Felismina Mendes
@uevora.pt
Nursing
University of Evora
EDUCATION
Sociology PhD
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Felismina Rosa Mendes, Margarida Sim-Sim, Maria Laurência Gemito, Maria da Luz Barros, Isaura da Conceição Serra, and Ana Teresa Caldeira
Springer Science and Business Media LLC
AbstractThe coronavirus disease 2019 (COVID-19) has infected many institutionalised elderly people. In Portugal, the level of pandemic fear among professional caregivers of the elderly is unknown, as are its predictive factors. This study aimed to investigate predictors of fear of COVID-19 among workers caring for institutionalised elderly people in nursing homes. This is a cross-sectional study using multiple linear regression applied to a population of 652 caregivers located in 14 municipalities in Central Alentejo, Portugal, at March 2021. The criterion variable was the fear of COVID-19. Standardised regression coefficients showed that the higher the level of education, the lower the level of fear (β = − 0.158; t = − 4.134; p < .001). Other predictors of the level of fear were gender, with women having higher levels (β = 0.123; t = t = 3.203; p < 0.001), higher scores on COVID-19-like suspicious symptoms (β = 0.123; t = 3.219; p < 0.001) and having received a flu vaccine (β = 0.086; t = 2.252; p = 0.025). The model explains 6.7% of the variation in fear of COVID-19 (R2Adj = 0.067). Health literacy can minimise the impact on the physical and mental health of these workers. In Central Alentejo, caregivers of the elderly play a fundamental role in social balance. Further studies are needed to better understand the factors that can improve their personal and professional well-being.
Sameh Eltaybani, Ayumi Igarashi, Ayse Cal, Claudia K. Y. Lai, Cristina Carrasco, Dianis Wulan Sari, Eunhee Cho, Gørill Haugan, Jorge D. Bravo, Nesreen A. Abouzeid,et al.
Wiley
AIMS
To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions.
DESIGN
Cross-sectional survey.
METHODS
Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines.
RESULTS
The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance.
CONCLUSIONS
Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks.
IMPACT
This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks.
PATIENT OR PUBLIC CONTRIBUTION
No Patient or Public Contribution.
Larissa Silva Sadovski Torres, Adriana Catarina de Souza Oliveira, Mayara Priscilla Dantas Araújo, Maria Débora Silva de Carvalho, Lívia Batista da Silva Fernandes Barbosa, Bruno Araújo da Silva Dantas, Carmelo Sergio Gómez Martínez, Francisco Arnoldo Nunes de Miranda, Felismina Rosa Parreira Mendes, and Gilson de Vasconcelos Torres
Public Library of Science (PLoS)
Our aim was to analyze the association between socioeconomic status and quality of life (QoL) among older people with depressive symptoms treated through the Primary Health Care (PHC) system in Brazil and Portugal. This was a comparative cross-sectional study with a nonprobability sample of older people in the PHC in Brazil and Portugal conducted between 2017 and 2018. To evaluate the variables of interest, the socioeconomic data questionnaire, the Geriatric Depression Scale and the Medical Outcomes Short-Form Health Survey were used. Descriptive and multivariate analyses were performed to test the study hypothesis. The sample consisted of n = 150 participants (Brazil n = 100 and Portugal n = 50). There was a predominance of woman (76.0%, p = 0.224) and individuals between 65 and 80 years (88.0%, p = 0.594). The multivariate association analysis showed that in the presence of depressive symptoms, the QoL mental health domain was most associated with the socioeconomic variables. Among the prominent variables, woman group (p = 0.027), age group 65–80 years (p = 0.042), marital status “without a partner” (p = 0.029), education up to 5 years (p = 0.011) and earning up to 1 minimum wage (p = 0.037) exhibited higher scores among brazilian participants. The portuguese participants showed an association between the general health status domain and woman group (p = 0.042) and education up to 5 years (p = 0.045). The physical functioning domain was associated with income of up to 1 minimum wage (p = 0.037). In these domains, the portuguese participants exhibited higher scores than the brazilian participants. We verified the association between socioeconomic profile and QoL in the presence of depressive symptoms, which occurred mainly among woman, participants with low levels of education and low income, with QoL aspects related to mental, physical and social health and self-perceived health. The group from Brazil had higher QoL scores than the group from Portugal.
