrative description. info:eu-repo/semantics/publishedVersion

RESUMO Objetivo Descrever a experiência no planejamento e desenvolvimento de um Curso de Atualização On-Line em Gerenciamento em Enfermagem destinado a enfermeiros nos contextos Brasil e Portugal. Método O desenho instrucional do Curso fundamentou-se na Teoria da Aprendizagem Significativa, na Andragogia e na Metodologia Dialética, valorizando a interação entre os atores e privilegiando os cenários de prática e a aplicação dos conceitos abordados. Resultados O Curso está estruturado em nove unidades teóricas, quatro estudos de caso e prova dissertativa. Foi avaliado positivamente pelos participantes, os quais referiram oportunidades de aquisição de novos conhecimentos; interação e intercâmbio de experiência; motivação em estudar os temas e autoaprendizagem. Conclusão Espera-se que a experiência descrita estimule a proposição de novos cursos e programas na modalidade de Educação a Distância, incrementando os processos de ensino e de aprendizagem para subsidiar análises futuras do seu impacto no desenvolvimento e no aprimoramento de competências gerenciais em enfermagem.

Childbirth is a universal phenomenon and a meaningful experience that has the potential to trigger developmental transitions, stress, anxiety and/or fear, which, at times, can negatively impact future childbirth experiences. An exploratory and descriptive study was conducted aiming to identify the levels of fear experienced by pregnant women associated with childbirth and their main causes. A convenience sample was selected. Data collection were carried out in an outpatient obstetric hospital in the northern region of Portugal, between July 2010 and July 2012. To evaluate the intensity of fear of childbirth a visual analogic scale of 10 points was applied. Interviews were conducted in order to identify the main causes of fear. Ethical approval and informed consent were obtained. Regarding the level of fear, the majority (98%) of pregnant women had fear of childbirth, 60.2% reported moderate fear and 28% intense fear. Anxiety, primiparity and lack of knowledge related to birthing were also found to increase the fear of childbirth. Some of the main causes of fear identified were: complications during childbirth; pain/suffering; not knowing how to cope with pain; not able to give birth; baby with malformation/disease and/or suffering. Most women feel moderate or intense fear of childbirth and this is associated to well identified causes with high impact on the woman and family. To minimize the effects of fear, an early intervention has to be considered, including childbirth education classes where nurses can address and work women’s fear in order to minimize it and promote a more positive experience.

The researchers' aim is to examine the psychometric properties of the European Portuguese version of the Wijma Delivery Expectancy/Experience Questionnaire version A (WDEQ-A). Data from 669 pregnant Portuguese women was collected between June and October of 2019. From the initial 33-item Portuguese version of the WDEQ-A, a 27-item instrument was developed. Five-factor solution explained 63.8% of the total variance. The factors defined by the researchers were: fear/lack of self-efficacy, loneliness, negative appraisal, lack of positive anticipation and concern for the child. Cronbach's alpha coefficient was 0.934. The European Portuguese version of the WDEQ-A is a reliable and valid tool to measure fear of childbirth on both nulliparous and multiparous women and can be a useful tool for cross-cultural research. Moreover, researchers support the use of this tool in clinical practice to recognize and address fearful women during prenatal period.