Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: The cardiac rehabilitation programs (CRP), in its different phases, allow the rehabilitation nurse to have a privileged intervention in the monitoring and care of the person submitted to a heart transplant, from the preoperative phase, in the mediate recovery period and late postoperative. It contributes to the autonomy and self-care of the person and his family, adapting to new health condition and increasing their quality of life, intervening in the various psychological and physiological changes resulting from transplant, with cardiac rehabilitation being an advantageous therapeutic option in this case. Objective: To analyze the health outcomes of Rehabilitation Nursing in a Cardiac Rehabilitation Program home-based.  Strategies / methodology: Case report of mixed approach integrated 7 cases. There were included person submitted to a heart transplant who have never been part of a cardiac rehabilitation program (CRP), manifesting changes in functional capacity.The following patient characteristics were defined as variables: time of transplant, age, gender and anthropometric measurements. Physiological parameters such as heart rate (HR), blood pressure (BP), subjective perception of effort (PSE) were evaluated using the modified Borg scale and 6-minute walk test, in 2 moments of follow-up consultation, with a 3-months interval. At first, after evaluation, a PRC was prescribed in a Home-based model. Telephone and email contacts were made to understand the difficulties experienced, as well as the level of compliance with the program. The measurement of results was made in a second moment of contact. Results: The integration in the CRP provided an improvement in functional capacity, with 85.71% of the cases of this study with clinically significant increase in the distance of the the 6-minutes walk test, with an improvement in the subjective notion of effort in 57.14% of subjects. There were improvements in the status of the common nursing diagnoses identified, such as Intolerance to activity; Self-care: physical activity not compromised. There was also an improvement in the control of cardiovascular risk factors, such as diet, stress, among others, all patients changed part of their diet plan, resulting in Adherence to the non-compromised diet.100% of patients present speeches in favor of improving the quality of life related to the program and monitoring. There were no adverse events during the program. Conclusions: In this study it is observed that the participation in phase III of CRP is safe and translates improvement of the functional capacity, greater capacity of adherence to the dietary regime and control of cardiovascular risk factors, being associated with positive discourses of quality of life.

Pulmonary Rehabilitation is the non-pharmacological treatment indicated for people with COPD, with physical exercise and health education focused on the development of self-care and self-management, promoting physical, emotional condition, adherence to the therapeutic regime and quality of life. It is intended to demonstrate the effectiveness of a home PR program. Method: Quantitative case study that took place over 8 weeks, with biweekly multidisciplinary intervention, using exercise training, education sessions and telephone follow-up. Functional assessment was performed at admission and discharge, using the instruments Clinical CCQ Questionnaire, Sit and Stand Test (T S&L) and Barthel Index. Results: A 70-year-old man, diagnosed with COPD, performed 16 face-to-face training sessions as planned. It presented significant functional evolution: initial CCQ 4.5, final 3.2; T S&L initial 5, final 14; Initial Barthel index 55, final 90. Conclusion: The outlined pulmonary rehabilitation program demonstrated effectiveness and safety, promoting significant functional improvement.

Introduction: Stroke is one of the leading causes of morbidity and mortality worldwide, resulting in a variety of deficits, motor and cognitive-behavioral, as well as emotional. Thus, rehabilitation nursing has great importance in helping the patient regain lost capacities and become independent again, including family in this process. However, the work of the rehabilitation nurse should not be restricted to the acute phase and should be extended over time, especially after returning home, when problems related to a higher degree of dependence arise. Objective: Analyze deviations from the plan defined at discharge by the rehabilitation nurse. Method: An exploratory, descriptive, retrospective and quantitative study involving 339 patients. Results: Patients have a mean age of 71 years, are predominantly male, and the predominant vascular event was ischemic stroke. The majority of patients presented functional and motor improvement after discharge. Several problems were identified in the consultation and corrective measures were taken to prevent them from worsening and to promote future corrections. Statistically significant relationships were established between the degree of dependence and the institutionalization of the patients, as well as between the cognitive alterations and the degree of dependence. Conclusion: The results made it clear that even after discharge, patients with stroke need support, support, guidance, teaching and training to improve outcomes and prevent complications. Hence, the work of the rehabilitation nurse should extend beyond the discharge of the patient with stroke, with a view to the future with greater security.

