Pedro Parreira

Competências Relacionais de Ajuda nos enfermeiros: validação de um instrumento de medida

Considerando a importância da avaliacao das competencias relacionais de ajuda nos enfermeiros, torna-se necessario utilizar instrumentos fiaveis e adaptados aos contextos. Assim, o objectivo deste estudo foi avaliar as propriedades psicometricas do Inventario de Competencias Relacionais de Ajuda (ICRA), atraves da realizacao de estudos de fiabilidade e validade, no sentido de aumentar o grau de confianca ou de exatidao que podemos ter na informacao obtida por meio da utilizacao deste instrumento. O estudo quantitativo foi realizado numa amostra de 690 enfermeiros, que exerciam funcoes em seis hospitais e oito centros de saude em Portugal. Os resultados obtidos indicam a existencia de uma estrutura multidimensional das competencias relacionais de ajuda diferenciando-se em quatro dimensoes (competencias genericas, empaticas, de comunicacao e de contacto), com correlacoes positivas entre si. O valor de Alpha Cronbach obtido por dimensao foi superior a .79, revelador de uma boa consistencia interna dos itens por fator.

Helping Relationship Skills in nurses: the validation of a measurement instrument

Considerando a importância da avaliacao das competencias relacionais de ajuda nos enfermeiros, torna-se necessario utilizar instrumentos fiaveis e adaptados aos contextos. Assim, o objectivo deste estudo foi avaliar as propriedades psicometricas do Inventario de Competencias Relacionais de Ajuda (ICRA), atraves da realizacao de estudos de fiabilidade e validade, no sentido de aumentar o grau de confianca ou de exatidao que podemos ter na informacao obtida por meio da utilizacao deste instrumento. O estudo quantitativo foi realizado numa amostra de 690 enfermeiros, que exerciam funcoes em seis hospitais e oito centros de saude em Portugal. Os resultados obtidos indicam a existencia de uma estrutura multidimensional das competencias relacionais de ajuda diferenciando-se em quatro dimensoes (competencias genericas, empaticas, de comunicacao e de contacto), com correlacoes positivas entre si. O valor de Alpha Cronbach obtido por dimensao foi superior a .79, revelador de uma boa consistencia interna dos itens por fator.

Intervenções de enfermagem e flebites decorrentes de cateteres venosos periféricos. Revisão sistemática da literatura.

Nursing care provided to patients using peripheralvenous catheters (PVC) is a constant need due to the highfrequency of catheter use.The aim of...

Adaptação transcultural da Infiltration Scale para o português

Objective To translate, adapt and evaluate the psychometric properties of the Infiltration Scale for the Portuguese culture. Methods A methodological study of trans-cultural adaptation to evaluate the psychometric properties of the Infiltration Scale, conducted in a cohort study with 110 adults undergoing intravenous therapy. Results In the translation and cultural adaptation, language adjustments were discussed by researchers and a panel of experts, achieving an agreement of 85.71% for clinical criteria, except for “Possible numbness”. The scale identified infiltration in 48 patients (60% prevalence). Edema was the most evident sign in the insertion site and areas adjacent to the venous catheter. The internal consistency, determined by Cronbach’s alpha, was 0.85. Conclusion The scale adapted to the Portuguese culture presented linguistic equivalence to the original, proved valid and reliable, with good internal consistency for assessing infiltration. The systematic evaluation of infiltration using the scale can support decision-making and the implementation of preventive measures.

Translation and adaptation of the Phlebitis Scale for the Portuguese population

Background: The use of a scale such as the Phlebitis Scale is recommended to assess phlebitis since it allows standardizing the assessment and documenting care effectiveness. Objectives: To translate, adapt, and assess the psychometric properties of the Phlebitis Scale for the Portuguese population. Methodology: Methodological study of translation and assessment of the psychometric properties of the Phlebitis Scale in a nonprobability sample with 110 patients using 526 peripheral venous catheters. An exploratory factor analysis was performed with Varimax rotation in principal components for analyzing the construct validity and internal consistency of the scale using Cronbach’s alpha coefficient. Results: A 35.5% of phlebitis incidence was observed. The factor analysis revealed 2 levels of severity, with the first grade explaining 41.5% of variance. Internal consistency was .78 and .90. Conclusion: The Escala Portuguesa de Flebite (Portuguese Phlebitis Scale) showed linguistic equivalence to the original and adequate internal consis tency for assessing phlebitis. However, a new scale structure is proposed to improve the interpretation and identification of the grades of phlebitis.

Cross-cultural adaptation of the primary health care satisfaction questionnaire

Objective To develop the cross-cultural validation and assessment of the psychometric properties of the Questionnaire about the quality and satisfaction dimensions of patients with primary health care. Methods Methodological cultural adaptation and assessment study of the psychometric properties, involving 398 users from a primary care service. The construct validity was verified through principal components factor analysis and internal consistency assessment as determined by Cronbach’s alpha, using SPSS. Results A factorial structure was identified that is equivalent to the original instrument, showing six factors that explain 70.81% of the total variance. All internal consistency coefficients were higher than 0.84, indicating appropriate psychometric properties. Conclusion The results show that the Brazilian Portuguese version of the instrument is culturally and linguistically appropriate to assess the satisfaction of users attended in primary care services.

