Nursing School of Coimbra

Background: Anxiety and stress are common during pregnancy and can impact the health of the pregnant woman and the newborn. There is a lack of research focused on identifying weaknesses that promote equity in the care of pregnant women. The objective of this study was to describe the levels of anxiety and stress during the three trimesters of pregnancy and to compare whether there are differences according to obstetric and gynecological variables. Methods: A descriptive prospective longitudinal and correlational observational study was carried out. Non-probability sampling was carried out with 176 women. The Pregnancy-Related Anxiety Questionnaire and the Perceived Stress Scale were used. Results: The prevalence of anxiety was 23.9%, 17%, and 17.6%, and mean stress scores reached 32.24, 33.02, and 49.74 in the first, second, and third trimesters, respectively. In comparison, without miscarriages, anxiety was higher during the first trimester. In multiparous women who had suffered a miscarriage, anxiety was higher in the first trimester. Conclusions: Anxiety is higher during the first trimester. Mean stress levels are higher during the third trimester compared to the other two trimesters. Care for these vulnerable pregnant women can impact society’s health system and align with the Sustainable Development Goals of Health and Well-being and Gender Equality in others.

Introduction The concept of transition refers to the shift from hospital-based care to home-based palliative care, encompassing the physical, emotional, and logistical adjustments patients and families face. This study aimed to synthesize the experiences of people in palliative situations at home. Methods A systematic review using thematic synthesis was guided using Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) to organize the extracted information. Preparation of the qualitative synthesis followed ENTREQ—Enhancing transparency in reporting the synthesis of qualitative research recommendations. The literature search was carried out in MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection, ProQuest, and Worldcat, until October 31, 2023, for articles addressing the experiences of people over 18 years of age in a palliative situation at home. Data analysis employed thematic synthesis, involving inductive coding, development of themes, and interpretative synthesis to provide a comprehensive understanding of patient experiences. Results Of the 441 articles identified, 17 studies were included. Data analysis was guided by Meleis ‘s Theory of Transitions, and six distinct categories were included in the conditions of the transition (facilitators or inhibitors): “Personal Facilitators,” “Community Facilitators,” “Social Facilitators,” “Personal Inhibitors,” “Community Inhibitors,” and “Social Inhibitors.” Conclusions Findings indicate that the unique nature of the palliative condition and self-perception requires nursing care adapted to the person's experiences. The data collected and the analysis carried out in this thematic synthesis of the literature collectively contributed to identifying the facilitating and inhibiting factors regarding the complex transition process, considering the Theory of Transitions. The findings highlight the importance of personalized care approaches that address patients’ emotional, social, and logistical needs during the transition to home-based palliative care. They underscore the need for enhanced communication, caregiver support, and accessible healthcare resources to improve patient and family experiences, guiding future interventions and policy development in palliative care.

University students are at increased risk of developing burnout and psychological distress from high academic workloads and performance expectations. The purpose of this study is to analyze the relationship between psychological and lifestyle variables and academic burnout, as well as to identify burnout risk profiles in psychology students. This study used a cross-sectional design and included 274 Portuguese psychology students, the majority being undergraduates (72.6%). Participants were assessed on psychological well-being, psychological distress, difficulties in emotional regulation, type of diet, physical activity, sleep quality, and burnout. The results showed that psychological distress, difficulties in emotional regulation, and sleep quality were positively associated with burnout, while psychological well-being was negatively associated. Using machine learning algorithms, two distinct profiles were found: “Burnout Risk” and “No Risk”. A total of 62 participants were identified as belonging to the burnout risk profile, showing higher levels of distress, emotional regulation difficulties, poor psychological well-being and sleep quality, pro-inflammatory diet, and less physical activity. The accuracy of the three machine learning models—Random Forest, XGBoost, and Support Vector Machine—was 95.06%, 93.82%, and 97.53%, respectively. These results suggest the importance of health promotion within university settings, together with mental health strategies focused on adaptive psychological functioning, to prevent the risk of burnout.

This study investigates the perceptions and practices of Portuguese higher education students regarding the circular economy (CE), emphasising their knowledge, attitudes, and behaviours toward sustainable resource management. Carried out by the Working Group on Circular Economy and Waste Management of the Portuguese Sustainable Campus Network (RCS), the research used an online survey targeting students from 20 higher education institutions (HEIs), resulting in 400 responses. The findings indicate that while students generally hold positive views of the CE, their understanding of its practical applications, such as waste reduction and resource efficiency, remains limited. Only a small proportion of students reported exposure to CE-related topics in their curriculum, revealing a gap in academic integration. This study also identifies significant demographic variations in CE awareness and practices, influenced by factors such as age, field of study, and employment status. These insights underscore the need for HEIs to strengthen CE education and actively involve students in hands-on sustainability initiatives, fostering a generation equipped to drive the transition toward a circular economy.