Objective: To describe, from the perspective of continuity of care, a clinical case where there has been monitoring by rehabilitation nurses for a year, involving different contexts of health care provision. Materials and method: The case reports to a patient with multimorbidity, who has been the target of health care in four different contexts over the past year: ECCI, acute hospital admission, maintenance / rehabilitation hospital admission and ambulatory. In each of the described contexts, the user was subject to an assessment by the rehabilitation nurse, which resulted in the implementation of a rehabilitation plan whenever the clinical condition allowed. In each of the isolated contexts, there was a positive functional and / or clinical evolution, which translates into significant evolution when comparing the chronological extremes of the period in question. Between each different context, there was formal and informal communication of clinical data, including the rehabilitation plan underway at the time of the transition between contexts. Results and discussion: From the analysis of the exposed data, it is possible to make the following inferences: a) there was a positive evolution of the user's functional condition between the beginning and the end of the period under analysis (total recovery of muscle strength, balance and autonomy of the users). self-care); b) in each individual context, and whenever the patient's clinical condition allowed, a specific rehabilitation plan was implemented, which resulted in functional and clinical gains; c) although there was formal and informal communication between contexts about the rehabilitation plan, a unique and dynamic rehabilitation plan was not followed; d) possibly, a unique and dynamic rehabilitation plan would allow to achieve the results obtained more quickly, due to the greater fluidity of care between contexts. Conclusion: It is possible to have long-term rehabilitation strategies in complex clinical cases, even if several contexts of health care provision come into equation. Although the communication between the different contexts allows the sequencing of the respective rehabilitation plans, there is room for improving the continuity of care between different services and the ambition is to adopt a single, transversal and dynamic rehabilitation plan; a possible way for this improvement will be the formalization of direct communication between its professionals, as a complement to the use of the information systems in use.

Background: Immobility in critically ill patients is conditioned by the condition of the disease or by the effect of drugs, but in both cases, it emerges as a problem from the perspective of functional recovery. The decrease in muscle mass and joint amplitude delay or hinder the processes of recovery from spontaneous ventilation and self-care. When bed rest is required, safe rehabilitation nursing care is a resource to mitigate the problems associated with immobility. Objective: Evaluate the results of rehabilitation nursing care after the application of a structured passive joint mobilization care intervention in critically ill patients. Methods: Qualitative study, case study type. The case of an adult person in a critical situation is presented and eight joint mobilization sessions were carried out by a rehabilitation nurse. Joint amplitude was evaluated using goniometry before and after the application of a rehabilitation program. Study approved by the ethics committee. Results: It was found that in 26 days of admission to the intensive care unit, the joint amplitude remained in the different segments and there were gains in the supination movements of the forearm, left hand extension and right knee flexion. Passive joint mobilization exercises did not interfere with the stability of physiological parameters or adaptation to the ventilatory prosthesis. Conclusion: The results reveal that there is no decrease in joint amplitude and are sensitive to rehabilitation nursing care, in a structured and regular mobilization plan. There were gains in health and the minimization of complications associated with immobility. Other studies should be carried out in order to parameterize not only the intervention plan but also the evidence of the results obtained.

Passam dois anos desde o lançamento da Revista Portuguesa de Enfermagem de Reabilitação. Dois anos de um percurso que obrigou a dedicação e trabalho redobrados por parte de uma vasta equipa, mas dois anos de um percurso que conduziu a uma aprendizagem constante e frutífera. É com muito orgulho que o afirmo: estamos de parabéns; a Enfermagem de Reabilitação está de parabéns! Ao longo destes dois anos a qualidade dos artigos publicados é evidente. Para isto, muito tem contribuído a dedicação de um grupo profissional que investiga muitas vezes em circunstâncias adversas. A Pandemia que nos assola colocou a nu alguns dos problemas existentes no Serviço Nacional de Saúde em Portugal, com a necessidade de retirada de horas de cuidados especializados a enfermeiros especialistas e respetiva alocação dessas horas para cuidados de enfermagem gerais. Esta necessidade, para além de clara demonstração da falta de enfermeiros em alguns contextos, impediu que muitos cidadãos acedessem a cuidados de enfermagem de reabilitação e que se viram, assim, coartados de um direto constitucional de acesso equitativo a cuidados de saúde, particularmente de reabilitação, como definido no artigo 64º ponto 3.a) da Constituição da República Portuguesa. Quando o país precisou que os Enfermeiros de Reabilitação estivessem presentes, estivemos. Aguardamos a devida e merecida reciprocidade. Urge a definição clara, por parte das instituições de saúde, das horas específicas de cuidados de enfermagem de reabilitação. A par desta definição, de forma a criar um corpo de conhecimento próprio ainda mais forte, será determinante que nos próximos meses os enfermeiros de reabilitação sejam capazes de: Aumentar a investigação fora do contexto académico para atribuição de grau, com investigação específica aplicada aos contextos da prática clínica; Fomentar que a investigação de âmbito académico seja produzida nos contextos clínicos; Ver aprovados projetos de investigação de aplicação clínica; Aumentar ainda mais a produção científica e respetiva publicação em revistas científicas da especialidade.   Que o sucesso destes dois anos da Revista Portuguesa de Enfermagem de Reabilitação seja a rampa de lançamento para muitos mais anos de publicação de artigos de referência no âmbito das competências específicas da Enfermagem de Reabilitação.

