Transcultural Translation and Validation of Lasater Clinical Judgment Rubric©.

OBJECTIVES: to translate and cross-culturally validate the Lasater Clinical Judgment Rubric© (LCJR©) instrument for nursing students. METHODS: the application of LCJR-PT© was preceded by a linguistic translation into Portuguese, based on the translation-back-translation method. This psychometric study involved 32 nursing students from a program in Portugal. Data were collected through observations of two independent observers during the performance of the practices developed by the students, through the scenarios validated by experts of high and of medium-fidelity simulation. RESULTS: of the 64 observations obtained from the practices of nursing students, the value of intra-class correlations in the 4 aspects of the instrument exceeded 0.792. There was a global Cronbach's alpha of LCJR-PT© of 0.921 and 0.876 in Observers 1 and 2 respectively, with a statistically significant level of agreement. CONCLUSIONS: the LCJR-PT© is a valid and reliable instrument, demonstrating a high potential for its use in clinical education and nursing research.

Transcultural Translation and Validation of Lasater Clinical Judgment Rubric© / Tradução e Validação Transcultural da Lasater Clinical Judgment Rubric© / Traducción Transcultural y Validación de la Lasater Clinical Judgment Rubric©

ABSTRACT Objectives: to translate and cross-culturally validate the Lasater Clinical Judgment Rubric© (LCJR©) instrument for nursing students. Methods: the application of LCJR-PT© was preceded by a linguistic translation into Portuguese, based on the translation-back-translation method. This psychometric study involved 32 nursing students from a program in Portugal. Data were collected through observations of two independent observers during the performance of the practices developed by the students, through the scenarios validated by experts of high and of medium-fidelity simulation. Results: of the 64 observations obtained from the practices of nursing students, the value of intra-class correlations in the 4 aspects of the instrument exceeded 0.792. There was a global Cronbach's alpha of LCJR-PT© of 0.921 and 0.876 in Observers 1 and 2 respectively, with a statistically significant level of agreement. Conclusions: the LCJR-PT© is a valid and reliable instrument, demonstrating a high potential for its use in clinical education and nursing research.

RESUMO Objetivos: traduzir e validar transculturalmente o instrumento Lasater Clinical Judgment Rubric© (LCJR©) para estudantes de Enfermagem. Métodos: a aplicação do LCJR-PT© foi precedida por tradução linguística ao português, baseando-se no método de traduçãoretradução. Este estudo psicométrico envolveu 32 estudantes de Enfermagem de um programa em Portugal. Os dados foram recolhidos mediante observações de dois observadores independentes durante o desempenho das práticas desenvolvidas pelos estudantes por meio dos cenários validados por peritos em simulação de alta e média fidelidade. Resultados: das 64 observações das práticas de estudantes de Enfermagem, o valor das correlações por intraclasse nos quatro aspectos do instrumento ultrapassou os 0,792. Identificou-se um alfa de Cronbach global na LCJR-PT© de 0,921 e 0,876 nos observadores 1 e 2, respectivamente, com um nível de concordância estatisticamente significante. Conclusões: a LCJR-PT© é um instrumento válido e confiável, demonstrando um alto potencial para seu uso na educação clínica e pesquisa em enfermagem.

RESUMEN Objetivos: traducir y validar transculturalmente el instrumento Lasater Clinical Judgment Rubric© (LCJR©) para estudiantes de Enfermería. Métodos: aplicación del LCJR-PT© precedida por traducción lingüística al portugués, basándose en el método de traducción y retraducción. Estudio psicométrico involucró 32 estudiantes de Enfermería de un programa en Portugal. Datos recolectados mediante observaciones de dos observadores independientes durante el desempeño de prácticas desarrolladas por estudiantes mediante los escenarios validados por peritos en simulado de alta y mediana fidelidad. Resultados: de las 64 observaciones de prácticas de estudiantes de Enfermería, el valor de correlaciones por intraclase en los cuatro aspectos del instrumento sobrepasó 0,792. Identificado un alfa de Cronbach global en el LCJR-PT© de 0,921 y 0,876 en los observadores 1 y 2, respectivamente, con un nivel de concordancia estadísticamente significante. Conclusiones: el LCJR-PT© es un instrumento válido y confiable, demostrando un alto potencial para su uso en educación clínica e investigación en enfermería.

Clinical Decision-Making in Nursing Scale (CDMNS-PT©) in nursing students: translation and validation.

OBJECTIVES: to validate, for the Portuguese population, the Clinical Decision-Making Nursing Scale© (CDMNS©). METHODS: this methodological study involved 496 nursing students who filled in a questionnaire created using sociodemographic and academic data, and the scale to evaluate the making of decisions in nursing. RESULTS: the confirmatory factorial analysis showed that the adjustment of the factorial structure has good quality, being made up by three factors (X2/gl = 2.056; GFI = 0.927; CFI = 0.917; RMSEA = 0.046; RMR = 0.039; SRMR = 0.050). For the scale to be reliable, it had to include only the reliability of the scale required it to be constituted by 23 items, with correlation values that varied from 0.184 and 0.610, and a global Cronbach's Alpha of 0.851, which showed its good reliability. CONCLUSIONS: the CDMNS-PT© is valid and reliable, showing a high potential to be used in clinical practice and investigation.

