Browsing by Author "Albuquerque, Sara"
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- Bereavement support guidelines for caregivers in palliative care: A scoping reviewPublication . Coelho, Alexandra; Albuquerque, Sara; Neto, David DiasPalliative care teams’ support practices for bereavement vary substantially. Clinical guidelines are needed to promote concerted, evidence-based intervention. The goal of the present study is to identify and synthesize the principles and clinical guidelines that ensure best practices in bereavement support for family caregivers accompanied in palliative care. A scoping review was conducted based on a systematic search of articles in academic databases (EBSCO, PsycINFO, PubMed, Web of Science, Psychology and Behavioral Sciences Collection, Scopus) and Google (2010–2024). The review included articles focused on the principles, guidelines, and clinical recommendations for bereavement support for adult family caregivers in palliative care. Quality appraisal of guidelines was conducted using the AGREE II instrument. Of the 1,489 references identified, 20 documents were included, mostly governmental or institutional norms and clinical guidelines from gray literature. Quality appraisal revealed gaps in evidence selection, resource implications, updates and monitoring criteria. Eight fundamental principles were identified, from which several clinical guidelines were derived, organized according to the moments of assessment and intervention throughout the bereavement process, including pre and post-death period: (1) organizing support for the family caregiver; (2) assessing needs and establishing a care plan; (3) ensuring information and support for the family caregiver; (4) preparing for death; (5) support at the time of death; and (6) bereavement support post-death. In addition to universal support and information measures, regular assessment procedures should be adopted for timely referrals based on individual needs.These guidelines cover the temporal variation of care and the multidimensional and multiple-actor nature of palliative care. Implementing these guidelines and evaluating their impact will allow for the standardization of best practices and improve the quality of bereavement support in palliative care.
- Does meaning-making mediate COVID-19 restrictions’ impact on grief and psychological symptoms?Publication . Batista, João; Albuquerque, Sara; Delalibera, Mayra; Oliveira, João T.; Coelho, AlexandraThe COVID-19 pandemic imposed substantial restrictions on funeral ceremonies,profoundly affecting grief experiences. This study investigated the mediating role ofmeaning-making in the relationship between these restrictions and prolonged griefdisorder (PGD) symptoms, anxiety, depression, and trauma. A longitudinal studyinvolving 141 bereaved individuals was conducted, with assessments at two time points:3–6 months (T1) and 9–12 months (T2) post-loss. Structural equation modeling re-vealed that the psychological impact of restrictions on death and funeral ceremonieshad indirect effects on anxiety and prolonged grief symptoms through meaning-making,particularly the footing in the world subscale. These findings underscore the im-portance of understanding the complex interplay between pandemic-related re-strictions and grief experiences, emphasizing the pivotal role of meaning-making inadapting to loss during those challenging times.
- Effectiveness of empower-grief for relatives of palliative care patients: Protocol for an exploratory randomized controlled trial.Publication . Neto, David Dias; Coelho, Alexandra; Albuquerque, Sara; Silva, Ana Nunes da; PsychOpenBackground: Grief reactions of relatives of palliative care patients are seldom addressed. Most interventions focus on Prolonged Grief Disorder (PGD) and not on its prevention. This is particularly relevant in palliative care, in which death is the result of a difficult period of a terminal illness, making caregivers particularly vulnerable to psychological distress. The purpose of the present exploratory trial is to test the efficacy of a selective intervention (Empower-Grief) for the initial problematic grief reactions and to study potential predictors of adherence and efficacy. Method: This is an exploratory Randomized Controlled Trial (RCT) studying Empower-Grief compared with Treatment as Usual (TAU). Participants will be relatives or caregivers of palliative and oncological patients with initial indicators of risk of developing PGD and will be randomly allocated to Empower-Grief and TAU. Participants will be assessed prior, at the end and six months after the intervention. The primary outcome considered will be symptoms of PGD. The assessment includes measures of anxiety and depression, coping, attachment, psychological flexibility, posttraumatic growth, social support and therapeutic alliance. Results: The trial is ongoing. Forty-four participants will be invited to participate. Conclusion: This study addresses the need for the development of empirically grounded and feasible interventions aimed at dealing with initial problematic reactions in grief, exploring potential predictors and possible venues for personalizing intervention and understanding the mechanism through which these interventions operate.