Elaine Santana, Felismina Mendes, Joana Bernardo, Rosa Silva, Pedro Melo, Pollyanna Lima, Alessandra Oliveira, and Luciana Reis
MDPI AG
This study aims to understand the difficulties in caring for the older adults with functional dependence from the perspective of Brazilian and Portuguese caregivers. This is a study based on the Theory of Social Representations, based on the Thematic Content Analysis proposed by Bardin, carried out with 21 informal caregivers of older adults in Brazil and 11 informal caregivers of older adults in Portugal. The instrument consisted of a questionnaire with sociodemographic data and data on health conditions along with an open interview with guiding questions on the theme of care. Data were analyzed using the Content Analysis technique proposed by Bardin, with the help of the QRS NVivo® Version 11 software (QSR International, Burlington, MA, USA). Three categories emerged from the speeches: “Caregiver burden”, “Caregiver support network” and “Older adults resistance”. The main difficulties mentioned by caregivers were associated with family articulation in meeting the needs of their older adults, whether due to the excessive demand of tasks, which results in overloading the caregiver, or the behaviors of the older adults themselves, or even the availability of a truly supportive and effective network.
Mayara Araújo, Thaiza Nobre, Vilani Nunes, Adriana Oliveira, Felismina Mendes, and Gilson Torres
E.U. European Publishing
Marta Cossetin Costa, Felismina Rosa Parreira Mendes, Daiana Kloh Khalaf, Vanessa Piccinin Paz, Fernanda Moura D’Almeida Miranda, and Maria de Fátima Mantovani
FapUNIFESP (SciELO)
ABSTRACT Objective: to know the generalized resistance resources of people deprived of liberty with systemic arterial hypertension in a triple border region. Method: a qualitative study based on the theoretical framework of Salutogenesis, in which 38 people deprived of liberty in Foz do Iguaçu, Paraná, Brazil, participated from February to July 2022. Guiding questions were used in the interviews which were submitted to thematic content analysis. Results: 12 generalized resistance resources emerged in the reports of people deprived of liberty with systemic arterial hypertension: health team; access to medications; work; lifestyle habits: food, physical activity and restriction of access to drugs/cigarettes/alcoholic beverages; stress/anxiety control; reading and games; religiosity; family; self-care; cellmates; and employees. Conclusion: people deprived of liberty with systemic arterial hypertension have generalized resistance resources to manage their life and health, which are related to personal care, the social group and the environment. It is noteworthy that once they are identified, the generalized resistance resources can be used by health professionals to manage SAH, other chronic diseases and aid in health promotion.
Jéssica Maria Arouca de Miranda, Dalyanna Mildred de Oliveira Viana, Anderson Antônio Lima dos Santos, Áquila Filêmon de Andrade Costa, Bruno Araújo da Silva Dantas, Francisco Arnoldo Nunes de Miranda, Felismina Rosa Parreira Mendes, and Gilson de Vasconcelos Torres
MDPI AG
Background: The interaction of quality of life (QoL) with functionality, nutrition and depression has been studied, but few studies have compared different realities. Our objective was to compare the associations of QoL with impaired functionality, nutritional status and depressive symptoms among older people patients treated in primary health care (PHC) in Brazil and Portugal. Methods: Cross-sectional, comparative study was conducted with primary data from PHC services in Brazil and Portugal with users over 65 years old. Participants’ scores were classified as “impaired” and “preserved” for QoL, functional decline, nutrition and depression. We used Pearson’s chi-square test, Fisher’s exact test and the Mann–Whitney U test. Results: Our sample had a total of 150 PHC users. We found lower QoL scores in Brazil, which were associated with the risk of functional decline for the domains Physical Functioning, General Health Perceptions, Mental Health dimensions and Physical Health. Nutritional impairment in the group from Portugal included the domains of Vitality and Social Role Functioning. For depressive impairment, Portugal showed an association with the domains Mental Health, Vitality and Social Role Functioning. Conclusions: QoL was associated with functional and nutritional impairment and depressive symptoms, highlighting physical, mental and social characteristics related to the perception of well-being.
