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Abstract Background Hope is an important resource that helps patients and families thrive during difficult times. Although several studies have highlighted the importance of hope in different contexts, its specific manifestations in the realm of advanced chronic illness need further exploration. In this study, we sought to elucidate the intricate interplay between the construct of hope and the lived experience of advanced chronic illness within patient-caregiver dyads. Our objectives were (a) to explore the dyadic experience of hope as a changing dynamic over time for patients living with advanced chronic illness and their informal caregivers and (b) to evaluate variations of hope and symptom burden across time. Methods We conducted a longitudinal mixed-methods study with a convergent design between December 2020 and April 2021. Patients living with advanced chronic illness and informal caregivers participated as a dyad (n = 8). The Herth Hope Index scale was used to measure dyads' level of hope and the Edmonton Symptom Assessment System was used to measure patients’ symptom burden. Descriptive statistics were undertaken. A thematic analysis as described by Braun and Clarke was conducted to analyze dyadic interview data. Dyads' experience of hope was described by using the six dimensions of hope in the Model of Hope of Dufault and Martocchio. Results Dyadic scores of hope and patients' symptom burden were stable over time. The constructs of hope in dyads included “Living one day at the time,” “Having inner force/strength,” and “Maintaining good health.” Changes in patterns of hope were captured for each dyad in their transition over time. Data converged for all dyads except one. Conclusions The findings of our study show a constant presence of hope even in the face of adversity. Healthcare professionals must find ways to promote hope in dyads of patients living with advanced chronic diseases. Nurses play a pivotal role; dyadic interviews should be promoted to create a safe space for both patients and informal caregivers in order to share experiences. More research is needed to address patients' and informal caregivers' hope in chronic illness because current hope-based interventions primarily target cancer diagnoses.

Enquadramento: a família que acompanha o doente crítico ao Serviço de Urgência, faz parte integrante do doente crítico e da prestação dos cuidados. Objetivo: sintetizar a evidência científica da eficácia da comunicação/informação realizada pelo enfermeiro na diminuição da ansiedade, stress, aceitação da doença/saúde/ aumento da segurança do doente e família. Metodologia: revisão Sistemática da Literatura teve por base a metodologia PICO, procedeu-se à pesquisa nas bases de dados Pubmed CINAHL, Medline, SciELO e Scopus realizada em novembro de 2022. Resultados: identificados 539 artigos, sendo que após retirados os artigos duplicados, os que não cumpriam os critérios de inclusão e qualidade metodológica, o estudo foi suportado em 5 artigos, nestes estudos participaram familiares, com mais de 18 anos, recrutados no Serviço de Urgência. A diminuição dos níveis de ansiedade e o aumento da aceitação da doença foi verificada na maioria dos estudos. Conclusão: verificou-se que a família do doente crítico no Serviço de Urgência beneficia da existência do Enfermeiro Facilitador da Comunicação/informação, havendo necessidade de mais investigação sobre esta temática, sendo importante envolver os enfermeiros para esta temática.

Objective: The main objective of this study was to describe the translation, cultural adaptation, and content validation process of the French National Surveillance Programme for Pleural Mesothelioma (FNSPPM) questionnaire for the Portuguese context. Methods: A search was conducted in the PubMed database and Web of Science, in the period from January 1, 1960, to December 31, 2022, to select the questionnaire. Forward and reverse translations, calculation of the content validity index (CVI) by a panel of experts (n = 9), and cognitive interviewing with individuals with at least one exposure to asbestos (n = 10) were performed. Experts rated items on a Likert scale (1-4) based on their relevance. The item-level content validity index (I-CVI), scale-level content validity index based on the average method (S-CVI/Ave), and scale-level content validity index based on the universal agreement method (S-CVI/UA) were calculated. Results: The final version of the FNSPPM questionnaire for the Portuguese context resulted from a translation and content validation process. The panel of experts considered the questionnaire relevant, with an I-CVI of up to 0.78 in 68 of 69 of the questions, an S-CVI/Ave of 0.98, and an S-CVI/UA of 0.90. The participants in the cognitive interviews reported an understanding of the questionnaire. Conclusion: A validated FNSPPM questionnaire for the Portuguese context is now available to study individuals with pleural mesothelioma (PM) and asbestos exposure.