- Empower-grief for relatives of cancer patients: Implementation And findings from an exploratory randomized controlled trialPublication . Dias Neto, David Manuel; Coelho, Alexandra; Silva, Ana Nunes; Garcia-Marques, Teresa; Albuquerque, SaraGrief reactions among relatives of palliative care patients are often overlooked, with most interventions targeting Prolonged Grief Disorder (PGD) rather than its prevention. Few interventions have been developed for individuals at risk. This study aimed to evaluate the efficacy of Empower-Grief, a selective intervention designed to address early problematic grief reactions and to explore predictors of its effectiveness. This exploratory randomized controlled trial (RCT) compared Empower-Grief with Treatment as Usual (TAU) among relatives or caregivers of palliative and oncological patients at risk of developing PGD. A total of 46 participants were assessed at baseline, post-intervention, and six months later. The primary outcome was PGD symptoms, with additional measures including anxiety, depression, coping strategies, attachment style, psychological flexibility, post-traumatic growth, social support, and therapeutic alliance. The final analyses indicate equivalence between Empower-Grief and TAU, suggesting that both interventions yielded comparable outcomes in reducing PGD symptoms and associated psychological distress. The initial symptoms and therapeutic alliance were predictors of the results in both post- and follow-up moments. This study contributes to the evidence on grief interventions in palliative care, highlighting the importance of structured support for bereaved caregivers. While Empower-Grief demonstrated comparable effectiveness to TAU, its lower intensity, ease of training, and application make it a promising treatment option.
- EMPOWER-Grief: Reforçar e mobilizar o potencial para o bem-estar e resiliência emocional prevenção no luto no lutoPublication . Coelho, Alexandra; Albuquerque, Sara; Dias Neto, David; Silva, Ana Nunes Da; Resende, Andrea; Nogueira, Daniela; Tavares, Tatiana; Minhós, InêsO EMPOWER-Grief é uma intervenção cognitivo-comportamental baseada na aceitação, destina-se a pessoas que vivenciam o luto após a perda de um ente querido. Desenvolvido para prevenir a Perturbação de Luto Prolongado (PLP), o programa visa reduzir o evitamento experiencial, comum entre as pessoas em luto, através da exposição regulada ao distress e estratégias baseadas na aceitação. O EMPOWER-Grief por seis sessões, cada uma com duração de 50 minutos e duas adicionais de follow-up. O presente manual fornece descrições detalhadas das sessões, incluindo objetivos específicos e tarefas a serem administradas de forma flexível. Além disso, oferece materiais de apoio, como exercícios de grounding e treino de respiração, destinados a ajudar as pessoas em luto na regulação emocional e no processamento cognitivo. O propósito do manual é capacitar os profissionais a implementar uma intervenção eficaz, promovendo o bem-estar e a resiliência emocional das pessoas durante o processo de luto.
- Estudos psicométricos da versão portuguesa da Escala de Impacto Familiar (EIF)Publication . Albuquerque, Sara; Fonseca, Ana; Pereira, Marco; Nazaré, Bárbara; Canavarro, Maria CristinaO diagnóstico de deficiência num filho pode implicar mudanças na dinâmica e no funcionamento da família, com exigências adicionais ao nível da prestação de cuidados. De forma a avaliar os efeitos da condição da criança nos pais, enquanto prestadores de cuidados, foi desenvolvida a Escala de Impacto Familiar (EIF) – Impact on Family Scale (Stein & Riessman, 1980). O objectivo do presente estudo é apresentar as características psicométricas da EIF. A versão portuguesa da escala foi administrada a uma amostra de 144 pais e mães, cujo filho recebeu um diagnóstico de deficiência, utentes da Maternidade Doutor Daniel de Matos (Hospitais da Universidade de Coimbra) e de associações que prestam apoio a pais de crianças com deficiência. Para além da EIF, o protocolo de avaliação incluiu o instrumento de avaliação de qualidade de vida da Organização Mundial de Saúde (WHOQOL-Bref; The WHOQOL Group, 1998), o Índice de Stress Parental (Abidin, 1990) e a subescala de Contribuições Positivas do Kansas Inventory of Parental Perceptions (Behr, Murphy, & Summers, 1992). A EIF apresentou boa consistência interna (alfa de Cronbach=.91) e estabilidade temporal (r=.80, p<.001), bem como resultados aceitáveis ao nível da validade de construto [χ2(90)=185.45, p<.001; CFI=.91; RMSEA=.08] e das validades convergente e discriminante. A EIF apresenta-se como uma escala particularmente útil para avaliar o impacto familiar da deficiência de um filho e as suas características psicométricas validam a sua utilização na população portuguesa.
- “I could not give him the funeral he deserved”: The role of alternative mourning rituals during the pandemicPublication . Manquinho, Susana; Albuquerque, Sara; Delalibera, Mayra; Coelho, Alexandra; Salvador, ÁgataAmid the COVID-19 pandemic, measures were enforced that constrained people's ability to engage in conventional funeral and mourning rituals, which in general serve as vital mechanisms for coping with the experience of loss. This study aimed to investigate how these limitations afected early grief symptoms and the infuence of alternative mourning rituals (paying tribute on social media, lighting candles in memory of the deceased, and using objects of the deceased) on moderating the relationship between individuals' perception of these limitations (such as being unable to perform the present body ceremony or fulfll the funeral wishes of the deceased) and the intensity of the grief symptoms. The study involved 227 participants, aged between 18 and 77 years, who had experienced the loss of a loved one during the pandemic. Results demonstrated that higher levels of perceived limitation in funeral ceremonies are associated with greater intensity of grief responses. Paying tribute on social media and lighting candles in memory of the deceased person moderated the relationship between the perception of limitation in fulflling the deceased’s wishes in relation to the funeral ceremonies and the intensity of the grief responses. Using objects moderates the relationship between the perception of limitation in performing a present body ceremony and the intensity of the grief responses. Results underline the relevance of psychological fexibility, in particular concerning alternative morning rituals, that can be used as a way of bufering the impact of the perception of limitation in funeral ceremonies on the intensity of grief responses. This study ofers a distinctive insight into bereavement during the pandemic, highlighting the role of fexibility in morning rituals in mitigating the deleterious efect of ritual restrictions on bereavement outcomes.