Hope in a depression therapeutic group: a qualitative case study.

OBJECTIVE: to understand the perceptions of hope for people with depression in the context of a therapy group. METHODS: using a qualitative case study approach, a semi-structured in-depth interview and a self-report questionnaire were conducted with seven women with depression integrated in a therapy group at a Portuguese day-care psychiatric unit. Data collection and analysis used triangulation of sources. RESULTS: the participants evidenced hope founded on the positive experiences of the past with a strong affiliation component. Hope management is done fundamentally through the interpersonal relationships established between the members of the group, based on communicational patterns that are established on a regular basis, mediated by the group therapist. CONCLUSION: the therapy group functioned towards the reinforcement of hope in people who experience depression, and it works as a motivation to manage the implications of illness in the participants' life and health project.

Hope in a depression therapeutic group: a qualitative case study / Esperança num grupo terapêutico de doentes deprimidos: estudo de caso qualitative / Esperanza en un grupo terapéutico de pacientes deprimidos: un estudio de caso cualitativo

ABSTRACT Objective: to understand the perceptions of hope for people with depression in the context of a therapy group. Methods: using a qualitative case study approach, a semi-structured in-depth interview and a self-report questionnaire were conducted with seven women with depression integrated in a therapy group at a Portuguese day-care psychiatric unit. Data collection and analysis used triangulation of sources. Results: the participants evidenced hope founded on the positive experiences of the past with a strong affiliation component. Hope management is done fundamentally through the interpersonal relationships established between the members of the group, based on communicational patterns that are established on a regular basis, mediated by the group therapist. Conclusion: the therapy group functioned towards the reinforcement of hope in people who experience depression, and it works as a motivation to manage the implications of illness in the participants' life and health project.

RESUMO Objetivo: Conhecer as percepções de esperança para pessoas com depressão no contexto de um grupo terapêutico. Métodos: Utilizando uma abordagem qualitativa de estudo de caso, foi realizada uma entrevista semiestruturada em profundidade e um questionário de autoavaliação com 7 mulheres com depressão integradas num grupo terapêutico num hospital de dia psiquiátrico português. Na coleta e análise de dados usou-se a triangulação de fontes. Resultados: Os participantes evidenciaram esperança alicerçada nas experiências positivas do passado com forte componente de afiliação. O gerenciamento da esperança é feito fundamentalmente por meio das relações interpessoais estabelecidas entre os membros do grupo, a partir de padrões comunicacionais que se estabelecem regularmente, mediados pelo terapeuta do grupo. Conclusão: O grupo terapêutico funcionou no sentido de reforçar a esperança nas pessoas que vivenciam depressão e funciona como uma motivação para gerir as implicações da doença no projeto de vida e saúde dos participantes.

RESUMEN Objetivo: Conocer las percepciones de esperanza de las personas con depresión en el contexto de un grupo terapéutico. Métodos: Con un enfoque de estudio de caso cualitativo, se realizó una entrevista en profundidad semiestructurada y un cuestionario de autoinforme con 7 mujeres con depresión integradas en un grupo terapéutico en una unidad psiquiátrica de atención diurna portuguesa. La recopilación y el análisis de datos utilizan la triangulación de fuentes. Resultados: Los participantes evidenciaron esperanza fundada en las experiencias positivas del pasado con un fuerte componente de afiliación. La gestión de la esperanza se realiza fundamentalmente a través de las relaciones interpersonales que se establecen entre los miembros del grupo, basadas en patrones comunicacionales que se establecen de forma regular, mediada por el terapeuta de grupo. Conclusión: El grupo terapéutico funcionó para reforzar la esperanza en personas que experimentan depresión y funciona como una motivación para manejar las implicaciones de la enfermedad en el proyecto de vida y salud de los participantes.

Evaluation of fall risk factors present during institutionalization of elderly people / Evaluación de factores de riesgo de caídas durante la institucionalización del anciano / Avaliação dos fatores de risco de queda durante a institucionalização do idoso

ABSTRACT Objectives: to describe the development and validation of the Scale of Practices of Evaluation of Fall Risk Factors during Institutionalization of Elderly People and to describe the practices of evaluation of communication of fall risks to institutionalized elderly people. Methods: methodological study, which allowed construction and determination of the psychometric properties of the Scale of Practices of Evaluation of Fall Risk Factors during Institutionalization of Elderly People, which was carried out in six long-term care institutions for elderly people, in 2018. Results: the scale showed satisfactory internal consistency, with a Cronbach's alpha of 0.949. It was designed to have three dimensions: practices of evaluation of biophysiological risk factors; practices of communication and training; and practices of evaluation of risks related to elderly people's putting on clothing and footwear. Conclusions: the risk factors that had their value recognized were related to mobility. There is not proper recognition of the importance of information about fall risk factors and communication between elderly people and health teams during institutionalization.