Abstract Objective: to compare the decision-making of Nursing students, before and after theoretical training on basic life support, using the practice of high-fidelity simulation and medium-fidelity simulation. Method: an experimental study was developed, pre- and post-test type, with quantitative, descriptive and inferential analysis, with theoretical training on basic life support and clinical simulation practices, and with evaluation of knowledge and decision-making of Nursing students, at three different moments - before the simulation scenario (T0), after the simulation scenario (T1) and after clinical teaching (T2). Results: 51 students participated in the research, with an average age of 20.25±3.804, of which 92.2% were female. Statistically significant differences (F=6.47; p=0.039) were evident regarding the definition of the problem and development of objectives in decision-making in the experimental group. Conclusion: Nursing students demonstrate an adequate level of knowledge and a good decision-making process, based on the most current instruments produced by scientific evidence, in clinical simulation scenarios in basic life support, and this innovative methodology should be deepened in the Nursing teaching.

Background: The Demand Control Support model is useful for studying work-related stress. The combination of high demand and a low level of control generates “job strain” (“job iso-strain” if poor support is added), with implications for the worker’s health and well-being. The aims of this study were to adapt, examine the factor structure of, and determine the reliability of, the Demand Control Support Questionnaire (DCSQ) short version for European Portuguese (DCSQ-PT). Methods: The scale was translated into Portuguese following a rigorous process and then applied to 501 workers from various professional sectors. An online survey was used to collect sociodemographic, professional, and Demand Control Support data. Validation was based on reliability and validity tests. Results: The mean age of the sample was 41.8 ± 10.3 years, and 50.1% of the participants were female. The results reveal good reliability (Cronbach’s alpha = 0.807) and validity. Confirmatory factor analyses demonstrated that a four-factor solution of the DCSQ-PT scale had a good fit to the data, as was the case for the original scale. The DCSQ-PT© with 16 items is composed of the following factors: social support at work; psychological demands; skill discretion; and decision authority. Conclusions: This validation allows an instrument to be obtained with 16 items for studying work-related stress in Portuguese workers.

Background:The relationship between exposure to asbestos and malignant pleural mesothelioma (MPM) is already well established. Nevertheless, much remains to be known about exposure thereto and the incidence and mortality from MPM. Objective: This systematic review aims to map the relationship between asbestos and MPM by studying the exposure to asbestos and the incidence and mortality of MPM. Methods: A systematic review was conducted relating asbestos and MPM. Exposure to asbestos, incidence, and mortality by MPM was reviewed. PubMed, Web of Science, Cochrane Library, RCAAP, DART-Europe, and the reference lists of included studies were searched, from January 1, 1960, to December 31, 2020. Methodological quality was checked, the risk of bias analysis was performed, a level of evidence grade was assigned, and descriptive data analysis was performed. Results: 3,484 unique citations were identified, which included seventeen observational studies that met inclusion criteria with a total of 1,104 patients. Heterogeneity is present between the included studies which range from a case series of 16 retrospective studies and 1 prospective study. Studies were mostly conducted in Europe, particularly in Italy (6), and were published between 1969 and 2020. The mean age of patients is approximately 66 years with a latency period between the first exposure and diagnosis of approximately 42 years. 14 studies present data regarding the occupational context and chrysotile and crocidolite are the most studied types of fibre. The incidence of cases occurred between the interval 1966 and 2014 and in 9 studies the mortality rate was 100% of patients. Conclusion: There is high evidence to support the relationships between asbestos and MPM. However, the relatively scant information provided by the studies reinforces the need for well-conducted research and implementation of National Mesothelioma Surveillance Centres at a global level.

Noninvasive ventilation (NIV) is a technique for breathing support that significantly improves gas exchange and vital signs, reducing intubation and mortality rates. Helmets, unlike facemasks, allow for longer-term treatment and better ventilation, also being more cost-effective. As of today, we have found no reviews addressing this topic. This review aims to identify, map, and describe the characteristics of the use of noninvasive ventilation through helmet interface in critically ill COVID-19 adult patients hospitalized in acute care settings throughout the multiple moments that defined the COVID-19 pandemic. This scoping review will follow the methodology for scoping reviews proposed by JBI. A set of relevant electronic databases will be searched using terms such as COVID-19, helmet, and noninvasive ventilation. Two reviewers will independently perform the study selection regarding their eligibility. Data extraction will be accomplished using a researcher’s developed tool considering the review questions. Findings will be presented in tables and a narrative description that aligns with the review’s objective. This scoping review will consider any quantitative, qualitative, mixed-methods studies and systematic review designs for inclusion, focusing on the use of helmet on critically ill adult patients with COVID-19 hospitalized in acute care settings.

