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- Death Unpreparedness Due to the COVID-19 Pandemic: A Concept AnalysisPublication . Costeira, Cristina; Dixe, Maria dos Anjos; Querido, Ana; Rocha, Ana; Vitorino, Joel; Santos, Cátia; Laranjeira, CarlosThe COVID-19 pandemic imposed changes upon the capacity of healthcare systems, with significant repercussions on healthcare provision, particularly at end-of-life. This study aims to analyze the concept map of death unpreparedness due to the COVID-19 pandemic, capturing the relationships among the attributes, antecedents, consequences, and empirical indicators. Walker and Avant’s method was used to guide an analysis of this concept. A literature search was performed systematically, between May 2022 and August 2023, using the following electronic databases on the Elton Bryson Stephens Company (EBSCO) host platform: Medical Literature Analysis and Retrieval System Online (Medline), Psychological Information Database (PsycINFO), Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Cochrane Library, and Nursing and Allied Health Collection. Thirty-four articles were retrieved. The unexpected and unpredictable impositions associated with inexperience and unskillfulness in dealing with COVID-19 configured challenges for healthcare professionals, family/caregivers, and even the dying person. Nine key attributes emerged in three main domains: (1) Individual: (a) disease-related conditions, (b) separation distress, and (c) scarcity of death and grief literacy; (2) Relational: (a) Dying alone, (b) poor communication, and (c) existential issues; and (3) Contextual: (a) disrupted collective mourning and grieving, (b) disrupted compassionate care and, (c) pandemic social stigma. This study contributed a full definition of death unpreparedness in a global pandemic scenario such as COVID-19. In this sense, feeling unprepared or unready for death brought new challenges to the bioecological resources of those affected. It is essential to embrace strategies capable of providing emotional and spiritual support in the dying process and to respect patient wishes. The lessons learned from COVID-19 should be applied to events with a comparable impact to minimize their consequences.
- Cancer Patients with Chronic Pain and Their Caregivers during COVID-19: A Descriptive StudyPublication . Costeira, Cristina; Paiva-Santos, Filipe; Pais, Nelson; Sousa, Ana Filipa; Paiva, Ivo; Carvalho, Dulce Helena; Rocha, Ana; Ventura, FilipaBackground: The sanitary measures imposed by COVID-19 intensified challenges in the pain management of cancer patients. Methods: A descriptive study was conducted in a chronic pain unit of an oncological hospital aiming to explore the experiences of cancer patients with chronic pain and their caregivers during the pandemic period, as well as identify strategies to improve care in chronic pain management. An electronic questionnaire was developed containing sociodemographic variables, the Depression, Anxiety and Stress Scale-21, and open-ended questions exploring the experiences and circumstances of pain management. Results: A total of 30 patients and 13 caregivers filled in the questionnaire. Patients revealed a higher level of depression, anxiety, and stress than caregivers, without statistically significant differences. Both groups mentioned having experienced difficulties in self-care, particularly in relation to sleep, nutrition, and recreation. In total, 83.7% patients needed pain relief medication related to uncontrolled pain. Both mentioned that they would have benefited from a digital application to ease the communication with the healthcare professionals of the chronic pain unit, as well as non-pharmacological interventions, such as therapeutic massage. Conclusions: Recognizing that chronic pain leads to significant limitations, it is essential to implement and anticipate objective and effective responses in pain management.
- Spiritual Care[Givers] Competence in Palliative Care: A Scoping ReviewPublication . Costeira, Cristina; Querido, Ana; Ventura, Filipa; Loureiro, Hugo; Coelho, Joana; Benito, Enric; Nabal, Maria; Dones, Monica; Specos, Marcela; Laranjeira, CarlosTo deliver spiritual care, professionals must be skilled in physical, mental, social, and spiritual care. Spiritual care competence includes knowledge, behaviors, attitudes, and skills that enable successful or efficient care. This review aims to identify the scope of competence and the specific skills, knowledge, and attitudes used in providing spiritual care to people needing palliative care, and the main challenges and facilitators. A scoping review was developed using the Joanna Briggs Institute methodology. Six databases (Web of Science; MEDLINE/Pubmed; Scopus; CINAHL; MedicLatina and SciELO) were searched in September 2023, with an update in January 2024. The resulting 30 articles were analyzed using a content analysis approach. Information was categorized into three domains: cognitive, affective, and functional (based on three personal resources: intrapersonal, interpersonal, and transpersonal). Palliative care professionals face a lack of training and insufficient preparation to deliver spiritual care. Spiritual care competence depends on professional spiritual development and experience, spiritual intelligence (cognitive), spiritual humility (affective), and having a critical and reflexive mind (functional). In the future, palliative care should seek to improve competent spiritual care. This review could help clarify the real configuration of competent spiritual care and lead to improvements in a professional’s empowerment when delivering effective spiritual care to patients and families.
