PSAU - Artigos em revistas internacionais
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- Components of multiple health behaviour change interventions for patients with chronic conditions: a systematic review and meta-regression of randomized trialsPublication . Silva, Carolina C.; Presseau, Justin; Van Allen, Zack; Dinsmore, John; Schenk, Paulina; Moreto, M.; Marques, Marta M.Interventions addressing more than one health behaviour at a time could be an efficient way of intervening to manage chronic conditions. Within a systematic review of multiple health behaviour change (MBHC) interventions, we identified key components of interventions in patients with chronic conditions, assessed how they are linked to theory, behaviour change techniques implemented, and evaluated their impact on intervention effectiveness. Studies were identified by systematically searching five electronic databases. Subgroup analyses and metaregressions were conducted to analyse the association between intervention components and behavioural changes. In total, 61 studies were included spanning different chronic conditions (e.g., cardiovascular conditions, type 2 diabetes). Most interventions sought to change behaviours simultaneously (72%), often targeting the ‘physical activity, diet and smoking’ cluster of behaviours (33%), and were not theory informed (55%). A total of 36 behaviour change techniques were identified, most commonly goal setting behaviour and self-monitoring of behaviour. Subgroup analyses indicated that MHBC interventions delivered entirely face-to-face might not be as effective for physical activity outcomes, and not using goal setting (behaviour) might be more effective for smoking cessation outcomes. Metaregressions indicated that a longer intervention duration may work best to achieve better physical activity outcomes. This review provides a comprehensive understanding of interventions and contributes to the field of MHBC by facilitating data-driven insights for future optimisation and dissemination.
- Positive youth development, mental stress and life satisfaction in middle school and high school students in portugal: outcomes on stress, anxiety and depressionPublication . Carvalho, Marina; Branquinho, Cátia; Moraes, Barbara; Cerqueira, Ana; Tomé, Gina; Noronha, Catarina; Gaspar, Tânia; Rodrigues, Nuno; Matos, M. G.Abstract: The relation between positive youth development and stress, anxiety and depression was studied considering the mediator role of psychological symptoms and life satisfaction. A total of 3109 students included in the “Psychological Health and Well-being” study of the School Observatory participated, including 1618 females and 1491 males aged between 11 and 18 years old (M = 14.45; SD = 1.88), belonging to different school groups in different regions of the country. Adolescents with higher stress, depression and anxiety levels reported lower levels of competence, confidence and connection, as well as more psychological symptoms and lower life satisfaction. The results also showed that adolescents with higher levels of competence, confidence and connection reported less psychological symptoms and more life satisfaction. Two separate mediation analyses were performed to analyse the role of mental distress and life satisfaction on the relationship between positive youth development indicators and stress, anxiety and depression. These analyses confirmed the predicted relationships and partial mediations between mental distress and life satisfaction. These results should be taken into account in public policies concerning young people’s health and education that should involve both targeted and indicated prevention strategies, including school and community-based interventions, in order to be effective.
- The impacts of Alexithymia and sexual distress on sexual functioning among portuguese womenPublication . Ribeiro, Celina Marques; Pereira, HenriqueIntroduction: Recognizing own’s emotions seems to have an important role regarding not only our overall well-being, but also our sexual functioning. Aims: The aim of this study is to analyze the association or impact of alexithymia on female sexual functioning. Methods: 459 Portuguese women, with a mean age of 34.57 years (SD = 10.27), ranging from 18 to 65 years, completed the Toronto Alexithymia Scale (TAS-20), the Female Sexual Distress Scale – Revised (FSDS-R) and, additionally, completed the Female Sexual Function Index (FSFI), indicating if and when a sexual relationship occurred in the last month. Results: The results showed that higher levels of alexithymia were associated with worse sexual functioning and higher levels of sexual distress. Higher levels of sexual distress were associated with worse sexual functioning. It was possible to establish a significant linear regression model between dimensions of alexithymia (difficulties in identifying feelings and difficulties in describing feelings) and sexual distress in sexual functioning; the variables together explained about 45.2% of sexual functioning in these women. Conclusions: The results emphasize the relevance of alexithymia’s dimensions in sexual functioning concerning women with or without sexual dysfunction, since they present themselves as significant predictors. Professionals working in women’s sexual health should take this into account for more effective assessment and intervention in matters concerning sexual health
- Development of the virtual-VIPP and a systematic review of online support for families during the COVID-19 pandemicPublication . Van IJzendoorn, Marinus; Stevens, Eloise; Bakermans-Kranenburg, MarianDuring the COVID-19 pandemic lockdowns made it impossible for parenting coaches to reach the families without digital means of communication. Several studies were initiated to transform existing parenting interventions into hybrid or fully online versions and to examine their feasibility, acceptability and efficacy. We present one such transformation in detail, the Virtual-VIPP which is based on Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). Furthermore, we report a systematic review of 17 published trials with online versions of parenting programs. Overall, online parenting interventions seem feasible to implement, are well-received by most families, and to show equivalent effects to face-to-face approaches. Careful preparation of technicalities and monitoring of fidelity are prerequisites. Advantages of online parenting interventions are their potentially broader reach, more detailed process documentation, and better cost-utility balance. We expect that online parenting interventions are here to stay, but their efficacy needs to be rigorously tested.
