Percorrer por autor "Coelho, Joana"
A mostrar 1 - 3 de 3
Resultados por página
Opções de ordenação
- Functional abolition of carotid body activity restores insulin action and glucose homeostasis in rats: key roles for visceral adipose tissue and the liverPublication . Sacramento, Joana F.; Ribeiro, Maria J.; Rodrigues, Tiago; Olea, Elena; Melo, Bernardete F.; Guarino, Maria P.; Fonseca-Pinto, Rui; Ferreira, Cristiana R.; Coelho, Joana; Obeso, Ana; Seiça, Raquel; Matafome, Paulo; Conde, Silvia V.Aims/hypothesis: We recently described that carotid body (CB) over-activation is involved in the aetiology of insulin resistance and arterial hypertension in animal models of the metabolic syndrome. Additionally, we have demonstrated that CB activity is increased in animal models of insulin resistance, and that carotid sinus nerve (CSN) resection prevents the development of insulin resistance and arterial hypertension induced by high-energy diets. Here, we tested whether the functional abolition of CB by CSN transection would reverse pre-established insulin resistance, dyslipidaemia, obesity, autonomic dysfunction and hypertension in animal models of the metabolic syndrome. The effect of CSN resection on insulin signalling pathways and tissue-specific glucose uptake was evaluated in skeletal muscle, adipose tissue and liver. Methods: Experiments were performed in male Wistar rats submitted to two high-energy diets: a high-fat diet, representing a model of insulin resistance, hypertension and obesity, and a high-sucrose diet, representing a lean model of insulin resistance and hypertension. Half of each group was submitted to chronic bilateral resection of the CSN. Age-matched control rats were also used. Results: CSN resection normalised systemic sympathetic nervous system activity and reversed weight gain induced by high-energy diets. It also normalised plasma glucose and insulin levels, insulin sensitivity lipid profile, arterial pressure and endothelial function by improving glucose uptake by the liver and perienteric adipose tissue. Conclusions/interpretation: We concluded that functional abolition of CB activity restores insulin sensitivity and glucose homeostasis by positively affecting insulin signalling pathways in visceral adipose tissue and liver.
- Spiritual Care Competence in Palliative Care: A Concept AnalysisPublication . Coelho, Joana; Querido, Ana; Costeira, Cristina; Laranjeira, Carlos; Carey, Lindsay B.Care is a multidimensional concept that includes spirituality as a dynamic and integrative aspect of human experience. Integrating spirituality into clinical practice enables a more comprehensive response to the full spectrum of human needs, which is why spiritual care competence emerges as an aptitude that fits the profile and skills to be developed by those working on care provision. Regrettably, not enough attention has been paid to spiritual care competence largely due to the lack of knowledge of professionals and what this entails. Therefore, this study aims to define the main attributes of the concept of Spiritual Care Competence in Palliative Care, identify its antecedents and consequences, examine its empirical referents, and clarify the conceptual boundaries. The concept analysis method of Walker and Avant was used. Main attributes were organized into three main domains: (1) intrapersonal resources, such as spiritual awareness, humility, sensitivity, confidence, wisdom, and intuition; (2) interpersonal resources, such as presence, active listening, compassion, and empathy; and (3) transpersonal resources, such as the ability to establish meaningful connections, assist in finding meaning, and explore hope. These domains can be nurtured over time but ultimately require professional maturity and experience. Antecedents of spiritual care competence include active engagement in care, formal training in spiritual care, and recognition of the individual's spiritual dimension. Consequences were identified for the person being cared for, the professional and the care environment and include suffering relief, reduced stress and anxiety, enhanced spiritual well-being, and lower healthcare costs. When spiritual care competence is intentionally cultivated and continuously developed, professionals advance toward the ideal of person-centered humanistic care, fostering better at the End-of-Life patient/family outcomes and contributing to professional satisfaction and personal fulfillment.
- Spiritual Care[Givers] Competence in Palliative Care: A Scoping ReviewPublication . Costeira, Cristina; Querido, Ana; Ventura, Filipa; Loureiro, Hugo; Coelho, Joana; Benito, Enric; Nabal, Maria; Dones, Monica; Specos, Marcela; Laranjeira, CarlosTo deliver spiritual care, professionals must be skilled in physical, mental, social, and spiritual care. Spiritual care competence includes knowledge, behaviors, attitudes, and skills that enable successful or efficient care. This review aims to identify the scope of competence and the specific skills, knowledge, and attitudes used in providing spiritual care to people needing palliative care, and the main challenges and facilitators. A scoping review was developed using the Joanna Briggs Institute methodology. Six databases (Web of Science; MEDLINE/Pubmed; Scopus; CINAHL; MedicLatina and SciELO) were searched in September 2023, with an update in January 2024. The resulting 30 articles were analyzed using a content analysis approach. Information was categorized into three domains: cognitive, affective, and functional (based on three personal resources: intrapersonal, interpersonal, and transpersonal). Palliative care professionals face a lack of training and insufficient preparation to deliver spiritual care. Spiritual care competence depends on professional spiritual development and experience, spiritual intelligence (cognitive), spiritual humility (affective), and having a critical and reflexive mind (functional). In the future, palliative care should seek to improve competent spiritual care. This review could help clarify the real configuration of competent spiritual care and lead to improvements in a professional’s empowerment when delivering effective spiritual care to patients and families.