João V. Vieira, Sérgio Deodato, and Felismina Mendes
SAGE Publications
Introduction: The implementation of futile nursing interventions seems to be a persistent problem in adult intensive care units. Understanding this phenomenon can contribute to its prevention and all deleterious effects associated with it. Objective: To identify the perceptions of expert nurses from adult intensive care units about therapeutic futility in nursing. Methods: This study consists of a conventional content analysis. Data was collected through a focus group interview that included five expert nurses in adult intensive care, with a minimum of fifteen years of professional experience in intensive care. To analyze the information, the technique of thematic categorical analysis was used, according to Bardin. Results: Four central categories were identified for the topic under study, for which several subcategories were identified that allow a better understanding of this phenomenon. Conclusion: Adult intensive care expert nurses advocate that therapeutic futility in nursing is a reality perceived by teams and families, which should be avoided due to the risk of potentiating the implementation of ethically reprehensible care.
João Vítor da Silva Vieira, Sérgio Deodato, and Felismina Mendes
SAGE Publications
Introduction Due to the constant scientific and technological development, health professionals are regularly confronted with situations in which there are always therapeutic options, regardless of the severity of the patient’s condition. However, regarding these therapeutic options as feasible in all situations can be harmful, since it is universally accepted that, despite all advances in health, there are inevitable limits and the promotion of some interventions may be useless or futile. Objective To characterize the use of the concept of futility in the health literature. Method Review of the literature following the Scoping Review protocol of the Joanna Briggs Institute. The research was performed in CINAHL, Cochrane, Pubmed, Scopus e Web of Science to identify studies published prior to 2020. Nineteen studies were selected. Results There is no universally accepted definition for the concept of futility. In the literature there are different conceptions for the concept of futility that point to qualitative and quantitative roots and that are associated with ethical dilemmas that make it difficult to conceptualize this concept and make it operational in clinical practice. Conclusion The central elements of the concept of futility include: the diagnosis of futility is closely related to clinical judgment; futility has both quantitative and qualitative roots; futility is always appreciated posteriori; futility is related to the lack of benefit. It is essential to promote a discussion that enables the definition of the concept and that makes it possible to promote ethical principles in care, especially when the inevitable limits of treatments are reached.
Bruno Araújo da Silva Dantas, Anna Carolyna Vieira Cavalcante, Jéssica Maria Arouca de Miranda, Gislani Acásia da Silva Toscano, Thaiza Teixeira Xavier Nobre, Felismina Rosa Parreira Mendes, Francisco Arnoldo Nunes de Miranda, Eulália Maria Chaves Maia, and Gilson de Vasconcelos Torres
Ovid Technologies (Wolters Kluwer Health)
Abstract We aimed to compare the association of depression with aspects of quality of life (QoL) among older people users of primary health care (PHC) living in Brazil and Portugal. We carried out an observational, cross-sectional and comparative study with a quantitative approach in the PHC scope in Brazil and Portugal, where we obtained a nonrandom sample of 150 participants aged 65 years or older (100 Brazilians and 50 Portuguese). We used the socioeconomic and health data questionnaire, the Medical Outcomes Short-Form Health Survey QoL (SF-36) questionnaire and the Beck Inventory. Among the socioeconomic profiles, most were females aged between 65 and 80 years in both countries. There was a significant difference between groups in the income variable, with 100.0% of Portuguese people earning up to 1 minimum wage (P value <.001), and the presence of chronic diseases in 92.0% of respondents in Portugal (P value = .033). In the association analysis, most aspects of QoL had a higher median score (>50.0) within the categorical variables of “absent” and “mild” depression. The Emotional role functioning, Physical role functioning, Physical functioning, Mental health, Total score domains and the Mental health and Physical health summary measures stood out with this behavior in Brazil and in Portugal, where these latter 2 presented moderate to strong correlation values (ρ > 0.400) in Portugal. Greater associations of depression on QoL were revealed in Portugal than in Brazil. Among their most expressive associations, the Physical role functioning (odds ratio [OR] = 4.776; 95.0% confidence interval [CI]: 2.41–9.43), Physical functioning (OR = 3.037; 95.0% CI: 3.037), Vitality (OR = 6.000; 95.0% CI: 1.56–23.07) and Total score (OR = 3.727; 95.0% CI: 2.24–6.17) domains and the Mental health summary measure (OR = 3.870; 95.0% CI: 2.13–7.02) stood out. Aspects related to the emotional, physical, functional and mental health components stood out. The association and correlation with depression were more expressive in Portugal compared to Brazil. However, similar results were obtained in Brazil but with less relevance.
