Maria de Lurdes da Costa Martins

SUMMARY: Goal: This study examines how entrepreneurial leadership influences intrapreneurship among registered nurses through the mediating roles of innovative leader behavior and individual entrepreneurial orientation. The study also aims to clarify the mechanisms through which leadership promotes innovation within healthcare organizations. Methods: A cross-sectional study was conducted with 760 registered nurses working in public and private healthcare institutions in Portugal. Data were collected through an anonymous online survey. Entrepreneurial leadership, innovative leader behavior, individual entrepreneurial orientation, and intrapreneurship were measured using validated instruments. Partial least squares structural equation modeling (PLS-SEM) was used to test the hypothesized relationships and mediation effects. Principal Findings: Entrepreneurial leadership was positively associated with innovative leader behavior and individual entrepreneurial orientation. Innovative leader behavior emerged as the strongest predictor of intrapreneurship. Innovative leader behavior and individual entrepreneurial orientation significantly mediated the relationship between entrepreneurial leadership and intrapreneurship. The findings indicate that entrepreneurial leadership promotes intrapreneurship primarily through leaders’ visible innovative actions, while individual entrepreneurial orientation provides an additional, though smaller, contribution. Practical Applications: Healthcare executives and nurse managers can strengthen intrapreneurship by fostering entrepreneurial leadership and encouraging leaders to model innovative behaviors. Leadership development programs should emphasize innovation, autonomy, experimentation, and opportunity recognition. Creating psychologically safe work environments and recognizing innovative contributions may enhance nurses’ entrepreneurial engagement and support organizational adaptability, service improvement, and long-term innovation capacity.

Purpose: To evaluate the impact of phase III cardiac rehabilitation (CR) protocol on the physical fitness of individuals with cardiac disease in a community-based setting. Design: A descriptive-correlational longitudinal study conducted at a community center in Portugal from November 2022 to January 2023. Methods: Participants underwent two evaluation points, 10 weeks apart, during which they completed 20 supervised rehabilitation sessions. Physical fitness was assessed using validated instruments for the Portuguese population. Data collection was performed by rehabilitation nurses, and data were analyzed using SPSS version 28. Results: The sample included 30 participants, mostly male (63.3%), with a mean age of 66.1 years. The majority were overweight (56.7%), and 43.3% had an elevated cardiovascular risk based on abdominal circumference. Statistically significant improvements were observed in abdominal circumference, lower limb strength, handgrip strength, and cardiorespiratory capacity. A nonsignificant but positive trend was also observed in body mass index. Clinical Relevance: This study highlights the importance of community-based Phase III CR exercises as a strategy to improve functional outcomes and reduce cardiovascular risk. These interventions require structured supervision to ensure safety and effectiveness. Conclusions: The Phase III CR protocol led to meaningful improvements in physical fitness and anthropometric indicators among cardiac patients, supporting the continued expansion of structured rehabilitation services in community settings.

Innovation is an essential factor for the survival, growth and competitive advantage of companies and health services. A theoretical model was developed and tested, portraying the interrelationships between entrepreneurial leadership, the leader’s innovative behavior, individual entrepreneurial orientation and innovation. This is a quantitative, descriptive-correlational, and cross-sectional study carried out by applying an online questionnaire to 760 nurses, working in health institutions in Portugal. The results indicate that the leader’s innovative behavior has an impact on innovation in nursing. Innovative behavior strongly influences an individual’s entrepreneurial orientation. Entrepreneurial leadership impacts innovative behavior and individual entrepreneurial orientation, and this last is mediated by the leader’s innovative behavior. The role of individual entrepreneurial orientation in innovation has not been confirmed. This study contributes to the literature on innovation by providing new evidence regarding the benefits of entrepreneurial leadership and the leader’s innovative behavior. It also contributes to the emerging literature on the antecedents of innovation. The results additionally have relevant health management implications.

Chronic pruritus, or persistent itching, is a debilitating condition that severely impacts quality of life, especially in palliative care settings. Traditional treatments often fail to provide adequate relief or are associated with significant side effects, prompting interest in alternative therapies. This review investigates the antipruritic potential of eight medicinal plants: chamomile (Matricaria chamomilla), aloe vera (Aloe barbadensis), calendula (Calendula officinalis), curcumin (Curcuma longa), lavender (Lavandula angustifolia), licorice (Glycyrrhiza glabra), peppermint (Mentha piperita), and evening primrose (Oenothera biennis). These plants are analyzed for their traditional applications, active bioactive compounds, mechanisms of action, clinical evidence, usage, dosage, and safety profiles. Comprehensive searches were conducted in databases including PubMed, Web of Science, Scopus, and b-on, focusing on in vitro, animal, and clinical studies using keywords like “plant”, “extract”, and “pruritus”. Studies were included regardless of publication date and limited to English-language articles. Findings indicate that active compounds such as polysaccharides in aloe vera, curcuminoids in turmeric, and menthol in peppermint exhibit significant anti-inflammatory, antioxidant, and immune-modulating properties. Chamomile and calendula alleviate itching through anti-inflammatory and skin-soothing effects, while lavender and licorice offer antimicrobial benefits alongside antipruritic relief. Evening primrose, rich in gamma-linolenic acid, is effective in atopic dermatitis-related itching. Despite promising preclinical and clinical results, challenges remain in standardizing dosages and formulations. The review highlights the necessity of further clinical trials to ensure efficacy and safety, advocating for integrating these botanical therapies into complementary palliative care practices. Such approaches emphasize holistic treatment, addressing chronic pruritus’s physical and emotional burden, thereby enhancing patient well-being.

