Rafaella Pessoa Moreira

To map evidence on climate-related exposures and mental health outcomes among older adults, and to characterise how social determinants of health are framed as vulnerability, protective, and recovery-related factors. A scoping review was conducted in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis and reported according to the PRISMA-ScR guidelines. The protocol was registered in the Open Science Framework. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, LILACS, SciELO, PsycINFO, the Cochrane Library, and Google Scholar, without language or date restrictions. Older adults were defined as individuals aged 60 years or older, consistent with the World Health Organization operational threshold. Study selection was conducted by two independent reviewers. Data extraction was followed by descriptive and thematic synthesis. Co-occurrence matrices were calculated only for empirical sources to reduce double counting from reviews and commentaries. A total of 740 records were identified; and 27 sources were included in the final synthesis. The principal exposure types mapped were heatwaves/extreme heat, floods, hurricanes/storms, wildfires, smoke exposure, and air pollution, including fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5). Anxiety, stress, depression, and post-traumatic stress disorder were the most recurrent mental health outcomes. The mapped evidence suggests that income, social support, social isolation, education, chronic disease/functional limitation, housing/geography, gender, and access to services or information frequently co-occurred with adverse outcome profiles. The available literature suggests that climate-related mental health risks among older adults are heterogeneous and socially patterned. The mapped evidence is consistent with a socioecological and cumulative vulnerability interpretation, although causal mediation cannot be established by this scoping review. Integrating mental health into climate adaptation strategies requires psychosocial risk stratification, continuity of care, and strengthening of community and service networks.

Background: Limited water access in the Brazilian Semiarid, exacerbated by climate change, increases the risk of diarrheal diseases in rural areas. This study aimed to investigate the seasonal interrelationships between water scarcity, socio-environmental characteristics, water quality, and health outcomes in rural communities. Methods: This descriptive field research was carried out in February, April, and September 2025 across three rural communities consisting of households without access to the public water supply network. Data were collected via structured questionnaires and water sampling from all domestic sources used. Hydroclimatic conditions were analyzed to characterize the regional climate scenario. Water quality from different sources was assessed using physicochemical and microbiological parameters. Statistical analyses included the Kruskal-Wallis test with Dunn’s post-hoc test for physicochemical data, Fisher’s Exact Test for microbiological data, and Cochran’s Q and Chi-square tests to evaluate the incidence of diarrhea. Results: In 2025, cumulative precipitation decreased in Quixeramobim (-35.2%) and Quixadá (-27.9%) compared to 2024, significantly impacting water source utilization. Families prioritized cisterns for drinking water while utilizing surface reservoirs and wells for hygiene. Water storage in rainfall cisterns fluctuated seasonally and were depleted faster due to inter-household sharing. Physicochemical analyses revealed significant seasonal and inter-community water quality variations, particularly in oxidation-reduction potential (ORP). Comparative analysis showed significant differences across all physicochemical parameters between sources: water tank trucks and the Integrated Rural Sanitation System (SISAR) exhibited higher temperatures and ORP, while wells showed higher alkalinity and electrical conductivity. Microbiologically, widespread total coliform contamination and the persistent presence of E. coli were observed across all sources. However, rainfall cisterns demonstrated the lowest levels of E. coli contamination. Diarrhea cases were reported continuously across the three communities, with 25% of cases affecting children, underscoring the heightened vulnerability of this age group. Conclusions: Although cisterns in the semiarid region are relatively safer sources, they are frequently replaced by less reliable alternatives during the dry season, increasing public health risks. Furthermore, storage conditions, domestic water handling, and adaptive strategies in response to water scarcity likely contribute to increased microbiological contamination.

Objective: To map and describe the digital health technologies and technology‐supported interventions used by advanced practice nurses for cardiovascular risk management in primary health care, including the advanced nursing functions they support. Materials and Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute methodology and reported following PRISMA‐ScR. A systematic search was performed in PubMed/MEDLINE, Web of Science, Embase, Scopus, CINAHL, Cochrane Library and SciELO, as well as grey literature sources, including the CAPES Portal and Epistemonikos. International studies published between January 2005 and May 2026 were eligible, without language restrictions. Two reviewers independently selected and charted the evidence; a third reviewer resolved unresolved disagreements. Results: A total of 3919 records were identified and 12 studies met the inclusion criteria. The evidence was grouped into four categories: technology‐supported structured nurse‐led care programmes; clinical decision support and algorithm‐based software; telehealth, telenursing and telerehabilitation; and mobile or home‐based self‐management technologies. The structured programmes combined nursing care pathways with organizational, educational, communication, protocol‐based, algorithmic or digital resources that supported programme delivery. The studies covered primary prevention, secondary prevention, chronic disease management and cardiac rehabilitation. The technologies and interventions supported clinical decision‐making, risk stratification, monitoring and follow‐up, health education, self‐management support and lifestyle counselling and care coordination. Conclusion: Digital health technologies and technology‐supported interventions can strengthen advanced cardiovascular nursing practice when embedded in clearly defined care pathways. Their principal contribution is to connect clinical decision support, longitudinal follow‐up and supported self‐management; their broader value depends on workflow integration, role clarity, equitable access and appropriate governance. Registration: The protocol was registered in the Open Science Framework on May 22, 2024.

