Maria Manuela Ferreira Pereira da Silva Martins

Physical examination: How to examine the arm with arteriovenous fistula

Physical examination has demonstrated its effectiveness in identifying complications of arteriovenous fistula (AVF). It should be initiated at the stage prior to the construction of the AVF and continue in its accomplishment, maturation, and subsequent use in the treatment of hemodialysis. Nurses should incorporate the physical examination in their practices, in order to preserve the vascular net of patients and assist in the recognition of complications of AVF. It is intended to describe aspects of the physical examination that enable the identification of the AVF complications including: infection, accessory veins, venous stenosis, steal syndrome, high‐output cardiac failure, and venous hypertension.

Dos contextos da prática à (co)construção do modelo de cuidados de enfermagem de família

Frente a los desafios que se colocan a los enfermeros, en el desarrollo de cuidados centrados en la familia, como contexto y unidad de intervencion, realizamos una investigacion dirigida para la intervencion familiar, en el contexto de los Cuidados de Salud Primarios. De naturaleza cualitativa, adoptamos la metodologia de investigacion accion, en una trayectoria de cinco etapas, integradas en un ciclo de estudios. De los resultados del diagnostico, a traves del analisis comparativo de los modelos conceptuales con las practicas de cuidados a la familia, surgio la necesidad del cambio, iniciado con un proceso formativo. Teniendo como marco teorico el Modelo Sistemico, el Modelo Calgary de Evaluacion de la Familia y el Modelo Calgary de Intervencion en la Familia, se (re)construyo el modelo de cuidados de enfermeria a la familia haciendolo operacional a traves de la definicion de las areas de atencion e intervencion. La (co)construccion del modelo a partir de las necesidades identificadas por los enfermeros, legitimado por las tomas de decision de los mismos, se constituye en la base de discusion, en el contexto de la enfermeria de familia.As nurses face challenges in the development of care focused on the family as a context and unit of intervention, this research aimed to identify family intervention processes in the context of Primary Healthcare. This qualitative-based study adopted the investigation-action approach on a study plans five-step path. By means of the comparative analysis of family care practices and conceptual models, the diagnosis results brought forth the need for change triggered by training processes. Having the Systemic Model, the Calgary Family Assessment Model, and the Calgary Family Intervention Model as references, the family nursing care model was (re)constructed and operationalized through the definition of attention and intervention areas. The (re) construction of the model from the needs identified by nurses and legitimated by their decision-making processes is the basis for family nursing focused discussions.

Parceria nos cuidados de enfermagem em pediatria: do discurso à ação dos enfermeiros

While it is recognized that paediatric nursing is now particularly sensitive to parental involvement in the care of hospitalized children, numerous studies...

An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: a randomised controlled trial

OBJECTIVE This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. DESIGN Single-blind, randomised controlled trial. SETTING University laboratory. PARTICIPANTS Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25). INTERVENTION A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. OUTCOME Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). RESULTS Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, p<0.001, Partial Eta Squared=0.57) and a main effect for time (F (2, 43)=3.76, p=0.03, Partial Eta Squared=0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F (1, 43)=21.90, p<0.001, Partial Eta Squared=0.34) confirmed a clear positive effect of the intervention when compared to the control. CONCLUSION This study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12612000301864.

Nurses’ attitudes regarding the importance of families in pediatric nursing care

Affective, cognitive and behavioral components affect nurses´ attitudes to include families in the care processes. The purpose of this study was to investigate the attitudes of nurses about the importance of including families in nursing care. Data collection was performed in pediatric and maternal-child unit of a Brazilian university hospital. A sample of 50 nurses completed the Portuguese version of the instrument Families’Importance in Nursing Care-Nurses’ Attitudes (FINC-NA). The results indicated that nurses have supportive attitudes regarding families participation in nursing care. Attitudes of lower support for involving families in nursing care were found among nurses with older age, more time in the profession and who had no previous contact with contents related to Family Nursing. The application of the instrument in other contexts of assistance may help to illuminate important aspects of the challenges to implementing a family-centered approach in clinical practice.

Saúde mental em cuidadores informais de idosos dependentes pós-acidente vascular cerebral

Context: Cerebrovascular accident (CVA) is a challenge due to its social impact, and its repercussions on the lives of victims and families. It is, therefore...