BackgroundSubstance abuse has an impact on various cognitive domains, including memory. Even though this impact has been extensively examined across different subdomains, false memory has been sparsely studied. This systematic review and meta-analysis seek to synthesize the current scientific data concerning false memory formation in individuals with a history of substance abuse.MethodsPubMed, Scopus, the Cochrane Library, Web of Science, and PsycINFO were searched to identify all experimental and observational studies in English, Portuguese, and Spanish. Studies were then examined by four independent reviewers and, if they met the inclusion criteria, assessed for their quality. The Cochrane Risk of Bias Tool for randomized controlled trials (RCT) and the Joanna Briggs Institute (JBI) critical appraisal checklists for quasi-experimental and analytic cross-sectional studies were used to assess the risk of bias.ResultsFrom the 443 screened studies, 27 (and two more from other sources) were considered eligible for full-text review. A final 18 studies were included in the present review. Of these, 10 were conducted with alcoholics or heavy drinkers, four focused on ecstasy/polydrug users, three were done with cannabis users and one focused on methadone maintenance patients with current cocaine dependence. Regarding false memory type, 15 studies focused on false recognition/recall, and three on provoked confabulation.ConclusionsNone but one of the studies considering false recognition/recall of critical lures found any significant differences between individuals with a history of substance abuse and healthy controls. However, most of the studies taking into account false recognition/recall of related and unrelated events found that individuals with a history of substance abuse showed significantly higher rates of false memories than controls. Future research should continue to consider different types of false memories as well as their potential association with relevant clinical variables.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266503, identifier: CRD42021266503.

BackgroundEffective medication management is one of the essential preconditions for enabling polymedicated home-dwelling older adults with multiple chronic conditions to remain at home and preserve their quality of life and autonomy. Lack of effective medication management predisposes older adults to medication-related problems (MRPs) and adverse health outcomes, which can lead to the degradation of a patient’s acute clinical condition, physical and cognitive decline, exacerbation of chronic medical conditions, and avoidable health care costs. Nonetheless, it has been shown that MRPs can be prevented or reduced by using well-coordinated, patient-centered, interprofessional primary care interventions. ObjectiveThis study aimed to explore the feasibility and acceptability of an evidence-based, multicomponent, interprofessional intervention program supported by informal caregivers to decrease MRPs among polymedicated home-dwelling older adults with multiple chronic conditions. MethodsThis quasi-experimental, pre-post, multisite pilot, and feasibility study will use an open-label design, with participants knowing the study’s objectives and relevant information, and it will take place in primary health care settings in Portugal and Switzerland. The research population will comprise 30 polymedicated, home-dwelling adults, aged ≥65 years at risk of MRPs and receiving community-based health care, along with their informal caregivers and health care professionals. ResultsBefore a projected full-scale study, this pilot and feasibility study will focus on recruiting and ensuring the active collaboration of its participants and on the feasibility of expanding this evidence-based, multicomponent, interprofessional intervention program throughout both study regions. This study will also be essential to projected follow-up research programs on informal caregivers’ multiple roles, enhancing their coordination tasks and their own needs. Results are expected at the end of 2024. ConclusionsDesigning, establishing, and exploring the feasibility and acceptability of an intervention program to reduce the risks of MRPs among home-dwelling older adults is an underinvestigated issue. Doing so in collaboration with all the different actors involved in that population’s medication management and recording the first effects of the intervention will make this pilot and feasibility study’s findings very valuable as home care becomes an ever more common solution. Trial RegistrationSwiss National Clinical Trials Portal 000004654; https://tinyurl.com/mr3yz8t4

ABSTRACT. Falls are a complex problem for the older population residing in nursing homes. Despite recommendations, many difficulties remain in the evaluation of and systematic information on fall risk factors. Objectives: To build and validate the Scale for Practices of Identification of and Information on Fall Risk Factors in the Admission of Older Adults; to describe the practices of professionals in identifying and providing information on fall risk factors in the admission of older adults; and to associate these practices with the training, experience, and age of the caretakers. Methods: This is a methodological study. Based on a literature review, we analyzed the contexts, consulted specialists, selected indicators, and designed the scale, which was evaluated by experts. The process included a pre-test, reformulation, application, and validation. Results: The response rate was 65.52%. The validated scale has 13 items and 2 dimensions: risk factor evaluation practices and information practices; it presents good psychometric properties (α=0.913) to evaluate the risk of falls in the admission of older adults. Conclusions: Caregivers who received training during professional activities had better practices as to the provision of information to older adults about the risk of falls. The risk associated with gait and balance changes is more significant compared to the cognitive state.