RESUMEN Objetivos: describir la construcción y validación de la escala de prácticas de evaluación de factores de riesgo de caídas durante la institucionalización del anciano, y describir las prácticas de evaluación y comunicación de riesgo de caídas al anciano institucionalizado. Método: estudio metodológico que permitió construir y determinar las propiedades psicométricas de las Escala de Prácticas de Evaluación de Riesgo de Caídas durante la institucionalización del anciano, realizado en seis hogares para ancianos, en 2018 Resultados: la escala muestra una consistencia interna de α=0,949 y 3 dimensiones: prácticas de evaluación de factores de riesgo biofisiológicos; prácticas de comunicación y formación; prácticas de evaluación de riesgos relativos a calzado y vestimenta del anciano. Conclusiones: los factores de riesgo evaluados están asociados a la movilidad. Está infravalorada la información sobre factores de riesgo de caída durante la institucionalización, y la comunicación de los mismos en los equipos de trabajo.

RESUMO Objetivos: descrever a construção e validação da escala de práticas de avaliação dos fatores de risco de queda durante a institucionalização do idoso e descrever as práticas de avaliação e comunicação do risco de queda aos idosos institucionalizados. Método: estudo metodológico, que possibilitou a construção e determinação das propriedades psicométricas da Escala de Práticas de Avaliação do Risco de Queda durante a Institucionalização da pessoa idosa, que decorreu em seis instituições de longa permanência para idosos, em 2018. Resultados: a escala apresenta uma consistência interna de α=0,949 e 3 dimensões: práticas de avaliação dos fatores de risco bio fisiológicos; práticas de comunicação e formação; práticas de avaliação do risco relacionados com o calçar e vestir do idoso. Conclusões: os fatores de risco valorizados estão associados à mobilidade. Há uma desvalorização da informação sobre os fatores de risco de queda, ao longo da institucionalização, e da comunicação dos mesmos nas equipes de trabalho.

Adolescent students attitudes towards sexuality: the construction and validation of a scale / Atitudes dos alunos adolescentes sobre a sexualidade: construção e validação de uma escala

ABSTRACT Objective: To construct a scale of adolescents' attitudes towards sexuality and to determine their psychometric characteristics. Methods: Methodological study conducted with 394 students from the 8th to 12th grades of a school in central Portugal. They answered a questionnaire consisting of the Adolescent Students' Attitude Scale for Sexuality (E3AS) and socio-demographic and academic data. The project received a favorable opinion from the National Data Protection Commission (authorization No. 10421/2017). Construct validity analysis was performed through exploratory factor analysis and internal consistency was performed through Cronbach's alpha. A maximum error probability of 5% was considered. Results: The mean age of the sample was 14.9±1.4 years, with 53.3% being female. The instrument consisted of 34 items distributed into five factors: F1. Family planning and sex education (α=0.826); F2. First sexual relationship (α=0.819); F3. Violation of sexual rights and who to turn to in the event of unplanned pregnancies (α=0.695); F4. Gender expression and identity (α=0.542), and F5. Unplanned pregnancy and parenting (α= 0.761), with a total alpha value of 0.766, accounting for 45.3% of total variance. Conclusions: The psychometric adequacy of the E3AS for the Portuguese population allows us to affirm that it is a valid and reliable instrument that can be used in future studies to assess the attitudes of adolescent students towards sexuality.

RESUMO Objetivo: Construir uma escala de atitudes dos adolescentes em face da sexualidade e determinar as suas caraterísticas psicométricas. Métodos: Estudo metodológico realizado com 394 alunos do 8º ao 12º ano de escolaridade de uma escola da região Centro de Portugal que responderam a um questionário constituído da Escala de Atitudes dos Alunos Adolescentes em face da Sexualidade e de dados sociodemográficos e acadêmicos. O projeto recebeu parecer favorável da Comissão Nacional de Proteção de Dados (autorização nº 10421/2017). Realizou-se a análise de validade do constructo, por análise fatorial exploratória, e de consistência interna, por alfa de Cronbach. Foi considerada probabilidade de erro máximo de 5%. Resultados: A média de idades da amostra foi de 14,9±1,4 anos, e 53,3% dos participantes eram do sexo feminino. O instrumento foi constituído de 34 itens distribuídos por cinco fatores: Fator 1. Planejamento familiar e educação sexual (α=0,826); Fator 2. Primeira relação sexual (α=0,819); Fator 3. Violação dos direitos sexuais e a quem recorrer na gravidez não planejada (α=0,695); Fator 4. Expressão e identidade de gênero (α=0,542); Fator 5. Gravidez não planejada e parentalidade (α=0,761). O valor do alfa total da escala foi 0,766, o que explica 45,3% da variância total. Conclusões: A adequação psicométrica da escala para a população portuguesa permite afirmar que se trata de um instrumento válido e confiável, que poderá ser utilizado em estudos futuros com o intuito de avaliar as atitudes dos alunos adolescentes em face da sexualidade.

Hope-based interventions in chronic disease: an integrative review in the light of Nightingale.

OBJECTIVE: To identify the available evidence in the scientific literature about the strategies or interventions used to promote hope in people with chronic diseases. METHOD: An integrative literature review of literature published between 2009-2019, which was conducted in online browsers/databases: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Forty-one studies were found, of which eight met the inclusion criteria. RESULTS: Most studies used a quantitative approach. There was a predominance of studies from Asia and America, addressing patients with multiple sclerosis, diabetes, congestive heart failure, and cancer. Hope-based interventions were categorized by the hope attributes: experiential process, spiritual/transcendence process, rational thought process, and relational process. CONCLUSION: Hope-based interventions, in its essence, are good clinical practices in the physical, psychological, social and spiritual domains. This is congruent with the vision of nursing, first proposed by Florence Nightingale. There seem to be gaps in the literature regarding specific hope promoting interventions.