Felismina Mendes, Joana Pereira, Otília Zangão, Catarina Pereira, and Jorge Bravo
Springer Science and Business Media LLC
Abstract Background Mental disorders are highly prevalent in older people, being depression a predominant disorder. Evidence points to a possible relationship between depression and violence against older people. Nonetheless, the role of the depressive symptomology severity in the risk of violence against older people remains unclear. Thus, this study’s main objective was to analyze the relationship between geriatric depressive symptomatology and the risk of violence against older people. Methods This exploratory study involved 502 community-dwelling older persons aged 65 to 96 years (73.3 ± 6.5). Measures were performed using the Geriatric Depression Scale and the Risk Assessment of Violence against the Non-Institutionalized Elderly scale. Results One hundred nineteen older people (23.7%) had mild/moderate depressive symptomology, and twenty-six (5.2%) had severe depressive symptomology. There were significant relationships between the severity of depressive symptomatology and the risk of violence (p < 0.05). The presence of depressive symptomatology increased the likelihood of being victims of violence, particularly among women (odds ratio: 2–8, p < 0.05). Conclusions The severity of depressive symptomatology plays an essential role in the risk of violence against community-dwelling older people. Moreover, it was found that older persons with depression symptomatology were at higher risk of being victims of violence. Our study findings support the need for protective measures within mental health national or regional policies to prevent depression and violence against community-dwelling older people.
Catarina Pereira, Guida Veiga, Gabriela Almeida, Ana Rita Matias, Ana Cruz-Ferreira, Felismina Mendes, and Jorge Bravo
Springer Science and Business Media LLC
Abstract Background Fall risk assessment and determination of older adults’ individual risk profiles are crucial elements in fall prevention. As such, it is essential to establish cutoffs and reference values for high and low risk according to key risk factor outcomes. This study main objective was to determine the key physical fitness, body composition, physical activity, health condition and environmental hazard risk outcome cutoffs and interval reference values for stratified fall risk assessment in community-dwelling older adults. Methods Five-hundred community-dwelling Portuguese older adults (72.2 ± 5.4 years) were assessed for falls, physical fitness, body composition, physical (in) activity, number of health conditions and environmental hazards, and sociodemographic characteristics. Results The established key outcomes and respective cutoffs and reference values used for fall risk stratification were multidimensional balance (low risk: score > 33, moderate risk: score 32–33, high risk: score 30–31, and very high: score < 30); lean body mass (low risk: > 44 kg, moderate risk: 42–44 kg, high risk: 39–41 kg, and very high: < 39 kg); fat body mass (low risk: < 37%, moderate risk: 37–38%, high risk: 39–42%, and very high: > 42%); total physical activity (low risk: > 2800 Met-min/wk., moderate risk: 2300–2800 Met-min/wk., high risk: 1900–2300 Met-min/wk., and very high: < 1900 Met-min/wk); rest period weekdays (low risk: < 4 h/day, moderate risk: 4–4.4 h/day, high risk: 4.5–5 h/day, and very high: > 5 h/day); health conditions (low risk: n < 3, moderate risk: n = 3, high risk: n = 4–5, and very high: n > 5); and environmental hazards (low risk: n < 5, moderate risk: n = 5, high risk: n = 6–8, and very high: n > 8). Conclusions Assessment of community-dwelling older adults’ fall risk should focus on the above outcomes to establish individual older adults’ fall risk profiles. Moreover, the design of fall prevention interventions should manage a person’s identified risks and take into account the determined cutoffs and respective interval values for fall risk stratification.
