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- The use of non-pharmacological interventions for the comfort of patients in palliative care: a scoping review protocolPublication . Coelho, Adriana; Parola, Vítor; Cardoso, Daniela; Escobar, Miguel; Apóstolo, JoãoThe objective of this scoping review is to examine and map the non-pharmacological interventions implemented and evaluated to provide comfort in palliative care. More specifically, the review will focus on the following questions: 1. What non-pharmacological interventions have been implemented and evaluated to provide comfort in patients with incurable and advanced diseases? 2. What are the characteristics (duration, dose and frequency) of these interventions? 3. In what contexts (home care, palliative care unit or hospice) are the non-pharmacological interventions implemented and evaluated? 4. In which populations (cancer and non-cancer patients) are the non-pharmacological interventions implemented and evaluated?
- Review of mental health first aid programsPublication . Costa, Tiago; Sampaio, Francisco; Sequeira, Carlos; Ribeiro, Isilda; Parola, VítorMental health first aid programs are interventions to empower the community to help people with mental health problems/ crises. A review of these programs was conducted in accordance with the guidelines of the Joanna Briggs Institute. Published and unpublished works from 2009 to 2019 were considered. The review included 252 studies. Several Mental Health First Aid programs were identified, with varying characteristics, participants, and contexts of implementation. These group interventions were carried out among lay people to health professionals, and in adolescents to the elderly. Additionally, they were conducted in-person and/or virtually, using psychoeducational methods and informational materials. The programs ranged from 30 minutes to 24 hours. These interventions can address nursing foci, and the characteristics of the facilitators are similar to those of mental health nurses. Therefore, this review highlighted the opportunity for nurses to explore Mental Health First Aid programs.
- The effects of guided imagery on comfort in palliative carePublication . Coelho, Adriana; Parola, Vítor; Sandgren, Anna; Fernandes, Olga; Kolcaba, Katharine; Apóstolo, JoãoGuided imagery (GI) is a nonpharmacological intervention that is increasingly implemented in different clinical contexts. However, there have been no studies on the effect of GI on the comfort of inpatients of palliative care (PC) units. Therefore, the aim of this study was to evaluate the effects of GI on the comfort of patients in PC. A 1-group, pretest-posttest, pre-experimental design was used to measure differences in heart rate, respiratory rate, pain, and comfort in patients (n = 26) before and after a 2-session GI program. The intervention featuring GI increased comfort, measured by an Abbreviated Holistic Comfort Scale and the visual analog comfort scale (P < .001), and decreased heart rate (P < .001), respiratory rate (P < .001), and pain, as measured by the (numerical) visual analog pain scale (P < .001). This study demonstrates that the use of an intervention featuring GI increases the comfort of oncology patients admitted to a PC unit. The use of GI by nurses is inexpensive, straightforward to implement, and readily available and may result in the provision of comfort care.
- Inovar a praxe: integração numa escola de enfermagem promotora de saúde – Escola Superior de Enfermagem de Coimbra. In I. Brito (Cood), Pesquisa-Ação Participativa na Co-Criação de Instituições de Ensino Superior Promotoras de Saúde.Publication . Pedroso, R; Perdigão, A; Armando, S; Brito, I; Paiva, L; Simões, M; Simões, C; Margalho, M; Neves, M; Cristina, R; Lopes, R; Coutinho, V; Parola, Vítor
- Efficacy of reminiscence in cognition, depressive symptoms and quality of life in institutionalized elderly: a systematic reviewPublication . Gil, Isabel; Costa, Paulo; Parola, Vítor; Cardoso, Daniela; Almeida, Maria; Apóstolo, JoãoObjective: To identify the best available evidence on the efficacy of Reminiscence Therapy in cognition, depressive symptoms and quality of life in elderly individuals with cognitive impairment. Method: The methodology proposed by the Joanna Briggs Institute was used. Studies focused on group Reminiscence Therapy aimed at institutionalized elderly people with cognitive impairment aged 65 or over were considered. The critical analysis, extraction and synthesis of results was performed by two independent researchers. Results: Four randomized clinical trials and two quasi-experimental studies (n=296) were included. Given the heterogeneous characteristics of studies found, it was impossible to perform a meta-analysis. Of the six studies included, two presented statistically significant results for efficacy in cognition, and three for efficacy in reducing depressive symptoms. In none of the studies was evaluated the elderly’s quality of life. Conclusion: Reminiscence Therapy has potential efficacy for maintaining cognition and decrease of depressive symptomatology in the target population.
- Use of non-pharmacological interventions for comforting patients in palliative carePublication . Coelho, Adriana; Parola, Vítor; Cardoso, Daniela; Bravo, Miguel Escobar; Apóstolo, JoãoPalliative care aims to provide the maximum possible comfort to people with advanced and incurable diseases. The use of non-pharmacological interventions to promote comfort in palliative care settings has been increasing.However, information on implemented and evaluated interventions, their characteristics, contexts of application, and population is scattered in the literature, hampering the formulation of accurate questions on the effectiveness of those interventions and, consequently, the development of a systematic review.
