Browsing by Author "Laranjeira, Carlos"
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- An in-depth introduction to arts-based spiritual healthcare: Creatively seeking and expressing purpose and meaningPublication . Laranjeira, Carlos; Querido, AnaArt therapy entails a therapeutic relationship that allows the expression and exploration of mental and spiritual needs through art (Bell, 2011). It integrates artistic creation, making use of different artistic mediators (Martins, 2013). Through various forms of artistic expression, a person communicates and explores their feelings and intimacy (Lev, 2020). Creative development allows the individual to break forms of resistance, recognize their own capabilities, and feel greater self-esteem and wellbeing (Hu et al., 2021; Ryff, 2021). Exercising creativity enables a differentiated view of oneself and favors the encounter of alternative points of view regarding psychological and spiritual issues (Alvarenga et al., 2018). The aim is personal growth and contact with our sensitive world and emotional development. In the art-therapeutic process, the artistic experience through creation enriches the imaginary and contributes to self-knowledge, driving the elaboration of internal contents and personal transformation (Martins, 2013; Ettun et al., 2014). In the art-therapeutic setting, different artistic mediators facilitate creation, expression and communication, including plastic, musical, dramatic, body, literary, and playful expression. These constitute the technical and material basis for creation. Considering the particular symbolic, expressive, and creative characteristics of different resources and understanding the therapeutic potential of each resource and how they can meet individual needs is fundamental to effective Art Therapy. Nota: Extrato retirado da introdução do artigo.
- The Arabic Version of the Patient Health Questionnaire‐2 (PHQ‐2): Psychometric Evaluation Among Mothers of Children With Intellectual DisabilitiesPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A; Aljaberi, Musheer A.; El-Gazar, Heba Emad; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alamer, Rasmieh; Amer, Faten; Pakai, Annamaria; Fekih-Romdhane, Feten; Lidoriki, EiriniAim: Mothers of children with intellectual disabilities are particularly vulnerable to mental distress due to demanding and exhausting caregiving. However, in the Arab world, they are seldom screened for depression because of limited diagnostic resources. Addressing the urgent need for brief and reliable screening tools, this study evaluated the psychometric properties of the Arabic version of the Patient Health Questionnaire-2 (PHQ-2) among 85 Saudi mothers. Design: A cross-sectional study. Methods: The construct, convergent, and divergent validity of the PHQ-2 was examined through a latent variable model (LVM), while its cutoff score was examined through receiver-operating characteristic (ROC) curve analysis. Results: The unidimensional PHQ-2 (item loadings > 0.7) was positively predicted by stress and negatively predicted by high mood and happiness, supporting its convergent and divergent validity. The PHQ-2 effectively predicted low mood, poor sleep quality, nightmares, high stress, low general physical health, and willingness to join a psychological support program (area under the curve [AUC] range = 0.72–0.84, p values < 0.001). The best balance between sensitivity and specificity was achieved at the PHQ-2 threshold ≥ 2.5, while the cutoff ≥ 3.5 demonstrated a higher positive predictive value (PPV) for all outcomes (range = 30.0–78.8 vs. 23.0–70.8). Conclusions: The PHQ-2 is a brief, valid tool, which at cutoffs ≥ 2.5 and ≥ 3.5 can reliably detect clinically significant depression and related psychological and physical adverse effects. Mothers scoring ≥ 3.5 may require a clinician-based examination for depression, and they may benefit from specific mental health literacy interventions. However, the results should be interpreted with caution given convenience sampling, a small sample size, and elevated distress levels in the current population. These limitations highlight the need to replicate the study with larger, randomly selected samples from more diverse populations. Implications for Practice: Nurses can efficiently screen for depression and its mental/physical sequelae, as well as monitor response to treatment using only two items. The study provided two well-interpreted cutoffs of the PHQ-2, with real-world implications for mental health screening in under-resourced settings. Reporting Method: The study adhered to STROBE guidelines. Patient or Public Contribution: No patient or public contribution. Copyright © 2025 Amira Mohammed Ali et al. Nursing Research and Practice published by John Wiley & Sons Ltd.