Introdução: A elevada taxa de readmissão hospitalar de pessoas com dependência no autocuidado é um problema atual preocupante e com impacto nas instituições de saúde nacionais e internacionais. Uma das principais causas relaciona-se com a necessidade de capacitar os cuidadores informais com competências adequadas para o cuidar. Atualmente o processo de capacitação, quando realizado, ocorre antes do momento da alta hospitalar de forma informal. Objetivos: Desenvolver um modelo colaborativo de capacitação que inclua uma plataforma digital composta por uma aplicação web e uma aplicação móvel, permitindo e facilitando o apoio na capacitação dos cuidadores informais para cuidar do seu familiar em casa e capacitar profissionais de saúde para a utilização desse modelo. Pretende-se, assim, diminuir a taxa de readmissão hospitalar da pessoa dependente no autocuidado; melhorar a sua qualidade de vida e dos seus cuidadores informais. Método: projeto transdisciplinar, colaborativo de aprendizagem baseada na prática que incluiu a participação de estudantes de diferentes áreas científicas (terapia da fala, terapia ocupacional, dietética e nutrição, fisioterapia, enfermagem, engenharia informática, artes e design), professores, investigadores e parceiros. Projeto de ação-investigação no qual os materiais desenvolvidos foram sendo testados na população-alvo o que permitiu reajustes durante o desenvolvimento da plataforma. Resultados: Foi desenvolvido o Modelo de Capacitação do Cuidador Informal para Cuidar da Pessoa com Dependência que contempla instrumentos de avaliação das necessidades de autocuidado, a plataforma Help2Care e a respetiva aplicação móvel. Esta é destinada aos cuidadores informais e profissionais de saúde e permite aceder a toda a informação necessária referente às necessidades da pessoa com dependência no autocuidado e comunicar com o profissional de saúde responsável pelo caso. Na plataforma existem materiais de capacitação nas diferentes áreas do autocuidado (higiene e conforto, alimentação, vestir e despir, medicação, mobilidade e transferência, comunicação, eliminação vesical e intestinal, resolução de problemas) e em diferentes formatos (vídeo, fotografia, imagem e manuais). Foi também desenvolvido o Manual do Cuidador: apoiar no autocuidado de utentes e cuidadores informais, disponível na plataforma. Conclusões: Os objetivos delineados foram atingidos o que se reflete no material desenvolvido, bem como nas sessões desenvolvidas a nível nacional para capacitar os profissionais de saúde para o uso do Modelo de Capacitação do Cuidador Informal para Cuidar da Pessoa com Dependência. Estima-se que as ferramentas desenvolvidas contribuam para a diminuição da taxa de readmissão hospitalar da pessoa com dependência no autocuidado, contribuindo para a melhoria da qualidade de vida da pessoa e dos seus cuidadores informais.

ABSTRACT Falls are a major problem in nursing homes due to their high prevalence and impact on the functioning of elderly. Objective: This study aims to: a) construct and validate a scale for assessing the practices and behaviors of professionals from nursing homes after falls in elderly; b) describe practices and behaviors after falls; and c) associate practices and behaviors with professionals’ length of experience, training and age. Methods: This is a correlational study, conducted in a sample of 152 professionals from six nursing homes. The study adhered to all of the Declaration of Helsinki principles. Results: The scale constructed has a Cronbach’s alpha of 0.938. The 12 items of the scale are grouped into two factors. The most expressive indicators are the communication of fall episodes that result in severe injuries (4.64 ± 0.812) and the communication of falls that result in injuries and need intervention from health technicians (4.61 ± 0.832). We found no significant statistical difference between length of professional experience, training and age when associated with professional practices and behaviors after falls in elderly (p > 0.05). Conclusion: Future studies should investigate the association of post-fall professional practices and behaviors with fear of another fall, fall recurrence, and changes in functioning of the elderly following a fall.

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.

