Validation of the Portuguese version of the Evidence-Based Practice Questionnaire

OBJECTIVES: To describe the process of translation and linguistic and cultural validation of the Evidence Based Practice Questionnaire for the Portuguese context: Questionário de Eficácia Clínica e Prática Baseada em Evidências (QECPBE). METHOD: A methodological and cross-sectional study was developed. The translation and back translation was performed according to traditional standards. Principal Components Analysis with orthogonal rotation according to the Varimax method was used to verify the QECPBE's psychometric characteristics, followed by confirmatory factor analysis. Internal consistency was determined by Cronbach's alpha. Data were collected between December 2013 and February 2014. RESULTS: 358 nurses delivering care in a hospital facility in North of Portugal participated in the study. QECPBE contains 20 items and three subscales: Practice (α=0.74); Attitudes (α=0.75); Knowledge/Skills and Competencies (α=0.95), presenting an overall internal consistency of α=0.74. The tested model explained 55.86% of the variance and presented good fit: χ2(167)=520.009; p = 0.0001; χ2df=3.114; CFI=0.908; GFI=0.865; PCFI=0.798; PGFI=0.678; RMSEA=0.077 (CI90%=0.07-0.08). CONCLUSION: confirmatory factor analysis revealed the questionnaire is valid and appropriate to be used in the studied context.

Process and results of the development of an ICNP® Catalogue for Cancer Pain

This was a methodological study conducted to describe the process and results of the development of an International Classification for Nursing Practice (ICNP®) Catalogue for Cancer Pain. According to the International Council of Nurses (ICN), this catalogue contains a subset of nursing diagnoses, outcomes, and interventions to document the implementation of the nursing process in cancer patients. This catalogue was developed in several steps according to the guidelines recommended by the ICN. As a result, 68 statements on nursing diagnoses/outcomes were obtained, which were classified according to the theoretical model for nursing care related to cancer pain into physical (28), psychological (29), and sociocultural and spiritual (11) aspects. A total of 116 corresponding nursing interventions were obtained. The proposed ICNP® Catalogue for Cancer Pain aims to provide safe and systematic orientation to nurses who work in this field, thus improving the quality of patient care and facilitating the performance of the nursing process.

Nursing care mapping for patients at risk of falls in the Nursing Interventions Classification

Objective: Identifying the prescribed nursing care for hospitalized patients at risk of falls and comparing them with the interventions of the Nursing Interventions Classifications (NIC). Method: A cross-sectional study carried out in a university hospital in southern Brazil. It was a retrospective data collection in the nursing records system. The sample consisted of 174 adult patients admitted to medical and surgical units with the Nursing Diagnosis of Risk for falls. The prescribed care were compared with the NIC interventions by the cross-mapping method. Results: The most prevalent care were the following: keeping the bed rails, guiding patients/family regarding the risks and prevention of falls, keeping the bell within reach of patients, and maintaining patients’ belongings nearby, mapped in the interventions Environmental Management: safety and Fall Prevention. Conclusion: The treatment prescribed in clinical practice was corroborated by the NIC reference.


Asleep or not asleep? Evaluation of the Quality of Patients’ Sleep in Critical Care Nursing

Sleep is important for the recovery of a critically ill patient, as lack of sleep is known to influence negatively a person’s cardiovascular system, mood, orientation, and metabolic and immune function and thus, it may prolong patients’ intensive care unit (ICU) and hospital stay. Intubated and mechanically ventilated patients suffer from fragmented and light sleep. However, it is not known well how non-intubated patients sleep. The evaluation of the patients’ sleep may be compromised by their fatigue and still position with no indication if they are asleep or not. The purpose of this study was to evaluate ICU patients’ sleep evaluation methods, the quality of non-intubated patients’ sleep, and the sleep evaluations performed by ICU nurses. The aims were to develop recommendations of patients’ sleep evaluation for ICU nurses and to provide a description of the quality of non-intubated patients’ sleep. The literature review of ICU patients’ sleep evaluation methods was extended to the end of 2014. The evaluation of the quality of patients’ sleep was conducted with four data: A) the nurses’ narrative documentations of the quality of patients’ sleep (n=114), B) the nurses’ sleep evaluations (n=21) with a structured observation instrument C) the patients’ self-evaluations (n=114) with the Richards-Campbell Sleep Questionnaire, and D) polysomnographic evaluations of the quality of patients’ sleep (n=21). The correspondence of data A with data C (collected 4–8/2011), and data B with data D (collected 5–8/2009) were analysed. Content analysis was used for the nurses’ documentations and statistical analyses for all the other data. The quality of non-intubated patients’ sleep varied between individuals. In many patients, sleep was light, awakenings were frequent, and the amount of sleep was insufficient as compared to sleep in healthy people. However, some patients were able to sleep well. The patients evaluated the quality of their sleep on average neither high nor low. Sleep depth was evaluated to be the worst and the speed of falling asleep the best aspect of sleep, on a scale 0 (poor sleep) to 100 (good sleep). Nursing care was mostly performed while the patients were awake, and thus the disturbing effect was low. The instruments available for nurses to evaluate the quality of patients’ sleep were limited and measured mainly the quantity of sleep. Nurses’ structured observatory evaluations of the quality of patients’ sleep were correct for approximately two thirds of the cases, and only regarding total sleep time. Nurses’ narrative documentations of the patients’ sleep corresponded with patients’ self-evaluations in just over half of the cases. However, nurses documented several dimensions of sleep that are not included in the present sleep evaluation instruments. They could be classified according to the components of the nursing process: needs assessment, sleep assessment, intervention, and effect of intervention. Valid, more comprehensive sleep evaluation methods for nurses are needed to evaluate, document, improve and study patients’ quality of sleep.