- Qualidade de vida e sintomatologia psicopatológica em pais de crianças com diagnóstico de deficiência/anomalia congénita : A importância das características de resiliênciaPublication . Albuquerque, Sara; Pereira, Marco Daniel de Almeida; Fonseca, Ana; Canavarro, Maria CristinaO objetivo do presente estudo consistiu em avaliar a adaptação parental, em termos de sintomatologia psicopatológica e qualidade de vida (QdV), bem como avaliar a influência das características de resiliência parental na sua adaptação, bem como na adaptação do(a) parceiro(a). A amostra foi constituída por 90 participantes (45 casais), pais de crianças com um diagnóstico de deficiência/AC. O protocolo de avaliação incluiu a Escala de Resiliência para Adultos (ERA), o Inventário de Sintomas Psicopatológicos (BSI-18) e o instrumento de avaliação de QdV da Organização Mundial de Saúde, WHOQOL-Bref. Os resultados mostraram que as mães apresentaram valores mais elevados na dimensão ansiedade (p<.01), no índice geral de gravidade (p<.01) e pior QdV psicológica (p<.05). As mães apresentaram valores mais elevados de resiliência, em particular de coesão familiar (p<.05). Em ambos os pais, a resiliência mostrou-se associada a menor sintomatologia psicopatológica e a resultados mais elevados de QdV. A resiliência materna não se mostrou significativamente associada à adaptação paterna mas, constatou-se que níveis elevados de resiliência paterna se associaram a menor sintomatologia psicopatológica e melhor QdV materna. Os resultados deste estudo evidenciam o papel protetor da resiliência na adaptação parental ao diagnóstico de anomalia congénita da criança. Adicionalmente, estes resultados enfatizam a necessidade de avaliar e promover os recursos parentais. Por fim, ressalta-se a necessidade de avaliação do casal como unidade de análise e os potenciais efeitos cruzados no desenho de intervenções terapêuticas, reforçando-se o papel da relação conjugal e do contexto interpessoal em que esta problemática ocorre.
- Utrecht grief rumination scale (UGRS): Psychometric study of validation of the Portuguese versionPublication . Araújo, Liliane; Albuquerque, Sara; Coelho, Alexandra; Delalibera, Mayra; Paulino, PaulaGrief rumination is characterized by recurring, repetitive, self-focused thoughts about the causes and consequences of loss and loss-related emotions. This cognitive process is a transdiagnostic risk factor for mental disorders, such as prolonged grief. The aim of this study was to analyze the psychometric properties of the Portuguese version of the Utrecht Grief Rumination Scale (UGRS). The sample consists of 242 bereaved adult participants with Portuguese nationality. Confirmatory Factor Analysis showed that the hierarchical model showed a better fit to the data. Average Variance Extracted was also calculated to measure convergent and divergent validity. Test-criterion validity was investigated by analyzing associations between grief rumination and measures of posttraumatic stress, prolonged grief, anxiety, and depression. Using McDonald’s Omega and Cronbach’s Alpha, all subscales showed adequate reliability. The UGRS showed acceptable psychometric properties, standing out as a valid instrument for practice and research in psychology in the area of bereavement.
- Validation of the Portuguese version of the Integration of Stressful Life Experiences Scale (ISLES) in a sample of bereaved individualsPublication . Albuquerque, Sara; Henriques, Mariana; Rosa, Pedro Joel; Delalibera, Mayra; Neimeyer, Robert A.; Coelho, Alexandra; Batista, JoãoThe Integration of Stressful Life Experiences Scale (ISLES) evaluates the ability to integrate stressful experiences into one's meaning system. This study aimed to validate ISLES for the Portuguese population, utilizing a sample of 242 adults who had lost a significant other. The sample was predominantly female, educated, married, or in consensual unions, and actively employed. Confirmatory factor analysis revealed a two-factor structure, consisting of 13 items, showing adequate local and global goodness-of-fit and supporting the proposed original structure. Convergent evidence based on internal structure was found for the two dimensions (Comprehensibility and Footing in the World). Regarding reliability, Cronbach’s alpha and McDonald's omega computed for each factor showed good internal consistency and the average inter-item correlation was considered satisfactory. This psychometric support for ISLES underscores its relevance in enhancing the knowledge of meaning-making processes in the Portuguese context.