- Effectiveness of Interventions for changing more than one behavior at a time to manage chronic conditions: A systematic review and meta-analysisPublication . Silva, Carolina C.; Presseau, Justin; Van Allen, Zack; Schenk, Paulina; Moreto, M.; Dinsmore, John; Marques, Marta M.Background Health behaviors play a significant role in chronic disease management. Rather than being independent of one another, health behaviors often co-occur, suggesting that targeting more than one health behavior in an intervention has the potential to be more effective in promoting better health outcomes. Purpose We aimed to conduct a systematic review and meta-analysis of randomized trials of interventions that target more than one behavior to examine the effectiveness of multiple health behavior change interventions in patients with chronic conditions. Methods Five electronic databases (Web of Science, PubMed, CINAHL, EMBASE, and Cochrane) were systematically searched in November 2023, and studies included in previous reviews were also consulted. We included randomized trials of interventions aiming to change more than one health behavior in individuals with chronic conditions. Two independent reviewers screened and extracted data, and used Cochrane’s Risk of Bias 2 tool. Meta-analyses were conducted to estimate the effects of interventions on change in health behaviors. Results were presented as Cohen’s d for continuous data, and risk ratio for dichotomous data. Results Sixty-one studies were included spanning a range of chronic diseases: cardiovascular (k = 25), type 2 diabetes (k = 15), hypertension (k = 10), cancer (k = 7), one or more chronic conditions (k = 3), and multiple conditions (k = 1). Most interventions aimed to change more than one behavior simultaneously (rather than in sequence) and most targeted three particular behaviors at once: “physical activity, diet and smoking” (k = 20). Meta-analysis of 43 eligible studies showed for continuous data (k = 29) a small to substantial positive effect on behavior change for all health behaviors (d = 0.081–2.003) except for smoking (d = −0.019). For dichotomous data (k = 23) all analyses showed positive effects of targeting more than one behavior on all behaviors (RR = 1.026–2.247). Conclusions Targeting more than one behavior at a time is effective in chronic disease management and more research should be directed into developing the science of multiple behavior change.
- The first portuguese open dialogue pilot project interventionPublication . Tavares, Sofia; Ribeiro, Joana; Graça, Sofia; Araújo, Bruna; Puchivailo, Mariana; Pereira, João G.Introduction: In 2020, the Directorate General of Health (DGS), a central service of the Ministry of Health in Portugal, approved and co-financed the first Open Dialogue program in the country. The present report aims to demonstrate the preliminary results of the first year of the project, implemented in the northern interior region of Alentejo. Methods: Seven people at the Center of Concern (PCC) and 21 family members/social networks received care through Open Dialogue; four external social workers and psychologists were also involved in the project as members of the support network. A total of 160 network meetings were undertaken, reaching as many as 27 per month in the busiest periods. Based on a previous Italian Research Protocol, developed by Pocobello et al. (non-published manuscript), quantitative and qualitative data were collected in and after the clinical meetings involving PCC and their family/social network, through a multi-method approach: clinical history interview (e.g., generic research on sociodemographic data, duration of untreated symptoms, reasons for requesting help, possible hospitalizations, and/or treatments/therapies) and the following scales applied every five sessions (e.g., CORE-OM, BSI, GAF, and LSNS-6). Results: The preliminary results indicate an improvement in global functioning and the enlargement of social network size/support, a decrease in symptoms, and a negative correlation between the number of sessions and the LSNS6. Medication use remained largely unchanged at the end of the project. Discussion: In general, even with a small sample, the results are considered satisfactory and seem to be aligned with the vast majority of Open Dialogue studies, which for several decades have consistently pointed toward better recovery rates than treatment as usual as well as increased client satisfaction. We expect that the results presented can boost further research and help strengthen the OD approach.
