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Special Issue "Primary Care and Geriatric Nursing"

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: 31 January 2024 | Viewed by 10297

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Special Issue Editors

Prof. Dr. Maria Adriana Henriques

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Guest Editor

Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: healthy aging; complex interventions; falls; community health interventions; public health interventions; fundamental care; chronic disease

Prof. Dr. Andreia Costa

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Guest Editor

Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: social prescribing; health literacy; healthy aging; complex interventions; falls

Prof. Dr. Cristina Lavareda Baixinho

E-Mail Website
Guest Editor

Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Community Nurse Department, Nursing School of Lisbon, 1900-160 Lisbon, Portugal
Interests: falls; transitional care; knowledge transfer; home security; musculoskeletal disorders

Special Issue Information

Dear Colleagues,

The increase in life expectancy, in chronic diseases, the number of older people with disabilities, functional decline, and dementias have changed the morbidity profile and contributed to the emergence of new healthcare needs that promote health literacy and increase autonomy and independence so that the person can age within the community and at home.

This challenges and weaknesses in research and healthcare to this population, especially the most vulnerable and those with lower levels of health literacy, became clear during the COVID-19 pandemic, which contributed to isolation and difficulties in accessing care and aggravated some situations of chronicity, hindering the pooling of efforts to meet the emerging needs of individuals, families, and the community, conditioning support to elderly people and hindering transition to the role of informal caregivers.

In this Special Volume dedicated to “Primary Care and Geriatric Nursing”, we challenge nurses and other professionals to disseminate studies, systematic reviews, and experience reports focused on new models of care delivery to community-dwelling older people and caregivers—interventions that promote active aging in the context of people's lives, ensuring and enhancing community resources, for example, through social prescription, chronic disease management in the community, and accident prevention in the community and safety in this care practice environment.

Prof. Dr. Maria Adriana Henriques
Prof. Dr. Andreia Costa
Prof. Dr. Cristina Lavareda Baixinho
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

social prescribing
health literacy
healthy ageing
complex interventions
falls
community health interventions
public health interventions
transitional care
fundamental care
home security

Published Papers (11 papers)

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Research

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Open AccessArticle

Relationship between Burden, Quality of Life and Difficulties of Informal Primary Caregivers in the Context of the COVID-19 Pandemic: Analysis of the Contributions of Public Policies

Tania Gaspar

Marta Raimundo

Sofia Borges de Sousa

Marta Barata

and

Tulia Cabrita

Int. J. Environ. Res. Public Health 2023, 20(6), 5205; https://doi.org/10.3390/ijerph20065205 - 15 Mar 2023

Viewed by 677

Abstract

The study aimed to characterize and understand the difficulties experienced by informal caregivers from a bio-psychosocial and environmental perspective, taking into account the socio-demographic and health characteristics of the informal caregiver and the person cared for, quality of life, perceived burden, social support, and the impact of the COVID-19 pandemic on the informal caregiver and the person cared for. The participants were 371 informal primary caregivers, 80.9% female, aged between 25 and 85 years, mean 53.17 (SD = 11.45) years. Only 16.4% of the informal caregivers benefited from monitoring and training for informal caregiver skills; 34.8% received information on the rights of the person being cared for; 7.8% received advice or guidance on the rights and duties of the informal caregiver; 11.9% of the caregivers benefited from psychological support; and 5.7% participated in self-help groups. A convenience sample was used, and data were collected via an online questionnaire. The main findings show that the major difficulties experienced by caregivers are related to social constraints, the demands of caring, and the reactions of the person cared for. The results reveal that the burden of the main informal caregivers is explained by the level of education, quality of life, level of dependence of the person cared for, level of difficulties, and social support. The COVID-19 pandemic impacted caregiving by increasing the perceived difficulty of accessing support services, such as consultations, services, and support; causing distress feelings in the caregiver, such as, anxiety and worry; increasing the needs and symptoms of the person cared for; and increasing the degree of isolation, for both, the informal caregiver and the person cared for. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

Open AccessArticle

Patient-Reported Outcomes and Experiences Assessment in Women with Breast Cancer: Portuguese Case Study

Joaquim Abreu de Sousa

Salomé Gonçalves-Monteiro

and

Int. J. Environ. Res. Public Health 2023, 20(4), 2931; https://doi.org/10.3390/ijerph20042931 - 08 Feb 2023

