Percorrer por autor "Dias Neto, David Manuel"
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- 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.
- Responding to grief-related needs in older adults: Protocol for a community-based matched-care trial (GriefDiff)Publication . Neto, David Dias; Coelho, Alexandra; Barbosa, Miguel; Albuquerque, Sara; Dias Neto, David ManuelBackground Prolonged grief disorder (PGD) affects a significant proportion of bereaved people and may be especially burdensome in later life, when cumulative losses, health problems, and reduced social resources can hinder adjustment. Grief support is often reactive, and many older adults do not access timely, appropriate care. GriefDiff will study a differentiated, community-based model that matches intervention intensity and format to individual risk and relational needs. Methods GriefDiff is a mixed-methods (QUAN→QUAL) protocol. The quantitative component is a three-arm, tiered, parallel-group superiority randomised controlled trial delivered in community settings across Portugal, in collaboration with a national grief association. Eligible participants are Portuguese adults aged ≥60 years, bereaved 1–12 months, with a significant emotional bond to the deceased. After consent, participants complete a grief-risk tool and a mutuality-based relational-needs screener. Stratified block randomisation allocates participants to Information and Grief Literacy (IGLiteracy; one group session plus bi-weekly SMS reminders), an Individual Self-Help Program (ISelfHP; older-adult web app with optional offline materials and brief telephone guidance), or Moderated Self-Help Groups (MSHGroups; manualised weekly groups). Assessments occur at baseline, 3 months (post) and 6 months (follow-up). The primary outcome is prolonged grief symptoms; secondary outcomes are depression and anxiety. Target sample is N=324 (108/arm). Analyses will follow an intention-to-treat approach and will use mixed-effects models for repeated measures with fixed-sequence gatekeeping. Qualitative focus groups will compare matched versus non-matched allocations to clarify perceived fit, identify barriers, and inform future implementation strategies for differentiated grief care. Discussion Developing scalable, differentiated community responses will help address a growing societal challenge while meeting the needs of older adults. By evaluating programme effectiveness and refining the screening procedure, this study aims to inform the development and implementation of needs-based grief care in community settings