Flebite e infiltração: traumas vasculares associados ao cateter venoso periférico

Objetivos: determinar la tasa de incidencia y los factores de riesgo para los indicadores sensibles a los cuidados de Enfermeria, flebitis e infiltracion, en pacientes portadores de cateteres venosos perifericos (CVPs). Metodo: se trata de un estudio de cohorte entre 110 pacientes. Se utilizaron escalas para evaluar y documentar la flebitis y la infiltracion. Se recogieron variables sociodemograficas y clinicas, relativas al CVP, a la medicacion y a la internacion. Se realizo un analisis descriptivo e inferencial, y modelacion logistica multivariada. Resultados: la tasa de incidencia de flebitis e infiltracion fue de 43,2 y 59,7 por mil cateteres-dia, respectivamente. Se removio la mayoria de los CVPs en las primeras 24 horas debido a dichos traumas vasculares. Los factores de riesgo para la flebitis fueron: el tiempo de internacion (p=0,042) y el numero de cateteres insertados (p<0,001); para la infiltracion: la piperacilina/tazobactan (p=0,024) y el numero de cateteres insertados (p<0,001). Conclusion: la investigacion documento la incidencia de indicadores sensibles a los cuidados de Enfermeria (flebitis e infiltracion) y evidencio nuevos factores de riesgo relacionados con la infiltracion. Posibilito, tambien, una reflexion sobre los cuidados de Enfermeria para prevenir los traumas vasculares y sobre las indicaciones y contraindicaciones del CVP, con la implantacion del PICC auxiliando en las practicas de Enfermeria como alternativa del CVP.ABSTRACT Objective: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). Method: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. Results: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). Conclusion: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.

Organizational commitment, psychometric qualities and invariance of the Meyer and Allen Questionnaire for Portuguese Nurses

ABSTRACT Objective: to evaluate the psychometric qualities of the Portuguese version of the Organizational Commitment Questionnaire for the nursing context, through confirmatory analysis and invariance, aiming to evaluate the reliability, internal consistency, construct validity and external validity of the instrument. Method: confirmatory factor analysis of the Portuguese version of the questionnaire was carried out with a sample of 850 nurses, in hospital context. The analysis was complemented using specification search. Goodness of fit was evaluated through different indices. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples of the same sample, in order to confirm the external validity of the factorial solution. Results: the refined model demonstrated good overall fit (χ2/df=6.37; CFI=0.91; GFI=0.92; RMSEA=0.08; MECVI=0.62). The factorial structure was stable (λ:Δχ2(14)=18.31; p=0;193; Intercepts: Δχ2(14)=22.29; p=0.073; Covariance: Δχ2(3)=6.01; p=0.111; Residuals: Δχ2(15)=22.44; p=0.097). Conclusion: the simplified model of the questionnaire demonstrated adequate goodness of fit, representing a stable factorial solution. The instrument was fit to monitor and evaluate the organizational commitment of Portuguese nurses.

Construction and validation of forms: systematization of the care of people under hemodialysis

OBJECTIVE create and validate forms to subsidize the systematization of nursing care with people on hemodialysis. METHOD institutional case study to support the systematization of assistance from the construction of forms for data collection, diagnoses, interventions and nursing results, using cross-mapping, Risners reasoning, Neumans theory, taxonomies of diagnoses, interventions and nursing results with application in clinical practice and validation by focal group with specialist nurses. RESULTS 18 people on hemodialysis and 7 nurses participated. Consensus content of form matter with specialist nurses in the area (Crombach 0.86). The papers captured 43 diagnoses, 26 interventions and 78 nursing results depicting human responses in their singularities. FINAL CONSIDERATIONS the validated forms fill a gap by enabling the capture of human responses from people on hemodialysis and by subsidizing the planning of nursing care on a scientific basis.

Practice environment scale of the nursing work index: Portuguese version and psychometric properties

AIM To assess the psychometric properties regarding the Portuguese version of the Practice Environment Scale of the Nursing Work Index. BACKGROUND The Practice Environment Scale of the Nursing Work Index is the most widely used measure for assessing the practice environment. A model with a higher number of factors appears to be more adequate to Portuguese settings. METHOD A confirmatory factor analysis was performed to the Practice Environment Scale of the Nursing Work Index using a sample of 850 Portuguese nurses. Three models were tested: the original model, a seven-factor model and a higher-order model. An analysis of invariance was performed in two subsets to confirm the stability of the solution. RESULTS The seven-factor model fit better to the data than the original model. After refinement, this solution showed suitability and a stable factor structure. Reliability, convergent validity and discriminant validity were confirmed. A second-order factor solution also showed suitability. CONCLUSION The seven-factor structure of the Practice Environment Scale of the Nursing Work Index showed a better goodness-of-fit to Portuguese settings than the original structure. The second-order factor solution allows an overall assessment of practice environments. IMPLICATIONS FOR NURSING MANAGEMENT The Portuguese version of the Practice Environment Scale of the Nursing Work Index is a valuable tool for assessing Portuguese nursing practice environments. The seven-factor solution of the Practice Environment Scale of the Nursing Work Index showed high specificity.