- Assessment of Job Satisfaction in Nurses: Contributions to Health ManagementPublication . Costeira, Cristina; Santos-Costa, Paulo; Oliveira-Salgueiro, Anabela; Santos, Cátia; Pais, Nelson; Ventura, FilipaBackground: Evidence reflects that job satisfaction is an indicator of the quality of health care. Health managers and decision-makers cannot neglect its importance and should promote organizational interventions for its assessment and improvement. Objective: This study aims to (i) compare the job satisfaction experienced by nurses with the one desired (ii) identify the lowest areas of current satisfaction and (iii) reflect in areas of lowest and higher job satisfaction. Method: A descriptive study carried out in September 2021 with thirty oncology nurses, who were asked to fill out an electronic questionnaire with the professional life wheel coaching tool. This coaching diagnostic tool assesses the current satisfaction level and the desired satisfaction level from 1 to 10. The inquired areas were: salary, career progression, relationships with managers, relationships with the team, relationships with patients/family, professional environment, feeling of institutional belonging, working conditions, appreciation/recognition, and professional fulfillment. Ethical assumptions were preserved. Results: The results suggest that oncology nurses have important levels of job dissatisfaction. The lowest values of experienced job satisfaction were related to career development, while the highest were related to team relationships. Regarding the desired job satisfaction, the salary was the area presenting the least need for correction. The relationship with patients and families was identified as the area with the greatest desire for improvement. There was a weak correlation between job satisfaction and age, and job satisfaction and professional experience. Discussion and Conclusion: The relationship with the team was one of the areas identified by nurses as significant for their levels of satisfaction, revealing the importance of promoting the development of healthful and effective relationships. Promoting relationships with patients and families is also important as this area was identified as a desire for greater professional development. Health care institutions and nurse managers aiming at the promotion of job satisfaction should plan interventions focusing on the areas of lower job satisfaction and towards younger nurses, who have less experience in clinical environments. Such an approach will likely allow the nurses to feel valued and will reduce the gap between experienced and desired job satisfaction.
- Pain Assessment in Patients during Hemodialysis Treatment: Quality Improvement ProjectPublication . Rodrigues, Rita; Costeira, CristinaPain is a prevalent symptom in patients with chronic kidney disease, related to disease progression, comorbidities, and required immobility during dialysis treatment. Nurses must perform detailed pain assessments to manage pain effectively during hemodialysis treatment. This quality improvement project, reported using SQUIRE 2.0, aims to describe pain characteristics in chronic kidney disease patients in a hemodialysis unit clinic in Portugal, implement strategies to improve the pain assessment process in patients with chronic kidney disease during hemodialysis treatment, and assess nurses’ satisfaction with the implemented strategies. The study was conducted in a Portuguese hemodialysis clinic, with patients and nurses, in three phases: diagnostic study, protocol implementation, and a descriptive study to assess nurse satisfaction. Seventy-five patients (mean age 71 ± 12.6 years) participated, with 64% reporting moderate chronic pain daily and 48% during hemodialysis treatment. Thirteen nurses considered the pain assessment protocol important, rating their satisfaction at 7.92 ± 1.32 (0–10). Standardizing practices through protocol implementation is likely to improve care and increase nurse satisfaction.
- Person-Centered Practice in the Portuguese Healthcare Services: A Scoping Review ProtocolPublication . Ventura, Filipa; Costeira, Cristina; Silva, Rosa; Cardoso, Daniela; Oliveira, CláudiaRecognizing the importance of the international advancements on person-centered prac tice (PCP) with positive implementation outcomes at the varied levels of healthcare systems, this scoping review will examine the PCP in Portuguese healthcare services. The Joanna Briggs Institute (JBI) guidance for scoping reviews will be followed. The Population (P) Concept (C) Context (C) mnemonic will scaffold research questions, the inclusion and exclusion criteria, and the searching strategy. Literature reporting on person-centeredness domains at the macro-, meso-, and micro levels applied to Portuguese healthcare services in Portuguese and English will be considered for inclusion. Accordingly, MEDLINE, CINAHL, SCOPUS, LILACS, SCIELO, Open Access Scientific Repository of Portugal (RCAAP), and Open gray will be searched. The literature will be screened for eligibility by two independent reviewers, first by title and abstract and subsequently by full text. A data extraction matrix designed to answer the research questions will be used for the included literature. The charted data will be thematically analyzed and presented graphically, with a narrative description of the literature characteristics. The results are expected to inform healthcare stakeholders at varying levels about the PCP domains where further improvements might be required in order to raise the quality of care to the international gold standards.
