Individuals with disabilities are regarded as a highly vulnerable population group, particularly as far as oral health is concern. However, few studies have assessed the impact of the oral condition on the quality of life of these individuals. Therefore, the aim of this study is to expand knowledge on the oral health status of the Portuguese adults with mild intellectual disability, and to assess how the patient’s oral health is related to their quality of life. A sample of 240 adults with mild intellectual disabilities linked to the Portuguese Federation for Intellectual Disability, were interviewed using a previously validated version of the Oral Health Impact Profile. An oral health examination was also conducted using three oral health indexes: Clinical Oral Health Index (COHI); Clinical Oral Care Needs Index (COCNI) and the Clinical Oral Prevention Index (COPI). Sociodemographic characteristics and dental health factors were also collected, following statistical analysis. More than half of the individuals (54,9%) presented one or more problems of major to severe impact on health (COHI level 2); only 4,6% of the individuals do not need treatment or examination (COCNI level 0) and 85% of the study sample needs measures of educational or preventive action (COPI level 1). In 76,9% of the participants, oral health had impact on the quality of life. The most affected dimensions of life were physical pain with 61,9%, followed by psychological discomfort and psychological disability with 45,1% and 45%, respectively. With relation to oral health factors and sociodemographic variables it was verified that fewer teeth and higher self-perception of need for dental treatment had a negative impact on the quality of life. On the other hand, institutionalization and an increase in at least one category in the self-perception of the oral health status had a positive impact on the quality of life. Given the high burden of oral disease and the considerable impact on quality of life found in this study, the establishment of guidelines to improve the oral health and quality of life of these individuals should be regarded as imperative.

BackgroundThe purpose of this study is to develop a Portuguese version of the Oral Health Impact Profile (OHIP-14) and validate it for people with mild intellectual disability (OHIP-14-MID-PT).MethodsThe Portuguese version of the questionnaire was drawn up from the original English version, following internationally defined guidelines. Interviews were conducted with 240 individuals living in (or attending) institutions of the central region of Portugal that are affiliated with Humanitas (Portuguese Federation for Intellectual Disability) to measure oral health related quality of life (OHRQoL). The interview also included a sociodemographic and oral health questionnaire followed by an intraoral examination. Two types of reliability were analyzed: test-retest (ICC) and internal consistency (Cronbach´s α, inter-item and item-total correlations). Convergent and divergent validities were also assessed, and a confirmatory factor analysis was performed using the maximum likelihood method.ResultsThe OHIP-14-MID-PT presented high reliability (ICC = 0.999; Cronbach's α = 0.922). The inter-item correlation coefficient ranged from 0.277 to 0.749, and the item-total correlation coefficient varied between 0.529 and 0.718. Lower OHIP-14-MID-PT total scores were significantly associated with: a self-perception of better oral health status (r = -0.545, p<0,001) and reduced need for dental treatment (U = 2366.5, p<0,001), more natural teeth (χ2 = 29.74, p<0,001) and better results in the clinical oral health index (COHI) (χ 2 = 18.50, p<0,001); the results support the convergent and divergent validities of the questionnaire.ConclusionsOHIP-14-MID-PT has proved to be a consistent, valid and reliable instrument with good psychometric properties to determine the impact of oral health on quality of life in adults with mild intellectual disabilities in Portugal.

ObjectiveTo describe the different rehabilitation care models in practice in Portuguese adult intensive care units.MethodsA simple observational (cross-sectional) study was conducted through an online survey sent to the head nurses or individuals responsible for the 58 adult intensive care units that are part of the database of the Sociedade Portuguesa de Cuidados Intensivos.ResultsWe identified three models of organization of rehabilitation care: care provided by the staff of the intensive care unit (22.9%), care provided by specialized external teams (25.0%), and a mixture of the previous models, combining the two situations (52.1%). In the first model, the care was provided mainly by nurses with specialization in rehabilitation and, in the second model, the care was provided by physiotherapists. No significant differences were found between the models regarding the availability of care, in hours/day or days/week (p = 0.268 and 0.994, respectively), or results such as length of hospital stay in intensive care, ventilation time, or mortality rate in the unit (p = 0.418, 0.923, and 0.240, respectively).ConclusionThe organization of rehabilitation care in Portuguese intensive care units is unique and heterogeneous. Despite different care organization models, the availability of hours of care is similar, as are the overall results observed in patients.

