Browsing by Author "Marques, Marta Moreira"
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- A cross-cultural perspective on psychological determinants of chronic fatigue syndrome: A comparison between a portuguese and a dutch patient samplePublication . Marques, Marta Moreira; De Gucht, Véronique; Leal, Isabel Pereira; Maes, StanBackground Few studies focus on cross-cultural differences in Chronic fatigue syndrome (CFS). Purpose This study aimed to (1) compare fatigue severity and impairment, somatic complaints, psychological distress, and quality of life (QoL) in a population of Portuguese and Dutch patients; (2) explore the differential contribution of behavioral and cognitive determinants of fatigue severity; and (3) investigate the relation between fatigue severity and somatic complaints on one hand and QoL on the other in both populations. Method Eighty-five female patients from Portugal (Mean age0 47.54) and 167 female CFS patients from The Netherlands (Mean age044.93) participated in the study. All participants were surveyed for demographic and clinical characteristics, fatigue severity, somatic symptoms, psychological distress, (physical and psychological) QoL, physical activity, behavior regulation patterns, and illness representations. Results Cross-cultural differences were found in relation to working status, duration of fatigue symptoms, psychological distress, somatic complaints, and psychological QoL. Although behavioral characteristics and illness representations were significantly associated with fatigue severity in both Portuguese and Dutch patients, there were important differences in the determinants of CFS. Moreover, higher levels of fatigue and severity of other somatic complaints were related to poor QoL. Conclusions These findings show cross-cultural similarities and differences in clinical characteristics and psychological determinants of CFS that are important in view of diagnosis and treatment.
- Differential effects of behavioral interventions with a graded physical activity component in patients suffering from chronic fatigue (syndrome) : An updated systematic review and meta-analysisPublication . Marques, Marta Moreira; De Gucht, Véronique; Gouveia, Maria João Pinheiro Morais; Leal, Isabel Pereira; Maes, StanAn updated systematic review and meta-analysis was conducted to (1) evaluate the effects of behavioral and psychological interventions containing a graded physical activity component upon fatigue severity, physical functioning, physical activity and psychological distress, and to (2) examine potential moderator effects of trial characteristics (type of control, setting, provider, length of treatment, psychological component, flexibility in physical activity, and minimal face to face patient–provider contact). Pertinent content of selected studies was extracted and rated on a scale of methodological quality. Sixteen randomized controlled trials (N = 2004) were included in the meta-analyses. Significant small to medium effect sizes (Hedge's g = 0.25 to g = 0.66) were found for all outcomes at post-treatment (M = 5.2 months) and follow-up (M = 11.7 months), with the exception of physical activity at post-treatment (g = 0.11). The largest effects were found for fatigue severity (g = 0.61 to g = 0.66). Subgroup analyses revealed that minimal contact interventions had additional beneficial effects upon fatigue (g = 0.96) and depression (g = 0.85). Interventions provided by psychologistspsychotherapists and interventions conducted in secondary–tertiary settings also resulted in more beneficial effects on fatigue. We found some indication of publication bias. The small number of studies and variability between them are limitations of this study. Future research should explore additional moderating effects in order to improve the effectiveness of interventions.
- Effects of a self-regulation based physical activity program (the “4-STEPS”) for unexplained chronic fatigue : A randomized gontrolled trialPublication . Marques, Marta Moreira; De Gucht, Véronique; Leal, Isabel Pereira; Maes, StanBackground: This study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue, the “4- STEPS to control your fatigue program”. Method: A 12-week randomized controlled trial was conducted. Adult patients meeting the CDC criteria for idiopathic chronic fatigue were randomized to either the control condition (standard care) or the intervention condition (4-STEPS). The 4-STEPS was based on self-regulation principles and consisted of motivational interviewing and self-regulation skills training. All patients were assessed at baseline and post-treatment (12 weeks) for fatigue severity (primary outcome) and impact, physical activity (leisure time physical activity, number of daily steps and personal activity goal progress), health-related quality of life, somatic distress and psychological distress (depression and anxiety). Results Ninety-one patients (45 intervention and 46 control patients) received the allocated intervention. At post-treatment, statistical analysis revealed a significant difference for subjective experience of fatigue (4.73 points; g=0.51) in favour of the intervention group. Mixed design ANCOVAs showed a significant effect of the 4-STEPS on fatigue severity, leisure time physical activity, personal activity goal progress and healthrelated quality of life. No significant effects were found for number of daily steps and somatic and psychological distress. Conclusion: The 4-STEPS program has significant beneficial effects at post-treatment. This brief self-regulation-based intervention looks promising for the management of unexplained chronic fatigue.
