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Silva-Cardoso J, Santos J, Araújo I, Andrade A, Morais Sarmento P, Santos P, Moura B, Marques I, Peres M, Ferreira JP, Agostinho J, Pimenta J. conTemporary reflectiOns regarding heart failure manaGEmenT - How to ovERcome the PorTuguese barriers (TOGETHER-PT). Rev Port Cardiol 2024; 43:225-235. [PMID: 37689388 DOI: 10.1016/j.repc.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/11/2023] [Accepted: 05/02/2023] [Indexed: 09/11/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Heart failure (HF) is a complex clinical syndrome that is a significant burden in hospitalisations, morbidity, and mortality. Although a significant effort has been made to better understand its consequences and current barriers in its management, there are still several gaps to address. The present work aimed to identify the views of a multidisciplinary group of health care professionals on HF awareness and literacy, diagnosis, treatment and organization of care, identifying current challenges and providing insights into the future. METHODS A steering committee was established, including members of the Heart Failure Study Group of the Portuguese Society of Cardiology (GEIC-SPC), the Heart Failure Study Group of the Portuguese Society of Internal Medicine (NEIC-SPMI) and the Cardiovascular Study Group (GEsDCard) of the Portuguese Association of General and Family Medicine (APMGF). This steering committee produced a 16-statement questionnaire regarding different HF domains that was answered to by a diversified group of 152 cardiologists, internists, general practitioners, and nurses with an interest or dedicated to HF using a five-level Likert scale. Full agreement was defined as ≥80% of level 5 (fully agree) responses. RESULTS Globally, consensus was achieved in all but one of the 16 statements. Full agreement was registered in seven statements, namely 3 of 4 statements for patient education and HF awareness and 2 in 4 statements of both HF diagnosis and healthcare organization, with proportions of fully agree responses ranging from 82.9% to 96.7%. None of the HF treatment statements registered full agreement but 3 of 4 achieved ≥80% of level 4 (agree) responses. CONCLUSION This document aims to be a call-to-action to improve HF patients' quality of life and prognosis, by promoting a change in HF care in Portugal.
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Affiliation(s)
- José Silva-Cardoso
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal.
| | - Jonathan Santos
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; ARS Norte, ACES Vale Sousa Norte, USF Torrão, Portugal
| | - Inês Araújo
- Clínica de Insuficiência Cardíaca, Serviço de Medicina III, Hospital S. Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal; NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Aurora Andrade
- Serviço de Cardiologia, Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
| | - Pedro Morais Sarmento
- Departamento de Medicina Interna e Hospital de Dia de Insuficiência Cardíaca do Hospital da Luz de Lisboa, Lisboa, Portugal
| | - Paulo Santos
- CINTESIS - Centre for Health Technology and Services Research, Porto, Portugal; RISE - Health Research Network, Portugal; MEDCIDS, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Brenda Moura
- Serviço de Cardiologia, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Irene Marques
- Serviço de Medicina Interna, Centro Hospitalar Universitário do Porto (CHUPorto), Porto, Portugal; Unidade Multidisciplinar de Investigação Biomédica - Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Marisa Peres
- Serviço de Cardiologia, Hospital de Santarém, Santarém, Portugal
| | - João Pedro Ferreira
- Unic@RISE, Serviço de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Université de Lorraine, Inserm, Centre d'Investigations Cliniques-Plurithématique 14-33, and Inserm U1116, CHRU, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Nancy, France
| | - Joao Agostinho
- Serviço de Cardiologia, Departamento de Coração e Vasos, Hospital de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisboa, Portugal; CCUL, Centro Académico de Medicina de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Joana Pimenta
- Serviço de Medicina Interna, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; UnIC@RISE, Departamento de Medicina, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
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Gürarslan Baş N, Karatay G, Arikan D. Weaning practices of mothers in eastern Turkey. J Pediatr (Rio J) 2018; 94:498-503. [PMID: 28893515 DOI: 10.1016/j.jped.2017.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 05/30/2017] [Accepted: 06/14/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The study aimed to determine the practices used by breastfeeding mothers to wean their children from the breast. METHOD This qualitative-quantitative research was conducted with mothers whose children were registered the pediatric clinics of a state hospital between June and September 2016. In accordance with a purposeful sampling method, 232 mothers of children between the ages of 2 and 5 years were included in the study. Data were collected through face-to-face interviews using a questionnaire with demographic characteristics of mothers as well as their weaning practices. The data obtained were analyzed with a computer-assisted program using number and percentage distributions. RESULTS The mean breastfeeding duration was 19.00±7.11 months. It was determined that the majority of mothers (56.5%) used traditional methods for weaning their children. These included applying substances with a bad taste (58.1%) to their breasts, covering their breasts with various materials (26.2%) to make the child not want to nurse anymore, and using a pacifier or feeding bottle (9.2%) to substitute for the mother's breast. CONCLUSIONS It was observed that more than half of the mothers were used some traditional practices that could cause trauma in their children, instead of natural weaning.
