Maria dos Anjos Dixe

Crianças e jovens autistas: impacto na dinâmica familiar e pessoal de seus pais

CONTEXTO: O autismo e considerado uma perturbacao do neurodesenvolvimento, com implicacoes severas no comportamento, comunicacao e na interacao social, tornando-se uma fonte de preocupacoes para os pais. OBJETIVO: Determinar as necessidades dos pais de criancas e jovens com autismo e relacionar essas necessidades com funcionalidade, estrategias de coping familiar, estado emocional e a satisfacao com a vida. METODOS: Um estudo correlacionado foi desenvolvido numa amostra nao probabilistica, de conveniencia, constituida por 50 pais de criancas e jovens autistas. Os pais preencheram um questionario constituido por dados sociodemograficos, o Family Needs Survey (FNS); Family Adaptability and Cohesion Evaluation Scales (FACES-III), Escala de Ansiedade, Depressao e Stress (EADS), Family Crisis Oriented Personal Scales (F-COPES) e o Indice de Bem-Estar Pessoal (IBP). Para analise dos dados, recorreu-se a tecnicas de estatistica descritiva e inferencial. RESULTADOS: Mais informacoes sobre os servicos (medicos e de seguranca social) de que o filho possa vir a beneficiar-se foi a necessidade mais referida pelos pais. Os pais com mais necessidades apresentaram estados afetivos mais negativos, utilizaram mais estrategias de reenquadramento e aquisicao de apoio social - relacoes intimas. Em media, os pais reportaram um valor de bem-estar pessoal acima da mediana, contudo inferior ao apurado para a media da populacao portuguesa. CONCLUSAO: Ser pai de uma crianca ou jovem com autismo representa ter necessidades insatisfeitas que podem ter implicacoes tanto no nivel pessoal como no familiar. Sugere-se que se providenciem recursos nas vertentes social, educativa e de saude, no sentido de criar, de forma planeada e abrangente, servicos que respondam as necessidades especificas dessas familias.

Revalidação do Holistic Comfort Questionnaire: Family para cuidadores de pessoas com doença crónica avançada

Enquadramento: O conforto é fundamental na prática de enfermagem pelo que emerge a necessidade de instrumentos úteis e válidos para o avaliar. Objetivos: Determinar as características psicométricas do Holistic Comfort Questionnaire – Family (HCQ-F) para a população Portuguesa e, avaliar o nível de conforto dos cuidadores de pessoas com doença crónica e avançada. Metodologia: Estudo metodológico com uma análise do tipo quantitativo, realizado a 314 cuidadores. Para o estudo das propriedades psicométricas, calculámos medidas descritivas de resumo, correlações de cada item com o total e, o alfa de Cronbach. Para a análise fatorial, utilizámos a rotação ortogonal do tipo varimax e a extração de fatores com valores próprios > 1. Resultados: Da determinação da consistência interna e análise fatorial dos itens do HCQ-F resultou o Holistic Comfort Questionnaire – Cuidadores – Portugal (HCQ-C-PT) com 18 itens que se distribuíram por 3 fatores: alívio, tranquilidade e transcendência (α=0,795). Conclusão: Os resultados sugerem que o HCQ-C-PT apresenta validade e consistência interna adequados para avaliar o conforto em cuidadores de pessoas com doença crónica avançada.

Programas de educação dirigidos ao utente com diabetes mellitus tipo 2: revisão sistemática da literatura

Increased longevity and health problems associated with the increased incidence of chronic disease, particularly diabetes, which has documented implication...

Prevalência e características da violência no namoro entre adolescentes escolares de Portugal

