Millenium - Journal of Education, Technologies, and Health

Practices' systematization of stoma site marking in patients undergoing unplanned surgery: an improvement quality project

Igor Soares-Pinto — 2023-11-23

Introduction: In unplanned surgery, stoma site marking is unusual, increasing the risk of complications. Data on stoma site marking in a hospital in the northern region of Portugal and guidance in emergency situations are unavailable.

Objective: To increase bowel elimination stoma site marking for patients undergoing unplanned surgery.

Methods: A protocol for a best practice implementation project based on the Plan-Do-Check-Act cycle and consists of 4 phases: identification of the problem; analysis of the causes and the definition of the specific objectives; planning and implementing the intervention, checking the results, proposing corrective measures, standardizing procedures, and training the team. Data will be gathered using questionnaires for nurses, analysis of existing information systems, and the implementation of an audit grid. Results: The first two phases allowed the identification of the main shortcomings and draft of a multimodal intervention that will comprise educational strategies, implementation of a decision-making algorithm, and audit. A decrease in skin complications is expected. Increased confidence, independence in stoma self-care, and awareness of stoma living are also anticipated. Implementing this project may lead to a reduction in healthcare costs and an overall improvement in the quality of life of the person with a stoma.

Conclusion: Evidence suggests that stoma site marking is paramount to improve patient’s health outcomes. Results from this project may offer new strategies to cope with management shortcomings in health systems.

New trends in vegetarian latent food diversification: from evidence to clinical practice

Joana Miranda — 2023-12-14

Introduction: Food is a strong determinant of health and an act of expression of affection. Alongside a vast array of updates in latent food diversification, we are witnessing a paradigm and cultural change, with new food trends emerging in family diets. There is also evidence of the health benefits of consuming plant-based foods and for the sustainability of the planet.

Objective: After a need identified in practice, this study aimed to systematize health professional's perspectives on the dietary diversification of latent vegetarians, supporting measures to improve the quality of care.

Methods: According to the methodological principles of a systematic review, the EBSCO and PUBMED platforms were used, based on the PRISMA protocol, and the terms were measured as MesH Browser descriptors, from which 13 articles were extracted.

Results: With this review, it was possible to map the current scientific evidence and identify parallels between the studies found, the standards of the European reference entities, and clinical practice, which promote a more sustained nursing intervention.

Conclusion: The results obtained are relevant to better empower families, by specialized professionals and holders of adequate training. It is important to produce more knowledge, emphasizing diet planning and monitoring, in order to mitigate the risks of nutritional deficiencies (appropriate and individualized supplementation), which could compromise the child's development.

Care negotiation in a pediatric ward: discourses and practice

Carolina Nobre — 2024-04-16

Introduction: The negotiation process between parents, children, and nurses during hospitalization must be structured for a successful interaction. However, there is limited scientific evidence on parents' perspectives.

Objective: Understand the negotiation process that takes place between nurses and parents in the Pediatric Ward.

Methods: A qualitative descriptive study was conducted with 11 parents using semi-structured interviews. The data was analyzed using content analysis techniques by Bardin (2016).

Results: Five domains emerged from the discourse and perspectives of parents regarding care negotiation. The structuring conditions and knowledge of the child and family serve as foundations to support the negotiation process. During the negotiation itself, two roles converge: the parental role, involving the assumption and adaptation to the parental role, and the role of the nurses. Some behaviors promote negotiation, aimed at making the process more natural. However, some behaviors on the part of the nurses could hinder negotiation. Post-discharge support is acknowledged as an essential extra support once the child returns home.

Conclusion: The findings provide clarification of the roles of the different participants in care negotiation, with potential contributions to the implementation of actions that improve the negotiating process in a more sustained and intentional manner.

Palliative needs in a list of users of a family health unit from an urban center

Diana Pacheco — 2024-04-24

Introduction: The Portuguese population is aging, and palliative needs are expected to increase. One of the barriers to timely access to a palliative care approach is the difficulty in identifying patients who could benefit from them. Most patients with palliative needs are in the community, whereby Primary Health Care teams are in the best position to identify these patients. Different studies have evaluated palliative needs in a hospital context, and to date it has not been possible to identify national studies in Primary Care.

Objective: Evaluate palliative needs in a list of patients of a Family Health Unit.

Methods: Cross-sectional observational study on a sample of patients aged 65 years or older from a list of a Portuguese Family Health Care, through the application of the SPICT-PT™.

Results: A total of 188 patients aged 65 years or older were included. Cardiovascular disease was the most frequent main underlying disease (n=57, 30,3%), followed by oncologic disease (n=31, 16,5%) and hypertension (n=28, 14,9%). 50 patients were identified as having palliative care needs (SPICT-PT^TM-positive), which had a median age significantly higher than that of the SPICT-PT^TM-negative, with no statistical differences concerning gender. All the patients referred to the Palliative Care team were SPICT-PT^TM-positive.

Conclusion: More studies are needed to evaluate the nature and complexity of palliative needs in Primary Care and to address the strategies used after the identification of these needs.