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Affiliation(s)
| | - Gülnaz Karatay
- Munzur University, School of Health Science, Tunceli, Turkey
| | - Duygu Arikan
- Atatürk University, Nursing Faculty, Erzurum, Turkey
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Cassol PB, Quintana AM, de Campos Velho MTA. LIFE SUPPORT USE: PERCEPTION OF THE NURSING STAFF IN HAEMATO ONCOLOGY. Revista Baiana Enferm 2015; 29:106-114. [PMID: 35027779 PMCID: PMC8754392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The aim was to understand the perception of the nursing staff of a haemato-oncology inpatient unit on the use of life support in case of offend-of-life situations. This is qualitative research, with 23 professionals from nursing staff (nurses, nursing technicians and nursing assistants) of a teaching Hospital in southern Brazil. For the production of the data the semi-directed interview was used, recorded during September and October 2013, being interpreted by category content analysis. The results evidenced the dilemma in which the use of vital support is perceived as suffering for the terminally-ill patient, but cannot be dissociated from care practices. It is concluded that the perceptions of the nursing staff is ambiguous, due to the different sentiments caused by the use of technologywith the terminally ill. Thus, it may be considered that approach and reflections during training can help to minimize the conflicts in professional performance.
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Affiliation(s)
- Paulo Barrozo Cassol
- Mestre em Enfermagem. Mestrando em Extensão Rural. Especialista em Educação Ambiental pela Universidade Federal de Santa Maria (UFSM). Especialista em Gestão Hospitalar. Graduado em Enfermagem pela UFSM. Membro do Grupo de Pesquisa Cuidado à Saúde das Pessoas, Famílias e Sociedade. Membro do Comitê de Bioética do Hospital Universitário de Santa Maria
| | - Alberto Manuel Quintana
- Doutor em Ciências Sociais, Postdoc em Bioética. Professor Titular do Departamento de Psicologia da Universidade Federal de Santa Maria
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Cruz MJB, Dourado LFN, Bodevan EC, Andrade RA, Santos DF. Medication use among children 0-14 years old: population baseline study. J Pediatr (Rio J) 2014; 90:608-15. [PMID: 24953722 DOI: 10.1016/j.jped.2014.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 03/27/2014] [Accepted: 03/28/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Determine the prevalence of medication use in children and adolescents in 20 municipalities of Vale do Jequitinhonha, Minas Gerais-Brazil, showing the main groups and variables that may have influenced use. METHODS Descriptive population-based survey sample of 555 interviews, selected by simple random cluster sampling of 137 census tracts. Inclusion criteria were age ≤ 14 years, mandatory interview with the legal guardians, and regardless of having received medications. Regarding the usage pattern, participants were divided into two groups: consumption and non-consumption of drugs. A descriptive analysis of the variables and tests of association were performed. RESULTS The prevalence of drug consumption was 56.57%, and 42.43% showed no consumption. The use of medicinal plants was 72.9% for drug users and 74.3% for non-users. The health conditions for consumption were cough, common cold, flu, nasal congestion or bronchospasm (49.7%), fever (5.4%), headache (5.4%), diarrhea, indigestion, and abdominal colic (6.7%). In cases of self-medication, 30.57% of the drugs were given by the mother, and 69.42% were prescription drugs. Self-medication was prevalent using paracetamol (30.2%), dipyrone (20.8%), and cold medicine (18.8%). There was increased use of analgesics/antipyretics, followed by respiratory medications, systemic antibiotics, histamine H1 antagonists, and vitamins/antianemics. CONCLUSIONS The prevalence of drugs use in children was high, indicating the need for formulating educational programs aiming at the awareness of caregivers regarding rational use.
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Affiliation(s)
- Maria J B Cruz
- Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil.