ADOLESCENT STUDENTS' ATTITUDES TOWARDS SEXUALITY: THE CONSTRUCTION AND VALIDATION OF A SCALE.

OBJECTIVE: To construct a scale of adolescents' attitudes towards sexuality and to determine their psychometric characteristics. METHODS: Methodological study conducted with 394 students from the 8th to 12th grades of a school in central Portugal. They answered a questionnaire consisting of the Adolescent Students' Attitude Scale for Sexuality (E3AS) and socio-demographic and academic data. The project received a favorable opinion from the National Data Protection Commission (authorization No. 10421/2017). Construct validity analysis was performed through exploratory factor analysis and internal consistency was performed through Cronbach's alpha. A maximum error probability of 5% was considered. RESULTS: The mean age of the sample was 14.9±1.4 years, with 53.3% being female. The instrument consisted of 34 items distributed into five factors: F1. Family planning and sex education (α=0.826); F2. First sexual relationship (α=0.819); F3. Violation of sexual rights and who to turn to in the event of unplanned pregnancies (α=0.695); F4. Gender expression and identity (α=0.542), and F5. Unplanned pregnancy and parenting (α= 0.761), with a total alpha value of 0.766, accounting for 45.3% of total variance. CONCLUSIONS: The psychometric adequacy of the E3AS for the Portuguese population allows us to affirm that it is a valid and reliable instrument that can be used in future studies to assess the attitudes of adolescent students towards sexuality.

Help2care: ehealth strategies for self care of users and caregivers based on Nightingale's work.

OBJECTIVE: To report the experience of design and implementation of the Help2Care (an ehealth program that aims to support informal caregivers of dependent people); and to identify its structure and functionality. METHODS: This is a Portuguese experience report about Help2Care, a practice-based action research project carried out between 2017 and 2019, having as a guiding axis Florence Nightingale's concepts about the relevance of the home-care environment. RESULTS: The Help2Care program revealed itself to be a valuable support tool for providing better healthcare learning, counselling, and assistance of the informal caregivers of dependent people. Different ehealth strategies were used to empower caregivers in self-care in order to have a safe transition between contexts of care at the time of patient discharge. CONCLUSION: Help2Care allows to inspire other ways of providing care, as well as a reduction in the readmission rate in health organizations for patients who reveal poor care support in home environments.

Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls.

OBJECTIVE: determine the psychometric properties of the safety practices and behaviors dimension of the Scale of Practices and Behaviors of Institutionalized Elderly People to Prevent Falls in a sample of elderly people with cognitive decline. METHOD: methodological study, with a quantitative approach, to assess the psychometric properties of the mentioned scale in a sample with 102 elderly people with cognitive decline who lived in two long-term care institutions for the public in this age group. Internal consistency evaluation was carried out by calculating the Cronbach's alpha coefficient; interobserver reliability was expressed by Cohen's kappa coefficient; and temporal stability, by obtaining Spearman correlation. Compliance with all ethical procedures was observed. RESULTS: the dimension of safety practices and behaviors showed α = 0.895 for its 11 items. Seven out of the 11 items reached good to excellent agreement among the experts for interobserver reliability. Kappa index values indicated that the instrument is valid and reliable. Safety practices and behaviors were influenced by institutionalization time, being at least 85 years old, and gait skills. CONCLUSION: the results pointed out that the instrument has good reproducibility and is valid and reliable, which allows its use in clinical practice in elderly people with cognitive decline as well as in research.

Effects of an education program on knowledge and self-perception of school personnel in preparing to care for type 1 diabetes students.

OBJECTIVE: To assess the academic and professional background of school personnel; to assess the impact of the Diabetes + Support given by School Personnel to Children with Type 1 Diabetes Program on the school personnel's knowledge and confidence to support students with type 1 diabetes; to compare their level of knowledge with the academic and professional variables of the school personnel. METHODS: A quasi-experimental pre-test/post-test study design without a Control Group. Study with a sample of 129 (before intervention - T0) and 113 (after intervention - T1) pre-school to secondary school personnel from participating schools, with at least one student with type 1 diabetes. The project was approved by the Ethics Committee of the Portuguese Ministry of Education. RESULTS: Most school personnel included in the study were teachers (51.2%). After training, they were more confident than before to support children with type 1 diabetes (p<0.05). Regarding knowledge levels, the differences between T0 (10.8±2.8; P 50 =11) and T1 (13.7±2.1; P 50 =11) were statistically significant (p<0.001). Of the 113 school personnel who participated in the final assessment, 89 (78.85%) increased their level of knowledge. CONCLUSION: The program was effective to enhance knowledge and boost confidence to support students with diabetes.

Violence in intimate relationships in adolescents: effectiveness of an intervention by peers through forum theater.