Catarina Pereira, Jorge Bravo, Gorete Reis, and Felismina Mendes
Springer Science and Business Media LLC
Abstract Background Falls and violence against older people might represent a joint public health problem, as both may result in injury, fear, social isolation, sedentary behavior and dependence or even death. The ESACA project “Aging safely in Alentejo - Understanding for action” was designed to promote the healthy aging of older people in Alentejo by preventing the occurrence of falls and violence. This study aimed to report the ESACA protocol and the preliminary outcomes. Methods The ESACA study has a twofold design as a cross-sectional study that included retrospective and prospective surveys. The participants were 508 community-dwelling older people. Assessments included falls, the risk of violence against older people, sociodemographic characteristics, health-related measurements, fear of falling, anthropometric measures and body composition, functional physical fitness, physical activity, and environmental hazards. Results Among the participants, 43% were fallers, 21% were recurrent fallers, and 22% were victims of one or more kinds of violence (psychological: 17.1%, physical: 5.6%, and patrimonial: 3.0%). Moreover, the cumulative results suggested high risk on several risk factors for falling (7 factors: 0.6% to 2 factors: 17.4%) and of violence (26.7%). Conclusions In the ESACA project, a wide range of potential influencing factors on falls and violence risk factors were measured, and comprehensive quality control measures were applied. Overall, the results suggest that for falls and violence prevention strategies to be effective, it is essential to evaluate, diagnose, and inform all stakeholders in a directed and useful way. Moreover, we believe that our project outcomes may help change mindsets and behaviors by involving people in active aging and well-being programs that promote exercise and avoid isolation.
Cristina Carrasco, Felismina Mendes, Jorge Bravo, Catarina Pereira, and Pablo Tomas‐Carus
Wiley
BACKGROUND
There are a variety of intrinsic determinants which are key to understand the reasons for older people to stay (or not) active.
OBJECTIVES
To identify and analyse the factors underlying the physical activity engagement in older Portuguese living in a rural area.
METHODS
A total of 504 community-dwelling older adults (aged ≥65 years) were enrolled in this cross-sectional study. Sociodemographic data, physical activity levels, physical fitness and body composition were analysed.
RESULTS
Gender, age, income level, lower body strength, overweight, muscle mass and sedentarism (sitting time) were significantly associated with different physical activity levels. The multinomial logistic regression pointed out that dynamic balance, BMI and sitting time for moderate levels, as well as muscle mass for high levels, were the main independent factors that seem to influence the engagement in these levels compared to low physical activity levels. Additionally, classification tree analysis confirmed sitting time, dynamic balance and gender as discriminating factors for physical activity levels.
CONCLUSION
Physical fitness-related variables seem to mainly determine the levels of physical activity in the studied population. Thus, nursing care must promote the integration of physical activity into daily life routines of community-dwelling older adults, especially in rural areas.
IMPLICATIONS FOR PRACTICE
The diverse nature of factors influencing physical activity must be taken into account in primary health care, particularly in rural areas. Nursing care for older people must promote the integration of physical activity into daily life routines of community-dwelling older adults.
João V. Vieira, Sérgio Deodato, and Felismina Mendes
SAGE Publications
Introduction Intensive care units are contexts in which, due to the remarkable existence of particularly technological resources, interventions are promoted to extend the life of people who experience highly complex health situations. This ability can lead to a culture of death denial where the possibility of implementing futile care and treatment cannot be excluded. Objective To describe nurses’ perceptions of adult intensive care units regarding the therapeutic futility of interventions implemented to persons in critical health conditions. Method Review of the literature following the Scoping Review protocol of the Joanna Briggs Institute. The Population, Concept, and Context mnemonic was used to elaborate the research question and the research was performed using the EBSCOHost search engine in the CINAHL Complete databases, MEDLINE Complete, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews to identify studies published between 1990 and 2019. Seven studies were selected. Results Nurses consider that therapeutic futility, a current problem in adult intensive care units, may have a negative impact on persons in critical health conditions and that contributes directly to resource expenditure and moral conflicts and consequently leads to emotional exhaustion. Conclusion Due to the complexity of this concept, knowing and understanding people’s and families’ perceptions is crucial to the decision-making process, for which reason nurses can play a key role in managing these situations.