Expert Committee is the stage IV for the process of cross cultural adaptation. The expert committee’s role is to consolidate all the versions of the questionnaire and develop what would be considered the prefinal version of the questionnaire for field testing. In this article, the method aims to obtain semantic, idiomatic, experiential and conceptual equivalence of the Sensory Processing Measure - Preschool source and target version by an expert committee. A purposely selected group of professionals, composed of four occupational therapists specialized in sensory processing disorders intervention with more than ten years’ experience in paediatrics, together with a specialist in the translation and validation of instruments, formed the focus group. They compared the two versions (SPM-P Home Form and School Form) and made significant changes to the instrument at a weekly meeting for a consecutive month in order to adapt it to Portuguese culture. The expert committee achieved equivalence between the source and target version in four areas: Semantic equivalence, Idiomatic equivalence, Experiential equivalence and Conceptual equivalence. Several items were adapted and the instrument can now be pre-tested and can start collecting a sample of a hundred children.

Background: Cerebral neuroplasticity is compromised due to substance abuse. There is damage to neuronal areas that are involved in memory and executive functioning. Treatments with worse outcomes are often associated with cognitive deficits that have resulted from substance dependence. However, there is evidence that cognitive training can lead to improvements in cognitive functions and can be useful when treating addictions. This systematic review aims to synthesize evidence on the effectiveness of cognitive training in memory, executive functioning, and processing speed in individuals with substance use disorder (SUD).Methods: The Joanna Briggs Institute's PICO strategy was used to develop this systematic literature review. Four databases were searched (PubMed, the Cochrane Library, Web of Science, and PsycINFO) to identify controlled randomized clinical studies and quasi-experimental studies, in English, Portuguese, and Spanish, from 1985 to 2019. The literature found was examined by two independent reviewers, who assessed the quality of studies that met the inclusion criteria. The Cochrane risk-of-bias tool for the randomized controlled trials and the ROBINS-I tool for non-randomized studies were used to assess the risk of bias. In data extraction, the Cochrane Handbook for Systematic Reviews was considered.Results: From a total of 470 studies, 319 were selected for analysis after the elimination of duplicates. According to the inclusion criteria defined, 26 studies were eligible and evaluated. An evaluation was performed considering the participant characteristics, countries, substance type, study and intervention details, and key findings. Of the 26 selected studies, 14 considered only alcoholics, six included participants with various SUD (alcohol and other substances), three exclusively looked into methamphetamine-consuming users and another three into opioid/methadone users. Moreover, 18 studies found some kind of cognitive improvement, with two of these reporting only marginally significant effects. One study found improvements only in measures similar to the training tasks, and two others had ambiguous results.Conclusions: The included studies revealed the benefits of cognitive training with regard to improving cognitive functions in individuals with SUD. Memory was the most scrutinized cognitive function in this type of intervention, and it is also one of the areas most affected by substance use.Systematic Review Registration: [PROSPERO], identifier [CRD42020161039].

ABSTRACT Aims To understand how the fear of falls emerges and manifests itself in caregivers of institutionalized elders. Method It is a qualitative study, based on the Grounded Theory and carried out with 24 informal caregivers, 5 nurses, 2 physicians and 2 directors of two Portuguese nursing homes. Data collection took place through interviews, participant observation, and documentation analysis, between October 2016 and January 2018. Data was collected and analyzed simultaneously, following the stages of open, axial, and selective coding. Results The comparative analysis of the findings identified the conceptual category "Fear of falls in the caregivers of institutionalized elders". The main category is associated with the categories: maintaining safety, hidden fear of falls, the perceived self-efficacy in the prevention of falls, falls and interpersonal relations, previous experiences, and team support. Conclusions The fear has an influence on the self-efficacy perceived in the prevention of falls; the quality of the teamwork, in turn, is affected by previous negative experiences and by the support of the team.

Concerns about weight and body image are common among adolescents since they are particularly vulnerable to body-image dissatisfaction due to the normal physiological, social, and psychological changes they are going through. This study aims to analyse the relationship between food choice motivations and physical activity in body-image perception among adolescents. Twelve to sixteen years old adolescents were recruited from three school districts. The Portuguese version of the Food Choices Questionnaire (FCQ) was used to assess food choice motivators, and the Quantification de l'Activité Physique en Altitude Chez les Enfants was used to assess physical activity and to calculate daily energy expenditure (DEE). Body image perception was measured using Collins' sequence of seven silhouettes. Body image (dis)satisfaction was estimated by the present body shape minus the desired body shape. ANOVA and Kruskal-Wallis tests were performed to compare groups, and the post-hoc Bonferroni test was used to compare target groups. A multinominal logistic regression was performed to analyse the association between gender, age, hours of sport's competition, FCQ, and body dissatisfaction. All analyses were performed in IBM SPSS Statistics 26.0. The sample comprised 286 adolescents (51.4% females). Means of FCQ categories varied between 0.33 and 0.97 (range: −2 to 2). Regarding the categories of FCQ, statistically significant differences were found in the category of body satisfaction and weight control among the three groups (p = 0.004). A preventive effect was found of choosing food regarding body satisfaction and weight control, on body-image dissatisfaction.