OBJECTIVE: The main goal was the peer evaluation of the effectiveness of a health education intervention, also seeking the characterization of violent behaviors experienced by teens in intimate relationships. METHOD: A pretest-posttest quasi-experimental study was performed with a non-probabilistic sample of 197 teens of both genders without control group. The intervention performed consisted of one peer-run forum theater session about intimate violence in dating relationships of teens. RESULTS: Boys reported being both victims and perpetrators of violent behaviors more frequently than girls. The sample reported more behaviors associated with victimization than perpetration. Girls showed a higher level of knowledge on the topic and this knowledge increased after the intervention. CONCLUSION: Psychological violence is highly prevalent in dating relationships, particularly in cases of victimization. It seems essential to understand and act upon adolescents' perceptions about what violent behavior is. This study confirmed the effectiveness of health education in acquiring knowledge on this topic.

Violence in intimate relationships in adolescents: effectiveness of an intervention by peers through forum theater / Violência nas relações íntimas entre adolescentes: eficácia de uma intervenção mediada por pares por meio do teatro-fórum / Violencia en las relaciones íntimas entre adolescentes: efectividad de una intervención mediada por pares mediante el teatro fórum

Abstract Objective: The main goal was the peer evaluation of the effectiveness of a health education intervention, also seeking the characterization of violent behaviors experienced by teens in intimate relationships. Method: A pretest-posttest quasi-experimental study was performed with a non-probabilistic sample of 197 teens of both genders without control group. The intervention performed consisted of one peer-run forum theater session about intimate violence in dating relationships of teens. Results: Boys reported being both victims and perpetrators of violent behaviors more frequently than girls. The sample reported more behaviors associated with victimization than perpetration. Girls showed a higher level of knowledge on the topic and this knowledge increased after the intervention. Conclusion: Psychological violence is highly prevalent in dating relationships, particularly in cases of victimization. It seems essential to understand and act upon adolescents' perceptions about what violent behavior is. This study confirmed the effectiveness of health education in acquiring knowledge on this topic.

Resumo Objetivo: O principal objetivo foi a avaliação por pares da eficácia de uma intervenção educacional em saúde, também buscando a caracterização de comportamentos violentos vivenciados por adolescentes nas relações íntimas. Método: Um estudo quase-experimental pré e pós teste foi realizado com uma mostra não probabilística de 197 adolescentes de ambos os gêneros sem grupo controle. A intervenção realizada consistiu de uma sessão de teatro-fórum entre pares sobre violência íntima nos relacionamentos amorosos entre adolescentes. Resultados: Os meninos relataram ser tanto vítimas quanto perpetradores dos comportamentos violentos mais frequentemente do que as meninas. A amostra relatou mais comportamentos associados à vitimização do que perpetração. As meninas mostraram um nível mais alto de conhecimento sobre o assunto e esse conhecimento aumentou após a intervenção. Conclusão: A violência psicológica é altamente prevalente nos relacionamentos amorosos, particularmente nos casos de vitimização. Parece essencial compreender as percepções dos adolescentes sobre o que é um comportamento violento e agir nesse sentido. Este estudo confirmou a eficácia da educação em saúde na aquisição de conhecimento sobre esse tópico.

Resumen El principal objetivo: fue la evaluación por pares de la efectividad de una intervención educativa en salud, también buscando la caracterización de comportamientos violentos vividos por adolescentes en las relaciones íntimas. Método: Un estudio cuasi-experimental pre y post prueba fue llevado a cabo con una muestra no probabilística de 197 adolescentes de ambos géneros sin grupo control. La intervención realizada se constituyó en una sesión de teatro fórum entre pares acerca de la violencia íntima en las relaciones amorosas entre adolescentes. Resultados: Los chicos relataron ser tanto víctimas como perpetradores de los comportamientos violentos con más frecuencia que las chicas. La muestra relató más comportamientos asociados con la victimización que la perpetración. Las chicas mostraron un nivel más alto de conocimiento acerca del tema y dicho conocimiento se incrementó después de la intervención. Conclusión: La violencia psicológica es altamente prevaleciente en las relaciones amorosas particularmente en los casos de victimización. Parece esencial comprender las percepciones de los adolescentes acerca de qué es un comportamiento violento y actuar en ese sentido. Este estudio confirmó la efectividad de la educación sanitaria en la adquisición de conocimiento sobre ese tópico.

Effects of an education program on knowledge and self-perception of school personnel in preparing to care for type 1 diabetes students / Efeitos de um programa de educação nos conhecimentos e na autopercepção dos educadores escolares na preparação para cuidar de crianças diabéticas tipo 1

ABSTRACT Objective To assess the academic and professional background of school personnel; to assess the impact of the Diabetes + Support given by School Personnel to Children with Type 1 Diabetes Program on the school personnel's knowledge and confidence to support students with type 1 diabetes; to compare their level of knowledge with the academic and professional variables of the school personnel. Methods A quasi-experimental pre-test/post-test study design without a Control Group. Study with a sample of 129 (before intervention - T0) and 113 (after intervention - T1) pre-school to secondary school personnel from participating schools, with at least one student with type 1 diabetes. The project was approved by the Ethics Committee of the Portuguese Ministry of Education. Results Most school personnel included in the study were teachers (51.2%). After training, they were more confident than before to support children with type 1 diabetes (p<0.05). Regarding knowledge levels, the differences between T0 (10.8±2.8; P 50 =11) and T1 (13.7±2.1; P 50 =11) were statistically significant (p<0.001). Of the 113 school personnel who participated in the final assessment, 89 (78.85%) increased their level of knowledge. Conclusion The program was effective to enhance knowledge and boost confidence to support students with diabetes.