Viewed by 611

Abstract

In 2020, female breast cancer was the most commonly diagnosed cancer worldwide, representing the type of cancer with the highest incidence among women and the second most common cause of cancer death among women in all OECD countries. The conventional measures addressing the burden of breast cancer by measuring mortality, incidence, and survival do not entirely reflect the quality of life and patients experience when receiving breast cancer care. The main objective of this study is to capture patient-reported outcomes and experiences in women with breast cancer in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 378 women with breast cancer, with the age distribution being 19.8% aged 15 to 49 years and 80.2% aged 50 years and over. The data collection procedure and analysis followed the “OECD Breast Cancer Patient Reported Outcomes Working Group” protocol, allowing subsequent comparability with data from other OECD member countries. Most women were satisfied with the treatment outcome regarding the shape of their lumpectomy breast when wearing a bra (96.1%) and with the equal size of both breasts (78.3%). Findings on the WHO QOL-BREF showed that women manifest a lower score in well-being when compared with the general population or populations living with chronic diseases. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in breast cancer services in Portugal. Measuring PROMs and PREMs from Portuguese women receiving breast cancer care provides insightful evidence into the quality and value of cancer care. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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Open AccessArticle

Value-Based Health Care: Long-Term Care Insurance for Out-of-Pocket Medical Expenses and Self-Rated Health

Guangbo Ma

and

Kun Xu

Int. J. Environ. Res. Public Health 2023, 20(1), 192; https://doi.org/10.3390/ijerph20010192 - 23 Dec 2022

Viewed by 866

Abstract

Long-term care insurance (LTCI) is a significant approach in the effort to actively manage aging and the currently unmet need for aged care in China. Based on data from the 2011, 2013, 2015, and 2018 phases of the China Health and Retirement Longitudinal Study, we used the propensity score matching-difference in difference (PSM-DID) approach to explore the impact of LTCI on out-of-pocket medical expenses and self-rated health. Results showed that LTCI can significantly reduce out-of-pocket medical expenses by 37.16% (p < 0.01) per year and improve self-rated health by 5.73% (p < 0.01), which conforms to the spirit of “value-based health care”. The results were found to be stable in the robustness tests conducted. Currently, China is at the intersection of “low-value-based health care” and “value-based health care”. Improving the health level of aged individuals while keeping medical costs under reasonable control is crucial for formulating and implementing a new round of healthcare reform in China. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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Open AccessArticle

Emotional Universe of Nurse Case Managers Regarding Care for Elderly at Risk in Spain: A Hermeneutical Study

Ángeles Pastor-López

Pedro E. Ventura-Puertos

José Hernández-Ascanio

Vanesa Cantón-Habas

Pablo Martínez-Angulo

and

Manuel Rich-Ruiz

Int. J. Environ. Res. Public Health 2022, 19(24), 16445; https://doi.org/10.3390/ijerph192416445 - 08 Dec 2022

Viewed by 644

Abstract

The role of nurse case managers (NCM) involves a rarely visible emotional labor, even more when their role focuses on the care of elders at risk (EAR). Motivated by the lack of qualitative research on the emotional universe of NCM, this study explores the emotional universe (EU) of NCM regarding the care they provide to EAR in primary health care as well as the reasons that generate these emotions. An interpretative–phenomenological approach was implemented in southern Spain, with a purposive sampling that included nurses playing the NCM role for at least three years. Data collection was conducted in two periods (between September 2019 and July 2022). The primary collection tool was the semi-structured individual interview, with starting categories based on Bisquerra’s EU taxonomy. The analysis followed Ricoeur’s considerations, using the Nvivo software. In the NCM’s EU, the recognition of the social phenomena stands out, with an open feeling of empathy regarding the desire of the EAR to continue living at home. However, there was also helplessness, resignation, disappointment, and frustration when EAR rejected their proposals. Furthermore, the system’s limitations aroused compassion in the NCM and made them go beyond the limits of their role. This EU requires that their role be valued more, and higher responsiveness must be enforced to improve EAR care. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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Open AccessArticle

Healthcare Equity and Commissioning: A Four-Year National Analysis of Portuguese Primary Healthcare Units

and

Int. J. Environ. Res. Public Health 2022, 19(22), 14819; https://doi.org/10.3390/ijerph192214819 - 10 Nov 2022

Viewed by 1327

Abstract

Equal and adequate access to healthcare is one of the pillars of Portuguese health policy. Despite the controversy over commissioning processes’ contribution to equity in health, this article aims to clarify the relationship between socio-economic factors and the results of primary healthcare (PHC) commissioning indicators through an analysis of four years of data from all PHC units in Portugal. The factor that presents a statistically significant relationship with a greater number of indicators is the organizational model. Since the reform of PHC services in 2005, a new type of unit was introduced: the family health unit (USF). At the time of the study, these units covered 58.1% of the population and achieved better indicator results. In most cases, the evolution of the results achieved by commissioning seems to be similar in different analyzed contexts. Nevertheless, the percentage of patients of a non-Portuguese nationality and the population density were analyzed, and a widening of discrepancies was observed in 23.3% of the cases. The commissioning indicators were statistically related to the studied context factors, and some of these, such as the nurse home visits indicator, are more sensitive to context than others. There is no evidence that the best results were achieved at the expense of worse healthcare being offered to vulnerable populations, and there was no association with a reduction in inequalities in healthcare. It would be valuable if the Portuguese Government could stimulate the increase in the number of working USFs, especially in low-density areas, considering that they can achieve better results with lower costs for medicines and diagnostic tests. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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Open AccessArticle