BackgroundHigher-education students are particularly vulnerable to both everyday stressors and mental health problems. Public health emergencies may generate a range of unforeseen potential stressors for vulnerable individuals and communities. The current pandemic has apparently led to an increase in psychiatric symptoms among these students. ObjectiveThe goal of this study is to characterize the psychological impact of the COVID-19 pandemic among Portuguese and Swiss higher-education students. MethodsThis project will use a mixed methods sequential explanatory design in Portugal and Switzerland, with two consecutive phases. During Phase I, a quantitative study will assess the psychological responses of higher-education students during the COVID-19 pandemic. A convenience sampling method will be used for collecting information from students. The association between variables will be determined with univariable and multivariable analyses. During Phase II, qualitative data will be collected in order to understand the determinants of psychological stress and the strategies adopted by students as a result of the COVID-19 pandemic, as well as to identify their opinions and feelings about the teaching-learning process during quarantine. In this phase, participants will be selected using a maximum-variation sampling method. Data from focus group discussions will be coded and inductively analyzed using a thematic analysis approach. Finally, quantitative and qualitative results will be merged during interpretation to provide complementary perspectives. ResultsThis paper describes and discusses the protocol for this mixed methods study, which will be completed in December 2021. This study was formally approved by the local ethics committee (CE/IPLEIRIA/22/2020) in Portugal and authorized by the Swiss Association of Research Ethics Committees, swissethics (CER-VD-2020-02889). ConclusionsThis research can contribute to the development of teaching tools and methods that reinforce positive mental health strategies, hope, and adaptive coping among students, and to the development of a class on mental health interventions in the context of catastrophic and traumatic events. This project will also help government stakeholders as well as health and education professionals safeguard the psychological well-being of students facing an expanding COVID-19 pandemic. International Registered Report Identifier (IRRID)PRR1-10.2196/28757

Enquadramento: Assistir crianças em situação de risco e/ou perigo exige uma avaliação criteriosa, que conduza a uma decisão sustentada e coerente. Objetivos: Identificar os fatores de risco dos cuidadores que colocam em perigo as crianças e jovens referenciados à Comissão Proteção de Crianças e Jovens (CPCJ). Metodologia: Este estudo descritivo de abordagem qualitativa, realizado entre outubro e dezembro de 2018 teve como amostra 20 processos de crianças/jovens referenciados a uma CPCJ. A informação recolhida dos processos foi analisada através da técnica de Bardin. Resultados: Como cuidadores surgem os progenitores (54%), sendo a negligência a problemática mais elevada das crianças sinalizadas à CPCJ. Quanto aos fatores de risco, destacam-se as condições financeiras da família; necessidades inerentes ao desenvolvimento da criança e os métodos de disciplina; problemas comunicacionais; problemas de saúde mental e a ausência de suporte da família alargada, seguida dos padrões de relação familiares. Conclusão: Identificaram-se fatores de risco que poderão permitir a construção de um instrumento para uma avaliação concertada e consequente medida adequada às necessidades das famílias.

Enquadramento: As diferenças paradoxais identificadas entre a forma como as pessoas experienciam a dor, independente da sua intensidade, e o sofrimento a ela associado, relacionam-se com os sistemas de crenças e valores. Objetivos: Validar o Meaning in Suffering Test (MIST) para a população portuguesa e determinar as suas características psicométricas. Metodologia: Este estudo apresenta o processo de adaptação transcultural, realizado numa amostra de 187 pessoas com doença reumática músculo-esquelética (DRM), com recurso a questionário sociodemográfico, clínico e o MIST-P. Resultados: A amostra, maioritariamente do sexo feminino, tinha 49,9±12,1 anos. O MIST-P apresenta bons valores de fidelidade (alfa de Cronbach de 0,833). A análise fatorial determinou a organização dos 12 itens em 2 fatores: Sentido e respostas face ao sofrimento e Características subjetivas face ao sofrimento. A escala é estável no tempo (r = 0,844). Conclusão: O MIST-P é válido e fiável para a população portuguesa com DRM, tendo potencial para ser aplicado na investigação e na prática clínica de prevenção, controlo e integração do sofrimento inevitável.

