Conectar
To identify and synthesise the scientific evidence on determinants of self-care deficits in people with chronic wounds.
Scoping review based on the Joanna Briggs Institute guidelines.
This scoping review was conducted by a review team responsible for study screening, data extraction and synthesis. The categorisation of findings was grounded in Orem's Self-Care Deficit Theory and operationalised using the COM-B model and the Theoretical Domains Framework.
A comprehensive search, without date or language restrictions, was conducted in Web of Science, MEDLINE (PubMed), Cochrane Library, Scopus (Elsevier), SciELO, Ovid and EMBASE (Elsevier), from November 2023 to April 2024.
Of the 3076 records identified, 22 studies were included. Most were cross-sectional studies, with sample sizes ranging from seven to 1085 participants and a mean age of 61.45 years, predominantly involving people with venous leg ulcers and diabetic foot ulcers. Findings were synthesised into four categories: clinical, socioeconomic, behavioural and health system-related factors, indicating that multiple interrelated determinants influence engagement in self-care and contribute to persistent self-care deficits.
The findings demonstrate the vulnerability of people living with chronic wounds, arising from the complex interaction of clinical, psychosocial, socioeconomic and health service-related factors that determine self-care deficits. These deficits compromise wound healing, prolong treatment and negatively affect quality of life, underscoring the need for person-centred approaches to care.
This study reinforces the need for integrated and sustainable models of care grounded in person-centred practice, aimed at strengthening self-care capacities, enhancing clinical practice and informing more equitable health policies.
This review highlights the multifactorial nature of self-care deficits in people with chronic wounds. Nursing plays a key role in identifying barriers and strengthening capacities through Orem's supportive–educative system. Person-centred interventions improve adherence and continuity of care.
This review follows the PRISMA guidelines for reporting.
This study did not include patient or public involvement in its design, conduct, or reporting.
To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).
Qualitative descriptive study.
The study was conducted from July to August 2024 in two NICUs of a referral maternity hospital in Fortaleza, Brazil. Nineteen mothers of hospitalised premature newborns participated. Semi-structured interviews were conducted and subjected to thematic content analysis.
Mothers perceived BME as a meaningful act of protection and bonding, though some were unfamiliar with the practice. Emotional ambivalence was common, shaped by prior breastfeeding experiences and the context of prematurity. Discomfort related to privacy and shared spaces was noted. Support from healthcare professionals was essential to promote understanding and adherence.
Social representations of BME are shaped by emotional, social and institutional experiences. Anchored in prior breastfeeding experiences and cultural meanings of maternal care, the practice is objectified through both gestures of affection and tangible barriers.
Healthcare professionals, particularly nurses, should receive training to support mothers in BME. Structural improvements, privacy and emotional support are essential for fostering maternal autonomy and confidence.
This study highlights the barriers to BME, emphasising the role of healthcare support and the need for better infrastructure, privacy and training to enhance maternal confidence and breastfeeding.
The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.
None.
This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.
Fresh breast milk is considered the gold standard for reducing complications and improving survival in preterm infants. BME is recommended as an effective strategy to ensure the availability of fresh breast milk. Mothers' social representations of this practice remain underexplored within the neonatal intensive care context.
Explores mothers' social representations of BME in NICUs, addressing a significant gap in qualitative research. Reveals how emotional, social and institutional factors shape mothers' perceptions, motivations and challenges related to BME. Highlights the need for targeted professional support, improved infrastructure and privacy to enhance maternal autonomy and adherence to milk expression practices.
Healthcare professionals, particularly nurses, should receive specialised training to provide technical guidance and emotional support, enhancing mothers' confidence and autonomy in BME. Improving infrastructure and ensuring privacy in NICUs are crucial to creating supportive environments that facilitate milk expression and strengthen maternal–infant bonding. Institutional policies should integrate maternal-centred strategies to support breastfeeding continuity and promote humanised neonatal care.
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