Psychometric Properties of the Inventário Dimensional Clínico da Personalidade (IDCP) using the Rating Scale Model

The aim of this study was to evaluate the performance of the Dimensional Clinical Personality Inventory (DCPI) using Rasch-based person and item analysis. 1281 participants were recruited, between 18 and 90 years of age (M=26.64; SD=8.94), 431 men (33.6%) and 127 (9.9%) patients diagnosed with axis I disorders and/or axis II according to DSM-IV-TR. Results indicated the IDCP scales performed reasonably well, and the usefulness of the analyses presented, demonstrate the Rasch model’s applicability for clinical applications. Among the important tools offered by the Rasch model, we explore the use of the person-item map, which visually presents the intuitively understandable psychological construct along the dimensional scale of the instrument.

The Brazilian architecture in wood and the confrontations with the questions of the environment

Two discussions are imposed to the designers of wood constructions. The first one deals with the technical knowledge to project and execute buildings; the second one is concerned with the preservation of the environment, use of the wood in a sustainable way. The work presents the tendencies of the wood used in the Brazilian habitation architecture characterizing the used woods; how the construction technical solutions have developed and discusses about the necessity of using the wood in a conscious way, knowing its origin and control, sustainable use of the forests resources. It focalizes, mainly, the search of the designers to harmonize the use of the wood and the preservation of the forest biodiversity, when it deals with the native forest.

THE ANALYSIS OF ACTIVITIES NOT PERFORMED BY THE NURSING TEAM REGARDING THE DIAGNOSIS OF INEFFECTIVE BREATHING PATTERN IN THE ELDERLY

The objective of this cross-sectional, descriptive study was to identify the activities of the Nursing Intervention Classification considered as priorities for an Ineffective Breathing Pattern and not performed for elderly inpatients of a teaching hospital in the state of Goias. The study participants were 43 nursing professionals, and data collection was performed in the period spanning October to December 2008, after receiving approval from the Ethics Committee. It was observed that among the 67 activities considered to be priorities for the referred diagnosis, only seven were performed by all of the participants; the other activities, with a varied frequency, were not performed, with the main reason cited being that a professional from a different area completed the activity. It is understood that the fact that the nursing staff does not perform these activities can cause lack of complete coverage in nursing care; therefore there is a need for a legal apparatus to describe the activities that comprise professional practice exclusive to nursing personnel and those activities that have an interdisciplinary nature.

Distances walked in the six-minute walk test: suggestion of defining characteristic for the nursing diagnosis Ineffective Peripheral Tissue Perfusion

Distances walked in walking tests are important functional markers, although they are not accepted as defining characteristics of Ineffective Peripheral Tissue Perfusion. The aims of this study were to verify the distances participants with and without this nursing diagnosis walked in the six-minute walk test and if these measures may be considered defining characteristics of this phenomenon. Participants with (group A; n=65) and without (group B; n=17) this nursing diagnosis were evaluated regarding physical examination, vascular function and functional capacity. Participants of group A seemed to have worse vascular function and functional capacity compared with those of group B. Pain-free travelled distance was predictive of the nursing diagnosis. These results are important for the refinement of this diagnosis. In conclusion, this study provides evidences that the distances walked in the six-minute walk test may be considered defining characteristics of Ineffective Peripheral Tissue Perfusion.

Theory and Practice: A Matter of Words. Language, Knowledge and Professional Community in Social Work

The relation between theory and practice in social work has always been controversial. Recently, many have underlined how language is crucial in order to capture how knowledge is used in practice. This article introduces a language perspective to the issue, rooted in the ‘strong programme’ in the sociology of knowledge and in Wittgenstein’s late work. According to this perspective, the meaning of categories and concepts corresponds to the use that concrete actors make of them as a result of on-going negotiation processes in specific contexts. Meanings may vary dramatically across social groups moved by different interests and holding different cultures. Accordingly, we may reformulate the issue of theory and practice in terms of the connections between different language games and power relationship between segments of the professional community. In this view, the point is anyway to look at how theoretical language relates to practitioners’ broader frames, and how it is transformed while providing words for making sense of experience.

