Browsing by Author "Januário, Filipa"
Now showing 1 - 10 of 10
Results Per Page
Sort Options
- Construct Validity of the Brief Physical Activity Assessment Tool for Clinical Use in COPDPublication . Cruz, Joana; Jácome, Cristina; Oliveira, Ana; Paixão, Cátia; Rebelo, Patrícia; Flora, Sofia; Januário, Filipa; Valente, Carla; Andrade, Lília; Marques, AldaIntroduction Low physical activity (PA) levels are associated with poor health‐related outcomes in Chronic Obstructive Pulmonary Disease (COPD). Thus, PA should be routinely assessed in clinical practice. Objectives This study assessed the construct validity of the Brief Physical Activity Assessment Tool (BPAAT) for clinical use in COPD, and explored differences in age, sex and COPD grades. Methods After linguistic adaptation of the tool to Portuguese, 110 patients (66.4±9.6yrs, 72.7% male, FEV1=59.3±25.5%predicted) completed the BPAAT and received an accelerometer. The BPAAT includes two questions assessing the weekly frequency and duration of vigorous‐ and moderate‐intensity PA/walking, classifying individuals as insufficiently or sufficiently active. The BPAAT was correlated with accelerometry (moderate PA, MPA=1952‐5724 counts‐per‐min[CPM]); vigorous PA, VPA=5725‐∞CPM; moderate‐to‐vigorous PA, MVPA=1952‐∞CPM; daily steps), through: Spearman’s correlations (ρ) for continuous data; %agreement, Kappa, sensitivity and specificity, positive and negative predictive values (PPV, NPV) for categorical data. Results The BPAAT was weakly to moderately correlated with accelerometry (0.394≤ρ≤0.435, p<0.05), except for VPA (p=0.440). This was also observed in age (<65/≥65yrs), COPD grades (GOLD 1‐2/3‐4), and in male patients (0.363≤ρ≤0.518, p<0.05 except for VPA). No significant correlations were found in female patients (p>0.05). The BPAAT correctly identified 73.6% patients as ‘insufficiently active’ and 26.4% as ‘sufficiently active’. Agreement was fair to moderate (0.36≤kappa≤0.43; 73.6%≤%agreement≤74.5%; 0.50≤sensitivity≤0.52; 0.84≤specificity≤0.91, 0.55≤PPV≤0.79, 0.72≤NPV≤0.82). Conclusion The BPAAT may be useful to screen patients’ PA, independently of age and COPD grade, and identify male patients who are insufficiently active. Care should be taken when using this tool to assess vigorous PA or female patients.
- Hybrid Cardiac Telerehabilitation After Acute Coronary Syndrome: Self-selection Predictors and OutcomesPublication . Ferreira, José Bernardo; Cabral, Margarida; Santos, Rita; Ferreira, Marta; Fonseca-Pinto, Rui; Antunes, Alexandre; Januário, FilipaAims: To evaluate the effectiveness of a hybrid cardiac telerehabilitation (HCTR) program after acute coronary syndrome (ACS) on patient quality of life (QoL) and physical activity indices throughout phases 2-3 and establish predictors for hybrid program self-selection. Methodology: This single-centre longitudinal retrospective study included patients who attended a cardiac rehabilitation program (CRP) between 2018-2021. Patients self-selected between two groups: Group 1 – conventional CRP (CCRP); Group 2 – HCTR. Baseline characteristics were registered. EuroQol-5D (EQ-5D) and International Physical Activity Questionnaire (IPAQ) were applied at three times: T0 – phase 2 onset; T1 – phase 3 onset; T2 – 3 months after T1. Results: 59 patients participated (Group 1 – 27; Group 2 – 32). We found significant between-group differences regarding occupation (p=0.003). Diabetic patients were less likely to self-select into HCTR (OR=0.21; p<0.05). EQ-5D visual analogue scale and IPAQ result significantly improved between T0-T2 only for HCTR (p=0.001; p=0.021). Conclusions: HCTR was superior to CCRP on physical activity indices and QoL of ACS patients.
