Journal of Nursing Referência

The Effect of COVID-19 on Mortality: Underlying Causes of Excess of Deaths in Mainland Portugal

Cláudia Sofia Martins Pires — 2025-04-23

Background: The excess mortality during COVID-19 pandemic is not completely explained by the infection.

Objectives: To assess the underlying causes of the excess mortality during the pandemic in mainland Portugal (MP).

Methodology: Deaths by underlying cause and population, by gender and age (< 60, 60-69, 70-79 and > = 80), for 2015-2019 and 2020-2021 were obtained from INE. Assessment of differences between periods using the standardized mortality ratio (SMR) and respective 95% confidence interval (95%CI).

Results: The mortality due to “mental and behavioral disorders” was higher than expected in all groups, but particularly in younger (RPM = 168%; 95%CI:127-217) and older (RPM = 140%; 95%CI:137-144) women. Mortality due to “diseases of the genitourinary system” is higher than expected in older age groups, with SMR v between 110% (95%CI:105-114) and 113% (95%CI:104-122). Mortality due to “diseases of the circulatory system” is lower than expected in age groups up to 80 years old.

Conclusion: “Mental and behavioral disorders” and “diseases of the genitourinary system” appear associated with vulnerability in the context of the COVID-19.

Clinical and Epidemiologic Profile of Newborns Admitted to Neonatal Care Units of a High-Risk Maternity Hospital

Maria Carolina Silva Costa — 2025-03-25

Background: Due to the numerous complications that lead to the hospitalization of newborns after birth, comprehensive and humanized care is essential in neonatal care units within the Unified Health System.

Objective: To analyze the clinical and epidemiologic profile of newborns admitted to the neonatal care units of a major maternity hospital.

Methodology: A quantitative, cross-sectional study was conducted in a large public maternity hospital in the state of Piauí. The sample consisted of 85 newborns.

Results: Of all newborns, 54.1% were admitted to the Neonatal Intermediate Kangaroo Care Unit. The majority (50.6%) were baby girls with a mean gestational age of 34.5 weeks, ranging from 29 to 42, with respiratory problems as the main reason for hospitalization (67.1%), followed by prematurity (28.3%).

Conclusion: The characteristics of newborns, which reflect the complexity and diversity of conditions, require the formulation of health policies, the implementation of evidence-based care practices, and the promotion of positive neonatal outcomes.

Promotion of Healthy Intimate Relationships: Effectiveness of the Program Developed with Adolescents

Armando Manuel Marques Silva — 2025-01-30

Background: Adolescence is a crucial period for the intensification of social relationships and the beginning of the first romantic relationships. It is a strategic period for the implementation of programs that promote healthy intimate relationships and prevent violence.

Objective: To evaluate the effectiveness of a program designed to promote healthy intimate relationships among 9th grade students.

Methodology: A single-group pre-experimental study with pre- and post-intervention assessments and a 6-month follow-up. The sample consisted of 109 students in 9th grade. The Knowledge of Intimate Partner Violence (CVRI) and the Detection of Sexism in Adolescents (DSA) scales were used.

Results: Adolescents’ knowledge of intimate partner violence increased and remained high at follow-up. Female adolescents showed higher levels of knowledge, with a statistically significant difference (p < 0.001). Mean DSA scores d creased for both genders after the program and 6 months later.

Conclusion: The improvement in the knowledge about intimate partner violence and the decrease in sexist beliefs among adolescents indicate that participatory educational interventions promote healthy intimate relationships.

Citizen Science for Health in the Co-Creation of Evidence Summaries for Citizens

Sílvia Manuela Dias Tavares Silva — 2025-03-31

Background: Citizen science (CS) and health literacy (HL) promote citizen involvement in scientific research and access to health information. CS enables citizen involvement in co-creating knowledge, while HL enhances citizens’ ability to make informed decisions.

Objective: To systematize older citizen involvement in the co-creation of evidence summaries for citizens (ESC), creating a replicable process and making health information more accessible.

Methodology: Methodological, qualitative study based on the assumptions of Polit and Beck and conducted with older people residing in the community. The data were analyzed according to Bardin’s content analysis methodology.

Results: The participants were actively involved. They reflected on each step and contributed to enhancing the understanding of the information. This collaborative process results in a guide for ESC co-creation and co-validation.

Conclusion: The methodology proved effective in involving citizens in the ESC co-creation, promoting health literacy and increasing the social relevance of scientific research. The guide can be replicated and used by other professionals and researchers.

The Use of Technologies in The Development of Preschool Children: Parents’ Perspectives

Cristiana Vaz Ribeiro — 2025-04-01

Background: The use of technology by preschool children has increased in recent years, with the first exposure occurring at an earlier age, which can influence their development and family dynamics.