Background: To date, no instrument in Portugal has evaluated the attitudes of the population about advance care directives. This paper describes the development and testing of the General Public's Attitudes Toward Advance Care Directives (GPATACD) Scale. Design and Methods: Methodological study. The development of the instrument was based on a literature review, updated in 2018. Face and content validity were verified by an expert panel and piloted among six participants. Data were collected in an online survey of 1024 Portuguese adults. The obtained data were analyzed using Varimax rotation, while the reliability was evaluated by calculating Cronbach’s alpha. Results: The scale achieves good Item-Content Validity Index (I-CVI) values, between 0.89 and 1.00, and scale-CVI values of 0.91. A principal component analysis generated four dimensions with 26 items as a final scale, with overall Cronbach’s alpha of 0.848. Conclusions: The findings demonstrate that the scale is valid and reliable as a vehicle for assessment of the general public's attitudes toward advance care directives.

Enquadramento: A área da saúde tem-se adaptado ao uso de tecnologia, recorrendo a esta como um aliado relevante em programas de monitorização e prevenção da obesidade e problemas associados. Objetivo: Avaliar a aceitação do programa e-terapêutico TeenPower em adolescentes. Metodologia: Estudo misto sequencial realizado em 47 alunos do 6º ao 8º ano de escolaridade em Portugal. Na primeira fase, os dados foram recolhidos através de questionário incluindo dados sociodemográficos, questionário de aceitação, escolhas alimentares, (in)satisfação com a imagem corporal, perfil do estilo de vida e e-literacia em saúde. A segunda fase incluiu uma sessão interativa online com fórum de discussão, seguida de análise de conteúdo de Bardin. Resultados: A aceitação do programa TeenPower por parte dos adolescentes apresenta um valor médio positivo nos 4 fatores avaliados pela escala. Verificou-se ainda que a e-literacia em saúde está positivamente relacionada com a perceção de utilidade do TeenPower. Conclusão: A aceitação favorável de programas e-terapêuticos pode permitir a inovação e melhoria na prevenção da obesidade, respondendo eficazmente às expectativas e necessidades dos adolescentes.

Objetivo: descrever as práticas dos cuidadores na gestão do risco de queda de idosos institucionalizados e relacionar as práticas com a idade, formação e tempo de exercício profissional dos cuidadores. Método: estudo correlacional, de abordagem quantitativa. A população foram os profissionais de seis instituições de longa permanência para idosos portugueses. Utilizou-se a Escala de Práticas de Intervenção para Prevenção de Quedas de Idosos Institucionalizados. Resultados: Os 53 indicadores demonstram que as práticas são globalmente boas, entretanto é preocupante a utilização de medidas de restrição física da mobilidade, como medida preventiva. Verificou-se não haver diferença estatisticamente significativa entre o número de anos de atividade profissional, a idade das cuidadoras, a formação e as suas práticas no âmbito das quedas dos idosos. Conclusão: as práticas adotadas são positivas, mas nem sempre são mantidas, não estão associadas às variáveis em estudo. Descritores: Acidentes por quedas. Idoso. Instituição de Longa Permanência para Idosos. Institucionalização. Cuidadores.

Objectives: This systematic review aimed to understand the current state of the art about the effectiveness of mindfulness-based relapse prevention (MBRP) on individuals with substance use disorders (SUD), taking into account not only SUD variables (e.g., cravings, frequency of use) but also other relevant clinical variables (e.g., anxiety and depressive symptoms, quality of life). Methods: A comprehensive search of electronic databases was conducted to identify studies that investigate MBRP interventions on individuals with SUD. Studies that met the inclusion criteria were synthesized and assessed using systematic review methods. Results: Thirteen studies were included in the present review. The methodological quality of the included studies was moderately strong. Nine studies (69.2%) used the traditional 16 h MBRP program. Six studies (46.1%) chose to use a co-intervention treatment ranging from the treatment as usual (TAU) to cognitive behavioral therapy. All but one study indicated that their interventions produced positive effects on at least one addiction outcome measure. None of the interventions were evaluated across different settings or populations. Conclusions: Despite some heterogeneity regarding the type of MBRP program used, results support the effectiveness of these interventions in the SUD population, especially in reducing cravings, decreasing the frequency of use, and improving depressive symptoms.

