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- Analysis of the cost of maintaining effective donors and nondonors of organs and tissues in intensive care unitsPublication . Silva, Aline Moraes; Junior, Marcos Antonio Ferreira; Cardoso, Andreia Insabralde de Queiroz; Cury, Elenir Rose Jardim; Frota, Oleci Pereira; Azevedo, Isabelle Campos; Santos, Viviane Euzebia Pereira; Meza, Leticia Lima; Martins, MatildeThe costs of potential donors are not fully known in Brazil, as in other countries, bespecially during the period that patients remain in intensive care units. This study aims to evaluate the cost of maintaining effective donors and nondonors of organs and tissues for transplants in intensive care units using the microcosting technique. An economic cost analysis using 3 retrospective cohorts constructed from secondary data collected over a 1-year period from medical records of deceased patients who had a protocol opened for brain death investigation. Cost measurement followed the 8 steps of the Time-Driven Activity-Based Costing method. The average cost of the effective donor was US$3220.04. The cost of the nondonor due to family refusal was US$1346.48. The cost of the nondonor due to medical refusal was US $1144.90. Organs and tissues donated but not collected totaled US$16,656.92. A review of work processes and adopting strategies to mitigate the failure to complete donations in all outcomes are necessary, since the sum of the amounts spent on medical refusal, family refusal, and problems preventing collection amounted to a total of US$104,121.66 in 1 year.
- Analysis of the cost of maintaining effective donors and nondonors of organs and tissues in intensive care unitsPublication . Silva, Aline Moraes; Ferreira Júnior, Marcos Antonio; Cardoso, Andreia Insabralde de Queiroz; Cury, Elenir Rose Jardim; Frota, Oleci Pereira; Azevedo, Isabelle Campos; Santos, Viviane Euzébia Pereira; Meza, Leticia Lima; Martins, MatildeA transplant occursthroughadonor, whocanbealiveor deceased, toasickindividualcalledarecipient[1]. Organs specifically inrelationtothedeceaseddonorcanbeobtainedfrom a donorinastateofbraindeath(BD)oraftercirculatorydeath[2]. Organs suchastheheart,lungs,kidneys,liver,pancreasandintes- tine,and/ortissuessuchascorneas,sclera,skin,bones,cartilage, tendons,menisci,musclefascia,heartvalves,andbloodvessels can beharvestedinthecaseofdeceaseddonorsinBD[2]. Thelogisticsforharvestingtooccurmustbeorganizedaccordingtothemaximumischemiatimesupportedbyeachorganandthetransplantproceduretobeperformed;themaxi mumtimesfortheseinBrazilare4hoursforaheart,4to6hoursforalung,12hoursforaliverandpancreas,andupto48hoursforthekidneys[3].
- Loss of quality of corneas stored in hypothermic preservation media during processing and evaluation in an eye bank: a cohort studyPublication . Mota, Felipe Machado; Júnior, Marcos Antonio Ferreira; Hilgert, Christiana Velloso Rebello; Frota, Oleci Pereira; Azevedo, Isabelle Campos; Santos, Viviane Euzébia Pereira; Martins, Matilde; Maidana, Gustavo Moura; Menezes, Bethânia Karoline Alvaro; Abes, Bruna Dias; Borges, Sara Raquel Pinto; Neves, Guilherme ParreiraThis study aimed to analyze factors associated with the loss of quality of corneas stored in hypothermic preservation media durin processing and evaluation in an eye bank. A cohort study was conducted using records from 422 donors (844 corneas) between January 1, 2022, and March 31, 2024. Corneal quality was determined through slit-lamp biomicroscopy based on 13 morphological criteria, with tissues classified on a Likert-type scale from 0 (excellent) to 4 (unacceptable). For analysis, corneas were grouped as higher quality (scores 0–2: excellent, good, and fair) and lower quality (scores 3–4: poor and unacceptable). The outcome was defined as progression from higher to lower quality between the first and second evaluations. No statistically significant associations were found between donor clinical sociodemographic variables and progression to lower quality. The relative risk (RR) of progression to the lower-quality group according to the storage medium (Optisol-GS vs Eusol-C) was low, RR 1.01 (95% Confidence Interval: 0.94 – 1.07), possibly due to the short interval between evaluations (≤ 4 days). However, a significant trend toward higher scores was observed during the second evaluation. These findings suggest that donor characteristics, processing factors, and the preservation medium did not significantly influence the deterioration of corneal quality within the analyzed period. The differences observed between the evaluations are possibly related to the subjective nature of slit-lamp assessment rather than true tissue degradation.