BACKGROUND: Ankylosing spondylitis (AS) is a sustained inflammatory pathology that manifests as increasing rigidity and a continuous decline in spinal flexibility, leading to increasing lumbar pain during rest. OBJECTIVES: This study primarily aimed to evaluate depression assessments using the Beck Depression Inventory (BDI) and delineate depressive symptomatology in patients diagnosed with AS compared to those without this condition. DESIGN AND SETTING: A comparative study was conducted in Medical Centers in Málaga, Spain. METHODS: A cohort of 102 participants, with a mean age of 46,80 ± 10,54 years, was divided into two sets: 51 individuals diagnosed with AS (cases) and another 51 without AS (controls), each harmonized across variables such as body mass index, age, and sex. Demographic variables were systematically gathered from each participant, and the BDI responses were accurately recorded and subsequently analyzed for comparison. RESULTS: Of the total sample, the sex distribution was 29.4% male and 70.6% female. BDI scores were higher for the AS group (19.25 ± 15.5) than for the control group (5.33 ± 7). Notably, there were clear statistical differences (P < 0.01) in the BDI categories, with elevated levels observed in participants with AS. CONCLUSION: Individuals with AS experienced higher levels of depression than those without AS. Furthermore, there were sex differences within the case group, with a higher percentage of women than men at any level of depression. Notably, there was a moderate inverse correlation between the number of years since diagnosis and depression level. KEYWORDS (MeSH terms): Comorbidities; Anxiety; Behavioral symptoms; Bone diseases AUTHOR’S KEYWORDS: Beck depression inventory; Psychological assessment; Chronic inflammatory diseases

Background: Aging is a global phenomenon closely associated with changes in cognitive function and mental health. These conditions substantially burden public health systems and adversely affect the quality of life of older adults. This study aimed to examine changes in depressive symptoms and cognitive function over a 12-month follow-up period in a cohort of Brazilian older adults attending primary care. Methods: This observational longitudinal study included a randomized sample of individuals aged ≥60 years residing in São Paulo, Brazil, and registered at a Primary Healthcare Unit (PHU). Data collection involved administering a sociodemographic and health questionnaire along with two validated instruments: the Geriatric Depression Scale-15 (GDS-15) and the Mini-Mental State Examination (MMSE). Linear regression models were used for the analyses. Results: A total of 368 older adults were included, with 63% being men and a mean age of 74.65 years. After one year, depressive symptoms showed a notable increase, with the mean GDS-15 score rising from 5.97 to 7.48 (Cohen-d = 0.542). Likewise, there was a decrease in the mean MMSE score ranging from 19.11 to 18.88 (Cohen-d = 0.216). Adjusted regression analyses revealed that depressive symptoms at baseline (B = 0.696; p = 0.048; R² = 0.19) and cognitive function at baseline (B = 0.444; p < 0.001; R² = 0.26) were predictive of their respective deteriorations over the follow-up period. Conclusions: Depressive symptoms and cognitive decline place a significant burden on public health systems in aging societies. These findings underscore the importance of continuous monitoring and early intervention strategies to mitigate their impact and enhance the quality of life for older adults.

Worldwide non‐health professionals and volunteers (NHPV) in humanitarian settings assist asylum seekers, and they need to be empowered to recognise and refer people with mental health problems and provide psychosocial support in multicultural contexts. The APT4U2 program, aligned with mental health nurses' competencies, addresses this gap. The aim of this study was to present the development of a standardised training program for NHVP work with young asylum seekers. Following the development phase of the Medical Research Council's Complex Interventions methodology, the study follows the main steps: I – Mapping existing evidence on mental health training programs for NHPV working with asylum seekers and refugees; II – Identifying NHPVs' training needs and experiences and III – Developing the APT4U2 Program. The program underwent validation by eight experts in mental and psychiatric nursing, education, public health and psychology. The APT4U2 Program is prepared for 11 h and consists of three modules and five lessons. The APT4U2 Program is an easy‐to‐use training program constructed and to be administered by mental health nurses to NHPV who want to work with young asylum seekers. This evidence can guide mental health nurses in training worldwide NHPV who work with asylum seekers.