- Motivation and physical activity in COPD: An exploratory studyPublication . Pimenta, Sara; Flora, Sofia; Silva, Cândida G.; Oliveira, Ana; Morais, Nuno; Ribeiro, José; Silva, Fernando; Caceiro, Rúben; Carreira, Bruno P.; Januário, Filipa; Andrade, Lília; Rodrigues, Fátima; Brooks, Dina; Burtin, Chris; Marques, Alda; Cruz, JoanaA key factor for the adoption of an active lifestyle is self-determined motivation; however, it is often overlooked in COPD. Understanding the motives underlying patients’ decision to be (or not) physically active will provide insight into future interventions. This study assessed the motives for patients with COPD to engage in physical activity (PA) and their association with PA behaviour. A cross-sectional study was conducted in stable patients with COPD. Motivation was assessed with the Exercise Motivation Inventory-2 (EMI-2; score 0[Not at all true for me]–5[Very true for me]; 5 dimensions) and PA with accelerometry [ActiGraph-GT3X+, 7 days; moderate to vigorous PA (MVPA), steps/day]. Spearman’s correlations (ρ) were used to assess their relationship. 60 participants were enrolled (67.2±7.7 years; 76.7% men; FEV1 49.5±19.7pp). Patients’ motives to be physically active were mostly Health, Fitness and Psychological. Correlations with PA were weak and non-significant (p>0.05) (Table 1). Patients with COPD value Health, Fitness and Psychological motives to be physically active, although these are not related to their PA behaviour. Findings highlight the complex nature of PA and the need to further explore factors influencing PA and motivation in this population.
- Perfil de atividade física de pessoas com Doença Pulmonar Obstrutiva Crónica (DPOC) em PortugalPublication . Raposo, João; Pimenta, Sara; Alves-Guerreiro, José; Flora, Sofia; Caceiro, Rúben; Morais, Nuno; Oliveira, Ana; Silva, Cândida G.; Ribeiro, José; Silva, Fernando; Januário, Filipa; Carreira, Bruno P.; Rodrigues, Fátima; Marques, Alda; Cruz, JoanaIntrodução e objetivos: A participação em atividade física (AF) regular está associada a um menor risco de mortalidade e melhor qualidade de vida relacionada com a saúde. Apesar de se saber que as pessoas com Doença Pulmonar Obstrutiva Crónica (DPOC) apresentam níveis baixos de AF quando comparadas com indivíduos saudáveis da mesma idade e sexo, desconhece-se ainda a caracterização diária dos níveis de AF destas pessoas em Portugal. Este estudo teve como objetivos caracterizar o perfil de AF de pessoas com DPOC portuguesas e explorar a sua relação com características clínicas. Material e Métodos: Foi realizado um estudo observacional transversal em pessoas com DPOC clinicamente estáveis, nas regiões Centro e Lisboa e Vale do Tejo. Foram recolhidos dados sociodemográficos, antropométricos, função pulmonar [Volume Expiratório Forçado no 1º segundo (FEV1)], sintomas e exacerbações (GOLD ABCD), dispneia (modified Medical Research Council), tolerância ao exercício (teste de marcha dos 6-min) e estado de saúde (COPD Assessment Test). A AF foi avaliada através de acelerometria (ActiGraph GT3X+) durante 7 dias e consistiu em: tempo despendido em AF Moderada a Vigorosa (AFMV) e em AF Total (min/dia), e número de passos/dia. Realizou-se estatística descritiva e correlações de Spearman (ρ) entre as variáveis de AF e as medidas clínicas. Resultados: Os participantes (n=102, 82 do sexo masculino, FEV1=48±19%previsto) apresentaram uma mediana [Q1–Q3] de 20 [9–41] min/dia em AFMV, 144 [100–208] min em AF Total e realizaram 4438 [2821–6944] passos/dia. Apenas 24% dos participantes atingiram ≥7000 passos/dia e 41% os ≥30 min/dia de AFMV recomendados na literatura. O tempo despendido em AFMV e o n.º de passos/dia apresentaram correlações moderadas com a dispneia (ρ=-0.401 e ρ=0.537, respetivamente; p<0.001) e com a tolerância ao exercício (ρ=0.560 e ρ=0.525, respetivamente; p<0.001). O tempo em AFMV apresentou ainda correlação com os graus ABCD (ρ=-0.430, p<0.001). Conclusões: A maioria das pessoas com DPOC é fisicamente inativa. Os sintomas, exacerbações e tolerância ao esforço estão associados à AF nesta população e devem ser considerados em intervenções de promoção de AF.