A família como foco dos cuidados de enfermagem em meio hospitalar: um programa educativo

This paper reports an educational program experience for nurses on caring for the family, at the hospital environment. The objective was to train nurses for the care of the family. The strategies adopted for teaching/learning focused on the Calgary Model of Assessment and Family Intervention, with a group of nurses from a general hospital located in the north of Portugal. In the subjective evaluation of the participants, the pedagogic experience was useful because they could recognize the need for a change on nursing care, and move towards an integrated approach to the family attention.This paper reports an educational program experience for nurses on caring for the family, at the hospital environment. The objective was to train nurses for the care of the family. The strategies adopted for teaching/learning focused on the Calgary Model of Assessment and Family Intervention, with a group of nurses from a general hospital located in the north of Portugal. In the subjective evaluation of the participants, the pedagogic experience was useful because they could recognize the need for a change on nursing care, and move towards an integrated approach to the family attention.

Construction and validation of a scale of assessment of self-care behaviors with arteriovenous fistula in hemodialysis

Several guidelines recommend the importance of educating the patient about the care of vascular access. Nurses have a key role in promoting the development of self‐care behaviors by providing the necessary knowledge to patients, so that they develop the necessary skills to take care of the arteriovenous fistula (AVF). This article describes the process of building a scale of assessment of self‐care behaviors with arteriovenous fistula in hemodialysis (ASBHD‐AVF). This is a cross‐sectional study in which the development, construction, and validation process followed the directions of the authors Streiner and Norman. This is a convenience sample, sequential, and nonprobabilistic constituted by 218 patients. The study was conducted in two stages during 2012–2014. The first phase corresponds to the scale construction process, 64 patients participated, while the second corresponds to the evaluation of metric properties and 154 patients participated. The principal component analysis revealed a two‐factor structure, with factorial weights between 0.805 and 0.511 and between 0.700 and 0.369, respectively, explaining 39.12% of the total variance of the responses. The Cronbachs alpha of the subscale management of signs and symptoms is 0.797 and from the subscale prevention of complications is 0.722. The ASBHD‐AVF revealed properties that allow its use to assess the self‐care behaviors in the maintenance and conservation of the AVF.

From practice contexts towards the (co)construction of family nursing care models

Frente a los desafios que se colocan a los enfermeros, en el desarrollo de cuidados centrados en la familia, como contexto y unidad de intervencion, realizamos una investigacion dirigida para la intervencion familiar, en el contexto de los Cuidados de Salud Primarios. De naturaleza cualitativa, adoptamos la metodologia de investigacion accion, en una trayectoria de cinco etapas, integradas en un ciclo de estudios. De los resultados del diagnostico, a traves del analisis comparativo de los modelos conceptuales con las practicas de cuidados a la familia, surgio la necesidad del cambio, iniciado con un proceso formativo. Teniendo como marco teorico el Modelo Sistemico, el Modelo Calgary de Evaluacion de la Familia y el Modelo Calgary de Intervencion en la Familia, se (re)construyo el modelo de cuidados de enfermeria a la familia haciendolo operacional a traves de la definicion de las areas de atencion e intervencion. La (co)construccion del modelo a partir de las necesidades identificadas por los enfermeros, legitimado por las tomas de decision de los mismos, se constituye en la base de discusion, en el contexto de la enfermeria de familia.As nurses face challenges in the development of care focused on the family as a context and unit of intervention, this research aimed to identify family intervention processes in the context of Primary Healthcare. This qualitative-based study adopted the investigation-action approach on a study plans five-step path. By means of the comparative analysis of family care practices and conceptual models, the diagnosis results brought forth the need for change triggered by training processes. Having the Systemic Model, the Calgary Family Assessment Model, and the Calgary Family Intervention Model as references, the family nursing care model was (re)constructed and operationalized through the definition of attention and intervention areas. The (re) construction of the model from the needs identified by nurses and legitimated by their decision-making processes is the basis for family nursing focused discussions.

Families with twins - a systematic review

Parenthood is among the developmental transitions that set major challenges for contemporary families. When there is a twin pregnancy, those challenges incre...