Atividades de enfermagem que contribuem para a qualidade dos cuidados: análise fatorial confirmatória da escala / Actividades de enfermería que contribuyen para la calidad de los cuidados: análisis factorial confirmatoria de la escala / Nursing activities that contribute to the quality of care: confirmatory factorial analysis of the scale

Objetivo: analisar a estrutura fatorial da Escala de Percepção das Atividades de Enfermagem que Contribuem para a Qualidade dos Cuidados. Método: estudo metodológico com participação de 3.451 enfermeiros de 36 hospitais portugueses. Além da realização da análise fatorial confirmatória, para avaliação da confiabilidade do modelo fatorial obtido, utilizou-se o alfa de Cronbach e a confiabilidade compósita. Resultados: os pesos fatoriais da solução encontrada foram majoritariamente elevados; os valores dos índices de ajustamento do modelo foram razoáveis; o alfa de Cronbach foi elevado para a totalidade da escala e para cinco dimensões, sendo aceitável em apenas uma dimensão. A confiabilidade compósita também foi elevada em cinco dimensões, excepto em uma, considerada como aceitável. Todas as atividades apresentaram uma confiabilidade individual elevada. Conclusão: em comparação com a escala original, o modelo fatorial identificado contempla seis dimensões e não sete, produzindo uma escala confiável e válida, passível de aplicação no contexto hospitalar.

Objetivo: analizar la estructura factorial de la Escala de Percepción de las Actividades de Enfermería que Contribuyen para la Calidad de los Cuidados. Método: estudio metodológico con la participación de 3.451 enfermeros de 36 hospitales portugueses. Además de la realización del análisis factorial confirmatoria, para la evaluación de la fiabilidad del modelo factorial obtenido, se utilizó el alfa de Cronbach y la fiabilidad compuesta. Resultados: los pesos factoriales de la solución encontrada fueron mayoritariamente elevados; los valores de los índices de ajuste del modelo fueron razonables; el alfa de Cronbach fue elevado para la totalidad de la escala y para cinco dimensiones, siendo aceptable en apenas una dimensión. La fiabilidad compuesta también fue elevada en cinco dimensiones, excepto en una, considerada como aceptable. Todas las actividades presentaron una fiabilidad individual elevada. Conclusión: en comparación con la escala original, el modelo factorial identificado contiene seis dimensiones e no siete, produciendo una escala confiable y válida, pasible de aplicación en el contexto hospitalario.

Objective: to analyze the factorial structure of the Perception Scale of Nursing Activities that Contribute to the Quality of Care. Method: a methodological study with 3,451 nurses from 36 Portuguese hospitals. In addition to carrying out confirmatory factorial analysis, Cronbach's alpha and composite reliability were used to assess the reliability of the obtained factorial model. Results: the factorial weights of the solution found were mostly high; the values ​​of the model's adjustment indexes were reasonable; Cronbach's alpha was elevated for the entire scale and five dimensions, being acceptable in only one dimension. The composite reliability was also high in five dimensions, except for one, considered acceptable. All activities showed high individual reliability. Conclusion: Compared to the original scale, the identified factorial model contemplates six dimensions and not seven, producing a reliable and valid scale, which can be applied in the hospital context.

Presence of Cryptosporidium spp. and Giardia duodenalis in Drinking Water Samples in the North of Portugal

Cryptosporidium and Giardia are 2 protozoan parasites responsible for waterborne diseases outbreaks worldwide. In order to assess the prevalence of these protozoans in drinking water samples in the northern part of Portugal and the risk of human infection, we have established a long term program aiming at pinpointing the sources of surface water, drinking water, and environmental contamination, working with the water-supply industry. Total 43 sources of drinking water samples were selected, and a total of 167 samples were analyzed using the Method 1623. Sensitivity assays regarding the genetic characterization by PCR and sequencing of the genes, 18S SSU rRNA, for Cryptosporidium spp. and beta,-giardin for G. duodenalis were set in the laboratory. According to the defined criteria, molecular analysis was performed over 4 samples. Environmental stages of the protozoa were detected in 25.7% (43 out of 167) of the water samples, 8.4% (14 out of 167) with cysts of Giardia, 10.2% (17 out of 167) with oocysts of Cryptosporidium and 7.2% (12 out of 167) for both species. The mean concentrations were 0.1-12.7 oocysts of Cryptosporidium spp. per 10 L and 0.1-108.3 cysts of Giardia duodenalis per 10 L. Our results suggest that the efficiency in drinking water plants must be ameliorated in their efficiency in reducing the levels of contamination. We suggest the implementation of systematic monitoring programs for both protozoa. To authors' knowledge, this is the first report evaluating the concentration of environmental stages of Cryptosporidium and Giardia in drinking water samples in the northern part of Portugal.

Biological and Genetic Characterization of Cryptosporidium spp. and Giardia duodenalis Isolates from Five Hydrographical Basins in Northern Portugal

To understand the situation of water contamination with Cryptosporidium spp. and Giardia spp. in the northern region of Portugal, we have established a long-term program aimed at pinpointing the sources of surface water and environmental contamination, working with the water-supply industry. Here, we describe the results obtained with raw water samples collected in rivers of the 5 hydrographical basins. A total of 283 samples were analyzed using the Method 1623 EPA, USA. Genetic characterization was performed by PCR and sequencing of genes 18S rRNA of Cryptosporidium spp. and beta-giardin of Giardia spp. Infectious stages of the protozoa were detected in 72.8% (206 of 283) of the water samples, with 15.2% (43 of 283) positive for Giardia duodenalis cysts, 9.5% (27 of 283) positive for Cryptosporidium spp. oocysts, and 48.1% (136 of 283) samples positive for both parasites. The most common zoonotic species found were G. duodenalis assemblages A-I, A-II, B, and E genotypes, and Cryptosporidium parvum, Cryptosporidium andersoni, Cryptosporidium hominis, and Cryptosporidium muris. These results suggest that cryptosporidiosis and giardiasis are important public health issues in northern Portugal. To the authors' knowledge, this is the first report evaluating the concentration of environmental stages of Cryptosporidium and Giardia in raw water samples in the northern region of Portugal.