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- Hot flushes and night sweats in midlife : Why do some women have them and others do not?Publication . Pimenta, Filipa; Marôco, J. P.; Ramos, Catarina; Leal, I.This study investigated what predicts the occurrence of hot fl ushes (HF) and night sweats (NS). A community sample of 992 women (42-60 years) answered a questionnaire to collect socio-demographic, health and menopause-related, as well as lifestyle information. Depressive mood and stress, as well as HF and NS (in terms of presence, frequency and intensity), were also assessed. Structural equation modelling was used to build a structural model to predict the occurrence of both vasomotor symptoms. Results: Stress predicted NS (β =.154; p =.006), whereas depressive mood was linked to the occurrence of HF’s (β =.149; p =.006). Being peri-menopausal and post-menopausal, among several other characteristics, were also signifi cant predictors of the occurrence of both HF and NS. This study supports a distinguished infl uence of stress and depressive mood in NS and HF respectively, probably due to the nature of psychological symptoms. Moreover, signifi cant associations between vasomotor symptoms and socio-demographic, health and menopause-related characteristics, and alcohol were confirmed.
- Perceived control, lifestyle, health, socio-demographic factors and menopause: Impact on hot flashes and night sweatsPublication . Pimenta, Filipa; Leal, I.; Marôco, J. P.; Ramos, CatarinaObjective: To develop a model to predict the perceived severity of hot flashes (HF) and night sweats (NS) in symptomatic middle-aged women. Methods: This was a cross-sectional study of a community-based sample of 243 women with vasomotor symptoms. Menopausal status was ascertained using the ‘Stages of Reproductive Aging Workshop’ criteria. Women’s ‘perceived control’ over their symptoms was measured by a validated Portuguese version of the Perceived Control over Hot Flushes Index. Structural equation modelling was employed to construct a causal model of self-reported severity of both HF and NS, using a set of 20 variables: age, marital status, parity, professional status, educational level, family annual income, recent diseases and psychological problems, medical help-seeking behaviour to manage menopausal symptoms, use of hormone therapy and herbal/soy products, menopause status, intake of alcohol, coffee and hot beverages, smoking, physical exercise, body mass index and perceived control. Results: Significant predictors of perceived severity were the use of hormone therapy for both HF (B = −.245; p = .022) and NS (B = −.298; p = .008), coffee intake for both HF (B = −.234; p = .039) and NS (B = −.258; p = .029) and perceived control for both HF (B = −1.0; p < .001) and NS (B = −1.0; p < .001). The variables explained respectively 67% and 72% of the variability in the perceived severity of HF and NS. Women with high perceived control had a significantly lower frequency (t(235) = 2.022; p = .044) and intensity of HF (t(217) = 3.582; p < .001); similarly, participants with high perceived control presented a lower frequency (t(235) = 3.267; p < .001) and intensity (t(210) = 3.376; p < .001) of NS. Conclusion: Perceived control was the strongest predictor of the self-reported severity of both HF and NS. Other causal predictors were hormone therapy and caffeine intake. All three were associated with less severe vasomotor symptoms.
- Menopausal symptoms: Is spirituality associated with the severity of symptoms?Publication . Pimenta, Filipa; Marôco, J. P.; Ramos, Catarina; Leal, I.The aim of this study was to explore whether spirituality was associated with menopausal symptoms. Menopausal symptoms, spirituality, health and menopausal status, and socio-demographic variables were assessed in a community sample of 710 peri- and postmenopausal women. A structural model was explored using structural equation modeling. The results evidence spirituality as a significant contributor regarding the severity of most menopausal symptoms. Among others, spirituality had a significant weight in depressive mood (b = -.414; p\.001), anxiety (b = -.308; p<.001), cognitive impairment (b = -.287; p<.001), aches/pain (b = -.148; p<.001), vasomotor (b = -.125; p = .005) and sexual symptoms (b = -.211; p<.001). Some socio-demographic variables, as well as perceived health, also predicted the menopausal symptoms’ severity. Therefore, spirituality can have a positive impact on the menopausal symptoms’ reporting.
- Brief cognitive-behavioral therapy for weight loss in midlife women: A controlled study with follow-upPublication . Pimenta, Filipa; Leal, I.; Marôco, J. P.; Ramos, CatarinaObjective: Cognitive-behavioral therapy (CBT) has proven to be effective in weight reduction. This study explores whether individual, 8-session CBT can promote weight loss in midlife women. Methods: Anthropometric (weight, abdominal perimeter, and body mass index calculation), psychological (health-related and sexual quality of life, stress, anxiety, and depression), and behavioral measures (binge eating disorder and restrained, external, and emotional eating) were assessed at baseline (T1), posttreatment (T2), and 4-month follow-up (T3), for a total of 21 women at baseline; the CBT group (n = 11) and the control group (n = 10; waiting list) were comparedResults: Statistically significant effects that were dependent on the intervention were observed on weight (F = 4.402; P = 0.035; ηp2 = 0.404; π = 0.652) and body mass index (F = 3.804; P = 0.050; ηp2 = 0.369; π = 0.585); furthermore, marginally significant effects were observed on external eating (F = 2.844; P = 0.095; ηp2 = 0.304; π = 0.461). At follow-up, women in the CBT group presented with lower weight, abdominal perimeter, body mass index, and external eating; higher health-related quality-of-life and restrained eating were also observed in this group. Most differences identified were at a marginally significant level. Moreover, at follow-up, none of the participants of the CBT group met the criteria for binge eating disorder, whereas the number of women with binge eating disorder in the control group remained the same through all three assessments. Conclusion: An effective, though small, weight loss was achieved. Changes in quality of life were also observed. Moreover, changes in external eating behavior were successful.
- Group Intervention Program to Facilitate Post-Traumatic Growth and Reduce Stigma in HIVPublication . Santos, Nuno Tomaz; Ramos, Catarina; Almeida, Margarida Ferreira De; Leal, I.Background: Research on post-traumatic growth (PTG) and HIV is scarce and the relationship between PTG and stigma is controversial. Group psychotherapeutic interventions to facilitate PTG in clinical samples are effective but none exist to simultaneously decrease stigma in the HIV population. The main objective was to evaluate the effectiveness of an intervention in increasing PTG and decreasing stigma in HIV, as well as to explore relationships between the variables. Methods: Quasi-experimental design with a sample of 42 HIV-positive adults (M = 46.26, SD = 11.90). The experimental group (EG) was subjected to a 9-week group intervention. Instruments: CBI, PTGI-X, PSS-10, HIV stigma, emotional expression, HIV stress indicators, HIV literacy, and skills. Multiple linear regression analysis was performed to assess the relationship between the variables. Results: There was an increase in PTG and a significant decrease in stigma in all domains and subscales in the EG. Compared to the control group, stigma (t(42) = −3.040, p = 0.004) and negative self-image (W = −2.937, p = 0.003) were significant, showing the efficacy of the intervention. Discussion: The intervention demonstrated success in facilitating PTG, attesting that in order to increase PTG, personal strength, and spiritual change, it is necessary to reduce stigma and negative self-image. The research provides more information on group interventions for PTG in HIV, relationships between variables, and population-specific knowledge for professionals.