- Atividade Psicomotora e Comportamento Auto e HeteroagressivoPublication . Valentim, Olga; Laranjeira, Carlos; Querido, Ana
- Auto-estigma numa amostra de adultos portugueses com doença mentalPublication . Laranjeira, Carlos; Querido, Ana; Moreira, Maria Isabel Figueiredo; Tribovane, Mónica Alves; Fernandes, Raquel PedrosaO estigma em Saúde Mental ocorre quando se rotula negativamente uma pessoa com doença mental, que leva à discriminação e segregação da mesma. Dá-se em forma de crenças, atitudes e comportamentos que trazem consequências negativas na vida da pessoa que é estigmatizada. Quando a vítima internaliza estas noções como reais acentuam-se os efeitos nefastos que impactam as várias dimensões da sua vida. Os objetivos deste estudo visaram: a) averiguar o nível de auto-estigma das pessoas com doença mental; e b) correlacionar o nível de auto-estigma com as variáveis autoestima, ideação suicida e, paralelamente, com as caraterísticas sociodemográficas (género, escolaridade e atividade profissional), tempo de tratamento e conhecimento percebido sobre saúde/doença mental. Trata-se de um estudo quantitativo de natureza descritivo-correlacional realizado em fevereiro de 2020, através da aplicação de um questionário a utentes de um departamento de Psiquiatria do um centro hospitalar da zona centro de Portugal, dos quais foram selecionados 58 casos para estudo. Os resultados obtidos evidenciam que elevados níveis de auto-estigma estão relacionados com menores níveis de autoestima, e um maior risco de ideação suicida. Foram ainda encontradas associações entre o aumento do auto-estigma em pessoas com baixas habilitações literárias e sem atividade profissional. Neste sentido, a implementação de programas de intervenção deverá seguir uma abordagem mista (i.e., psicofarmacoterapia e terapias cognitivocomportamentais) capaz de reduzir o estigma internalizado e fortalecer a autoestima. PALAV
- Avaliação Objetiva e Subjetiva do UtentePublication . Querido, Ana; Tomás, Catarina; Laranjeira, Carlos
- Awareness and Attitudes towards Advance Care Directives (ACDs): An Online Survey of Portuguese AdultsPublication . Laranjeira, Carlos; Dixe, Maria dos Anjos; Gueifão, Luís; Caetano, Lina; Passadouro, Rui; Querido, AnaEvidence shows that facilitated advance decisions can increase the number of meaningful and valid Advance Care Directives (ACDs) and improve the quality of care when EndOf-Life (EOL) is near. Little is known about the awareness and attitudes of Portuguese adults towards ACDs. The present study aims to assess the knowledge, attitudes, and preferences of a sample of Portuguese adults regarding EOL care decisions and ACDs. (2) Methods: A total of 1024 adults were assessed with an online cross-sectional survey collecting information on sociodemographic factors, knowledge, attitudes and preferences regarding advance decisions and EOL care. (3) Results: Participants had a mean age of 40.28 ± 11.41 years. Most were female and had a professional background related to healthcare. While 76.37% of participants had heard of ACDs, only a small percentage (2.34%) had actually ever made an ACD. Knowledge levels were weakly correlated with attitudes regarding ACDs (r = −0.344; p < 0.01). (4) Conclusions: Participants lacked a comprehensive understanding about ACDs, but revealed positive attitudes towards their use and usefulness. Further research can inform efforts to improve ACD engagement in this population. The discussion about ACDs should be part of health promotion education with a focus on planning for a comfortable and peaceful death
- Breaking bad news in complex palliative care situations through role-play simulationPublication . Laranjeira, Carlos; Querido, Ana IsabelBackground: One of the most important components in the repertoire of nursing communication skills is the ability to ‘break bad news’ to patients and families. This article presents a pilot role-play simulation conducted at a Portuguese undergraduate nursing program with senior-level students. Methods: The simulation was designed to aid nursing students to develop communication skills necessary to care for the critically ill patient nearing the EOL. This approach had two main learning outcomes: a) improve students’ ability to break bad news and build their confidence in that ability, and b) assist students to engage in the process of self- and peer reflection. Thirty students were recruited from palliative care nursing course, they had no previous experience with this type of simulation. The simulation took place on three separate theoretical-practical classes with ten students each one. Prior to each role-play, three students were randomly role-played both the nurse, the patient and the relative roles. Students who were not assigned active roles observed the simulation and provided feedback during the debriefing period. Students were encouraged to reflect on issues related to the communication of bad news using the Gibbs´ reflective cycle. Results: Themes of students’ responses during the debriefing included an overall positive feeling about the experience and their performance (n=25), nevertheless, students acknowledged they lacked confidence in their skills to communicate effectively (n=12). They indicated that they felt more prepared to meet the patient‘s physical needs than emotional needs. All students also reported valuing working together as a team as it fostered meaningful sharing of ideas. Conclusions: As a result of this kind of learning, the student develops greater capacity for treating others with the respect and understanding required in palliative care nursing. This may inform his or her understanding and capacity to help the other person.
