Adjunct teacher at School of Health Sciences-Polytechnic of Leiria (ESSLei), worked as a specialist nurse in Surgery service (2007-2021) and pain unit (non-pharmacological therapies group) (2011-2021) of the Portuguese Institute of Oncology in Coimbra.
EDUCATION
Cristina Raquel Batista Costeira (RN; Msn; PhD) have a degree in specialist nurse in medical-surgical.
Doctor in New Contexts of Psychological Intervention in Education, Health, and Quality of Life and a master’s in nursing management. She is also a Chinese Traditional Medicine therapist. Postgraduate in teams and people management. Interest in palliative care, pain management, complementary therapies; clinic supervision; health management and quality of life. Developed and published research in several national and international journals and magazines.
RESEARCH, TEACHING, or OTHER INTERESTS
Nursing, Oncology, Medical–Surgical Nursing, Surgery
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Scopus Publications
Scopus Publications
Practices and Challenges in Portuguese Early Childhood Intervention: A Descriptive Study Cristina Costeira, Inês Lopes, Saudade Lopes, Vanda Varela Pedrosa, Susana Custódio, et al. Children, 2026 Background/Objectives: Early Childhood Intervention (ECI) services are critical for supporting children with developmental needs and their families. Despite an established legislative framework, challenges related to accessibility, equity, resources, and standardization of practices persist. This study aimed to describe the perspectives of early intervention professionals in Portugal regarding current barriers, facilitators, and priority areas for improvement within the system. Methods: A descriptive study was conducted involving 82 professionals working in early intervention in Portugal. Data were collected using a survey specifically developed by the research team, grounded in a comprehensive literature review and professional expertise. The instrument was validated through a Delphi Panel with two rounds involving six experts in ECI. Data from open-ended questions were analyzed using content analysis, identifying categories and sub-categories to describe the responses, and descriptive statistics for the closed-ended questions. Results: Professionals highlighted the need to update the National ECI System (SNIPI), improve accessibility, and ensure equitable access to early intervention services. Participants reported limited resources, a lack of standardization in practices, and emphasized the importance of professional training and continuous professional development. The findings also pointed to the urgent need for investment and functional and structural restructuring of early intervention services. Various barriers and facilitators were identified. Conclusions: The study provides valuable insights into the perspectives of early intervention professionals, identifying critical areas for policy improvement, resource allocation, and practice standardization.
Mapping the Second Victim Experience Among Western Nurses: A Scoping Review Cristina Costeira, Helena Junqueira, Pedro Quintas, Ângela Pragosa, Ema Mata, et al. Healthcare Switzerland, 2026 Background/Objectives: The second victim phenomenon is increasingly recognized as a significant issue affecting nurses involved in adverse events resulting from clinical decisions or interventions. Although patients and families, considered the first victims, are directly impacted, nurses often undergo challenges as second victims. With the growing awareness of these effects, this study aimed to map recent evidence on the second victim phenomenon among nurses in Western countries. Methodology: A Scoping Review was conducted following the Joanna Briggs Institute methodology in September 2024 and updated in November 2025. Eligibility criteria were defined using the PCC (Population, Concept, Context) framework. Searches were performed in PubMed, CINAHL, SciELO, and Scopus. Two independent reviewers carried out study selection, data extraction, and synthesis. Rayyan® supported screening, performed in two phases: title/abstract review and full-text analysis. Data extraction was conducted in Excel®, and data were analyzed using descriptive statistics and categorized into thematic areas. The review followed PRISMA-ScR guidelines and was registered in the Open Science Framework. Results: Of the 111 articles retrieved, 39 met the inclusion criteria. Evidence shows that although several support programs exist for nurses as second victims, they are often perceived as inadequate or inconsistently implemented. Second victim experience is associated with physical (e.g., sleep disturbances), emotional (e.g., fear), and psychological (e.g., distress) symptoms, with consequences such as absenteeism, professional dissatisfaction, loss of meaning in life, and even suicide. Conclusion: Findings highlight the need for more comprehensive, accessible, and consistently implemented support strategies to meet the complex needs of nurses affected by the second victim phenomenon.