- Well‐being trajectories in breast cancer and their predictors: A machine‐learning approachPublication . Karademas, Evangelos; Mylona, Eugenia; Mazzocco, Ketti; Pat‐Horenczyk, Ruth; Sousa, Berta; Oliveira‐Maia, Albino J.; Oliveira, Jose; Roziner, Ilan; Stamatakos, Georgios; Cardoso, Fatima; Kondylakis, Haridimos; Kolokotroni, Eleni; Kourou, Konstantina; Lemos, Raquel; Manica, Isabel; Manikis, George; Marzorati, Chiara; Mattson, Johanna; Travado, Luzia; Tziraki‐Segal, Chariklia; Fotiadis, Dimitris; Poikonen‐Saksela, Paula; Simos, PanagiotisObjective:This study aimed to described istinct trajectories of anxiety/depression symptoms and overall health status/quality of life over a period of 18 months followinga breast cancer diagnosis,and identify the medical, socio-demographic,lifestyle, and psychologica lfactors that predict these trajectories.Methods:474 females (mean age=55.79 years) were enrolled in the first weeksafter surgery or biopsy. Data from seven assessmentpoints over 18 months, at 3-month intervals,were used. The two outcomeswere assessedat all points. Potential predictors were assessed at baseline and the first follow‐up. Machine‐ Learning techniques were used to detect latent patterns of change and identify the most important predictors. Results: Five trajectories were identified for each outcome: stably high, high with fluctuations, recovery, deteriorating/delayed response, and stably poor well‐being (chronic distress). Psychological factors (i.e., negative affect, coping, sense of control, social support), age, and a few medical variables (e.g., symptoms, immune‐ related inflammation) predicted patients' participation in the delayed response and the chronic distress trajectories versus all other trajectories. Conclusions: There is a strong possibility that resilience does not always reflect a stable response pattern, as there might be some interim fluctuations. The use of machine‐learning techniques provides a unique opportunity for the identification of illness trajectories and a shortlist of major bio/behavioral predictors. This will facilitate the development of early interventions to prevent a significant deterioration in patient well‐being
- Psychedelic treatments for mental health conditions pose challenges for informed consentPublication . Seybert, Carolina; Cotovio, Gonçalo; Madeira, Luís; Ricou, Miguel; Pires, Ana Matos; Oliveira-Maia, Albino J.
- A qualitative study of imaginary pills and open-label placebos in test anxietyPublication . Buergler, Sarah; Sezer, Dilan; Busch, Alexander; Enzmann, Marlon; Bakis, Berfin; Locher, Cosima; Bagge, Niels; Kirsch, Irving; Carvalho, Claudia; Gaab, JensBackground The efficacy of open-label placebos (OLPs) has been increasingly demonstrated and their use holds promise for applications compatible with basic ethical principles. Taking this concept one step further an imaginary pill (IP) intervention without the use of a physical pill was developed and tested in a randomized controlled trial (RCT). To explore participants’ experiences and views, we conducted the first qualitative study in the field of IPs. Methods A reflexive thematic analysis (RTA) of semi-structured interviews with test anxious students (N = 20) was nested in an RCT investigating an IP and OLP intervention. In addition, openended questions from the RCT were evaluated (N = 114) to corroborate the RTA and pill characteristics were included to more accurately capture the IP experience. Results Four key themes were identified: (1) attitude towards the intervention, (2) applicability of the intervention, (3) experience of effects, and (4) characteristics of the imagination. The IP intervention was well-accepted, easily applicable, and various effects, pill characteristics and appearances were described. While many participants did not desire a physical pill, either due to the absence of the imagination component or aversion to pills, the approach was considered to be cognitively and time demanding, which in turn, however, encouraged the establishment of a therapeutic ritual that protected against the increase in test anxiety during the preparation phase. OLP findings were comparable, and especially the importance of a treatment rationale was stressed in both groups, counteracting an initial ambivalent attitude. The RTA findings were supported by the open-ended questions of the RCT.IPs appear to be a well-accepted and easily applicable intervention producing a variety of beneficial effects. Thus, the IP approach might serve as an imaginary based alternative to OLPs warranting further investigations on its application to harness placebo effects without a physical pill.
- “I feel like I’m living the authenticity of my being”: Gender identity developmental trajectories of trans youth in PortugalPublication . Conceição, Marta; Moura, Jaime; Costa, Pedro AlexandreBackground: Research into the identity development of trans people has been emerging, but there is still a need for further study. While significant processes for identity construction take place during late adolescence and early adulthood, it is important to understand which milestones are associated with the trajectories of gender identity (GI) development. Aims: The present study aimed at exploring the gender identity (GI) developmental trajectories of young Portuguese trans people and the processes associated with them. Methods: Interviews were conducted with sixteen young people aged between 16 and 26, recruited through LGBTI+formal associations and informal online groups, as well as through psychology and sexology consultations. The interviews were conducted face-to-face and online and were analyzed through thematic analysis, which aims to identify, analyze and report patterns in a qualitative data series. Results: Six themes were identified and linked to developmental milestones. These were related to: (1) Discomfort in relation to the gender assigned at birth and its social roles; (2) Body discomfort; (3) Discovery of trans identities; (4) Disclosure of GI; (5) Perceived support; (6) Authentic living of GI. Linked to these themes, four sub-themes were identified as well. Discussion: Based on the life course theory, moments of transition and turning points were identified, as well as social influences such as historical time and place. Thereby, this study contributed to a better understanding of trans youth’s GI developmental trajectories in the Portuguese context, where the study on this topic is still emergent, also contributing to inform the path to be taken at the international level regarding socio-legal policies concerning trans youth.