Aging, Obstetrics and Gynecology, Health Policy, Nursing
10
Scopus Publications
Scopus Publications
Professional Pain Management Strategies in the Emergency Department for Patients With Critical Illnesses Álvaro Gomes, Adriana Taveira, Ana Macedo Dimensions of Critical Care Nursing DCCN, 2026 Background: Pain is a leading reason for emergency department (ED) visits among patients with critical illness (PWCIs), yet pain management remains inconsistent and often suboptimal. The lack of standardized protocols and documentation gaps further complicates effective care. Objectives: This study aimed to characterize pain assessment and management practices for PWCIs in the ED and basic emergency service (BES) and identify improvement opportunities. Methods: A retrospective analysis was performed on 10,802 patient records from a major hospital in northern Portugal. Adults with moderate or severe pain, triaged as yellow, orange, or red, were included over a 90-day period. Data on pain assessment, interventions, and reassessment were analyzed using descriptive statistics. Results: Of 27,212 episodes, 96.3% involved pain as the primary complaint. Physicians were the main prescribers of pharmacological measures, especially in higher-priority cases, while nonpharmacological interventions were underutilized. Documentation of pain reassessment was incomplete, with significant gaps in both physician and nursing records. No nurse-initiated analgesia protocol was in place during the study period. Conclusions: This study highlights persistent gaps in pain management for PWCIs in the ED and BES. The implementation of targeted protocols, ongoing training, and regular audits has the potential to significantly improve pain management practices and patient outcomes. Continued focus on multidisciplinary collaboration and evidence-based protocols is essential for advancing emergency care quality.
On–Off Childhood? A Rapid Review of the Impact of Technology on Children’s Health Diana Borges, Inês Pinto, Octávio Santos, Ivone Moura, Iara Rafaela Ferreira, et al. Healthcare Switzerland, 2025 Background/Objectives: The use of digital technologies among children and adolescents has been increasing exponentially, raising concerns about the potential impacts on physical, mental, cognitive, educational, and social development. Understanding these effects is key to informing clinical and educational practices and public policies that promote digital wellbeing in childhood and adolescence. The main objective of this study was to map the latest available scientific evidence on the patterns of digital technology use by children and adolescents and its main impact, identifying risk factors, opportunities, and strategies for promoting digital wellbeing. Methods: A rapid review was carried out following the Joanna Briggs Institute (JBI) guidelines. Quantitative, qualitative, and mixed studies published between 2020 and 2025, in Portuguese or English, that addressed the use of digital technologies by children and adolescents were included. The assessment of methodological quality was based on JBI’s Critical Appraisal Tools. Results: Ten studies from diverse contexts showed an association between excessive screen time and risks of sedentary lifestyles, sleep disorders, anxiety, depression, attention difficulties, and low academic performance. Occasional benefits arose with adult mediation and educational use; parental mediation and socioeconomic background were key factors. Conclusions: The use of digital technologies is a complex and multifactorial phenomenon that requires integrated approaches; the promotion of digital literacy, public policies for equitable access to quality digital resources, and longitudinal and intercultural studies are recommended to clarify causal relationships and adapt interventions to local contexts.
Cardiovascular Disease in Women’s Prisons: A Qualitative Study of Dietary Habits from the Perspective of Professionals Ana Machado, Iara Ferreira, Mariana Rodrigues, Adriana Taveira, Francisca Linhares, et al. Nutrients, 2025 Background: Cardiovascular disease (CVD) is the leading cause of death worldwide and is exacerbated by poor dietary habits, particularly in settings such as women’s prisons. Incarcerated women are often exposed to ultra-processed foods, limited nutritional education, and restricted living conditions that increase their risk of CVD. Objectives: This study aimed to explore the challenges perceived by professionals in a Portuguese women’s prison regarding the prevention of CVD, particularly through dietary interventions. Methods: A qualitative, exploratory and descriptive study was conducted using a focus group with six professionals. Data were collected in July 2024 and analysed using thematic content analysis. Results: Three thematic categories emerged: (1) contextual challenges of the prison system (e.g., sedentary lifestyle, limited food options); (2) socio-cultural resistance to behavioural change (e.g., low adherence to health programmes, use of food as a coping mechanism); and (3) the need for sustainable and interdisciplinary intervention strategies. Conclusions: The findings highlight the complexity of promoting cardiovascular health in female prisoners. Interventions need to take into account mental health support, prisoner autonomy and institutional constraints. Future research should develop and test targeted, context-specific nutrition programmes in similar settings.
THERAPEUTIC PROGRAMMES FOR POST-INFARCTION OR AT-RISK PATIENTS: A SCOPING REVIEW Iara Rafaela Ferreira, Adriana Taveira, Ana Paula Macedo New Trends in Qualitative Research, 2025 Contextualização: As doenças cardiovasculares são a principal causa de morte em todo o mundo, principalmente devido ao aumento da prevalência do enfarte do miocárdio, com um impacto real no sistema de saúde e na qualidade de vida da pessoa cuidada. O desenvolvimento de intervenções preventivas de melhoria da autogestão da doença parece estar positivamente correlacionado com maiores ganhos em saúde. No entanto, verifica-se uma diversidade de práticas que não consideram as necessidades individuais da pessoa e que são insuficientes para promover a sua capacitação. Objetivos: Caracterizar os programas terapêuticos de prevenção secundária para os doentes e famílias pós-EAM, identificando e avaliando abordagens exemplares para a sua implementação. Metodologia: Scoping review estruturada pelas diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) 2021 e a mnemónica PCC: população, conceito e contexto. Pesquisa realizada nas bases de dados Scopus-Elsevier, PubMed e Web of Science, entre setembro de 2022 e novembro de 2023. Estudos qualitativos, quantitativos e mistos, publicados em inglês, espanhol ou português entre 2006 e 2023. Protocolo registado no Open Science Framework. Resultados: Foram incluídos 46 artigos provenientes de 24 países. A qualidade de vida, os níveis de satisfação, a adesão ao regime terapêutico (nutrição, medicação, exercício físico), a literacia em saúde, os custos de saúde, o tempo de permanência, a mortalidade e as morbilidades foram os principais resultados relatados. Considerações finais: Estes programas devem ser personalizados, mais acessíveis e ajustados às necessidades emocionais e informativas dos doentes. É importante integrar modelos de prestação de cuidados inovadores na conceção de novos programas de reabilitação cardíaca, como a telereabilitação. É necessário ampliar a investigação qualitativa e mista neste âmbito, com especial enfoque nas minorias populacionais e na implementação de avaliações de custo-efetividade.