This study aimed to develop a middle-range theory (MRT) on the phenomenon of fatigue in individuals with chronic kidney disease. It was a methodological study, conducted through an integrative literature review in Scopus, SciELO, and PubMed databases, which included 41 studies. The theory was developed in five steps: defining the theoretical approach, identifying core concepts, establishing causal relationships supported by clinical practice, designing a representative pictogram, and constructing explanatory propositions. This MRT includes 5 essential attributes, 13 clinical antecedents, 9 empirical referents, and 8 propositions, providing a conceptual framework that strengthens clinical reasoning and supports more precise nursing interventions.

Purpose: To identify clinical indicators related to ineffective health maintenance behaviors in kidney transplant recipients. Methods: Searches were conducted in 10 databases: PubMed, Embase, Scopus, Web of Science, PsycINFO, Ovid, CINAHL, Virtual Health Library, Google Scholar, and thesis and dissertation databases. Results: The final sample comprised 21 studies, from which 15 clinical indicators related to the nursing diagnosis ineffective health maintenance behaviors in kidney transplant recipients were identified. Of these, nine are included in the NANDA-I 2024–2026 taxonomy, whereas six emerged from the analysis of the included studies. The most frequently reported indicators were failure to act to prevent health problems, sedentary behavior pattern, nonadherence to health activities, and inappropriate health behavior pattern. Conclusion: This systematic review identified clinical indicators potentially related to the nursing diagnosis ineffective health maintenance behaviors in kidney transplant recipients, including indicators not currently included in the NANDA-I taxonomy. These findings expand the available evidence regarding this nursing diagnosis in this population; however, they require confirmation through clinical validation and diagnostic accuracy studies. Implications for nursing practice: The identified indicators may support nurses’ clinical reasoning and facilitate a more comprehensive assessment of health maintenance behaviors in kidney transplant recipients. However, their application in clinical practice should be interpreted with caution until their diagnostic performance has been confirmed through validation studies.

With the growing body of scientific evidence on anthropogenic climate change and the increasing awareness of its health impacts, nursing is called to assume a leadership role in addressing climate change as a public health priority. The objective of the study was to map nursing interventions directed at individuals with cardiovascular diseases and diabetes mellitus in the context of climate change. A scoping review was conducted in accordance with the Joanna Briggs Institute methodological framework and the PRISMA‐ScR checklist. Searches were carried out between 2022 and 2025 across electronic databases and gray literature sources, including BVS, EBSCO, EMBASE, Engineering Village, PubMed, Science.gov, Scopus, and Web of Science. Eligible studies included all research designs that addressed the guiding research question formulated using the PCC framework, with no restrictions on language or year of publication. Sixteen studies met the inclusion criteria. Findings highlighted that key nursing interventions encompass thermal regulation strategies, mitigation of environmental pollution, community capacity‐building, and monitoring of environmental risks and vital signs. Nursing practice involved patient and community education on exposure to extreme temperatures, reduction of pollutants, air quality monitoring, reinforcement of health education, and advocacy for public policies focused on climate adaptation. This review identified a wide range of nursing interventions tailored to the care of individuals with cardiovascular diseases and diabetes mellitus in the context of climate change. The evidence underscores the strategic role of nursing in mitigating climate‐related health impacts, spanning from environmental and vital sign monitoring to community empowerment and the promotion of thermal and environmental control strategies. The review protocol was registered with the Open Science Framework (DOI: 10.17605/OSF.IO/RHXEW).

Background: Nurse‐led cardiovascular health interventions have been reported to promote self‐management for chronic and acute diseases, fostering lifestyle changes and risk reduction. Objective: To evaluate the effectiveness of a nurse‐led cardiovascular intervention in the management of cardiovascular risk factors. Method: This randomized, controlled, and blinded clinical trial included 66 participants without comorbidities. The Intervention Group received a nursing consultation mediated by the e‐TEORISC software, based on nursing theory, across two sessions. This software optimizes nursing consultations for patients with cardiovascular risk by structuring nursing diagnoses, interventions, and outcomes. The Control Group received a single routine consultation following standard operational protocols. The primary outcome was the reduction of behavioral and psychological etiological factors associated with the nursing diagnoses. The follow‐up duration was 90 days for both groups. Results: The findings suggest that the intervention has potential clinical relevance for nursing practice, particularly in managing modifiable behavioral and psychosocial cardiovascular risk factors. Conclusion: The nurse‐led intervention, enhanced by e‐TEORISC, effectively reduced exposure to etiological factors impairing cardiovascular function, including alcohol use, stress, insufficient knowledge, and illicit substance consumption. Trial Registration: Brazilian Registry of Clinical Trials: RBR‐8y3qx39

Objetivo: Mapear as tecnologias voltadas à educação em saúde de pacientes cardiometabólicos durante a pandemia do COVID-19. Método: Revisão de escopo utilizando a estratégia População, Conceito e Contexto (PCC), alinhada ao método do Joanna Briggs Institute (JBI), com à seguinte questão de pesquisa: “Quais tecnologias estão disponíveis para a educação em saúde de pessoas com doenças cardiometabólicas durante a pandemia de COVID-19?”. Resultados: Foram selecionados oito artigos, publicados a partir de 2020 a 2022, que destacaram o uso da telemedicina, mídias sociais e aplicativos móveis. Embora a telemedicina tenha mostrado ampla aplicação, tecnologias como vídeos educativos e e-books foram menos exploradas, apontando para a necessidade de maior diversificação e inclusão digita. Conclusão: A telemedicina foi eficaz para esclarecer as principais dúvidas e promover maior interação entre a população e profissionais de saúde. As tecnologias foram aliadas estratégicas na promoção da saúde e no manejo de doenças cardiometabólicas, sendo indispensáveis para o gerenciamento de pandemias.