Risk-conscious Reconstruction in Pakistan-administered Kashmir. A Case Study of the Chakhama Valley

The Chakhama Valley, a remote area in Pakistan-administered Kashmir, was badly damaged by the 7.6-magnitude earthquake that struck India and Pakistan on 8 October 2005. More than 5% of the population lost their lives, and about 90% of the existing housing was irreparably damaged or completely destroyed. In early 2006, the Aga Khan Development Network (AKDN) initiated a multisector, community-driven reconstruction program in the Chakhama Valley on the premise that the scale of the disaster required a response that would address all aspects of people's lives. One important aspect covered the promotion of disaster risk management for sustainable recovery in a safe environment. Accordingly, prevailing hazards (rockfalls, landslides, and debris flow, in addition to earthquake hazards) and existing risks were thoroughly assessed, and the information was incorporated into the main planning processes. Hazard maps, detailed site investigations, and proposals for precautionary measures assisted engineers in supporting the reconstruction of private homes in safe locations to render investments disaster resilient. The information was also used for community-based land use decisions and disaster mitigation and preparedness. The work revealed three main problems: (1) thorough assessment of hazards and incorporation of this assessment into planning processes is time consuming and often little understood by the population directly affected, but it pays off in the long run; (2) relocating people out of dangerous places is a highly sensitive issue that requires the support of clear and forceful government policies; and (3) the involvement of local communities is essential for the success of mitigation and preparedness.

Text-book of advanced machine work, prepared for students in technical, manual training and trade schools, and for the apprentice and the machinist in the shop,

In 16 sections, each section separately paged, with the section number in heavy face type prefixed to the page numbers.

New trends in health architecture for children and the effects of the built environment on young patients

The objective of this thesis was to investigate the effects of the built environment on the outcome of young patients. This investigation included recent innovations in children's hospitals that integrated both medical and architectural case studies as part of their design issues. In addition, the intervention responded to man-made conditions and natural elements of the site. The thesis project, a Children's Rehabilitation Hospital, is located at 1500 N.W. River Drive in Miami, Florida. The thesis intervention emerged from a site analysis that focused on the shifting of the urban grid, the variation in scale of the immediate context and the visual-physical connection to the river's edge. Furthermore, it addressed the issues of overnight accommodation for patient's families, as well as sound control through the use of specific materials in space enclosures and open courtyards. The key to the success of this intervention lies in the special attention given to the integration between nature and the built environment. Issues such as the incorporation of nature within a building through the use of vistas and the exploitation of natural light through windows and skylights, were pivotal in the creation of a pleasant environment for visitors, employees and young patients.

The Decent Work Questionnaire (DWQ): Development and validation in two samples of knowledge workers

This research aimed to develop a questionnaire measure of workers’ perceptions of decent work. The initial pool of 72 items covered the substantive elements used by the International Labour Organization to characterize decent work. It was administered to workers from Portugal (N = 636) and Brazil (N = 1039) and submitted to exploratory and confirmatory factor analysis. The final 31-item version yields seven factor scores in addition to the global decent work score. With good reliability, convergent and discriminant validity indices, the DWQ could open new avenues for empirical studies of the decent work concept.

A study of the validity and reliability of the Brazilian version of the Body Shape Questionnaire (BSQ) among adolescents

OBJECTIVES: to produce evidence of the validity and reliability of the Body Shape Questionnaire (BSQ) - a tool for measuring an individual's attitude towards his or her body image. METHODS: the study covered 386 young people of both sexes aged between 10 and 18 from a private school and used self-applied questionnaires and anthropometric evaluation. It evaluated the internal consistency, the discriminant validity for differences from the means, according to nutritional status (underweight, eutrophic, overweight and obese), the concurrent validity by way of Spearman's correlation coefficient between the scale and the Body Mass Index (BMI), the waist-hip circumference ratio (WHR) and the waist circumference (WC). Reliability was tested using Wilcoxon's Test, the intraclass correlation coefficient and the Bland-Altman figures. RESULTS: the BSQ displayed good internal consistency (±=0.96) and was capable of discriminating among the total population, boys and girls, according to nutritional status (p<0.001). It correlated with the BMI (r=0.41; p<0.001), WHR (r=-0.10; p=0.043) and WC (r=0.24; p<0.001) and its reliability was confirmed by intraclass correlation (r=0.91; p<0.001) for the total population. The questionnaire was easy to understand and could be completed quickly. CONCLUSIONS: the BSQ presented good results, thereby providing evidence of its validity and reliability. It is therefore recommended for evaluation of body image attitudes among adolescents.

Psychometric properties of the DASS-Depression scale among a Brazilian population with chronic pain

Background: Depression is a common contributor to suffering and disability in people with chronic pain. However, the assessment of depression in this population has been hampered by the presence of a number of somatic symptoms that are shared between chronic pain, treatment side-effects and traditional concepts of depression. As a result, the use of depression measures that do not contain somatic items has been encouraged. Objective: This study examined the psychometric properties of the Depression sub-scale of the Depression Anxiety and Stress Scales (DASS) in a Brazilian chronic pain patient population. Method: Data on a number of measures were collected from 348 participants attending pain facilities. Results: Principal components and exploratory factor analyses indicated the presence of only one factor. Item analyses indicated adequate item-scale correlations. The Cronbach alpha was .96, which suggests an excellent internal consistency. Conclusion: The DASS-Depression scale has adequate psychometric properties and its further use with Brazilian chronic pain populations can now be supported. (c) 2008 Elsevier Inc. All rights reserved.