Does Reality Overcome the Expected? Survey on Informal Caregivers’ Profile: A Nurse-Led Study in Times of COVID-19

Maria Adriana Henriques

and

Int. J. Environ. Res. Public Health 2022, 19(18), 11394; https://doi.org/10.3390/ijerph191811394 - 10 Sep 2022

Viewed by 777

Abstract

The increasing overload of chronic conditions raises challenges for the health system. Informal caregivers have a major role in ensuring the quality of life of the cared-for person, despite the reported lack of working resources which can lead to unmet needs. This article reports on the first part of a nurse-led research project entitled ‘‘Informal caregiver’ profiles in Lisbon county: a health community approach.’ We aimed to support decision-making by developing an informal caregiver profile to promote tailored interventions. A survey addressing the dyad was developed and submitted to a convenient, network-based, stratified sample of carers aged 18 years or above. More than thirty community partners supported the identification of caregivers. Data were submitted to univariate descriptive analysis. A profile of the cared-for person and the informal caregiver was uncovered by identifying 639 caregivers, of whom the majority lived with the cared-for person. Only four percent planned the transition to a caregiver role, and no more than 10% had access to support programs. Approximately half of the respondents found that COVID-19 negatively impacted their performance in the caregiver role. Developing a local and tailored strategy with collaboration between healthcare professionals, academics, and community partners is key to ensuring that meaningful support is provided to caregivers. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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Open AccessArticle

Mental Health Patient-Reported Outcomes and Experiences Assessment in Portugal

Anabela Coelho

Katherine de Bienassis

and

Int. J. Environ. Res. Public Health 2022, 19(18), 11153; https://doi.org/10.3390/ijerph191811153 - 06 Sep 2022

Cited by 3 | Viewed by 1103

Abstract

Mental ill-health is increasingly recognized by policymakers for its significant human and economic toll. The main objective of this study is to capture patient-reported outcomes and experiences on mental health care in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 397 participants, 247 (62.2%) women, divided into four age groups: ages 16–24 years, ages 25–44 years, ages 45–65 years, and ages 66 years or older. The data collection procedure and analysis followed the OECD PaRIS Mental Health Working Group 2021 protocol allowing subsequent comparability with data from other OECD member countries. Findings on the WHO-5 Well-Being Index showed that women manifest a lower score in well-being following mental health care services use. This finding may be, at least in part, explained by the study population (mental health services users), including individuals with clinical depression which is more frequently observed in women. In terms of the level of satisfaction with treatment (provided by nurses, doctors, phycologists, etc.) the response “Yes, definitely” varied from 67% of answers regarding “time spent by care providers”, 76.3% “involvement in decisions” to 79.7% regarding “clarity of explanations” and 84.4% regarding the item courtesy and respect. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in mental health services in Portugal. The study results generate useful clinical information to help meet the expectations and needs of patients, contributing to a continuous improvement of mental health community services. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

Open AccessArticle

Ageing and Long-Term Informal Care: The Reality of Two Countries in Europe: Denmark and Portugal

Ana Catarina Maia

Paulo Nogueira

Maria Adriana Henriques

Carla Farinha

and

Andreia Costa

Int. J. Environ. Res. Public Health 2022, 19(17), 10859; https://doi.org/10.3390/ijerph191710859 - 31 Aug 2022

Viewed by 817

Abstract

The knowledge of long-term informal care is particularly interesting for social and health measures related to ageing. This study aims to analyze how Portugal differs from Denmark regarding long-term informal care, specifically referring to personal care received by older people. A cross-sectional study was developed in Portugal and Denmark through the Survey of Health, Ageing and Retirement in Europe (SHARE) in 2015, with a total of 2891 participants. Descriptive statistics and logistic regressions were performed. The findings suggest a significant association for older people from Portugal who receive long-term informal care from non-household caregivers and household caregivers. Moreover, as they age and are from Portugal, their availability to receive long-term informal care from non-household caregivers increases. Furthermore, older people in Portugal are more likely to receive long-term informal care from a household caregiver. It is important to take a closer look at long-term informal care in both countries and think about healthy ageing policies in the current context of the ageing population. This study provides knowledge about disaggregated health data on ageing in the European region, helping to fill research gaps related to older people. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