- Building Bridges for “Palliative Care-in-Place”: Development of a mHealth Intervention for Informal Home CarePublication . Laranjeira, Carlos; Dixe, Maria dos Anjos; Martinho, Ricardo; Rijo, Rui; Querido, AnaIn Palliative Care (PC), family and close people are an essential part of provision of care. They assume highly complex tasks for which they are not prepared, with considerable physical, psychological, social and economic impact. Informal Caregivers (ICs) often falter in the final stage of life and develop distress, enhancing emotional burden and complicated grief. The lack of available and accessible in-person counselling resources is often reported by ICs. Online resources can promote early access to help and support for patient-IC dyads in palliative care. The primary aim of this research is to co-design, develop and test the feasibility of the Help2Care-PAL mHealth app that addresses the needs of ICs of palliative patients cared for at home. This Digital Health Intervention (DHI) in palliative care will be used for education, symptom management, communication and decision-making, to enhance Quality of Life (QoL) of patients and ICs, fostering anticipatory grief and the reach and efficiency of services.
- Burden of the family caregivers of the person with mental illness in portugal: A cross sectional studyPublication . Laranjeira, Carlos; Querido, AnaThe provision of mental health care should be promoted at the community level, in order to facilitate their recovery process. Thus, the people who care for these individuals go through a situational transition, as they have to play the role of Family Caregivers (FC).
- Cardiometabolic Morbidity (Obesity and Hypertension) in PTSD: A Preliminary Investigation of the Validity of Two Structures of the Impact of Event Scale-RevisedPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A.; Laranjeira, Carlos; Atout, Maha; Khatatbeh, Haitham; Selim, Abeer; Alkhamees, Abdulmajeed A.; Aljaberi, Musheer A.; Pakai, Annamária; Al-Dwaikat, TariqBackground: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69–0.88), high convergent validity (item total correlations r range = 0.39–0.81, and correlations with the IES-R’s total score r range = 0.62–0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42–0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12–0.39) and the diagnosis of hypertension (r range = 0.12–0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES-R6, PSS-SR) classified the participants into two clusters according to their BMI (normal weight/low BMI vs. overweight/obese). Meanwhile, only the IES-R, PSS-SR, and IES-R3 dimensions successfully classified participants as having either normal blood pressure or hypertension. Participants in the overweight/obese and hypertensive clusters displayed considerably higher levels of most trauma symptoms. Input variables with the highest predictor importance in the cluster analysis were those variables expressing significant associations in correlations and ROC analyses. However, neither IES-R3 nor IES-R6 contributed to BMI or hypertension either directly or indirectly in the path analysis. Meanwhile, age significantly predicted both health conditions and current smoking. Irritability and numbing were the only IES-R dimensions that significantly contributed to current smoking. Conclusions: The findings emphasize the need for assessing the way through which various PTSD symptoms may implicate cardiometabolic dysfunctions and their risk factors (e.g., smoking and the intake of unhealthy foods) as well as the application of targeted dietary and exercise interventions to lower physical morbidity in PTSD patients. However, the internal and external validity of our tests may be questionable due to the low power of our sample size. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts, is pivotal to validate the results (e.g., in specific groups, such as those with confirmed traumatic exposure and comorbid mood dysfunction).