This paper presents a dataset from a study analyzing lower limb movement during a 10-meter walk test. The study utilized SensorTileBox sensors integrated into shin pads to capture detailed movement and environmental data from participants. The sensors recorded 3D accelerometer data (in milligravities), 3D gyroscope data (degrees per second), magnetometer readings (milligauss), and temperature (°C). The dataset was collected through a custom-made application that initiated the sensor readings while the patient performed the walk test. Alongside sensor data, additional demographic and health information, including age, gender, physical exercise habits, diet, and health conditions, were collected via a form stored in a YML file. This information provides context for the sensor measurements and allows for comprehensive analysis. All sensor measurements are time-stamped and stored in CSV format, with participant-specific data anonymized and organized in folders by numeric identifiers. This dataset offers a valuable resource for studying movement patterns in relation to physiological and lifestyle factors, particularly for elderly individuals. It could support research in biomechanics, rehabilitation, and sensor-based health monitoring.

Objective The goal of this review is to identify and map health professionals’ attitudes and behaviors that promote humanization of the care provided to adults with cancer, regardless of disease stage or treatment nature, in all health care provision contexts. Introduction In the challenging context of oncology care, it becomes imperative to adopt a humanized care paradigm. This paradigm should foster a relationship of respect and compassion between health professionals and people, and its interventions should be sensitive to their values, culture, and human dignity. Inclusion criteria Studies involving health professionals’ attitudes and behaviors focused on promoting humanization of the health care provided to people with oncological diseases will be considered for this review. Methods This review will follow the JBI methodology for scoping reviews. Publications will be identified via MEDLINE Complete, CINAHL Complete, MedicLatina, Psychology and Behavioral Sciences Collection, Scopus, and Web of Science. Additionally, backward and forward citation searches will be conducted, as will a thorough investigation of the gray literature. The studies identified will be screened by 2 independent reviewers based on their title and abstract, and then reviewed at the full-text level. The data will be extracted using a tool developed by the authors. The results will be summarized and presented in tables accompanied by a narrative summary. Review registration Open Science Framework https://osf.io/56ev9/

Background In the history of Neonatology, decades ago pain has been little studied because it was believed that newborns didn’t have the capacity to experience pain. Nowadays, there is enough evidence for the existence of neonatal pain but its adequate treatment is an aspect that is continuously evolving. The objective of this study was to evaluate the effectiveness of non-pharmacological analgesia therapies used to alleviate pain in newborns by analysing neonatal cortisol levels as biological markers of pain. Methods A systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the Cochrane Collaboration Handbook. Searches were performed in databases such as PubMed, Web of Science, Scopus, CINAHL, Cochrane Library and Science Direct until the end of May 2024. The search identified 1075 articles, of which 10 studies met the inclusion criteria and had the necessary data to develop the meta-analysis. Furthermore, in each meta-analysis, subgroups were performed: non-pharmacological analgesia vs. placebo, and pre-post intervention by gestational age. Results The meta-analysis found that breastfeeding exhibited a moderate effect size (SMD = -0.63; 95% CI = -1.07 to -0.19), sucrose showed a small effect (SMD = -0.15; 95% CI = -0.55 to 0.26), and skin to skin contact exhibited a large effect (SMD = -1.34; 95% CI = -2.21 to -0.46). Patients under 28 weeks have less post-intervention pain and showed a large effect (SMD = 1.44; 95% CI = 0.47 to 2.40), between 28 and 32 weeks they have more post-intervention pain and presented a small effect (SMD = -0.43; 95% CI = -0.86 to -0.0), and over 32 weeks they have an increased post-intervention pain and exhibited a large effect (SMD = -1.08; 95% CI = -1.65 to -0.51). Conclusions Non-pharmacological therapies showed efficacy in pain reduction based on neonatal cortisol levels. Skin to skin contact is the most effective method to reduce pain from invasive procedures, such as heel pricks in preterm infants under 28 weeks. Breastfeeding also demonstrated to be an effective and safe alternative to use for pain relief and to reduce cortisol levels. However, the cortisol results indicate that sucrose was not effective in reducing neonatal pain. Trial registration PROSPERO: CRD42023463831.

Introduction With the increase in the number of informal caregivers, their training becomes essential. The supervisory programs implemented by nurses play a leading role in caregiver training. Objectives To map the supervisory programs implemented by nurses to caregivers in the community. Methods A scoping review will be developed according to the guidelines of the Joanna Briggs Institute. Studies published and unpublished in English, Portuguese or Spanish since 1993 will be considered. The results of the research, study selection and inclusion process will be presented in a PRISMA flowchart for scoping reviews. Results Mapping the evidence will allow us to analyze the supervision programs implemented by nurses for caregivers in the community. The results will be presented through an extraction table according to the objectives. Conclusion This review is expected to constitute a starting point for the critical analysis of studies relating to supervisory programs implemented by nurses for caregivers.