- Efficacy of a randomized controlled self-regulation based physical activity intervention for chronic fatigue: Mediation effects of physical activity progress and self-regulation skillsPublication . Marques, Marta Moreira; de Gucht, Véronique; Leal, Isabel Pereira; Maes, StanObjective: Examine the medium-term effects of a brief physical activity (PA) self-regulation (SR) based intervention (4-STEPS program) for chronic fatigue, and explore the mediating effects of PA related variables and SR skills. Methods: A two-arm randomized controlled trial (Usual Care vs 4-STEPS) was carried out. The 4-STEPS program consisted of Motivational Interviewing and SR-skills training. Fatigue severity (primary outcome) and impact, PA, health-related quality of life (HrQoL), and somatic and psychological distress were assessed at baseline, post-treatment (12 weeks) and 12 months follow-up. Results: Ninety-one patients (45 intervention and 46 controls) were included. At follow-up, there were significant treatment effects on fatigue severity (g = 0.72) and fatigue impact, leisure-time PA, and physical and psychological HrQoL. No significant effects were found for number of daily steps and somatic and psychological distress. Fatigue severity at follow-up was partially mediated by post-treatment progress on a personal PA goal (effect ratio = 18%). Conclusion: Results suggest that a brief intervention, focusing on the formulation and pursuit of personal PA goals and the use of SR skills, produces sustained benefits for fatigue severity. Despite these promising results, dropout was high and the intervention was not beneficial for all secondary outcomes.
- Estudo da invariância fatorial do Questionário de Bem-estar espiritual (SWBQ) em praticantes de atividades físicas de inspiração orientalPublication . Gouveia, Maria João Pinheiro Morais; Ribeiro, José Luís Pais; Marques, Marta MoreiraObjetivo: O bem-estar espiritual (BEE) é um constructo sujeito a influências culturais na sua definição. O propósito deste estudo foi contribuir para a validação da versão portuguesa do Spiritual Well-being Questionnaire (SWBQ; Gomez & Fisher, 2003), através da confirmação da sua estrutura fatorial em praticantes de atividades físicas de inspiração oriental (AFO; e.g. tai-chi). Método: Participaram 342 praticantes de yoga (31%), tai-chi (32%), shorinji-kempo (30%) e meditação ativa (7%), de ambos os sexos (53% F) e com experiência continuada na atividade (M = 3,9; DP = 6,1 anos). Resultados: Análises Fatoriais Confirmatórias (AFC) revelaram índices de ajustamento menos favoráveis que os da amostra da população geral portuguesa (Gouveia et al., 2009) quer para o modelo de quatro fatores relacionados quer para o modelo hierárquico. Os modelos refinados ajustam adequadamente. Obtiveram-se bons índices de consistência interna e fiabilidade compósita para os quatro domínios e variância média extraída aceitável para o total de BEE. A Análise Multi-grupos demonstrou que apenas se verifica equivalência dos pesos fatoriais entre os grupos de exercício. Conclusão: Estes resultados contribuem para a validação da versão portuguesa da escala, confirmam impacto das normas culturais e sugerem vantagem na reformulação linguística de alguns itens. ------ ABSTRACT ------- Aim: Spiritual Well-being (SWB) is a concept influenced by cultural factors. The aim of the present study was to analyze the factorial validity of the Portuguese version of the Spiritual Well-being Questionnaire (SWBQ; Gomez & Fisher, 2003) in physical activities that are inspired by eastern values (e.g. tai-chi). Method: The sample consisted of 342 participants of yoga (31%), tai-chi (32%), shorinji-kempo (30%) and active meditation (7%), of both genders (53% F) and with experience on the respective exercise modality (M = 3.9; DP = 6.1 yrs.). Results: The adjustment indices of the Confirmatory Factor Analysis for both the four-factor structure and the second-order model were less favourable in the present study than the adjustment indices previously obtained with the general population (Gouveia et al., 2009). The refined models fit the data adequately. Internal consistency and composite reliability were good for each of the four SWB factors, and the total SWB mean variance extracted was acceptable. Multi-group analysis supported only factor loadings equivalence between exercise groups. Conclusion: These results contribute substantially to the validation of the Portuguese version of the SWBQ. Moreover, the results obtained confirm the possible effect of cultural norms when the questionnaire is answered, and point out the importance of reformulating some of the translated items in order to increase validity.