Falls cause impairment, dependency and isolation, increase comorbidity, and are the main cause of death by accident among the elderly. This descriptive study was performed through a document analysis, with the objective to identify the prevalence rate, incidence and characteristics of episodes of falling among elderly residents of an institution. Data were collected from 6,205 institutional records using a semi-structured instrument, and analyzed by descriptive statistics. A total 123 episodes of falling were identified. Of the 99 elderly subjects, 40.9% suffered at least one fall, 23 of which had two or more episodes. Women and the eldest patients fall more often, mostly at night and in their room, when they get up. Most situations did not result in injuries. Safety measures can prevent falls or their recurrence. Improving the quality of records of falls can help the systematic monitoring of these episodes and improve the quality of nursing care. Descriptors: Homes for the Aged; Accidental Falls; Nursing Care.

ABSTRACT. Falls in long-stay institutions for elderly people have a high prevalence, contributing to the physical and mental deterioration of institutionalized elderly. Objective: To determine the prevalence of falls among institutionalized elderly with and without cognitive decline, and to characterize the practices and behaviors of those with and without cognitive decline in managing fall risks, and relate them to some factors. Methods: The present correlational study was carried out with a sample of 204 institutionalized elderly, 50% of whom had cognitive decline. Results: The elderly with cognitive decline (40.2%) fell less often than those who did not have cognitive decline (42.2%) (p>0.05). Safety practices and behaviors were better in the elderly with cognitive decline (p

The Conversation Analysis Profile for People with Aphasia (CAPPA) provides specific information about strengths and weaknesses of the communication between people with aphasia and their family caregiver within a conversational context.OBJECTIVE:The aim of this paper was to present the results of the first stages of cross-cultural adaptation of the CAPPA for the European Portuguese language.METHODS:This methodology study describes the translation and back-translation processes, following the recommended steps to that end. In addition, following the consent of one of the original authors, the process of content validation of the CAPPA commenced. The instrument was submitted for assessment before a panel of experts in the area, who constituted the population of this study.RESULTSAfter the translation and back-translation processes, a panel of experts was convened to adapt the Delphi technique. Some questions were excluded on the basis of ambiguity, relevance and potential repetition. Suggestions made by the expert panel were included in a revised version of the tool. 159 items obtained a 100% consensus in relevance, and 157 items were considered suitable by the expert panel, validating the content of the instrument.CONCLUSIONThe final version will now be applied to the target population in order to carry out the psychometric validation.

ABSTRACT Objective: To evaluate the effectiveness of an intervention program in practices and behaviors of a health team to prevent falls in hos pitalized elderly people. Method: This was an action, mixed-methods, and longitudinal study that applied an intervention based on TeamSTEPPS®, and organized into five domains: team training, communication, leadership, monitoring, and mutual support. The population was nurses and nursing aides who worked at the medical service of a Portuguese hospital center. Data were obtained by consulting process records and interviews, and by applying the Scale of Practices and Behaviors of Teams for Fall Prevention. Results: There was improvement in all indicators of the scale, with evident progress in discussion of risk factors and preventive measures to be implemented. Conclusion: This intervention promoted decision-making regarding the preventive measures to be applied to each elderly person and improved communication and the interest in identifying the causes of falls to prevent their recurrence.

RESUMO: Nos últimos anos, tem havido na literatura uma larga estimativa de prevalência de desordens do processamento sensorial. A avaliação dessas dificuldades deve fazer parte da competência dos profissionais que desenvolvem o seu trabalho com crianças que as apresentam por meio de instrumentos validados. Este estudo examina a consistência interna e homogeneidade dos itens da versão portuguesa do Sensory Processing Measure-Preschool (SPM-P). Foi aplicado o SPM-P a cem crianças entre os 2 e os 5 anos de idade que frequentavam a creche e o jardim de infância com o objetivo de determinar a sua fiabilidade e a validade. A análise da correlação de Pearson (homogeneidade dos itens) e do alfa de Cronbach (consistência interna) determinou a exclusão de quatro itens. Os valores de alfa de Cronbach para as várias dimensões (“Participação Social”, “Visão”, “Audição”, “Toque”, “Consciência Corporal”, “Equilíbrio”, “Planeamento Motor e Ideias”) oscilou entre ‹=0.742 (“Visão” e “Toque”) e ‹=0.908 (“Consciência Corporal”). Os resultados deste estudo mostram que o SPM-P é um instrumento de rastreio válido e fiável para despistar as dificuldades de processamento sensorial das crianças Portuguesas com idades compreendidas entre os 2 e os 5 anos integradas em contexto escolar.