Implications for the use of non-invasive mechanical ventilation at home, from the perspective of the individual

Virgínia Guedes — 2024-03-13

Introduction: Non-invasive mechanical ventilation is part of the ventilation therapy modality and is mostly used in the home context. Although there are many studies relating to ventilation therapy experiences in a hospital context, little has been investigated about the use of this therapy in a home context.

Objective: To describe the implications of the use of NIMV at home from the individual's perspective.

Methods: Exploratory and descriptive study of a qualitative nature with a total of 10 participants. Data collection was carried out through a semi-structured interview, which was subsequently treated using content analysis.

Results: 6 categories emerged related to the implications of using NIMV at home: people involved, complications, benefits, difficulties, adaptive strategies, and implemented habits.

Conclusion: The use of NIMV in a home context has implications for the individual. The results of this study may contribute to deeper knowledge of the topic. The family nurse must integrate this knowledge in the design of the care process for the person using NIMV in the home and family.

Nurses' perceived difficulties in preoperative patient preparation: a qualitative study

Marco Gonçalves — 2024-03-26

Introduction: The role of the nurse in the preoperative period involves identifying the client's needs and the risk factors related to the entire perioperative period. This preoperative preparation is not always a straightforward process and has some challenges that are important to explore in order to highlight the autonomous intervention of nurses during this period.

Objective: To explore the difficulties perceived by nurses in the preoperative preparation of clients undergoing scheduled general surgery.

Methods: An exploratory, qualitative study was carried out. To collect data, 23 semi-structured interviews were carried out with nurses who had been working in operating theatres or general surgery departments for more than 5 years. The data was analyzed using Bardin's content analysis technique.

Results: Three thematic units emerged from the content analysis: difficulties experienced, contributions of the preoperative nursing consultation, and aspects to be taken into account when organizing the consultation. The difficulties mentioned by the nurses centered on the preparation of the surgical client and the conditions for this preparation.

Conclusion: Identifying nurses' perceptions of the preoperative preparation that is currently carried out for clients undergoing scheduled general surgery made it possible to find out about the difficulties they experience. Preoperative preparation should be structured and take into account various dimensions such as physical, emotional, knowledge and logistical aspects. These results will contribute to improving the nursing care provided during the perioperative period.

Bioethics in Genetics: between science and art

Ana Rita Soares — 2023-09-07

Medical Genetics is a transversal and multidisciplinary medical speciality whose activity encompasses, in a general and simplistic perspective, the diagnosis of rare genetic diseases and genetic counselling of hereditary pathologies. Genetic information is, more than medical information, health information and it has implications not only for the self but also for family members. Although this medical specialization deals with risks and probabilities based on exact sciences and rigorous laboratory methodology, it also keeps challenging professionals to think ethically in different daily situations. Even in cases where the law is specific and quite rigorous on how to deal with the problem, it can be challenging to know which is the most ethical conduct in this rarity world. Henceforth, some examples will be given to make us think about how genetics can be a science art with certainties and queries.

A methodological proposal to address the academic dropout phenomenon based on an intelligent prediction model: a case study

Adriana Villa-Murillo — 2023-11-22

Introduction: University dropout is now considered a complex phenomenon that goes beyond the number of students not enrolled and that is continuously growing, especially in the first years of study.

Objective: In the present study, a prediction model combining Survival Analysis, Decision Trees, and Random Forest, under the Machine Learning philosophy, is proposed for the early diagnosis of possible factors causing dropout in university students.

Methods: The proposal consists of 3 phases: the Survival Analysis that allows estimating the probability of permanence of the student (survival). Phase 2 starts from the probability value obtained in the previous phase and uses it as a response variable in the modeling process based on Decision Trees to establish survival patterns around the variables considered. Finally, in phase 3, the critical variables in the model are identified using the Random Forest.

Results: The proposed methodology allowed the design of a prediction model to identify the main segmentation variables in behavior patterns of possible cases of academic dropout.

Conclusion: Even though the proposal was developed considering a particular case of a Chilean university, the efficient combination of metaheuristics allows the extrapolation of the methodology to any context and academic reality. However, the conditions and needs of each institution must be considered.

Biohacking & transhumanism, mapping emerging discourses: a bibliometric review

Felipe Guevara-Pezoa — 2024-03-11

Introduction: Biohacking's emergence has reshaped scientific research, especially within transhumanism and biological manipulation. Evaluating its impact on the scientific community is crucial for defining future research directions and communication in this field.

Objective: To critically examine perspectives, approaches, and debates in academic literature to develop a comprehensive understanding of the ethical, social, and cultural implications of technological advancement within the transhumanist context.

Methods: SCOPUS and bibliometric analysis were employed to quantify biohacking's influence. Social Network Analysis identified key themes and research focus areas.

Results: North American and European countries led in scientific productivity. Published articles and citation impact showed a moderate to low index. Social Network Analysis highlighted ethical considerations, social implications, and an emerging discourse on cognitive evolution.

Conclusion: The results highlight the need for comprehensive education and communication strategies to ensure that the public is well-informed about the risks, benefits, and ethical considerations associated with genetic modification technologies. Therefore, more research on legislation and regulations is required.