RESUMO Objetivo Avaliar a formação acadêmica e profissional dos educadores escolares; avaliar o impacto do Diabetes + Apoio dado pelo Programa Responsáveis Escolares pelas Crianças com Diabetes Tipo 1 no nível de conhecimento e de confiança dos educadores escolares, para apoiar os alunos com diabetes tipo 1; comparar o nível de conhecimento dos educadores escolares com suas variáveis acadêmicas e profissionais. Métodos Estudo quasi-experimental, do tipo pré-teste/pós-teste sem Grupo Controle, realizado em amostra de 129 (antes da intervenção - T0) e 113 (pós-intervenção - T1) educadores escolares, da pré-escola ao ensino secundário, que trabalhavam em escolas com pelo menos uma criança/jovem com diabetes tipo 1. O projeto foi aprovado pelo Comitê de Ética do Ministério da Educação de Portugal. Resultados A maioria dos educadores escolares incluídos no estudo era professor (51,2%). Após a intervenção, os educadores escolares sentiram-se mais confiantes do que antes, para apoiar crianças com diabetes tipo 1 (p<0,05). Em relação aos níveis de conhecimento, as diferenças entre T0 (10,8±2,8; P50=11) e T1 (13,7±2,1; P50=11) foram estatisticamente significantes (p<0,001). Dos 113 educadores escolares que participaram da avaliação final, 89 (78,85%) aumentaram seu nível de conhecimento. Conclusão O programa foi eficaz para aumentar o conhecimento e a confiança dos educadores escolares para apoiar as crianças/jovens com diabetes tipo 1.

Interobserver analysis of safety practices and behaviors adopted by elderly people to prevent falls / Análise Interobservadores das práticas e comportamentos de segurança adotados pelos idosos institucionalizados para prevenir quedas / Análisis interobservadores de prácticas y comportamientos de seguridad adoptadas por ancianos institucionalizados para prevenir caídas

Objective: determine the psychometric properties of the safety practices and behaviors dimension of the Scale of Practices and Behaviors of Institutionalized Elderly People to Prevent Falls in a sample of elderly people with cognitive decline. Method: methodological study, with a quantitative approach, to assess the psychometric properties of the mentioned scale in a sample with 102 elderly people with cognitive decline who lived in two long-term care institutions for the public in this age group. Internal consistency evaluation was carried out by calculating the Cronbach's alpha coefficient; interobserver reliability was expressed by Cohen's kappa coefficient; and temporal stability, by obtaining Spearman correlation. Compliance with all ethical procedures was observed. Results: the dimension of safety practices and behaviors showed α = 0.895 for its 11 items. Seven out of the 11 items reached good to excellent agreement among the experts for interobserver reliability. Kappa index values indicated that the instrument is valid and reliable. Safety practices and behaviors were influenced by institutionalization time, being at least 85 years old, and gait skills. Conclusion: the results pointed out that the instrument has good reproducibility and is valid and reliable, which allows its use in clinical practice in elderly people with cognitive decline as well as in research.

Objetivo: determinar as propriedades psicométricas da dimensão das práticas e dos comportamentos de segurança da Escala de Práticas e Comportamentos dos Idosos Institucionalizados para Prevenir Quedas numa amostra de idosos com declínio cognitivo. Método: estudo metodológico, com abordagem quantitativa, para a avaliação das propriedades psicométricas da escala numa amostra de 102 idosos com declínio cognitivo, residentes em duas Instituições de Longa Permanência para Idosos. A avaliação da consistência interna foi efetuada pelo α de Cronbach, a confiabilidade interobservadores, calculada pelo coeficiente de concordância Kappa de Cohen e a estabilidade temporal, pela correlação de Spearman. Todos os procedimentos éticos foram contemplados no estudo. Resultados: a dimensão das práticas e dos comportamentos de segurança da escala apresentou um α=0,895 para os seus 11 itens. Na confiabilidade interobservador, 7 dos 11 itens obtiveram de boa a excelente concordância entre os juízes. Os valores do Índice Kappa evidenciam que o instrumento é válido e fidedigno. As práticas e os comportamentos de segurança são influenciados pelo tempo de institucionalização, idade superior a 85 anos e capacidade de marcha. Conclusão: os resultados indicam uma boa reprodutibilidade, o instrumento é válido e fidedigno, permitindo a utilização do instrumento na clínica em idosos com declínio cognitivo e na investigação.

Objetivo: determinar las propiedades psicométricas de la dimensión de prácticas y conductas de seguridad de la Escala de prácticas y comportamientos de los ancianos institucionalizados para prevenir las caídas, sobre una muestra de ancianos con deterioro cognitivo. Método: estudio metodológico de abordaje cuantitativo para evaluar las propiedades psicométricas de la escala sobre muestra de 102 ancianos con deterioro cognitivo, residentes en dos hogares para ancianos. Evaluación de consistencia interna verificada por α de Cronbach, confiabilidad interobservadores calculada por coeficiente de concordancia Kappa de Cohen, estabilidad temporal comprobada por correlación de Spearman. Fueron contemplados todos los procedimientos éticos. Resultados: la dimensión de prácticas y comportamientos de seguridad de la escala expresa α=0,895 para sus 11 ítems. En confiabilidad interobservadores, 7 de los 11 ítems obtienen buena o excelente concordancia entre los evaluadores. Los valores del índice Kappa evidencian que el instrumento es válido y fidedigno. Las prácticas de comportamiento de seguridad están influidas por el tiempo de institucionalización, edad superior a 85 años y capacidad de marcha. Conclusión: los resultados demuestran buena reproductividad, el instrumento es válido y confiable, pudiéndoselo utilizar en la clínica con ancianos con deterioro cognitivo y en la investigación.

