Browsing by Author "Vieira, Cristina"
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- Beyond the body image: A qualitative study on how adults experience lower limb amputationPublication . Senra, Hugo Renato Carreira Gomes; Oliveira, Rui Aragão Gomes; Leal, Isabel Pereira; Vieira, CristinaObjective: To explore adults’ experiences of lower limb amputation, focusing on the changes in self-identity related to the impairment. Design: A cross-sectional and qualitative study, using semi-structured interviews. Interviews were transcribed, coded and analysed by two independent researchers. Setting: A rehabilitation medicine service from a general public hospital. Participants: A convenience sample of 42 patients with lower limb amputation performed after the age of 18 and followed up in the physical medicine and rehabilitation department of a general hospital. Main outcome measures: A semi-structured interview, addressing three core areas: the emotional impact of amputation; the adjustment process; and the relation with the external resources. Results: Eight themes emerged from interviews: reactions and feelings about becoming amputee; changes in own life; problems in well-being; relation with the prosthesis; self-perceptions; aims related to the rehabilitation and future plans; relation with the rehabilitation; and perceived social support. These results supported a theoretical model for the self-identity changes related to limb loss. Conclusions: The self-identity changes after a lower limb amputation appear beyond the patient’s body image and functioning, affecting the patient’s awareness of the impairment, biographical self and any future projections.
- Depression and experience of vision loss in group of adults in rehabilitation setting: Mixed-methods pilot studyPublication . Senra, Hugo Renato Carreira Gomes; Vieira, Cristina; Nicholls, Elizabeth G.; Leal, Isabel PereiraThere is a paucity of literature regarding the relationship between the experience of vision loss and depression. Therefore, the current pilot study aimed to explore whether significant differences existed in levels of depression between adults with different vision loss experiences. A group of adults aged between 20 and 65 yr old with irreversible vision loss in a rehabilitation setting was interviewed. Semistructured interviews were conducted in order to explore patients’ experience of vision loss. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive levels; 39.5% (n = 15) of patients met CES-D criteria for depression. In addition, higher levels of depression (p < 0.05) were identified in patients whose interviews revealed greater selfawareness of impairment, inadequate social support, and longer rehabilitation stay. Current findings draw attention to variables such as self-awareness of impairment and perceived social support and suggest that depression following vision loss may be related to patients’ emotional experiences of impairment and adjustment processes.
- Psychologic adjustment to irreversible vision loss in adultsPublication . Senra, Hugo Renato Carreira Gomes; Barbosa, Fernando; Ferreira, Patrícia; Vieira, Cristina; Perrin, Paul B.; Rogers, Heather; Rivera, Diego; Leal, Isabel PereiraPurpose: To summarize relevant evidence investigating the psychologic adjustment to irreversible vision loss (IVL) in adults. Design: Irreversible vision loss entails a challenging medical condition in which rehabilitation outcomes are strongly dependent on the patient’s psychologic adjustment to illness and impairment. So far, no study has systematically reviewed the psychologic adjustment to IVL in adults. Methods: We reviewed all articles examining the psychologic adjustment to IVL in adults. We included articles published in English in peer-reviewed journals. We performed a keyword literature search using 4 databases (PubMed, EBSCO, Cochrane Library, and Science Direct) for all years through July 2014. We assessed risk of bias of selected studies using the RTI Item Bank for Assessing Risk of Bias and Confounding for Observational Studies of Interventions or Exposures and the Cochrane risk of bias tool for randomized controlled trials. Results: Of a total of 3948 citations retrieved, we selected 52 eligible studies published between 1946 and 2014. The majority of studies were observational and cross-sectional in nature. Our review suggests that high levels of depression occur during the adjustment to IVL. Better adjustment to IVL was associated with greater acceptance of vision loss and use of instrumental coping, good social support, positivity, and use of assistive aids. Conclusions: The overall findings indicate that IVL often has negative effects on patients’ quality of life and mental health and that such effects tend to remain over time. Specific factors and variables associated with the adjustment to IVL need to be clarified through further in-depth and longitudinal research.