- Caring in palliative care - a phenomenological study of nurses’ lived experiencesPublication . Parola, Vítor; Coelho, Adriana; Sandgren, Anna; Fernandes, Olga; Apóstolo, JoãoProviding palliative care involves serious challenges for nurses, such as end-of-life decisions, contact with people's suffering and dying, and increased risk of burnout. However, studies have revealed that the burnout level of health professionals working in palliative care is lower than that of health professionals working in other settings. This study aimed to describe the lived experiences of nurses caring in a palliative care unit. A phenomenological descriptive study was undertaken. Nine nurses were recruited from a palliative care unit in Portugal. Data were collected using individual interviews and analyzed following the method of Giorgi. Five themes reflect the essence of the lived experience: (1) experience centered on the relationship with the other (ie, the patient and the family), (2) experience centered on the relationship with one's own self, (3) exhausting experience, (4) rewarding experience, and (5) the team as a pillar. These findings can be valuable for understanding the challenges and strategies experienced by nurses caring in palliative care and for designing interventions that focus on reducing the risk of burnout among nurses-not only those working in palliative care but also those working in other contexts who experience regular contact with suffering and death.
- Burnout in palliative care settings compared with other settingsPublication . Parola, Vítor; Coelho, Adriana; Cardoso, Daniela; Sandgren, Anna; Apóstolo, JoãoA systematic review, using the guideline of the Joanna Briggs Institute, was conducted to explore the effect of working in palliative care settings, compared with other settings, on burnout among health care professionals. Multiple databases were searchedVCINAHL, PubMed, Scopus, and SciELOVas well as gray literature for studies published since 1975 that compared health professionals caring for patients older than 18 years in specialized palliative care settings (palliative care units, home care, or hospices) with health professionals working in other settings. Of the 539 studies retrieved, 7 cross-sectional studies were included in this review. Of these, six were conducted with nurses, and six used theMaslach Burnout Inventory.Working in palliative care (palliative care unit or hospices) was associated with lower levels of emotional exhaustion and depersonalization, as well as higher levels of personal accomplishment, compared with working in other settings. Evidence indicates that burnout levels seem to be lower among professionalsworking in palliative care compared with professionals working in other settings. Further research is needed to explore the strategies used by nurses working in palliative care that help them deal with burnout and to apply these same strategies to professionals working in other settings.
- Versión española del Hospice Comfort Questionnaire para evaluar el confort en pacientes en cuidados paliativos: Adaptación transcultural y validaciónPublication . Neves Coelho, Adriana; Parola, Vítor; Escobar Bravo, Miguel; Alves Apóstolo, JoãoObjetivo: Traducir, adaptar y validar el Hospice Comfort Questionnaire para su utilización en el ámbito de los cuidados paliativos españoles. Método: Han participado en este estudio un total de 67 pacientes ingresados en una Unidad de Cuidados Paliativos. El instrumento empleado ha sido el Hospice Comfort Questionnaire. Se adoptó una metodología dirigida a la equivalencia semántica, idiomática y conceptual del contenido de los ítems y la equivalencia psicométrica, mediante la evaluación de la fiabilidad, la validez de contenido y de criterio. Resultados: Respecto a la fiabilidad, se observaron comportamientos poco consistentes con el resto de la escala en siete ítems, que presentaran una correlación inferior a 0,20. Teniendo en cuenta los datos estadísticos y el análisis crítico de contenido de los ítems, se decidió eliminar solamente tres ítems. Una vez reducida la escala a 46 ítems, se midió la consistencia interna del total de la escala con un α de Cronbach de 0,89 y de cada grupo de ítems de cada estado del confort. El alfa de Cronbach del alivio fue de 0,72, de la tranquilidad 0,73, y de la trascendencia 0,75. Se constató validez de criterio a través del coeficiente de correlación de Spearman, obteniendo una correlación de 0,805 entre el Hospice Comfort Questionnaire versión española y la Escala Visual Analógica de Confort. Conclusiones: Los resultados muestran que la versión española del Hospice Comfort Questionnaire es un instrumento de evaluación de confort en cuidados paliativos con garantías psicométricas de calidad (buena fiabilidad y validez).
- The prevalence of burnout in health professionals working in palliative carePublication . Parola, Vítor; Coelho, Adriana; Cardoso, Daniela; Gea-Sanchez, Montserrat; Blanco-Blanco, Joan; Apóstolo, JoãoThe objective of this review is to examine the evidence on the prevalence of burnout among health professionals working in palliative care.More specifically, the review focuses on the following questions: What is the prevalence of burnout among health professionals working in palliative care? Is there a difference in the prevalence of burnout in different subgroups of health professionals working in palliative care (such as, but not limited to, nurses, physicians, social workers, psychologists)? Is there a difference in the prevalence of burnout among health professionals working in different contexts of palliative care (palliative care units, home care, hospices)?
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