Objective: To analyze parents’ perspectives on the influence of technology use on the development of preschool children.

Methodology: Descriptive study with a mixed approach. Data were collected through a questionnaire sent to parents of children aged 12 months to 6 years between June 9 and June 15, 2023.

Results: The sample consisted of 152 parents. In total, 94.2% of the children used technologies, with 56% using them daily. The most frequent positive aspect was the acquisition of new knowledge, and the most frequent negative aspect was dependence.

Conclusion: Parents’ perspectives on the influence of technology on the development of preschool children proved to be relevant as technology is increasingly present in their daily lives. Parents believe that technology use supports the development of their children, but it can also lead to dependence.

Nursing Assessment and Intervention in the Management of Delirium in Intensive Care: A Quantitative Study

Nuno Edgar Carones Esteves — 2025-04-23

Background: Delirium remains underdiagnosed and neglected in intensive care units (ICUs), significantly affecting the prognosis and recovery of critically ill patients.

Objectives: To assess nurses’ knowledge of scales used to assess delirium in critically ill patients and to identify reasons for not using them, risk factors for delirium, and nursing interventions used.

Methodology: A quantitative, descriptive, exploratory, and cross-sectional study involving 115 nurses from an ICU. The data collection instrument was a questionnaire.

Results: It was found that 44.3% of nurses were familiar with a scale for assessing delirium in critically ill patients, with the most commonly cited scale being the Confusion Assessment Method for the Intensive Care Unit. Only 5.2% of nurses used a delirium assessment scale, and the most frequently reported nursing intervention was “Promote a quiet environment” (57.9%).

Conclusion: Although nurses often do not assess delirium or assess it inadequately, they still implement interdependent and autonomous interventions to care for critically ill patients with delirium.

Oral Health Literacy of Parents of Primary School Children

Ana Maria Ferreira Oliveira — 2025-04-23

Background: Oral health is a global public health problem. In Portugal, 6.4 % of children do not have their needs met in this area.

Objectives: To characterize the oral health literacy of legal parents of children in 1st and 2nd grade and assess their perception of their oral health literacy level.

Methodology: An observational, cross-sectional, descriptive study was conducted with a non-probability sample of 84 legal parents. Data were collected using an online questionnaire administered by the research team and validated by experts.

Results: Most of the participants were mothers (89.3%), considered themselves to have a sufficient level of oral health literacy (91.7%), and less than half (46.4%) had received oral health education or information (47.6%). All the children brushed their teeth. The majority had never had an oral health problem (72.6%) and had sought medical care (81%). However, the study revealed some shortcomings in terms of oral hygiene and tooth brushing.

Conclusion: While parents perceive themselves as having oral health literacy, gaps remain in some areas.

Team Building as a Strategy for Retaining Health Professionals: A Descriptive Correlational Study

Sandra Galamba — 2025-03-24

Background: There is a global shortage of healthcare professionals, making their retention urgently needed to ensure effective healthcare coverage. External turnover among healthcare professionals constitutes a significant challenge with potential consequences for organizations, patients, and professionals.

Objective: To verify whether participation in a team training program is associated with the turnover intention of healthcare professionals in a healthcare team.

Methodology: A quantitative exploratory study was carried out. Thirty-four healthcare professionals took part in a structured teambuilding program to explore its association with their turnover intention.

Results: An association was found between participation in the team training program and the turnover intention of healthcare professionals. According to participants, the escape room activity was perceived as the most influential, while monthly meetings contributed the least.

Conclusion: Healthcare professionals who participated in teambuilding activities reported a lower turnover intention.

Pre-Hospital Care for Trauma Victims Based on Kolcaba’s Theory of Comfort

Filipe Melo — 2025-02-12

Background: The physical, emotional, and psychological discomfort of pre-hospital trauma victims is often neglected by focusing only on the ABCDE approach and acute pain. A more comprehensive approach to discomfort is essential for humanizing the care of trauma victims in pre-hospital settings.

Objective: To critically analyze Kolcaba’s theory of comfort in the management of discomfort in the pre-hospital care of trauma victims.

Main topics under analysis: Kolcaba’s theory of comfort is valuable for pre-hospital care, covering physical, emotional, and spiritual comfort. Based on the types of comfort - relief, ease, and transcendence - the theory suggests holistic assessment, empathic communication, psychological support, spiritual respect, a comfortable environment, and continuity of care. This allows for comprehensive, person-centered care that promotes humanized recovery in pre-hospital emergencies.

Conclusion: Kolcaba’s theory of comfort guides healthcare professionals in improving the physical, emotional, and spiritual recovery of trauma victims by providing a humanized and comprehensive approach to pre-hospital emergencies.