- Physical exercise adherence: The role of motivation, regulatory efficacy and competing goalsPublication . Marques, Marta MoreiraIntrodução. Os elevados índices de inactividade nas sociedades ocidentais e o conhecimento científico dos benefícios da prática regular de exercício físico, contribuíram para o impulsionar da investigação das variáveis psicológicas que podem estar associadas à adesão, manutenção, abandono e resistência à prática de exercício físico. O presente estudo, adoptando uma perspectiva de auto-regulação do comportamento (Maes & Karoly, 2005), analisou a relação entre a prática de exercício físico e a motivação (extrínseca e intrínseca), eficácia auto-reguladora e objectivos competitivos com a prática de exercício físico. Foi ainda objectivo deste estudo analisar a existência de diferenças nos níveis de fadiga, concentração, motivação, actividades diárias e sintomas psicológicos (problemas de sono, depressão e ansiedade), entre sujeitos com diferentes níveis de exercício físico. Método. Participaram no estudo 269 sujeitos adultos (21-65 anos), de ambos os sexos, distribuídos por diversos grupos de acordo com os seus níveis de actividade física: inactivos, activos irregulares, activos regulares (até 24 meses) e activos regulares (há pelo menos de 24 meses). Utilizando metodologia de inquérito, o estudo consistiu na aplicação de um conjunto de questionários, num único momento, aos participantes. O processo de recolha foi feito por email/correio. Os níveis de exercício físico foram recolhidos através de questões acerca do historial de actividade física dos participantes. Os instrumentos utilizados foram o Alameda 7 (Schoenborn, 1985), Behavior Regulation for Exercise Questionnaire (Markland& Tobin, 2004), Regulatory Self- Efficacy Scale, Competing Goals Scale (Gebhardt & Maes, 1998), Checklist of Individual Strength (Vercoulen, Swanink, Fennis, Galama, Van der Meer & Bleijenberg, 1994) and Brief Symptom Inventory (Canavarro, 1999). Todos os instrumentos apresentaram, nesta amostra, boas propriedades psicométricas. Resultados. Os resultados revelaram a existência de diferenças significativas nos níveis de eficácia auto-reguladora e motivação. Os sujeitos praticantes regulares de exercício físico apresentaram maior confiança na sua capacidade para ultrapassar barreiras à prática de exercício físico e regulação do comportamento mais autónoma, em comparação com os não praticantes e os praticantes irregulares. A quantidade de objectivos conflituantes com o exercício valorizados pelos indivíduos, apresentou igualmente diferenças significativas, neste caso, superior no grupo dos indivíduos inactivos. A análise discriminante efectuada extraiu uma função discriminativa ' significativa entre grupos, constituída pelas variáveis motivação e eficácia auto-reguladora. Verificou-se ainda existirem associações significativas positivas entre o tipo de regulação do comportamento e os níveis de eficácia auto-reguladora em todos os grupos de exercício físico. Os sujeitos não praticantes de exercício físico apresentaram os níveis mais elevados de fadiga, ansiedade e problemas de sono e, os níveis mais baixos de motivação e concentração. Discussão. Estes resultados contribuem para a compreensão dos factores psicológicos associados à prática de exercício físico. A investigação futura deverá examinar estas relações utilizando métodos longitudinais e de intervenção, de modo a observar de que forma estas variáveis permitem predizer modificações no comportamento de exercício físico ao longo do tempo. Considera-se que as intervenções dirigidas a aumentar os níveis de eficácia auto-reguladora, potenciar autonomia na regulação do comportamento (motivação intrínseca) e identificar e criar alternativas para objectivos competitivos, poderão ser úteis na promoção e manutenção da prática de exercício físico
- Práticas educativas parentais: Uma comparação entre famílias adoptivas e famílias não-adoptivasPublication . Marques, Marta Moreira; Martins, Eva DelgadoAs Práticas Educativas Parentais têm sido um assunto pouco estudado nas famílias adoptivas. Estas reflectem os comportamentos e acções parentais que estruturam o comportamento da criança e lhe proporcionam a maior autonomia e conforto possíveis, contribuindo assim para o seu desenvolvimento sustentável. Este estudo teve como objectivo perceber se existem diferenças entre as Práticas Educativas Parentais (PEP) em famílias adoptivas e não-adoptivas. Assim, participaram nesta investigação 16 famílias adoptivas e 16 famílias não-adoptivas, compostas por mãe, pai e criança entre os 7 e os 10 anos de idade. O instrumento utilizado na recolha dos dados foi a entrevista de práticas educativas parentais, que contempla quatro dimensões: Autonomia Apoiada, Estrutura, Afecto e Percepção da Família. Os resultados demonstraram-nos mais Práticas Educativas Parentais de Autonomia Apoiada, Estrutura e Afecto e uma melhor Percepção da Família nas famílias adoptivas que nas famílias não-adoptivas. Neste sentido, verificaram-se diferenças entre as PEP dos pais adoptivos em comparação com os pais não-adoptivos (sexo masculino) relativamente ao apoio prestado na integração e exploração social, ao uso de comportamentos indutivos na regulação do comportamento da criança e a um maior envolvimento afectivo. Esta maior participação nas tarefas parentais resulta numa melhor percepção das crianças e dos próprios pais relativamente à sua família. Por conseguinte, verificou-se que nas famílias adoptivas existe uma maior partilha das tarefas inerente às práticas educativas parentais, em contraste com um padrão mais tradicional nas famílias não-adoptivas, no qual a mãe assume a maior responsabilidade destas tarefas.