Aims This study aims to characterize the hygiene habits, the self‐perception of the need for treatment and the oral condition of a population with a disability. Methods and Results This research is part of an observational, cross‐sectional epidemiological study on oral health and quality of life of people with mild intellectual disabilities living in (or attending) institutions of the Central Region of Portugal that were affiliated with HUMANITAS (Portuguese Federation for Mental Disability) in 2016. A sociodemographic and oral health questionnaire, applied on the form of an interview to 240 individuals aged between 18 and 64 years, was used. Statistical analyses were performed using SPSS version 22.0. It was verified that 32.9% of the individuals had less than 20 teeth. Only 15% of all individuals used removable prosthesis. About 21% didn't do oral hygiene daily. Only 28.4% of the sample visited the dentist in the last 6 months. Note that 75.2% of the sample stated their need for dental treatment and less than half (37.4%) described their oral condition as good or superior. Conclusion Dental care among adults with intellectual disability is one of the most unattended health needs. Evidence suggests that inadequate oral health habits are more prevalent in the studied population than in the Portuguese population.

Background and PurposeMobilization of critical patients should be precocious and the inclusion of nursing in this task can be decisive in paradigm shift. The purpose of this study was to validate the Portuguese version of the intensive care unit Mobility Scale for nursing use.MethodsProspective multicenter observational study. Patients' mobility was evaluated by rehabilitation nurses in order to determine interobserver agreement. The validation criteria was tested by determining the correlation between the evaluation results of mobility, strength, and functionality levels at discharge.ResultsGood interobserver agreement (R = 0.98; K = 0.76). Positive correlation with muscle strength (R = 0.77) and functionality (R = 0.85) levels at discharge.ConclusionsBased on the correlations observed the scale is a valid instrument for nurses and could be a useful tool for routine use. More research is recommended to make the results more robust.

A aposta na saúde bucal, apesar de não ser devidamente valorizada por muitos Governos, é importante para o desenvolvimento da população já que a patologia oral pode ter efeitos nefastos nos mais diversos sistemas orgânicos que asseguram a sobrevivência dos pacientes. Em Portugal, a promoção da saúde bucal nunca foi uma prioridade para os sucessivos Governos. Apenas no ano de 2005 se implementou, no âmbito do Plano Nacional de Saúde, o Programa Nacional de Promoção da Saúde Oral (PNSO), que dez anos mais tarde, em 2015, sofreu novas alterações. O presente artigo realiza uma revisão teórica do desenvolvimento da promoção da saúde oral em Portugal, retratando toda a história da sua criação, evolução e perspectivas futuras e cobertura, desde o início do Programa até ao projeto de integração da Saúde Oral no âmbito da atenção primária à saúde.

Objetivo: Conhecer a importância da Enfermagem de Reabilitação nas unidades de cuidados intensivos (UCI’s) portuguesas. Métodos: Análise secundária do inquérito nacional de avaliação da organização dos cuidados de reabilitação, nas unidades de cuidados intensivos portuguesas. Resultados: Em Portugal há 2.9 enfermeiros por unidade, com formação especializada em reabilitação por unidade. Este valor aumenta nas unidades em que a reabilitação tem por base um modelo misto e diminui nas unidades que recorrem a equipas externas especializadas. 40% destes profissionais não desempenham funções na sua área de especialização e apenas 26.4% desempenham funções a tempo inteiro. As unidades com enfermagem de reabilitação a tempo inteiro efetuam mais frequentemente a avaliação da condição física na alta (38.7 versus 8.9%), contudo não há participação destes profissionais na avaliação pós-alta em nenhuma UCI. Não são observáveis diferenças nos resultados assistenciais entre as UCI que integram enfermeiros de reabilitação e as que não o fazem. Conclusão: Os enfermeiros com especialidade em enfermagem de reabilitação estão presentes na maioria das UCI’s nacionais e constituem uma peça importante nos cuidados prestados. Palavras-chave: enfermagem de reabilitação; cuidados intensivos; organização e administração

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