APPsyCI - Artigos em revistas científicas internacionais
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- Adaptation of the eco-anxiety scale to adult Portuguese native speakers: a validity and reliability studyPublication . Ferrajão, Paulo; Torres, Nuno; Martins, Amadeu QuelhasEco-anxiety is a multidimensional construct that includes emotional, behavioral and cognitive manifestations related to potential environmental calamities. There is a need to adapt and validate measures that evaluate eco-anxiety into Portuguese using a multi-trait approach. This study examined the psychometric properties of the Hogg Eco-Anxiety Scale (HEAS) in adult Portuguese speakers (18–83 years old). Data were collected on the Portuguese adaptation of the HEAS, environmental identity and psychological symptoms, and sociodemographic data. The construct validity of the HEAS was subsequently examined through exploratory and confirmatory factor analysis. The factorial structure of the original scale was the best explanation of the sample data. The scale showed good internal consistency and presented measurement invariance for both sex and age groups. The global score of the HEAS and the dimensions of emotional and behavioral symptoms were moderately associated with clinical symptoms. Females and younger participants presented higher levels of eco-anxiety apart from rumination symptoms. The results suggest the suitability of the HEAS as a valid measure to evaluate the different signs of eco-anxiety among adult Portuguese native speakers.
- 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.
- Bridging genetic insights with neuroimaging in Autism Spectrum Disorder — A systematic reviewPublication . Vilela, Joana; Rasga, Célia; Santos, João Xavier; Martiniano, Hugo; Marques, Ana Rita; Oliveira, Guiomar; Vicente, Astrid Moura; Maria Rasga, CéliaAutism Spectrum Disorder (ASD) is an early onset neurodevelopmental disorder characterized by impaired social interaction and communication, and repetitive patterns of behavior. Family studies show that ASD is highly heritable, and hundreds of genes have previously been implicated in the disorder; however, the etiology is still not fully clear. Brain imaging and electroencephalography (EEG) are key techniques that study alterations in brain structure and function. Combined with genetic analysis, these techniques have the potential to help in the clarification of the neurobiological mechanisms contributing to ASD and help in defining novel therapeutic targets. To further understand what is known today regarding the impact of genetic variants in the brain alterations observed in individuals with ASD, a systematic review was carried out using Pubmed and EBSCO databases and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review shows that specific genetic variants and altered patterns of gene expression in individuals with ASD may have an effect on brain circuits associated with face processing and social cognition, and contribute to excitation–inhibition imbalances and to anomalies in brain volumes.
- Bridging the gap: Environmental health literacy as key to adolescent well-being and sustainable behaviorsPublication . Matos, Margarida Gaspar de; Branquinho, Cátia; Domingos, Leonor; Guedes, Fábio Botelho; Cerqueira, Ana; Gaspar, TaniaAdolescents who possess environmental health literacy are more equipped to handle the effects of the environment on their health. This study uses data from Portugal’s 2022 HBSC survey to investigate the environmental health literacy (EHL) of teenagers. The Environmental Health Literacy Scale (EHLS) was verified by confirmatory component analysis. Within the framework of an ecosystem, this study investigates factors related to health and well-being. There are 7355 adolescents in the sample. EHLS_Social Norms and participation in volunteering activities were found to be significant predictors of EHL_Knowledge, which explained 25.2% of the variance in the final model. EHLS_Social Norms and EHLS_Knowledge accounted for 42.9% of the variance in EHL_Behaviors, while school grade was adversely connected with pro-environmental behavior. While actions and knowledge were major positive predictors, gender and school grades showed negative relationships, and EHL_Social Norms accounted for 46% of the variance. This study establishes a valid measure of environmental health literacy in adolescents, informing science education strategies and public health interventions.
- Diaphragm ultrasound for muscle strength assessment: A systematic literature reviewPublication . Leote, Joao; Monteiro, Margarida; Rocha, Cláudia; Rodrigues, Carolina; Pereira, Marco; Antunes, Maria Luz; Dias, Hermínia; Antunes, Maria da LuzObjective: To assess if diaphragmatic ultrasound (DU) reflects diaphragmatic muscle strenght when compared to respiratory tests and neurophysiological studies. Methods: A systematic literature review was conducted on adults undergoing DU, compared to any respiratory or neurophysiological technique. The search strategy was applied in PubMed, Scopus, and Web of Science, and the analysis was conducted using the PRISMA methodology. Three eligibility assessment stages were performed: title, abstract, and full-text reading. The risk of bias was evaluated using the RoB 2.0, ROBINS-I, and Newcastle-Ottawa Scale tools. Results: Out of 155 identified articles, 25 were selected for full-text review (14 nonrandomised studies, 8 case-control studies, and 3 randomised studies). The overall risk of bias was moderate, with the main biases related to population selection and intervention assessment. Twenty-three articles used maximal inspiratory pressure easurement as a comparator which showed a weak-to-moderate correlation, significant in 10 studies, with diaphragmatic excursion. Three studies reported a weak association between diaphragmatic thickening and sniff pressure. Five articles reported a concordant correlation between iaphragmatic thickening and compound muscle action potential amplitude, significant only in one study. Conclusion: The variability of results obtained across different pathologies does not support the use of DU alone to predict diaphragmatic muscle strength
- 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.