- Telehealth Adoption in an Outpatient Oncology Ward: A Best Practice Implementation ProjectPublication . Ventura, Filipa; Domingues, Helena; Almeida, Gisela; Cardoso, Daniela; Rodrigues, Rogério; Moreira, Isabel; Pires, Mariana; Gomes, Inês; Silva, Rosa; Oliveira, Cláudia; Cardoso, Ana Filipa; Ribeiro, Liliana; Costeira, CristinaTelehealth is increasingly taking place to support the transition of care and self-management of people living with cancer in outpatient oncology settings. Despite its recognised value, the scientific evidence points to disparities with regard to implementation of telehealth that might compromise the equity of access. Following the Joanna Briggs Institute (JBI) implementation approach, this project aims to promote the implementation of best practice recommendations for telehealth adoption in an outpatient oncology setting. Assisted by the Practical Application of Clinical Evidence System (PACES), the implementation process comprises three phases of (i) a baseline audit, (ii) feedback to the healthcare team and establishment of implementation strategies with the Getting Research into Practice (GRiP) tool, and (iii) a follow-up audit. The project is expected to allow the identification of barriers and facilitators for the implementation of telehealth in outpatient oncology and develop a strategy plan for its adoption, with the involvement of end-users and stakeholders. The successful adoption of telehealth according to the best available evidence will likely enhance equity of access to healthcare and quality of care at a distance.
- Monitoring and Management of the Palliative Care Patient Symptoms: A Best Practice Implementation ProjectPublication . Coelho, Adriana; Rocha, Ana; Cardoso, Daniela; Rodrigues, Rogério; Costeira, Cristina; Gomes, Sara; Parola, VitorBackground: In palliative care, symptoms are multiple and combined, evolving and changing, with a multidimensional character and multifactorial causes, and a high prevalence, negatively influencing the patient’s and family’s quality of life. Nurses who provide palliative care need to recognize and respond effectively to their patients’ symptoms. Methods: A project will be applied to implement the best practice in monitoring and managing palliative care patients’ symptoms. The Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool will be used. The JBI PACES and GRiP framework for promoting evidence-based healthcare involves three phases of activity. First, a baseline audit. In a second phase, feedback will be given to the project team after the conclusion of the baseline audit report. Then, a third phase will be conducted as a follow-up audit. Conclusions: This project will improve the practice of the nursing team in monitoring and managing the symptoms of palliative care patients, positively influencing the quality of life of the patient and his family. The implementation and dissemination of this project could boost its replication in other centres.
- Programa De Formação de Primeiros Socorros, Suporte Básico de Vida e Desfibrilhação Automática Externa do Instituto Politécnico de LeiriaPublication . Henriques, Carolina Miguel da Graça; Santos, Cátia Alexandra Suzano dos; Costeira, Cristina Raquel Batista; Lisboa, Felisbelo Rodrigues; Duarte, Hugo Miguel Santos; Sousa, Joana Sofia Dias Pereira deO Instituto Politécnico de Leiria está fortemente comprometido em garantir uma comunidade académica saudável e feliz. Neste sentido e com vista a que os socorristas do IPLeiria se sintam seguros na sua atuação desenvolveu-se este manual para que seja possível a todos que possuam formação no âmbito do socorrismo sedimentarem os seus conhecimentos e competências, através de uma revisão dos conteúdos lecionados. Uma prestação de primeiros socorros de forma correta faz toda a diferença quando os acidentes acontecem. Este manual é destinado a difundir conhecimentos gerais de primeiro socorro e foi elaborado no quadro de uma política institucional de salvaguarda pela saúde e segurança da comunidade académica do Instituto Politécnico de Leiria.
- Workplace stress in Portuguese oncology nurses delivering palliative care: A pilot studyPublication . Costeira, Cristina; Ventura, Filipa; Pais, Nelson; Santos-Costa, Paulo; Dixe, Maria dos Anjos; Querido, Ana; Laranjeira, CarlosOncology nurses often face complex end-of-life issues, underlining their need for specific training in palliative care. In this context, nurses experience several emotional and psychological dilemmas, which are often difficult to manage and result in high levels of workplace stress. This study aimed to determine the levels and work-related factors of workplace stress among oncology nurses. A descriptive baseline study was performed as part of a large four-phase study based on quantitative data collected from Portuguese oncology nurses. Of the 32 participating nurses, most were women, and the mean age was 42.69 10.04 years. Overall, nurses revealed moderate levels of stress. Younger nurses with less professional experience had difficulties dealing with issues related to death and dying. This pilot study supported the development of a program of six Stress Management Training Workshops (SMTW) to reduce stress and increase adaptative strategies. Assessing workplace stress among oncology nurses should be the focus of intervention by managers and institutional leaders.
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