Glícia Cardoso Nascimento, Gabriela Martins Santos, Samuel Ricardo Batista Moura, Ana Raquel Batista de Carvalho, Letícia da Silva Andrade, Luana Kelle Batista Moura, Felismina Mendes, Maria Adelaide Silva Paredes Moreira, and Maria Eliete Batista Moura
Bentham Science Publishers Ltd.
Objective: The study aimed at analyzing the international scientific publications on coronavirus infection and patient safety in health care. Methods: This research is a bibliometric study carried out by searching published articles in theISIWebofKnowledge/WebofScience database and analyzing the results through bibliometric analysis software HistCite. The selected time frame was between 1970 and 2020, and we used the following descriptors: “coronavirus infection” OR “severe acute respiratory syndrome” OR “COVID-19/SARS-CoV-2”. Results: We found 5,434 publications in 1,491 different journals; they are written by 18,274 authors linked to 4,064 institutions, which are located in 104 countries. In the citations analysis, the h-index was 155, and the average of citations each article received was 30.79. Conclusion: During the studied period, the Web of Science database showed two peaks of publications on coronavirus infections.The first comprised 768 articles published between 2003 and 2004 when a new coronavirus caused an outbreak of severe acute respiratory failure. The second consisted of 576 articles published between 2019 and 2020, during the period of the COVID-19 pandemic COVID-19. The knowledge on coronavirus infection should be widely shared so that new studies can be designed and the world scientific community can contribute to improving patient safety in healthcare and preventing new pandemics of severe acute respiratory infection caused by coronaviruses.
Susana Valido, Ermelinda do Carmo Caldeira, and Felismina Mendes
IGI Global
Sociodemographic changes occurring in past decades are reflected as increased population aging, resulting in a higher need to institutionalize elderly. Violence against elderly is a relevant public health problem. The aims of the present cross-sectional exploratory and descriptive study with a quantitative approach were to analyze burnout among formal caregivers at institutions for elderly and to assess the risk of violence against institutionalized elderly. As a part of project ESACA—Envelhecer com Segurança no Alentejo (Prevenir as Quedas e a Violência sobre Idosos)—Compreender para Agir (Aging Safely in Alentejo [Preventing Falls and Violence against Elderly]), the present study analyzed 34 formal caregivers from three institutions that provide care to elderly in the Evora district, Portugal. No situations involving violence against institutionalized elderly were detected. Most participants (96.3%) did not exhibit burnout, although they did report feeling physically and emotionally tired.
João V. Vieira, Sérgio Deodato, and Felismina Mendes
Hindawi Limited
Introduction. Intensive care units are systems organized for the provision of care to patients in critical situations. In general, it is suggested that intensive care consists of a multidisciplinary and interprofessional specialty. Nevertheless, the predominance, relative to the professions that incorporate these units, falls on nurses. A conceptual model of nursing provides a framework for reflection, observation, and interpretation of phenomena and, specifically, it provides guidelines and guidance for aspects of clinical practice. Objective. To understand the applicability of conceptual models of nursing in intensive care units. Method. Review of the literature following the Scoping Review protocol of the Joanna Briggs Institute. The research was performed in CINAHL, Cochrane, Pubmed, Scopus, and Web of Science to identify studies published prior to 2021. Fourteen studies were selected. Results. There is no conceptual model of nursing universally accepted as ideal for intensive care units. However, there is unanimity in the identification of several benefits associated with the application of a conceptual model of nursing in the care of critically ill patients. Conclusion. For the selection of a conceptual model of nursing for these contexts, the focus should be on the person and the choice should fall on the model that is most appropriate to the patient, and not on the philosophy that supports the model. Considering the nature of care, the nursing team can select a model or a combination of models.