- Relationship between Distress Related to Caregiver Burden and Physical Activity in Informal Caregivers of Patients with COPDPublication . Hipólito, Nádia; Ruivo, Adriana; Martins, Sara; Dinis, Beatriz; Flora, Sofia; Marques, Alda; Brooks, Dina; Silva, Cândida G.; Januário, Filipa; Silva, Sónia; Cruz, JoanaChronic obstructive pulmonary disease (COPD) can lead to increased dependence on the informal caregiver and, consequently, to distress associated with caregiving burden. In the general population, higher levels of physical activity (PA) are related to lower distress levels; however, this relationship has been scarcely studied in COPD. This study aimed to explore the relationship between distress and PA in informal caregivers of patients with COPD, and the influence of caregivers’ (age, sex) and patients’ (age, sex, lung function) characteristics and caregiving duration on this relationship. A cross-sectional study was conducted with 50 caregivers (62.7 ± 9.8 years, 88% female; 78% caring for a spouse/partner; 38% caring >40 h/week; patients’ FEV1=45.2 ± 21.3% predicted). Data collection comprised questions related to the caregiving context, distress related to caregiving burden assessed with the Informal Caregiver Burden Assessment Questionnaire (QASCI; total score, 7 subscales), and self-reported PA with the Habitual Physical Activity Questionnaire (HPAQ). Spearman’s correlation coefficient and linear regressions were used. Significant, negative and moderate correlations were found between the QASCI (28.5 ± 19.8) and the HPAQ (5.2 ± 1.3) (ρ=-0.46; p = 0.01); and between the HPAQ and some QASCI subscales (emotional burden ρ=-0.47; implications for personal life ρ=-0.52; financial burden ρ=-0.44; perception of efficacy and control mechanisms ρ=-0.42; p < 0.01). Two linear regression models were tested to predict QASCI total score including as predictors: 1) HPAQ alone (p = 0.001; r2=0.23); 2) HPAQ and caregiving h/week (p < 0.001; r2=0.34). Higher self-reported PA levels are related to decreased levels of distress associated with caregiver burden in COPD caregivers. Duration of caregiving may negatively influence this relationship.
- Reliability and validity of the international physical activity questionnaire short-form (IPAQ-sf) in COPDPublication . Flora, Sofia; Hipólito, Nádia; Santos, Liliana; Januário, Filipa; Silva, Sónia; Valente, Carla; Andrade, L; Rodrigues, Fátima; Marques, Alda; Cruz, JoanaPhysical activity (PA) may improve COPD prognosis, thus its assessment and promotion are crucial. The International Physical Activity Questionnaire Short-Form (IPAQ-sf) is widely used for assessing PA but there is limited evidence on its clinimetric properties in COPD. We assessed the test-retest reliability and validity of the IPAQ-sf in patients with COPD. Fifty-five participants (68.6±7.8yrs, 48 males, FEV1 52.3±22.5%pred) completed the IPAQ-sf, wore an accelerometer for 7 days and completed a second IPAQ-sf. Test-retest reliability/agreement was assessed with: Intraclass Correlation (ICC, 95%CI), 95% Limits of Agreement (LoA), standard error of measurement (SEM) and minimal detectable change (MDC95) for continuous variables; %agreement for categories (“active” vs “inactive”). Validity was assessed with Spearman’s correlations (ρ) between the IPAQ-sf (METs-min/week, time in vigorous [VPA] and moderate PA [MPA] per week) and accelerometry [time in MVPA, VPA and MPA per week] for continuous variables; %agreement, Cohen’s kappa, sensitivity and specificity (95%CI) for categories. Reliability was acceptable (ICC=0.738, 0.629→0.873) but with wide LoA (-5713→4793.3 METs-min/week). SEM and MDC95 were 1844.7 and 5113.3 METs-min/week, respectively. %agreement of the two IPAQ-sf was 85.5% (kappa=0.660, 0.444→0.876). Significant correlations were found between METsmin/week and accelerometry (0.515≤ρ≤0.596), except for VPA (p>0.05). %agreement between tools was 67.3% (kappa=0.350, 0.279→0.571) with high sensitivity (0.89, 0.887→0.891) but low specificity (0.46, 0.46→0.47). The IPAQ-sf could be used as PA measurement tool in COPD although caution is needed to avoid misclassification.