Objectives: Spirituality, emotional intelligence, and palliative care (PC) knowledge have a positive and direct influence on self-efficacy and on perception of preparation and ability to provide end-of-life (EOL) care. The aim of this work is to propose a conceptual model that relates spirituality, emotional intelligence, PC knowledge, self-efficacy, and the preparation and ability to provide EOL care by doctors and nurses.Methods: Quantitative, exploratory, descriptive, and inferential study applied to doctors and nurses in a hospital in the north of Portugal, between May and July 2022. The data collection instrument includes a questionnaire. The relationships between latent variables were evaluated using structural equation models by the partial least squares method using the Smart PLS 3.0 software. It was obtained the previous authorization of the ethics committee.Results: The results (n = 380) indicate that self-efficacy, spirituality, and PC knowledge have a positive influence on the ability to provide EOL care. Emotional intelligence and spirituality have a direct and positive effect on self-efficacy. There is no direct influence of emotional intelligence on the ability to provide EOL care, but emotional intelligence has an indirect effect mediated by self-efficacy.Significance of results: Spirituality, self-efficacy, and emotional intelligence are very important for the ability of doctors and nurses to provide EOL care. The identification of predictive factors of the ability to provide EOL care and the determination of the relationship between them can improve the provision of EOL care, reduction of health costs, timely and early referral of people to PC, and increase life quality.

Background: To describe the use of a telephone consultation (TC) hotline for palliative care (PC) patients and their families at home provided by a PC service, during the COVID-19 lockdown. Methods: Observational and cross-sectional study of a TC hotline performed by a PC service from 1 January to 31 December 2020. Data was collected through a record sheet completed during the call. Descriptive analyses were performed using the SPSS software (V.21 for Windows). Results: A total of 494 calls were retrieved (n=187 patients; 6500 minutes recorded). Compared to 2019, incoming calls increased 33.8%. Most callers were a family member (n=419) or a community health worker (n= 60). The peak of calls was registered in April (13.5%), May (13.2%) and October (15.0%). Main problems included uncontrolled symptoms (81.9%), need for medication (8.6%), information (4.8%) and consultation rescheduling (2.6%). In 81.9% of the cases, the call occurred during a crisis. The PC team solved 92.9% of the problems. Only 20 patients were admitted in the emergency department (this was 30.5% less compared to 2019). Conclusions: The TC is a feasible alternative to traditional in-person follow-ups. Callers considered it very useful, especially during the COVID-19 lockdown. Communication was improved and admissions to emergency services were reduced.

Objective: To describe mouth disorders in patients undergoing palliative care (PC); to identify predisposing factors for oral disorders and pharmacological and nonpharmacological strategies. Methods: Observational, exploratory, correlational, and descriptive study about mouth disorders of patients admitted to a hospital specializing in PC in Portugal, between November 6, 2019, and July 31, 2020. The data collection instrument was a questionnaire and the consultation of the patient's clinical file. It was obtained the previous authorization of the ethics committee and the patient's informed consent. Data were analyzed using the SPSS® software (V.26). Results: The sample was 46, 56.52% were over 71 years old, and the male sex ratio of 63.04%. Most of the patients had an advanced oncological disease, were polymedicated, had missing teeth, and no regular hygiene habits. Xerostomia and oral candidiasis were the most identified problems. Patients with oncological diseases have more probability to suffer from mouth disorders ( P = .047), compared to noncancer patients. Patients with frequent oral hygiene have fewer mouth disorders (rp = −0.304; P = .040). There is a considerable improvement in the tongue coating with an increase in oral hygiene ( P = .005). Mouth care plays is important in patient comfort (n = 45; 97.83%) and nonpharmacological strategies are effective for the relief of xerostomia (n = 35; 94.59%). Conclusions: Nonpharmacological strategies are effective in the treatment of xerostomia and tongue coating. More information to determine the effectiveness of the strategies in the treatment of mouth disorders is necessary.