Open AccessArticle

Perceptions and Representations of Senior Nursing Students about the Transition to Professional Life during the COVID-19 Pandemic

and

Int. J. Environ. Res. Public Health 2022, 19(8), 4466; https://doi.org/10.3390/ijerph19084466 - 07 Apr 2022

Viewed by 1241

Abstract

The COVID-19 pandemic caused disruptions in education systems worldwide. The suspension of face-to-face lectures and clinical placements directly impacted nursing students’ learning. This study aimed to identify the perceptions and representations of senior nursing students about the transition to professional life during the COVID-19 pandemic. This descriptive, observational, cross-sectional study used a web-based survey from a convenience sample of 162 senior nursing students, from nine different nursing schools. Data collection was carried out in the second quarter of 2020. Male students have more negative representations related to training (p = 0.048); working students have a better perspective of professional integration (p = 0.038); students who are in a relationship have a more positive perception of interaction with patients (p = 0.047); those who have already defined a service of choice have less insecurity and less fear of making mistakes (p = 0.043). Those who report anxiety about their first place of work have more negative representations about the future in other professional dimensions. The COVID-19 pandemic represents a frequent concern among students. However, it is a dimension that does not negatively contaminate other representations about the professional future. Overall, students showed concerns regarding their performance in providing direct care to the patient and lived up to their fellow nurses’ expectations. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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Other

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Open AccessStudy Protocol

The Organization of Home Palliative Cancer Care by Primary Health Care: A Systematic Review Protocol

Marcelle Miranda da Silva

Thayna Barros

Cristina Lavareda Baixinho

Andreia Costa

Eunice Sá

and

Maria Adriana Henriques

Int. J. Environ. Res. Public Health 2023, 20(6), 5085; https://doi.org/10.3390/ijerph20065085 - 14 Mar 2023

Viewed by 322

Abstract

Greater longevity and chronic diseases, such as cancer, require (re)organization of care for the sustainability of health systems and better quality of life. Palliative care organized by primary health care has positive outcomes, changing standards of care at the end of life, reducing hospitalizations and health costs and contributing to people’s autonomy to stay at home with controlled symptoms. However, in many countries, this is not possible because the provision of palliative cancer care is isolated or generalized, concentrated in the hospital, and without the strategic participation of primary care. In many developed countries, where palliative care is offered in an integrated way, home care has increased the people’s chances of receiving dignified care at the end of life. The aim of this review is to evaluate the organization of home palliative cancer care by primary care to improve the use of health resources and the quality of life of such patients. This systematic review protocol follows the Cochrane methodology to provide a narrative synthesis, with the resulting report guided by the Preferred Reporting Items for Systematic Reviews (PRISMA). Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

Open AccessStudy Protocol

Effectiveness of Music Therapy in People Living with Dementia: An Umbrella Review Protocol

E. Begoña García-Navarro

and

Helena José

Int. J. Environ. Res. Public Health 2023, 20(4), 3200; https://doi.org/10.3390/ijerph20043200 - 11 Feb 2023

Viewed by 760

Abstract

Background: Dementia stands out as a neurological disorder which constitutes a progressive decline in cognitive, behavioral, emotional, and social functioning. However, non-pharmacotherapy, such as music therapy, can be combined with pharmacological treatment as a possible strategy to improve functionality regarding the cognitive and non-cognitive dimensions of people diagnosed with dementia. Objectives: To analyze and synthesize published evidence regarding the effectiveness of music therapy in people diagnosed with dementia, concerning cognitive and non-cognitive outcomes. Design: Descriptive study protocol of an umbrella review. Methods and analysis: An umbrella review method will guide this study, focusing on an extensive search of published systematic reviews and meta-analyses reviews that include randomized controlled trials and other types of trials. Databases for the article search include ISI Web of Knowledge, Scopus, and Joanna Briggs Institute (JBI) EBP database, and EBSCO Host platform (Cochrane Database of Systematic Reviews, MEDLINE, and CINAHL). Two reviewers will independently review all titles and abstracts and identify articles considering the inclusion criteria. Afterward, two reviewers will independently extract relevant information from each article for the characterization table, and evaluate the quality of selected articles using the Measurement Tool for Evaluating Systematic Reviews (AMSTAR) 2 guideline. Relevance to clinical practice: Data from this study will aid in designing healthcare workers’ training courses, clinical intervention guidelines, and specific intervention protocols that support pharmacological interventions in treating dementia. Full article

(This article belongs to the Special Issue Primary Care and Geriatric Nursing)

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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

social prescribing
health literacy
healthy ageing
complex interventions
falls
community health interventions
public health interventions
transitional care
fundamental care
home security

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Special Issue "Primary Care and Geriatric Nursing"

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