- Cross-cultural adaptation and validation of the advanced practice nursing assessment instrument for the Portuguese context: a methodological studyPublication . Costa, Ivo Filipe Dias da; Ribeiro, Marlene Patrícia; Castro, Luísa; Teixeira, Andreia; Martins, MatildeAdvanced Practice Nursing (APN) is defined by the International Council of Nurses (ICN) as a field of nursing that expands the scope of professional practice by integrating theoretical and evidence-based knowledge acquired through advanced education, typically at the master’s level (1,2). This practice encompasses specialized functions, clinical autonomy, and leadership in highly complex contexts and is internationally recognized through roles such as Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP) (2,3). In Portugal, APN has been gaining relevance, following international trends and responding to emerging healthcare needs (4,5). The Portuguese Nursing and Midwifery Council (Ordem dos Enfermeiros) has established criteria and competencies for specialized practice, requiring advanced training to obtain the title of specialist nurse, which includes clinical, scientific, and human competencies for the provision of differentiated care (6). Despite this progress, the development of advanced roles in Portuguese nursing still faces challenges, particularly when compared to countries such as the United Kingdom, where APN is widely regulated and recognized (3,7).
- Effect of aromatherapy massage with foeniculum vulgare mill. seed essential oil compared to massage on anxiety, well-being, and sleep quality: an exploratory randomized studyPublication . Félix,Beatriz Pires; Rodrigues, Andreia; Sousa, Maria João; Pereira, Olívia R.Aromatherapy is a complementary and alternative medicine (CAM) widely used in the management of several mental and physical conditions. The fennel seed essential oil (FEO) has several biological activities and has been reported as potentially beneficial in the management of anxiety and sleep disorders. The present study aimed to evaluate the effects of aromatherapy massage using FEO compared to massage alone on reducing anxiety and improve sleep quality and overall well ]being. FEO was extracted by hydrodistillation, and its chemical composition was determined by GC‐MS. In the aromatherapy trial, 40 participants were randomly divided into the “Massage Group” (n = 20) and the “Aroma Massage Group” (n = 20). Individuals in the “Aroma Massage Group” were treated with 1.6% of FEO diluted in sweet almond oil, while the “Massage Group” only received the massage with sweet almond oil. The intervention consisted of one massage session every 15 days over a 2 months period. The questionnaires on anxiety (State‐Trait Anxiety Inventory), sleep quality (Pittsburgh Sleep Quality), and well‐being (WHO‐Five Well‐Being Index (WHO‐5)) were performed at four different times. Data were analyzed using SPSS software with a significance level of 5%. The major compound in FEO was trans‐Anethole (78.2%). In the aromatherapy trial, scores on the State Anxiety scale of the State‐Trait Anxiety Inventory (STAI), were significantly lower in the “Aroma Massage Group” compared to “Massage Group” with mean values of 32.47 ± 7.86 and 41.75 ± 11.74, respectively, in Questionnaire 3 (after the last session), corresponding to a difference of −9.28 (p = 0.007). No statistically significant differences were observed over time across the four assessment points, with p = 0.536 for the “Massage Group” and p = 0.381 for the “Aroma Massage Group.” Additionally, the “Aroma Massage Group” showed a higher proportion of individuals reporting strong well‐being (89%) and good sleep (32%) compared to the “Massage Group” (65% and 25%, respectively) in Questionnaire 4 (1 month after the end of the intervention), however, these differences were not statistically significant when considering mean questionnaire scores.
- Fear of falling in older adults: the role of fear of dependency and tiredness as key determinantsPublication . Pires, Patrícia Maria; Carvalho, Joana; Pires, Telma; Pires, Carlos; Ribeiro, OscarFear of falling (FoF) is a multifactorial condition with adverse health outcomes. Objective This study explored factors associated with FoF in community-dwelling older adults, with a particular focus on the role of fear of dependency and tiredness as potential determinants, building on the Multifactorial Causation Model of Falls and Fear of Falling proposed by Hadjistavropoulos et al. Methods A cross-sectional study of 509 adults aged ≥65 evaluated sociodemographic, clinical, and psychological factors. Simple and multiple linear regressions were used to identify FoF-related factors. Results FoF was significantly higher in women and increased with age. Other significant predictors included greater fear of dependency, poorer visual acuity, lower levels of physical activity, greater number of falls in the previous year, higher anxiety, tiredness, and lower mobility/balance (TUG) – which showed the strongest association with FoF (p < 0.05). The multiple regression model explained 47.3% of the variance in FoF. Conclusion Fear of dependency and tiredness were significant predictors of FoF and may represent additional determinants of FoF in community-dwelling older adults.
- Design and usability of an immersive virtual reality simulation in orthopaedic nursing education: a pilot studyPublication . Fernandes, Carla Sílvia; Galvão, Ana Maria; Volpe, Cris Renata Grou; Ferreira, Marta CamposThe increasing complexity of musculoskeletal surgical nursing education requires innovative pedagogical strategies that integrate immersive technologies with structured instructional design to enhance clinical reasoning and theory–practice integration. Aim: To design and develop a nursing process–structured immersive virtual reality simulation for orthopaedic nursing education and to pilot test its usability and educational appraisal among undergraduate nursing students. Design: Pilot mixed-methods study. Method: The simulation, NurseTechGames, was designed as a three-dimensional orthopaedic inpatient scenario structured sequentially according to the nursing process and incorporating gamification elements to support clinical reasoning. The intervention was implemented using Meta Quest 3 head-mounted displays. Usability was assessed using the System Usability Scale, and educational appraisal was measured using the Serious Educational Game in Nursing Appraisal Scale. Open-ended responses were analysed through qualitative content analysis. Participants were monitored during and after the sessions for potential cybersickness symptoms. Results: The simulation achieved a mean score of 83.15 on the System Usability Scale, indicating excellent usability. The total mean SEGINAS score was 95.58, reflecting a very high pedagogical evaluation across the dimensions of engagement, impact on learning, and content relevance. The qualitative analysis identified eight categories, with no reports of significant cybersickness symptoms: Perceived Learning Value, Clinical Transfer, Realism and Immersion, Engagement and Motivation, Technical Robustness, Development Potential, Minor Technical Issues, and Time Constraints. Conclusion: The immersive simulation NurseTechGames demonstrated high usability and strong pedagogical acceptance in musculoskeletal surgical nursing education. Future controlled and longitudinal studies are required to evaluate objective and sustained impact on learning outcomes.