Burnout protective patterns among oncology nurses: a cross-sectional study using machine learning analysis Ana Rocha, Cristina Costeira, Raul Barbosa, Florbela Gonçalves, Miguel Castelo-Branco, et al. BMC Nursing, 2025 Background Oncology nurses face unique and intense demands due to the nature of their work, caring for patients with life-threatening illnesses. The emergence of professional burnout among these nurses is influenced by several factors, highlighting the importance of identifying protective and risk factors to mitigate its impact. This study aims to identify burnout profiles and protective socio-demographic and work-related patterns associated with reduced burnout among oncology nurses. Methods A cross-sectional study was conducted with 150 oncology nurses at a specialized hospital exclusively dedicated to adult oncology treatment in Portugal. Data collection included a self-administered questionnaire incorporating the validated Portuguese version of Maslach Burnout Inventory (MBI). Statistical analyses were performed using SPSS and machine learning tools, specifically KMeans clustering and Random Forest algorithms. Results Six protective patterns against burnout were identified, characterized by conditions of permanent contracts, work-life balance, and supportive work environments. Moreover, factors such as holding management roles and being a parent of two or more children might even be protective in some circumstances, suggesting a nuanced relation between personal and professional factors. Machine learning analyses made apparent the unpredictability of burnout and highlighted the critical role of protective factors in mitigating its impact. Conclusions This study underscores the importance of resilience-building strategies and promoting protective factors, such as job stability, learned experience, and adequate rest, to reduce burnout risk among oncology nurses. Future research should validate these findings through hypothesis-driven analyses to inform targeted and context-specific burnout prevention programs. Clinical trial number Not applicable.
Patient Safety Culture in the Context of Critical Care: An Observational Study Inês Oliveira, Cristina Costeira, Joana Pereira Sousa, Cátia Santos Nursing Reports, 2024 Background: A robust safety culture is essential for ensuring high-quality healthcare delivery. From a nursing perspective, especially among critical patients, it fosters ongoing improvement by highlighting areas that need attention. Aims: This study aimed to evaluate the perception of patient safety culture among nurses within the critical care environment. Methodology: An observational study was conducted at a central hospital in Portugal employing the Hospital Survey on Patient Safety Culture (HSPSC) questionnaire. Results: The study encompassed 57, nurses predominantly female (73.7%), aged 25–64. Most participants were general nurses (77.2%), with a significant proportion (61.4%) working in the emergency department and possessing an average tenure of 13 years at the facility. The perception of critical patient safety culture (CPSC) was predominantly positive (40.6%), varying by department, with intensive care nurses reporting the highest positivity rates. Teamwork was identified as a strong point, receiving 80.7% positivity, highlighting it as a well-established domain in the CPSC, whereas other domains were recognised as requiring enhancements. Conclusions: The study pinpointed both strengths and weaknesses within the CPSC, offering a foundation for developing targeted strategies to bolster patient safety culture in critical care settings.
The Contribution of the Triage Nurse in the Optimisation of Door-to-Computed-Tomography Time in Stroke Raquel Antunes, Cristina Costeira, Joana Pereira Sousa, Cátia Santos Nursing Reports, 2024 A stroke is a time-sensitive emergency, so diagnosing and treating the victim promptly is extremely important. Therefore, the purpose of this study was to identify the influence of the Stroke Code Protocol’s activation on the door-to-computed-tomography (door-to-CT) time and determine whether factors such as previous Modified Rankin Scale (mRS), age, and gender influence its activation. A retrospective study was conducted in a Medical-Surgical Emergency Department in the centre of Portugal from 1 January 2021 to 31 December 2022. The sample was selected according to the diagnosis assigned at the time of clinical discharge from the Emergency Department and the Stroke Code Protocol activation criteria. It was observed that 113 (50%) suspected stroke victims who met the activation criteria for the Stroke Code Protocol did not have the protocol activated, which had a highly significant influence (p < 0.001) on door-to-CT time. It was determined that activation at triage has an average door-to-CT time of 35 ± 18 min, post-triage activation has an average door-to-CT time of 38 ± 26 min, and non-activation has an average door-to-CT time of 1 h 04 ± 45 min. The need to implement an institutional protocol for activating the Stroke Code Protocol and provide specialised training for the multidisciplinary team is reiterated.
Integrative medicine in anxiety disorders Diogo Amorim, José Amado, Irma Brito, Cristina Costeira, Nicole Amorim, et al. Complementary Therapies in Clinical Practice, 2018