Catarina Pereira, Jorge Bravo, Guida Veiga, José Marmeleira, Felismina Mendes, and Gabriela Almeida
Public Library of Science (PLoS)
The stepping-forward affordance perception test (SF-APT) fills an important gap within the screening of falls risk factors by considering the perception of affordances. The test showed to be a valid instrument for community-dwelling older adults falls risk assessment. The present study aimed to distinguish and test the key outcomes of the SF-APT usable for falls risk assessment in community-dwelling older adults to determine the respective cut-offs. This cross-sectional study enrolled 347 participants (73.1 ± 6.2 years; non-fallers: 57.9%; fallers: 42.1%; recurrent-fallers: 17.9%). Falls occurrence and SF-APT outcomes were assessed. Analyses were performed using multivariate binary logistic regression analysis and receiver operating characteristic (ROC). The area under the ROC curve was computed (AUC) for each built model explaining falling or recurrent falling. Results distinguished the Estimated stepping-forward, and Absolute-error in interaction with Error-tendency as the SF-APT key outcomes for falls risk assessment [AUCfalling: 0.665 (CI 95%: 0.608–0.723); AUCfalling recurrently: 0.728 (CI 95%: 0.655–0.797)]. Computed cut-offs’ analysis showed that (i) a boundary stepping-forward estimation >58 cm plus an underestimation bias >5 cm (>42nd percentile) avoid older adults to be recurrent-fallers, and (ii) a boundary stepping-forward estimation >62 cm plus an underestimation bias >6 cm (>54th percentile) avoid older adults to be fallers. In conclusion, results suggest that SF-APT is a valuable tool for falls risk assessment in community-dwelling older adults. Interventions targeting the prevention of falls should consider the above key outcomes and the respective cut-offs as alert red-flags.
Catarina Pereira, Jorge Bravo, Armando Raimundo, Pablo Tomas‐Carus, Felismina Mendes, and Fátima Baptista
Wiley
BACKGROUND
Falls and fall-related injuries along with fear of falling (FoF) seem to restrict activities of daily living (ADL), resulting in physical dependence. However, it is still unclear how falls and related injuries or FoF by themselves explain general and specific ADL dependence.
OBJECTIVES
To investigate the relationships between falls and related injuries, FoF and physical dependence on ADL in community-dwelling older adults, controlling for age, gender, physical activity and physical fitness as confounders.
METHODS
This cross-sectional descriptive study assessed 588 community-dwelling older adults. Falls and fall-related injuries, ADL dependence on basic, instrumental and advanced activities, FoF, demographic characteristics and health conditions were assessed through a questionnaire. Physical activity was measured through the International Physical Activity Questionnaire. Physical fitness was assessed by the Senior Fitness Test and the Fullerton Advanced Balance Scale. Body composition was measured through bioimpedance.
RESULTS
Severe injuries occurrence increased the likelihood of moderate and high physical dependence by 3 and 6 times, while FoF increased this likelihood by 3 and 7 times, respectively. Also, the occurrence of previous falls, resulting in severe injuries, increased the likelihood of dependence in two instrumental ADL (3 and 4 times), while FoF increased this likelihood in numerous basic, instrumental and advanced ADL (2-3 times). The FoF was shown to explain overall physical functioning dependence, by itself, representing a constraint on the performance of most basic, instrumental and advanced ADL.
CONCLUSION
The FoF showed to be a greater threat to ADL dependence than falls and related injuries. Assessment guidelines for older adults living in the community should include the FoF in clinical evaluation.
IMPLICATIONS FOR PRACTICE
Understand the isolated interplay of FoF and previous falls and injuries on ADL dependence among older adults allows healthcare professionals to perform more accurate clinical evaluations and develop more successful interventions to prevent further dependence.
Cristina Carrasco, Pablo Tomas‐Carus, Jorge Bravo, Catarina Pereira, and Felismina Mendes
Wiley
AIM AND OBJECTIVE
Ageing is associated with an increased risk of falling. Identification of risk factors is crucial for the prevention of falls in older people.
METHODS
A total of 508 older adults enrolled in a cross-sectional study. For the assessment of risk factors, the research team collected basic data and health-related information and performed morphofunctional evaluations (strength and flexibility of lower body and dynamic balance).
RESULTS
A significantly greater proportion of women experienced fall episodes within the past year. Additionally, certain chronic diseases were significantly more prevalent in the fall subgroup compared to the non-fall subgroup. The non-fall subgroup showed significantly better scores of lower body strength and dynamic balance than the fall subgroup.