OBJECTIVES: To identify the prevalence of dating violence among adolescents and discuss the association between the violent behaviors and the variables: age, gender and length of dating relationship. Methods: Epidemiological cross-sectional study. Sample: 1,268 male and female students, aged 16-24 years, enrolled in Portuguese secondary schools. Data were collected through questionnaires including sociodemographic data and data on dating violence victimization and perpetration behaviors. Results: 5.9% of the adolescents were involved in dating violence situations. Both genders used physical violence. Males were the greatest perpetrators and victims of psychological violence. Conclusion: A similar pattern of violence was found between genders in some behaviors, such as: hair pulling, choking, throwing objects, slapping, kicking, head-banging, and pushing. Therefore, further studies are needed to understand which factors influence the differences and similarities of dating violence. Key words: adolescence; adolescent behavior; violence Language: ptObjetivos: Identificar a prevalencia de violencia no namoro entre adolescentes e discutir a associacao entre os comportamentos de violencia e as variaveis: idade, sexo e tempo de namoro. Metodos: Estudo transversal epidemiologico. A amostra foi constituida por 1.268 estudantes de ambos os sexos, idades entre 16 e 24 anos, de escolas secundarias de quatro distritos da Regiao Central de Portugal. Na coleta de dados, foi utilizado um questionario contendo dados sociodemograficos e de comportamentos de vitimizacao e perpetracao de violencia no namoro. Resultados: 5,9% do total dos adolescentes referiram envolvimento em situacao de violencia no namoro. Ambos os sexos relataram uso de violencia fisica. Na violencia psicologica, o sexo masculino e o maior perpetrador e vitima. Conclusao: Os resultados apresentaram, em alguns comportamentos, similaridade do padrao de violencia entre os sexos, tais como: puxar os cabelos com forca; dar uma bofetada; apertar o pescoco; atirar objetos em outra pessoa; dar pontapes e cabecadas e dar empurroes violentos, indicando, portanto, que mais pesquisas sao necessarias para entender que fatores influenciam as diferencas e similaridades desse evento.

Knowledge of the Portuguese population on Basic Life Support and availability to attend training

OBJECTIVE To evaluate the level of knowledge and the availability of the Portuguese population to attend training in Basic Life Support (BLS) and identify factors related to their level of knowledge about BLS. METHOD Observational study including 1,700 people who responded to a questionnaire containing data on demography, profession, training, interest in training and knowledge about BLS. RESULTS Among 754 men and 943 women, only 17.8% (303) attended a course on BLS, but 95.6% expressed willingness to carry out the training. On average, they did not show good levels of knowledge on basic life support (correct answers in 25.9 ± 11.5 of the 64 indicators). Male, older respondents who had the training and those who performed BLS gave more correct answers, on average (p<0.01). CONCLUSION The skill levels of the Portuguese population are low, but people are available for training, hence it is important to develop training courses and practice to improve their knowledge.

Palliative care for end-of-life patients in a basic emergency service

This research sought to describe the care provided by the nursing staff of the Western Department of the Basic Emergency Service for end-of-life patients. This was a retrospective, quantitative, exploratory and descriptive (level I) study, which sought to research the nursing records of 83 patients from admission to death. Patients who met the following inclusion criteria were considered eligible: adults; had an oncological or nononcological, advanced and irreversible chronic disease; and died in the Basic Emergency Service in the period from January 2011 to December 2012. An instrument was created for data collection, the content, relevance and adequacy of which was validated by a panel of experts in the area of palliative care. The study protocol was approved by the Institutional Ethics Committee. The main results indicate that the majority of patients died in the Observation Room in a period between the first two and twenty-four hours. Nursing interventions favoured technical-instrumental care related to medical prescriptions and service routines such as venous punctures, catheterisations, taking blood samples for analysis, aspiration of secretions, intravenous administration of fluids and drugs for symptomatic control, and monitoring of vital parameters and the state of consciousness. With the proximity of death, the nurses favoured the registration of cardiorespiratory arrest, cardiopulmonary resuscitation manoeuvres and aspiration of secretions. In the recognition of predictive factors of imminent death, the nurses favoured the patients entry into a comatose state and aggravation of asthenia. In most patients, the entry into agony phase was not diagnosed.

ASA classification – What is the real impact of the introduction of the new clinical examples?

Aim The American Society of Anesthesiologists scale is used worldwide for the assessment of the physical status of patients proposed for anaesthesia interventions. This study aims to assess the level of agreement of the last updated American Society of Anesthesiologists classification version, with the introduction of examples for each class, and search for variables that could promote inconsistency. Methods An online questionnaire was sent to anaesthesiology specialists and residents in Portugal, describing 10 fictitious clinical cases. Sociodemographic and labour data were also correlated. Results/findings: A total of 243 anaesthesiology physicians participated. There was a high diversity in responses. Years of practice influence this diversity (P < 0.05). Discussion and conclusions: The need for a universal scale for classification of patients proposed for anaesthesia is consensual. Despite the last update in 2014, the American Society of Anesthesiologists classification continues to present limitations regarding consistency and objectivity. Efforts should be made to reduce their interpersonal variability.