Mental health literacy (MHL) is defined as the ability to obtain, understand, and use information to identify, manage, and prevent mental health problems and helps university health students to manage mental health challenges by reducing stigma, fostering resilience, and promoting coping strategies. Objectives: To assess MHL levels in Portuguese university health students and explore its relationship with academic life and psychosocial domains; Identify knowledge gaps and educational needs regarding a targeted MHL intervention. Methods: A convergent parallel mixed-methods study, involving collecting quantitative (online cross-sectional survey) and qualitative (focus group) data simultaneously, followed by a separate and integrative analysis. Results: Twenty-four students (75% female, mean age = 25.5) were included. Overall, differences were found in the MHL domains in terms of sex (p = 0.025), mental health history variables (p = 0.020; p = 0.044; p = 0.007), and a negative relation with academic environment satisfaction (rs = −0.571). Focus groups revealed the needs, gaps, and main characteristics for a targeted intervention. Integrative analysis used for data triangulation was possible and helped to converge and reinforce some of the data findings. Conclusions: This study highlights the importance of integrated methodological approaches to explore MHL among undergraduate health students. Also, it highlights the importance of promoting MHL through targeted interventions to enhance well-being and reduce distress in academic contexts.

Objectives: To analyze the effects of the combination of Extra Virgin Olive Oil (EVOO) supplementation and a health-related lifestyle intervention on disease activity and cardiovascular disease risk factors in Systemic Lupus Erythematosus (SLE). Methods: A total of 38 women with SLE were randomly assigned to EVOO (n = 9) and EVOO combined with multicomponent health promotion and physical exercise program (EVOO + HRLI) (n = 15) or control (CG) (n = 14) groups for 24 weeks. Baseline and post-intervention assessments were performed, collecting data on disease activity, accrual damage, blood biochemical parameters, arterial stiffness parameters, Framingham risk score, anthropometric and body composition measurements, and cardiovascular risk factors. Results: No changes in disease activity were observed in any group after the intervention. For cardiovascular risk, significant differences were observed in the intervention groups for systolic and mean blood pressure, with greater reductions in the EVOO + HRLI (p = 0.036 vs. p < 0.001; p = 0.017 vs. p < 0.001, respectively). The EVOO group showed significant reductions in BFM and BFP (p = 0.042, p = 0.022, respectively). The EVOO+ HRLI group also showed significant reductions in triglycerides (p < 0.001), Aix brachial (p = 0.037), central systolic blood pressure (p < 0.001), central pulse pressure (p = 0.05), body mass index (p = 0.006), body fat mass and skeletal muscle mass (p = 0.039) after the intervention. Conclusions: Our findings suggest that a multidisciplinary program integrating nutritional interventions, health education, and the promotion of regular physical activity in SLE patients has the potential to significantly improve cardiovascular risk factors and body composition parameters. Thus, integrating this approach into clinical practice alongside usual pharmacological treatments would be beneficial for SLE patients. Clinical Trial Registration: NCT05261529.

To maximize the potential of sex education, it is essential to optimize aspects related to the environment, the trainer–trainee interaction, and the quality of training. The objective of the present study was to identify and describe the satisfaction of higher education students with sex education training. An exploratory, descriptive, and cross-sectional study was carried out using the Student Satisfaction with Higher Education questionnaire, which was applied to a sample of 132 higher education students from several countries. In the statistical analysis using the SPSS software version 28, non-parametric tests were used, namely, the Mann–Whitney test and the Kruskal–Wallis test, in addition to Spearman’s correlation coefficient. Overall, the participants considered themselves very satisfied with the sex education training provided (χ = 4.77). The largest contribution to the satisfaction of the higher education students with the sex education training was the “quality of the training organization (environment and content)” (χ = 4.79). Educators and policymakers have the role of designing, implementing, and evaluating programs that satisfy college students and encourage them to strive for more sex education training aimed at promoting well-being, happiness, and sexual health.