CONCLUSION
Multivariable regression analysis revealed that gender and lower body strength seem to be the main risk factors for fall event (s) within the past year in community-dwelling older adults from the Portuguese region of Alentejo.
IMPLICATIONS FOR PRACTICE
Differences in fall risk factors due to gender, ethnicity and geography must be taken into account in clinical practice. Nurses must identify the environmental, social and individual risks that constitute health threats and trigger protective intervention programs. Nursing care for older people must also meet needs related to physical activity (e.g., strength-training exercise), since lower body weakness is strongly associated with falls.
Marco Jacinto, César Fonseca, Manuel Lopes, José Garcia-Alonso, Felismina Mendes, and Juan M. Murillo
Springer International Publishing
Background: The increase in the average life expectancy has increased the need for intensive care. In these units people remain under ventilatory support, remaining in bed for long periods. It is up to the rehabilitation nurse to intervene, reducing dependency and promoting self-care, conditioning a better quality of life. Objective: To identify the gains obtained through the intervention of the rehabilitation nurse. Methodology: Exploratory descriptive study following the methodology of Robert Yin’s case study and Manuel Lopes’s theory of medium range, using the ENCS scale and the Barthel Index as data collection instruments. Results/Discussion: It can be seen from the data analysis that the interventions of the rehabilitation nurse contributed to a functional improvement of the person, reducing dependence on self-care. Conclusion: All persons included in the professional intervention strategy improved functionally.
Gabriela Almeida, Jorge Bravo, Hugo Folgado, Hugo Rosado, Felismina Mendes, and Catarina Pereira
Public Library of Science (PLoS)
Thus far, few studies have examined the estimation and actual performance of locomotor ability in older adults. To our knowledge, there are no studies examining the relationship between stepping-forward estimation versus ability and fall occurrence. The aim of this study was to develop and assess the reliability and validity of a new test for fall risk assessment in community-dwelling older adults. In total, 347 participants (73.1 ± 6.2 years; 266 women) were assessed for their perception of maximum distance for the stepping-forward and action boundary. The test was developed following the existing literature and expert opinions. The task showed strong internal consistency. Intraclass correlation ranged from 0.99 to 1 for intrarater agreement and from 0.83 to 0.97 for interrater agreement. Multivariate binary regression analysis models revealed an area under the curve (AUC) of 0.665 (95% CI: 0.608–0.723) for fallers and 0.728 (95% CI: 0.655–0.797) for recurrent fallers. The stepping-forward affordance perception test (SF-APT) was demonstrated to be accurate, reliable and valid for fall risk assessment. The results showed that a large estimated stepping-forward associated with an underestimated absolute error works as a protective mechanism for fallers and recurrent fallers in community-dwelling older adults. SF-APT is safe, quick, easy to administer, well accepted and reproducible for application in community or clinical settings by either clinical or nonclinical care professionals.
Mônica Gisele Costa Pinheiro, Suerda Lillian da Fonseca Lins, Bruna Raquel da Silva Gomes, Clélia Albino Simpson, Felismina Rosa Parreira Mendes, and Francisco Arnoldo Nunes de Miranda
FapUNIFESP (SciELO)
Resumo OBJETIVO Analisar as relações contextuais da atenção à saúde na alta em hanseníase. MÉTODO Estudo analítico pautado no referencial teórico de análise do contexto, elaborado mediante revisão integrativa de literatura nas bases de dados SCOPUS, PUBMED, LILACS, SCIELO e BDENF, com descritores Hanseníase e Alta do Paciente, obtendo-se 14 publicações. RESULTADOS O contexto imediato aborda a atenção em saúde na alta em hanseníase; o contexto específico trata da hanseníase como problema de saúde pública; as concepções simbólicas que envolvem a hanseníase são abarcadas pelo contexto geral; e no metacontexto estão descritos programas e políticas de saúde que subsidiam o atendimento à pessoa com hanseníase. CONCLUSÃO Os elementos contextuais ressaltam a necessidade de garantir a atenção em saúde para os casos de hanseníase, do diagnóstico até o pós-alta, reconhecendo a hanseníase como problema de saúde pública. Apesar das limitações dos estudos bibliográficos, estes possuem relevância para a área da saúde.