Hope-based interventions in chronic disease: an integrative review in the light of Nightingale / Intervenciones de esperanza en la enfermedad crónica: una revisión integrativa a la luz de Nightingale

ABSTRACT Objective: To identify the available evidence in the scientific literature about the strategies or interventions used to promote hope in people with chronic diseases. Method: An integrative literature review of literature published between 2009-2019, which was conducted in online browsers/databases: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Forty-one studies were found, of which eight met the inclusion criteria. Results: Most studies used a quantitative approach. There was a predominance of studies from Asia and America, addressing patients with multiple sclerosis, diabetes, congestive heart failure, and cancer. Hope-based interventions were categorized by the hope attributes: experiential process, spiritual/transcendence process, rational thought process, and relational process. Conclusion: Hope-based interventions, in its essence, are good clinical practices in the physical, psychological, social and spiritual domains. This is congruent with the vision of nursing, first proposed by Florence Nightingale. There seem to be gaps in the literature regarding specific hope promoting interventions.

RESUMEN Objetivo: Identificar las evidencias disponibles en la literatura científica sobre las estrategias o intervenciones utilizadas para promover la esperanza en personas con enfermedad crónica. Método: Revisión integrativa de la literatura entre 2009 y 2019 realizada en navegadores/bases de datos online: b-On, EBSCO, PubMed, Medline, ISI, SciELO, PsycINFO, Google Scholar. Han encontrados 41 estudios, ocho de los cuales cumplieron los criterios de inclusión. Resultados: La mayoría de los estudios utilizó abordaje cuantitativo. Hubo predominancia de estudios de Asia y América, abordando pacientes con esclerosis múltiple, diabetes, insuficiencia cardíaca congestiva y cáncer. Las intervenciones han categorizadas por los atributos de la esperanza: proceso experiencial, proceso espiritual/ trascendente, proceso de pensamiento racional y proceso relacional. Conclusión: Las intervenciones basadas en la esperanza, en su esencia, son buenas prácticas clínicas en los dominios físico, psicológico, social y espiritual. Eso es congruente con la perspectiva de la enfermería holística propuesta por Florence Nightingale. Parece haber lagunas en la literatura en relación a las intervenciones específicas de promoción de la esperanza.

Help2care: ehealth strategies for self care of users and caregivers based on Nightingales work / Help2care: estratégias ehealth de autocuidado para usuários e cuidadores baseadas no trabalho de Nightingale / Help2care: estrategias eSalud de autocuidado para usuarios y cuidadores basadas en el trabajo de Nightingale

ABSTRACT Objective: To report the experience of design and implementation of the Help2Care (an ehealth program that aims to support informal caregivers of dependent people); and to identify its structure and functionality. Methods: This is a Portuguese experience report about Help2Care, a practice-based action research project carried out between 2017 and 2019, having as a guiding axis Florence Nightingale's concepts about the relevance of the home-care environment. Results: The Help2Care program revealed itself to be a valuable support tool for providing better healthcare learning, counselling, and assistance of the informal caregivers of dependent people. Different ehealth strategies were used to empower caregivers in self-care in order to have a safe transition between contexts of care at the time of patient discharge. Conclusion: Help2Care allows to inspire other ways of providing care, as well as a reduction in the readmission rate in health organizations for patients who reveal poor care support in home environments.

RESUMO Objetivo: Relatar a experiência sobre o desenho e implementação do Help2Care (um programa de eSaúde que visa apoiar os cuidadores informais de pessoas dependentes); e identificar a sua estrutura e funcionalidade. Método: Este é um relato de experiência Portuguesa sobre o Help2Care, um projeto de pesquisa-ação (2017-2019), tendo como eixo orientador os conceitos de Florence Nightingale sobre a relevância do ambiente de atendimento domiciliar. Resultados: O programa Help2Care revelou ser uma valiosa ferramenta de apoio para um melhor aprendizado, aconselhamento e assistência dos cuidadores informais de pessoas dependentes. Diferentes estratégias de eSaúde foram utilizadas para capacitar o cuidador no autocuidado, a fim de ter uma transição segura entre contextos de saúde no momento da alta do paciente. Conclusão: O Help2Care permite inspirar outras formas de prestar cuidados, bem como uma redução na taxa de readmissão nas organizações de saúde para pacientes que revelam insuficiente apoio de cuidados em ambientes domiciliares.