INTER-COLLABORATIVE NURSING SUPERVISION PROCESS BETWEEN HOSPITAL ORGANIZATIONAL MANAGEMENT MODELS AND ACADEMIA: A QUALITATIVE APPROACH Ana Macedo, Adriana Taveira New Trends in Qualitative Research, 2024 Introduction: Organizational management models influence supervisory activity in nursing. Collaborative practice between students and health professionals in the provision of person- and family-centred care allows them to evolve in the process of autonomy and knowledge transfer. However, this does not guarantee the acquisition of supervisory practices and inter-organisational interaction between the hospital and the academy, which are necessary for carrying out safe and qualified clinical procedures. However, this does not guarantee efficient acquisition of supervisory practices and inter-organizational interaction between hospital and academia, which are necessary to provide safe and effective clinical procedures. Objectives: The aim is to understand the possible dimensions of inter-organisational collaborative practice (academic and hospital), identifying its possible processes and results capable of guaranteeing the safety and quality of clinical procedures. Methods: This study emerges from a first mixed research intervention with N=50 nurse supervisors, non-randomized, using the snowball technique. We will, nevertheless, focus on its qualitative, exploratory, and descriptive approach, using the Focus Group technique in which seven nurse supervisors took part. By using Bardin's assumptions, we conducted the content analysis of the participants' speech. Results: The content analysis allowed us to recognise the Processes of Inter-Collaborative Supervision in Nursing as the main dimension of analysis. The results identify, on the one hand, potential threats, highlighted by the time dedicated to supervision and access to information in the hospital context and, on the other hand, opportunities for articulation, highlighted by the importance of involving the various actors in each context, both in planning training programmes and in using supervisory strategies. Conclusion: This study explores the collaborative processes of nursing supervision between academia and hospitals, highlighting common elements of care and education. It reveals the influence of both bureaucratic and anarchic models in shaping these relationships. The findings underscore the importance of inter-organizational coordination, which plays a critical role in effective health promotion practices.
Health management of malnourished elderly in primary health care: a scoping review Adriana Taveira, Bárbara Sousa, Patrício Costa, Ana Paula Macedo BMC Primary Care, 2022 Objectives The aim of this study, as the first review directed at Primary Health Care, is to identify the screening practices and health outcomes related to the care provided by Family Health Teams to the malnourished elderly people/population. Methods Following PRISMA and PICO strategies, searches were conducted in four electronic databases (PubMed, Web of Science, Scopus & EMBASE) on observational, qualitative, quantitative, or mixed studies, written in Portuguese, Spanish and English language, with participants of 65 years old or older at a community setting. The literature selected for this study ranges from the period 2011 to 2021; additional articles were included through reference lists. Results From the 483 studies identified, 16 were considered eligible to use in this work. The Mini Nutritional Assessment (MNA) score appears as the main criteria of choice, however, a standardized practice in the health systems regarding the use of screening methods has not been demonstrated. Studies are more oriented towards the analysis of the relationship of mortality/morbidity and malnutrition than towards the relationship of the cost and quality of life and malnutrition of the elderly. Discussion Malnutrition is one of the modifiable risk factors which contributes to the vulnerable condition of the elderly, with serious effects, especially when related to other comorbidities. Yet, several authors argue that the Primary Health Care intervention can minimize the negative impacts and improve the health outcomes.
Assessing equity and quality indicators for older people – Adaptation and validation of the Assessing Care of Vulnerable Elders (ACOVE) checklist for the Portuguese care context Adriana Taveira, Ana Paula Macedo, Nazaré Rego, José Crispim BMC Geriatrics, 2022 Background Development has promoted longer and healthier lives, but the rise in the proportion of older adults poses new challenges to health systems. Susceptibilities of older persons resulting from lower knowledge about services availability, health illiteracy, lower income, higher mental decline, or physical limitations need to be identified and monitored to assure the equity and quality of health care. The aim of this study was to develop equity indicators for the Assessing Care of Vulnerable Elders (ACOVE)-3 checklist and perform the first cross-cultural adaptation and validation of this checklist into Portuguese. Methods A scoping literature review of determinants or indicators of health (in)equity in the care of older people was performed. A total of 5 language experts and 18 health professionals were involved in the development and validation of the equity and quality indicators through expert opinion and focus groups. Data collected from focus groups was analyzed through directed or conventional content analysis. The usefulness of the indicators was assessed by analyzing the clinical records of 30 patients. Results The literature review revealed that there was a worldwide gap concerning equity indicators for older people primary health care. A structured and complete checklist composed of equity and quality indicators was obtained, validated and assessed. A significant number of non-screened quality or equity related potential occurrences that could have been avoided if the proposed indicators were implemented were detected. The percentage of non-registered indicators was 76.6% for quality and 96.7% for equity. Conclusions Applying the proposed checklist will contribute to improve the monitoring of the clinical situation of vulnerable older people and the planning of medical and social actions directed at this group.