Aim This study aimed to identify the content of documentation used between hospital and community care and describe the communication mechanisms that allow the continuity of care. Design We conducted a scoping review following the JBI recommendations. Methods The sources of the information used were obtained from the MEDLINE and CINAHL databases (via EBSCO), Web of Science, SCOPUS, Joanna Briggs Institute and Cochrane Database of Systematic Reviews. Additionally, grey literature was included. The databases searched from 2018 to 2023 for articles written in English and Portuguese. Two researchers independently screened articles based on inclusion and exclusion criteria, and a third researcher adjudicated disagreements. Results We retrieved 3217 articles, of which 5 were included. Six themes were summarised from these articles: Communication and information between clinical practice environments; Discharge letter content; The use of technologies in healthcare communication; Client empowerment in information communication; Factors hindering the safe transition of information between hospital and community; and Benefits of secure information transition between hospital and community. Implications for the Profession and/or Patient Care The results allow systematisation of the information that should accompany the person at the time of discharge to ensure the continuity of transitional care, including the patient/family's own perception of their difficulties and needs. Reporting Method PRISMA 2020.

Unlabelled: Psychic suffering is typical of the human condition and involves multideterminant factors in its origin, with significant influence from affective-relational-economic issues, invariably marked by negative and positive experiences. Objective: The objective of this study is to describe the process of construction and content validation of a set of nursing actions to integrate a mobile educational technology to assist individuals in psychic distress in primary health care. Methods: This was a methodological study in four stages: scope review, qualitative research, elaboration of a set of nursing actions and content validation. It was carried out from December/2022 to December/2023, with 16 Brazilian specialists, a minimum Content Validity Index of 80% and Cronbach's Alpha (α). Results: Six sets of actions were elaborated and evaluated: nursing actions in the initial assessment of the individual in psychic distress (99% α 0.47); nursing actions towards individuals in psychic distress with complaints associated with Depressive Disorder (93.4% α 0.84); nursing actions towards individuals in psychic distress with complaints associated with Anxiety Disorder (95.4% α 0.88); nursing actions towards individuals in psychic distress with Suicidal Ideation (96.3% α 0.71); nursing actions towards individuals in psychic distress resulting from the use of psychoactive substances (99.6% α 0.77) and; nursing actions towards individuals in psychic distress as a result of grief situations (98.6% α 0.28). Conclusions: The set of actions proved to be validated and to have acceptable reliability, thus contributing to supporting the development of educational technology. The conclusions of this research highlight the possibility for nurses to conduct nursing actions in the care of people in psychic distress, in a non-specialized context. In addition, this is a resource to improve the routine mental health care of nurses who work in primary health care.

Background/Objectives: Total knee Arthroplasty (TKA) is a prevalent treatment modality for degenerative knee diseases. Nevertheless, the success of the intervention is contingent on effective rehabilitation. The +PERTO® program (a Technological Rehabilitation Nursing Program) was developed as a mobile application comprising three phases to support patients during the perioperative period by providing exercises, information, and direct communication with healthcare professionals. The present study aims to evaluate the effects and usability of the +PERTO® program in patients undergoing total knee arthroplasty. Methods: In 2024, a hospital in northern Portugal conducted a pilot trial with eleven patients undergoing elective total knee arthroplasty. Researchers collected data both before surgery and six weeks after discharge. To evaluate effectiveness, software satisfaction, and usability, they used several assessment tools, including the Oxford Knee Score (OKS), SF-36v2, Visual Analog Scale (VAS), Short Physical Performance Battery (SPPB), QSEnf-10, and System Usability Scale (SUS). Researchers analyzed the data using both descriptive and inferential statistics. The hospital’s ethics committee and board of directors approved the study. Results: There was a significant reduction in pain (p = 0.041) and improvement in knee functionality (p = 0.010), physical performance (p = 0.038), and quality of life (p < 0.05). Patient satisfaction was high (QSEnf-10: 3.8/4), and the usability of +PERTO® was considered excellent (SUS: 96.6/100). Conclusions: The +PERTO® program proved to be an effective and innovative solution to support rehabilitation after TKA, promoting improvements in pain, functionality, and quality of life. This digital program stands out for its high rate of usability and its ability to modernize healthcare by providing a patient-centered approach.

Objectives: to evaluate health gains sensitive to nursing care in the context of long-term home care. Methods: this was a quantitative, retrospective study carried out in the north of Portugal. The sample consisted of 151 users aged 18 or over. Descriptive and correlational analysis, non-parametric tests and exploratory factor analysis were carried out. Results: the results revealed that the patients admitted were an ageing, dependent population with multimorbidities and low potential for rebuilding autonomy. The care provided by the home care team had a positive impact on improving functionality, controlling symptoms, reducing pressure ulcers and the risk of falls. Conclusions: there is an urgent need for effective investment in promoting home care, guaranteeing timely and equitable access to health care. It is necessary to invest in effective, efficient public policies, driven by social and economic sustainability, in order to guarantee better health outcomes for the population. Descriptors: Home Care Services; Health Gains; Long-Term Care; Aging; Nursing