RESUMEN Objetivo: Relatar la experiencia sobre el dibujo e implementación del Help2Care (un programa de eSalud que objetiva apoyar los cuidadores informales de personas dependientes); y identificar su estructura y funcionalidad. Métodos: Esta es una declaración de experiencia Portuguesa acerca del Help2Care, un proyecto de investigación-acción (2017-2019), con los conceptos de Florence Nightingale sobre la relevancia del ambiente de atención domiciliaria. Resultados: El programa Help2Care demostró ser una valiosa herramienta de apoyo para un mejor aprendizaje, asesoramiento y asistencia a los cuidadores informales de personas dependientes. Se utilizaron diferentes estrategias de eSalud para capacitar a los cuidadores en el autocuidado, para tener una transición segura entre los contextos de salud después del alta del paciente. Conclusión: El Help2Care permite inspirar otras formas de proporcionar atención, así como una reducción en la tasa de reingresos en organizaciones de salud para pacientes que revelan apoyo insuficiente en su casa.

Sexual behaviors: study in the youth.

OBJECTIVE: To characterize sexual behaviors in a sample of adolescents and youth. METHODS: An analytical descriptive study using a questionnaire about sexual behaviors, adapted from the World Health Organization. It was distributed to students from a Portuguese city aged 14-24 years, during two months. Two age groups were defined: G1 - students aged 14-19 years; G2 - aged 20-24 years. RESULTS: The sample included 2,369 students, 61% females and 70% in G1. The mean age of first sexual intercourse was 16.4±1.8 years; 93% used some contraceptive method in the first sexual intercourse. Out of those who did not use contraception in the first sexual intercourse, 83% were in G1 (p<0.001). Emergency contraception was used at least once by 54% (63% in G2, p<0.001). Among those who had unprotected sexual intercourses, 9% were under the influence of alcohol, 53.6% were female and 53.4% were in G2 (p<0.001). Homosexual contacts occurred in 21% of cases; in that, 62% in G1 and 84% among females (p<0.001). CONCLUSION: The use of contraceptionin the first sexual intercourse was common in our sample. However, the number of adolescents not using any contraceptive method in subsequent sexual intercourses, and the high percentage of them who consider it unnecessary, are a concern. Unprotected sexual intercourses, as well as unplanned intercourses and under influence of alcohol or drugs, especially in the youngest, urge the need for intervention regarding sexual education.

Sexual behaviors: study in the youth / Comportamentos sexuais: estudo em jovens

ABSTRACT Objective: To characterize sexual behaviors in a sample of adolescents and youth. Methods: An analytical descriptive study using a questionnaire about sexual behaviors, adapted from the World Health Organization. It was distributed to students from a Portuguese city aged 14-24 years, during two months. Two age groups were defined: G1 - students aged 14-19 years; G2 - aged 20-24 years. Results: The sample included 2,369 students, 61% females and 70% in G1. The mean age of first sexual intercourse was 16.4±1.8 years; 93% used some contraceptive method in the first sexual intercourse. Out of those who did not use contraception in the first sexual intercourse, 83% were in G1 (p<0.001). Emergency contraception was used at least once by 54% (63% in G2, p<0.001). Among those who had unprotected sexual intercourses, 9% were under the influence of alcohol, 53.6% were female and 53.4% were in G2 (p<0.001). Homosexual contacts occurred in 21% of cases; in that, 62% in G1 and 84% among females (p<0.001). Conclusion: The use of contraceptionin the first sexual intercourse was common in our sample. However, the number of adolescents not using any contraceptive method in subsequent sexual intercourses, and the high percentage of them who consider it unnecessary, are a concern. Unprotected sexual intercourses, as well as unplanned intercourses and under influence of alcohol or drugs, especially in the youngest, urge the need for intervention regarding sexual education.

RESUMO Objetivo: Caracterizar os comportamentos sexuais em uma amostra de adolescentes e jovens. Métodos: Estudo descritivo analítico, utilizando um questionário sobre comportamentos sexuais adaptado da Organização Mundial da Saúde. O questionário foi distribuído a estudantes entre os 14 e os 24 anos de uma cidade portuguesa, em período de 2 meses. Definiram-se dois grupos etários: G1, para estudantes de 14 a 19 anos; e G2, de 20 a 24 anos. Resultados: Da amostra, constaram 2.369 estudantes, sendo 61% do sexo feminino e 70% do G1. A média de idade da primeira relação sexual foi de 16,4± 1,8 anos. Foi utilizado método contraceptivo na primeira relação sexual em 93%. Dos que não utilizaram, 83% pertenciam ao G1 (p<0,001). Entre os estudantes, 54% recorreram pelo menos uma vez à contracepção de emergência (63% do G2; p<0,001). Dos que tiveram relações sexuais desprotegidas, 9% estavam sob influência do álcool. Destes últimos, 53,6% eram do sexo feminino e 53,4% pertenciam ao G2 (p<0,001). Os contatos homossexuais ocorreram em 21% dos casos, dos quais 62% eram do G1 e 84% do sexo feminino (p<0,001). Conclusão: O recurso à contracepção na primeira relação sexual foi uma prática comum na nossa amostra. No entanto, o número de adolescentes que não utiliza método contraceptivo nas relações subsequentes e a elevada percentagem que o considera desnecessária são preocupantes. Para além das relações sexuais desprotegidas, as relações não planejadas e sob o efeito de álcool ou drogas, sobretudo entre os mais novos, reforçam a necessidade de intervenção no âmbito da educação sexual.