Objective: to design a proposal for nursing care aimed at activity intolerance, in an individual with Stage 5 Chronic Kidney Disease undergoing hemodialysis. Methods: a case study and descriptive study, referring to a 76-year-old male undergoing hemodialysis. The Roper, Logan and Tierney Life Activities Model was used for data collection and NANDA-I, NIC and NOC taxonomy to support the care plan. Results: in the initial assessment, 6 autonomous nursing diagnoses were raised, of which one was highlighted as a priority: Activity intolerance (00092) and interventions that promote physical activity and physical exercise. Conclusion: nursing intervention has a fundamental role for the assessment and intervention in the scope of physical activity and physical exercise in people undergoing hemodialysis, which can reduce intolerance to activity and subsequently improve their quality of life.

Context: Laparotomy is a surgery involving an incision in the abdominal wall to access the abdominal cavity. There is controversial data regarding the benefits of the implementation of early respiratory exercises in the prevention of pulmonary complications after laparotomy surgery. Objective: To examine the evidence about the effect of incentive spirometry in reducing respiratory complications in laparotomy's postoperative patients. Methodology: A systematic review, following the Joanna Briggs Institute methodology. Multiple databases were searched: CINAHL Plus with Full Text, PubMed and Scopus, as well as gray literature for studies comparing adult patients submitted to laparotomy surgery with incentive spirometry prophylaxis in the postoperative versus adult patients submitted to abdominal surgery with no postoperative respiratory exercises and also Adult patients submitted to laparotomy abdominal surgery with incentive spirometry prophylaxis postoperative versus Adult patients submitted to abdominal surgery with any other type of postoperative respiratory exercises. Results: Of the 160 studies retrieved, 1 randomized prospective trial was included in this review. This study states that there’s no significant difference between the use of incentive spirometry and positive intermittent pressure. Conclusion: Although the efficacy of incentive spirometry was demonstrated, further research is needed to explore the incentive spirometry among patients submitted to abdominal surgery.

Introduction: Hip arthroplasty is a frequent surgery that, combined with pain and decreased mobility, increases dependence on self-care and is a predictor of loss of functionality. Objective: To determine the advantages of preoperative preparation consultation in the evolution of postoperative functionality of the person undergoing hip artroplasty. Method: Integrative Literature Review, eligibility criteria were defined for the bibliographic sample. Results: The bibliographic sample consisted of 16 articles that allow us to respond to the research objective. Structured recovery programs with preoperative consultation reduce postoperative complications and average length of stay, promote better pain management and faster recovery through an interprofessional approach. Conclusions: The rehabilitation program should start in the preoperative phase because increased knowledge about surgery, rehabilitation program and transition to the community translates into health, social and economic gains.

Background: Stroke is one of the main causes of disability, causing changes that are manifested in a restriction of the person's functionality, contributing to an increase of accidental falls. The identification of risk factors by the Nurse Specialist in Rehabilitation Nursing is imperative to avoid these events. Objective: To identify risk factors for falls in people with stroke. Methods: Systematic review of the literature, with research on the EBSCO Host® platform, in CINAHL and MEDLINE, in the period of the 1st and 31st of October 2017. The following research equation (Accidental Falls) AND (Stroke) AND (Risk Factors) were used. Results: A sample of 19 studies and a total of 22 risk factors were obtained, 12 of which are present in the NANDA-I taxonomy. Conclusions: This research allowed the identification of risk factors for stroke decline. This study contributes to the development of nursing discipline knowledge, and has implications for clinical practice, education and new research in a nursing care sensitive area.