| | - Lays F N Dourado
- Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Emerson C Bodevan
- Faculdade de Ciências Exatas e Tecnológicas, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Renata A Andrade
- Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
| | - Delba F Santos
- Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
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Aycan IO, Celen MK, Yilmaz A, Almaz MS, Dal T, Celik Y, Bolat E. [Bacterial colonization due to increased nurse workload in an intensive care unit]. Rev Bras Anestesiol 2014; 65:180-5. [PMID: 25990495 DOI: 10.1016/j.bjan.2014.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 05/02/2014] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION the rates of multiresistant bacteria colonization or infection (MRB+) development in intensive care units are very high. The aim of this study was to determine the possible association between the risk of development of nosocomial infections and increased daily nurse workload due to understaffing in intensive care unit. METHODS we included 168 patients. Intensity of workload and applied procedures to patients were scored with the Project de Recherché en Nursing and the Omega scores, respectively. The criteria used for infections were those defined by the Centers for Disease Control. RESULTS of the 168 patients, 91 (54.2%) were female and 77 (45.8%) were male patients. The mean age of female and male was 64.9±6.2 years and 63.1±11.9 years, respectively. The mean duration of hospitalization in intensive care unit was 18.4±6.1 days. Multiresistant bacteria were isolated from cultures of 39 (23.2%) patients. The development of MRB+ infection was correlated with length of stay, Omega 1, Omega 2, Omega 3, Total Omega, daily PRN, and Total PRN (p<0.05). There was no correlation between development of MRB+ infection with gender, age and Apache-II scores (p>0.05). CONCLUSION the risk of nosocomial infection development in an intensive care unit is directly correlated with increased nurse workload, applied intervention, and length of stay. Understaffing in the intensive care unit is an important health problem that especially affects care-needing patients. Nosocomial infection development has laid a heavy burden on the economy of many countries. To control nosocomial infection development in the intensive care unit, nurse workload, staffing level, and working conditions must be arranged.
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Affiliation(s)
- Ilker Onguc Aycan
- Departamento de Anestesiologia e Reanimação, Dicle University Hospital, Diyarbakir, Turquia.
| | - Mustafa Kemal Celen
- Departamento de Doenças Infecciosas, Dicle University Hospital, Diyarbakir, Turquia
| | - Ayhan Yilmaz
- Departamento de Anestesiologia e Reanimação, Women Health and Gynecological Hospital, Diyarbakir, Turquia
| | - Mehmet Selim Almaz
- Departamento de Anestesiologia e Reanimação, Lice States Hospital, Diyarbakir, Turquia
| | - Tuba Dal
- Departamento de Microbiologia, Dicle University Hospital, Diyarbakir, Turquia
| | - Yusuf Celik
- Departamento de Bioestatística, Dicle University Hospital, Diyarbakir, Turquia
| | - Esef Bolat
- Departamento de Anestesiologia e Reanimação, Bozok University Hospital, Yozgat, Turquia
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Aycan IO, Celen MK, Yilmaz A, Almaz MS, Dal T, Celik Y, Bolat E. Bacterial colonization due to increased nurse workload in an intensive care unit. Braz J Anesthesiol 2014; 65:180-5. [PMID: 25925029 DOI: 10.1016/j.bjane.2014.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 05/02/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION The rates of multiresistant bacteria colonization or infection (MRB+) development in intensive care units are very high. The aim of this study was to determine the possible association between the risk of development of nosocomial infections and increased daily nurse workload due to understaffing in intensive care unit. METHODS We included 168 patients. Intensity of workload and applied procedures to patients were scored with the Project de Recherché en Nursing and the Omega scores, respectively. The criteria used for infections were those defined by the Centers for Disease Control. RESULTS Of the 168 patients, 91 (54.2%) were female and 77 (45.8%) were male patients. The mean age of female and male was 64.9 ± 6.2 years and 63.1 ± 11.9 years, respectively. The mean duration of hospitalization in intensive care unit was 18.4 ± 6.1 days. Multiresistant bacteria were isolated from cultures of 39 (23.2%) patients. The development of MRB+ infection was correlated with length of stay, Omega 1, Omega 2, Omega 3, Total Omega, daily PRN, and Total PRN (p < 0.05). There was no correlation between development of MRB+ infection with gender, age and APACHE-II scores (p > 0.05). CONCLUSION The risk of nosocomial infection development in an intensive care unit is directly correlated with increased nurse workload, applied intervention, and length of stay. Understaffing in the intensive care unit is an important health problem that especially affects care-needing patients. Nosocomial infection development has laid a heavy burden on the economy of many countries. To control nosocomial infection development in the intensive care unit, nurse workload, staffing level, and working conditions must be arranged.
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Affiliation(s)
- Ilker Onguc Aycan
- Department of Anestesiology and Reanimation, Dicle University Hospital, Diyarbakir, Turkey.
| | - Mustafa Kemal Celen
- Department of Infection Diseases, Dicle University Hospital, Diyarbakir, Turkey
| | - Ayhan Yilmaz
- Department of Anestesiology and Reanimation, Women Health and Gynecological Hospital, Diyarbakir, Turkey
| | | | - Tuba Dal
- Department of Microbiology, Dicle University Hospital, Diyarbakir, Turkey
| | - Yusuf Celik
- Department of Biostatistic, Dicle University Hospital, Diyarbakir, Turkey
| | - Esef Bolat
- Department of Anestesiology and Reanimation, Bozok University Hospital, Yozgat, Turkey
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