Team practices in fall prevention in institutionalized elderly people: scale design and validation

Objective: determine and elaborate the psychometric characteristics of nursing team practices and develop a behavior scale for fall risk management in institutionalized elderly people. Method: the scale was designed based on a literature review and observation of the work of the teams in a long-term care institution for the elderly. The content of the scale was analyzed and the concordance index of the 14 initial items was checked by nine experts. The scale was applied to a sample of 152 caregivers from six long-term care institutions for the elderly. The research conformed to ethical principles. The anonymity of the participants and the confidentiality of the data were ensured. Results: after the determination of the psychometric characteristics, it was observed that the unidimensional scale had six items, with a Cronbach’s alpha of 0.918 and a score ranging from 6 to 30 points. Analysis of the results revealed that information about risk factors and team discussions regarding preventive measures are not always present, allowing specific team members to value different measures, which impairs continuity of the care and individualization of the measures before the assessed risk. Conclusion: the scale shows suitable psychometric features and can be used in investigation and clinical practice to assess the practices and behaviors of nursing teams in fall risk management in institutionalized elderly patients. DESCRIPTORS: Falls. Elderly people. Caregivers. Risk management. Psychometry. Behavioral assessment scale. http://dx.doi.org/10.1590/0104-07072017002310016

Falls in long-term care institutions for elderly people: protocol validation

Objectives To validate the content of a fall management risk protocol in long-term institutions for elderly people. Methods Methodological, quanti-qualitative study using the Delphi technique. The tool, based on the literature, was sent electronically to obtain consensus among the 14 experts that meet the defined inclusion criteria. Results The 27 indicators of the protocol are organized in three dimensions: prepare for the institutionalization (IRA=.88); manage the risk of falls throughout the institutionalization (IRA=.9); and lead the communication and formation (IRA=1), with a CVI=.91. Two rounds were performed to get a consensus superior to 80% in every item. Conclusion The values obtained in the reliability test (>0.8) show that the protocol can be used to meet the intended goal. The next step is the clinic validation of the protocol with residents of long-term care institutions for elderly people.

Prevalencia y características de la violencia en el noviazgo entre adolescentes en edad escolar en Portugal

OBJECTIVES: To identify the prevalence of dating violence among adolescents and discuss the association between the violent behaviors and the variables: age, gender and length of dating relationship. Methods: Epidemiological cross-sectional study. Sample: 1,268 male and female students, aged 16-24 years, enrolled in Portuguese secondary schools. Data were collected through questionnaires including sociodemographic data and data on dating violence victimization and perpetration behaviors. Results: 5.9% of the adolescents were involved in dating violence situations. Both genders used physical violence. Males were the greatest perpetrators and victims of psychological violence. Conclusion: A similar pattern of violence was found between genders in some behaviors, such as: hair pulling, choking, throwing objects, slapping, kicking, head-banging, and pushing. Therefore, further studies are needed to understand which factors influence the differences and similarities of dating violence. Key words: adolescence; adolescent behavior; violence Language: ptObjetivos: Identificar a prevalencia de violencia no namoro entre adolescentes e discutir a associacao entre os comportamentos de violencia e as variaveis: idade, sexo e tempo de namoro. Metodos: Estudo transversal epidemiologico. A amostra foi constituida por 1.268 estudantes de ambos os sexos, idades entre 16 e 24 anos, de escolas secundarias de quatro distritos da Regiao Central de Portugal. Na coleta de dados, foi utilizado um questionario contendo dados sociodemograficos e de comportamentos de vitimizacao e perpetracao de violencia no namoro. Resultados: 5,9% do total dos adolescentes referiram envolvimento em situacao de violencia no namoro. Ambos os sexos relataram uso de violencia fisica. Na violencia psicologica, o sexo masculino e o maior perpetrador e vitima. Conclusao: Os resultados apresentaram, em alguns comportamentos, similaridade do padrao de violencia entre os sexos, tais como: puxar os cabelos com forca; dar uma bofetada; apertar o pescoco; atirar objetos em outra pessoa; dar pontapes e cabecadas e dar empurroes violentos, indicando, portanto, que mais pesquisas sao necessarias para entender que fatores influenciam as diferencas e similaridades desse evento.