- Reliability and validity of the QASCI questionnaire to assess caregiving burden in COPDPublication . Hipólito, Nádia; Ruivo, Adriana; Martins, Sara; Flora, Sofia; Marques, Alda; Brooks, Dina; Silva, Cândida G.; Januário, Filipa; Cruz, JoanaIntroduction: Chronic obstructive pulmonary disease (COPD) often leads to an increased dependence on the informal carer, which can result in higher levels of distress, anxiety or depression associated with the burden of caregiving and, consequently, reduced quality of life (1). Several instruments have been used to assess carer burden in COPD; however, their measurement properties have been poorly assessed in this population (2). The Questionário de Avaliação de Sobrecarga do Cuidador Informal (QASCI) is a Portuguese questionnaire, originally created for carers of patients with stroke (3) and later validated in a sample with various chronic diseases, including respiratory diseases (4). However, its reliability and validity in informal carers of patients with COPD have yet to be established. Therefore, this study aimed to assess the reliability and validity of the QASCI questionnaire for informal carers of patients with COPD. Materials and Methods: The Portuguese questionnaire QASCI evaluates the distress associated with burden of caregiving (scores range from 0 to 100, with higher scores indicating higher levels of burden). It has 32 items divided in 7 subscales (emotional burden; personal life implications; financial burden; reactions to demands; mechanism of efficacy and control; familiar support; and satisfaction with the role). Each item is scored with a 5-point Likert scale. Reliability included internal consistency assessment using the Cronbach’s alpha. Construct validity was assessed using the following questionnaires: Zarit Burden Interview (ZBI) for concurrent validity; the Hospital Anxiety and Depression Scale (HADS) (anxiety and depression) and WHOQOL-Bref (quality of life) for convergent validity. Pearson’s (r) or Spearman’s (ρ) correlation coefficients were used according to the distribution of each variable. QASCI was expected to present a stronger (positive) correlation with ZBI than with HADS (r≥0.5) and a negative correlation with WHOQOL-Bref (r≤-.4) (3, 4). Results: Forty-one carers (62.4±10.1 years, 90.2% female; patients’ FEV1=43.7±19.7%pred) completed the questionnaires. Cronbach’s alpha of the full QASCI scale was .767 and the subscales presented values between .633 and .929. QASCI and ZBI had a very strong positive correlation (r=.914; p=.01). QASCI had a strong positive correlation with HADS anxiety (r=.608; p=.01) and depression (ρ=.617; p=.01) subscales and moderate to strong negative correlations with all the WHOQOL-Bref subscales (-.418 to .723, p=.01). Discussion and Conclusions: QASCI presented good internal consistency and construct validity results. QASCI seems to be a promising measure to evaluate distress levels associated with burden of caregiving in informal carers of patients with COPD.
- Test-retest reliability, agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in people with COPDPublication . Flora, Sofia; Marques, Alda; Hipólito, Nádia; Morais, Nuno; Silva, Cândida G.; Januário, Filipa; Rodrigues, Fátima; Carreira, Bruno P.; Cruz, J.Introduction This study assessed the test-retest reliability/agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in patients with chronic obstructive pulmonary disease (COPD). It also explored differences in its validity according to age, sex and GOLD airflow obstruction levels. Methods 62 participants (68 ± 8 years, 53 males, FEV1 51 ± 23%pred) completed the Portuguese IPAQ-sf, wore an accelerometer for 7 days and completed a second IPAQ-sf. Test-retest reliability/agreement was assessed with Intraclass Correlation Coefficient (ICC2,1), 95% Limits of Agreement (LoA), standard error of measurement (SEM) and minimal detectable change (MDC95) for continuous variables, and percentage of agreement (%agreement) for categories (“active”/“inactive”). Validity was assessed with 95% LoA and Spearman's correlations (ρ) between IPAQ-sf 2 (METs-min/week, time in vigorous [VPA], moderate PA [MPA] and walking) and accelerometry (time in MVPA, VPA, MPA and step counts) for continuous variables; %agreement, Cohen's kappa, and sensitivity specificity and±predictive values for categories. Correlations were also performed for age, sex and GOLD airflow obstruction grades. Results Reliability was good (ICC2,1 = 0.707) with wide LoA (-6446—6409 METs-min/week). SEM and MDC95 were 1840 and 4971 METs-min/week, respectively. %agreement between the two IPAQ-sf was 84% (kappa = 0.660). Positive, moderate and significant correlations were found between IPAQ-sf and accelerometry (0.396 ≤ ρ ≤ 0.527, p < 0.001), except for VPA (p > 0.05). The strongest correlations were found in age (<65 years) and male (0.466 ≤ ρ ≤ 0.653, p < 0.05). %agreement between tools was 65% (kappa = 0.313), with high sensitivity (0.830) but low specificity (0.500). Conclusions The IPAQ-sf seems valid to be used in COPD but caution on its widespread use is recommended as its accuracy may be limited.
- What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional StudyPublication . Pimenta, Sara; Silva, Cândida G.; Flora, Sofia; Hipólito, Nádia; Burtin, Chris; Oliveira, Ana; Morais, Nuno; Brites-Pereira, Marcelo; Carreira, Bruno P.; Januário, Filipa; Andrade, Lília; Martins, Vitória; Rodrigues, Fátima; Brooks, Dina; Marques, Alda; Cruz, JoanaMotivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.
- What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional StudyPublication . Pimenta, Sara; Silva, Cândida; Flora, Sofia; Hipólito, Nádia; Burtin, Chris; Oliveira, Ana; Morais, Nuno; Brites-Pereira, Marcelo; Carreira, Bruno P.; Januário, Filipa; Andrade, Lilia; Martins, Vitória; Rodrigues, Fátima; Brooks, Dina; Marques, Alda; Cruz, JoanaMotivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients’ motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.