- Percepção da carga de trabalho dos enfermeiros de um serviço de urgência médico-cirúrgicaPublication . Afonso, Arlindo José Cardoso; Magalhães, Carlos PiresAvaliar a perceção da carga individual de trabalho dos enfermeiros do Serviço de Urgência Médico-Cirúrgica de uma Unidade Local de Saúde do Norte de Portugal e explorar a relação entre a perceção da carga de trabalho e variáveis sociodemográficas e profissionais. Estudo transversal descritivo-correlacional e quantitativo. Recorreu-se à escala Individual Workload Perception Scale-Revised para avaliar a perceção da carga de trabalho. A análise utilizou os testes t ou U de Mann-Whitney, análise de variância ou Kruskal-Wallis. A média do escore global da escala foi de 73,73 (DP=9,21), indicando perceção moderadamente positiva. A dimensão “Suporte do enfermeiro gestor” apresentou a menor média por item (3,01). Verificaram-se diferenças estatisticamente significativas em função do tempo de exercício profissional (p=0,001) e do tempo de exercício no serviço atual (p < 0,001). A carga de trabalho percebida possui margem para melhorias por meio de ambientes mais positivos e sustentáveis.
- Impacto de uma atividade formativa no conhecimento de enfermeiros da emergência sobre via verde sepsePublication . Basto, Rita Pinto; Magalhães, Carlos PiresAnalisar o impacto de uma atividade formativa no desenvolvimento dos conhecimentos dos enfermeiros sobre a Via Verde Sepse na abordagem da pessoa em situação crítica. Estudo quase-experimental, com delineamento intra grupo e quantitativo, realizado com 61 enfermeiros de um serviço de emergência do Norte de Portugal. Um questionário foi aplicado antes e após uma atividade formativa entre novembro de 2024 e fevereiro de 2025. A eficácia foi analisada por meio do teste t para amostras pareadas. A pontuação média aumentou de 61,27 ± 17,18 para 85,76 ± 11,36 após a intervenção (t = –11,242; p < 0,001), respetivamente. Verificou-se redução dos níveis de conhecimento muito mau/mau e elevação do nível muito bom, que passou de 1,6% para 42,6% dos participantes. A atividade formativa apresentou impacto positivo e estatisticamente significativo ao fortalecer o conhecimento dos enfermeiros e favorecer o reconhecimento precoce da sepse.
- Conhecimento e dificuldades dos enfermeiros sobre as precauções básicas de controlo de infeçãoPublication . Coelho, Juliana Raquel da Silva; Baptista, GoreteAs Infeções Associadas aos Cuidados de Saúde (IACS) permanecem um desafio significativo, apesar das estratégias nacionais implementadas para o seu controlo. As Precauções Básicas de Controlo de Infeção (PBCI) constituem a primeira linha de defesa na prevenção das IACS, sendo essencial que os enfermeiros detenham conhecimento adequado. Objetivo: Analisar o nível de conhecimento, as perceções e os fatores condicionantes que influenciam a adesão dos enfermeiros às PBCI no Serviço de Urgência de uma Unidade Local de Saúde do Norte de Portugal. Métodos: Estudo quantitativo, descritivo, correlacional e transversal, realizado num serviço de urgência de uma Unidade Local de Saúde do Norte de Portugal. A amostra, por conveniência, integrou 83 enfermeiros. Os dados foram recolhidos por questionário autoaplicado e a suaanálise inferencialincluiutestes de Qui-quadrado e ANOVA(p < 0,05). Resultados: A maioria dos enfermeiros apresentou nível moderado de conhecimento (57,8%). A experiência profissional e o grau académico apenas revelaram uma associação com tendência positiva em relação ao conhecimento geral, enquanto a formação específica em controlo de infeção revelou impacto estatisticamente significativo no nível de conhecimento. A principalbarreira identificada foi o elevado número de doentes (79,5%). A formação contínua (92,8%) foi apontada como estratégia mais eficaz. Conclusão: Os enfermeiros apresentaram conhecimento moderado, mas com persistência de lacunas. Os resultados obtidos destacam a importância da formação contínua nesta área e a presença de dificuldades predominantemente organizacionais.