- Explaining the mental health consequences of internalized racial oppression: The mediating roles of family resilience and collective actionPublication . Ribas, Anna Luiza; Miranda, Mariana; Bú, Emerson Araújo doRacial oppression's institutional and interpersonal levels have had a substantial amount of empirical attention. Internalizedracial oppression (IRO) and the paths through which it negatively impacts mental health have received considerably lesserattention. In this cross‐sectional study with 226 self‐identified Black participants, we focus on colonial mentality, as a form ofIRO, and its association to depression. We argue that this detrimental effect happens because IRO limits the access to socialidentity resources, at both levels of the family system and wider society. The results revealed that the communication/problem‐solving dimension of family resilience mediated the effect of colonial mentality on depression. Support for the Black LivesMatter movement, a measure for collective action, was also a significant mediator but was, however, positively associated withdepression. This study is the first to quantitatively assess IRO's consequences on the mental health of Black individuals in apostcolonial European country. We discuss clinical implications
- The impact of community resilience, well-being, and community attachment on human service workers’ burnoutPublication . Henriques, Joana; Luís, Sílvia; Rivero, Catarina; Gonçalves, Sónia P; Tavares, Lara Patrício; Marujo, Helena ÁBurnout has become an increasingly prevalent condition, especially affecting professionals in direct contact with clients. Human service workers (HSWs) have quite emotionally taxing jobs supporting vulnerable groups. In developing a close relationship with the communities they work with, it could be possible that community-related variables have an impact on HSWs’ burnout. We aim to analyze the prevalence of burnout in a sample of HSWs from Portugal and the role of community resilience as a predictor of their burnout, as well as explore if their subjective well-being and community attachment could explain the relationship between community resilience and burnout, during the COVID-19 pandemic. Data were collected through an online questionnaire between August 2020 and January 2021 ( N = 598). Results indicate that HSWs presented medium to low levels of burnout, although 8.9% presented high levels. Those who reported lower levels of burnout perceived higher community resilience and had much higher well-being and community attachment. Findings point to community resilience having a significant direct effect on burnout and also an indirect effect, which was explained by subjective well-being and community attachment. Results seem to suggest that this sample's low-medium levels of burnout could be linked to the benefit of experiencing high community attachment and working in communities with high resilience, which consequently impacted their well-being and burnout. This highlights the crucial role of the work context in professionals’ mental health, showing that a broader context needs to be considered in professional mental health promotion programs.
- Loneliness during the COVID pandemic: Characteristics and associated risksPublication . Paiva, Teresa; Gaspar, Tânia; Tomé, Gina; Gaspar de Matos, MargaridaLoneliness is becoming progressively more frequent despite increasing communication facilities. The COVID lockdown and social interaction restrictions enhanced loneliness complaints in more vulnerable groups while increasing its global prevalence. Objective: To evaluate the prevalence, characteristics, and predictors of loneliness complaints during COVID19 Methods: The sample includes 5230 participants, 67.7% female, mean age 48.6 years and SD 14.30. To assure complexity/ diversity, an extensive internet survey with 177 questions was applied during the first COVID-19 pandemic wave in Portugal, including data from the Continent and Islands (Madeira and Azores). Results: The prevalence was higher in females, emerging adults, those living alone, living in a flat, and in a big city. The following variables were higher in LG (Loneliness Group): Stress, depression, anxiety, irritability, worries, Calamity Experience Check List (CECL), economic problems, Sleep latency and Awakenings, Screen time in TV, Mobile, Social networks, negative attitudes and negative behaviors, dependences from TV, Social networks and Games, morbidities, worsening of previous morbidities, and nightmares. The predictors were civil status, living alone, and having negative attitudes during the pandemic. Conclusions: The study allows us to conclude that loneliness during the COVID-19 pandemic was associated with health, psychological, behavioral, lifestyle, and housing-related factors; it could be predicted by the Calamity Experience Check List (CECL); Frequency of sexual activity; Negative attitudes; Positive attitudes; Negative Behaviors; Civil status; Living alone; Sleep latency weekdays; Sleep latency weekends. There were gender similarities and differences in loneliness predictors.