- Protocol for the “four steps to control your fatigue (4-STEPS)” randomised controlled trial: A self-regulation based physical activity intervention for patients with unexplained chronic fatiguePublication . Marques, Marta Moreira; De Gucht, Véronique; Maes, Stan; Leal, Isabel PereiraBackground: Unexplained Chronic Fatigue is a medical condition characterized by the presence of persistent, severe and debilitating medically unexplained fatigue, leading to impaired functioning and lower quality of life. Research suggests that physical activity can contribute to the reduction of fatigue and other somatic symptoms and can thus significantly improve physical functioning and quality of life in these patients. Based on the selfregulation (SR) theory of behaviour change, we developed a brief physical activity program for patients suffering from unexplained chronic fatigue which focuses on the training of self-regulation skills, the “4-STEPS to control your fatigue” program. Methods/Design: This is a multi-centre, randomised controlled trial (RCT) that will be carried out in local primary care centres and at the Portuguese Fibromyalgia and Chronic Fatigue Syndrome Patients Association. Patients aged between 18 and 65 and fulfilling operationalized criteria for Idiopathic Chronic Fatigue (ICF) and Chronic Fatigue Syndrome (CFS) will be recruited and randomly allocated to standard care (SC) or standard care plus a selfregulation based physical activity program (4-STEPS). Patients will be assessed at baseline, after the intervention (3 months) and at 12 months follow-up. The primary outcome is fatigue severity. Discussion: The results of the RCT will provide information about the effectiveness of a brief self-regulation intervention for promoting physical activity in patients with unexplained chronic fatigue. If the program proves to be effective, it may be considered as an adjunctive treatment for these patients.
- Psychometric properties of the portuguese version of the checklist of individual strength (CIS20-P)Publication . Marques, Marta Moreira; De Gucht, Véronique; Gouveia, Maria João Pinheiro Morais; Cordeiro, Andreia; Leal, Isabel Pereira; Maes, StanAim: The Checklist of Individual Strength (CIS20) is a well validated measure of fatigue severity, which has been adapted in several languages. As Portuguese is one of the most widely spoken languages in the world it is important to have a Portuguese adaptation of the CIS20. Method: Four hundred and thirty healthy Portuguese adults and 89 patients with chronic fatigue (CF) filled out the Portuguese version of the CIS20 (CIS20-P). The CF patients and a subsample of the healthy adults also filled out the SF-12v2 assessing health-related quality of life. Results: The CIS20 four-factor structure was confirmed (subjective experience of fatigue, concentration, motivation and physical activity scales). In general, internal consistency estimates were satisfactory, with the exception of the motivation scale. Moreover, a higher degree of fatigue severity was significantly associated with lower vitality and physical and psychological health-related quality of life. Conclusion: Our results indicate that the CIS20-P is a reliable and valid measure of fatigue severity. Future studies should establish Portuguese cut-off points for (sub)clinical levels of fatigue.
- Psychometric properties of the portuguese version of the Treatment Self-Regulation Questionnaire for Physical Activity (TSRQ - PA)Publication . Marques, Marta Moreira; De Gucht, Véronique; Maes, Stan; Gouveia, Maria João Pinheiro Morais; Leal, Isabel PereiraAim: The aim of the present study was to analyze the reliability and factorial validity of the Portuguese Version of the Treatment Self-Regulation Questionnaire for physical activity (TSRQ-PA). Method: In this study, 148 healthy adults (Mean age = 44.70, 96.6% women) and 89 chronic fatigue patients (Mean age = 47.39, 97.8% women) filled out questionnaires related to behaviour regulation style (TSRQ – PA) and physical activity. Results: The confirmatory factor analysis adjustment indices of a two-factor structure (Autonomous Regulation scale and Controlled Regulation scale) of the TSRQ-PA were satisfactory and internal consistency estimates were acceptable for both factors. A higher degree of autonomous behaviour regulation was significantly associated with higher levels of physical activity. Conclusion: These findings provide support for the validity and reliability of the TSRQ – PA for measuring behaviour regulation style for engaging in physical activity, in different settings.