ciTechCare - Comunicações em conferências com publicação em atas
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- 2ARTs: A Platform for Exercise Prescriptions in Cardiac Recovery PatientsPublication . Pereira, Andreia; Martinho, Ricardo; Pinto, Rui; Rijo, Rui; Grilo, CarlosDue to limited access, increasing costs and an ageing population, the global healthcare system faces significant coverage problems that call for innovative approaches. Health professionals are actively seeking alternative methods to provide care to an increasingly needy population, without increasing human effort and associated costs. eHealth platforms, which use technology to provide patient care, are emerging as transformative solutions for addressing these problems. This study is centered on the demand for a Decision Support System (DSS) in cardiology to enable doctors to prescribe individualized care inside Cardiac Rehabilitation Programmes (CRPs). The 2ARTs project’s main objective is to include a cardiac rehabilitation platform with a DSS within the hospital infrastructure. This DSS uses models to classify patients into different groups, delivering crucial information to assist with decisions regarding treatment. Regarding the DSS, Principal Component Analysis (PCA) emerged as a standout technique for dimensionality reduction, due to its interoperability with clustering algorithms and superior evaluation metrics. The most appropriate clustering technique was determined to be the K-means algorithm, which was supported by the experts analysis. In accordance with the goals of the 2ARTs project, this integration of PCA and K-means provides meaningful insights that improve reasoned decision-making.
- Addressing spiritual needs, facilities and barriers in portuguese palliative care: a cross-sectional surveyPublication . Laranjeira, Carlos A.; Querido, Ana IsabelBackground: Spiritual care is an essential component of Palliative Care (PC) and a dimension of holistic care that preserves dignity and helps sick people to find meaning in suffering and in life. The knowledge about its implementation is still scarce in the Portuguese context. This study aimed to evaluate the facilities, barriers and needs for spiritual care in PC. Method: We conducted a descriptive cross-sectional survey of 180 health professionals in the period November 2018 to September 2019 at PC units. The data were collected through an online questionnaire published on social networks, after approval by an Ethics Committee. Sociodemographic and professional data, spiritual beliefs and knowledge about the objectives and purposes of PCs were collected. These were evaluated using an instrument consisting of 26 statements of dichotomous response (true/false). Results: The average age of participants was 42.42 years (SD=11.35), most are female (82.2%), nurses (43.9%), and 70% work in the health field. The total sample has worked on average for 15.67 ± 10.28 years and more than half (58.9%) perform functions in palliative care. Most identify with a religious belief (87.8%), attaching great importance to spiritual/religious conviction (45% of participants). The results suggest that empathy and the therapeutic use of silence (82.2%) are facilitators of spiritual care. The key barriers refer to the lack of expert professionals and the organization of care (36.1%). The results also highlight the need for specific training in the area of spirituality, hope and intervention strategies (53.9%). Conclusion: This study has provided insight into spiritual care in PC in Portugal. Future studies are necessary to investigate the effects of spiritual care more fully, and to develop outcome measurements that appropriately capture the effects of the variety of spiritual care practices.
- Adventitious respiratory sounds to monitor lung function in pulmonary rehabilitationPublication . Jácome, Cristina; Cruz, Joana; Marques, AldaBackground: Peak expiratory flow (PEF) has been traditionally used to monitor lung function in patients with chronic obstructive pulmonary disease (COPD) before pulmonary rehabilitation (PR) sessions. However, PEF mainly reflects changes in large airways and it is known that COPD primarily targets small airways. Adventitious respiratory sounds (ARS - crackles and/or wheezes), are related to changes within lung morphology and are significantly more frequent in patients with acute exacerbations of COPD. Thus, ARS may be also useful for the routine monitoring of lung function during PR programs. Objective: This study explored the convergent validity of ARS and PEF in patients with COPD. Methods: 24 stable patients (66±9y; FEV1 71±19% pred) participating in a PR program were included. Assessments were conducted immediately before one PR session. Presence of ARS (crackles and/or wheezes) at posterior right chest was first assessed by a physiotherapist using a digital stethoscope (ds32a, ThinkLabs, CO, USA). Resting dyspnea was collected using the modified Borg scale (0-10) and PEF with a peak flow meter (Micro I, Carefusion, UK). Independent t-tests, Pearson and point-biserial correlations were used. Results: ARS were present in 5 participants (20.8%). Patients with ARS had a lower PEF than patients without ARS (294±62 l/min vs. 419±128l/min; p=0.048). PEF was negatively correlated with presence of ARS (r=-0.41; p=0.048). Resting dyspnea was negatively correlated with PEF (r=-0.41; p=0.039), but not with ARS (r=0.21; p=0.32). Conclusions: Findings suggest that both ARS and PEF offer complementary information before a PR session, but that ARS provide additional information on the patents’ respiratory status. Further research correlating ARS and PEF with patients’ performance and progression during PR is needed to strengthen the usefulness of assessing these parameters in PR.
- Ansiedade e Bem-Estar Subjetivo em Praticantes de Exercício: Estudo Exploratório em Contexto de Covid-19Publication . Silva, Carina; Filipe, Daniel; Cordeiro, Filipa; Frontini, Roberta; Antunes, Raul
- Assessing caregiving experience in COPD: content validity of the Zarit Burden InterviewPublication . Cruz, Joana; Marques, Alda; Souto-Miranda, Sara; Goldstein, Roger; Brooks, DinaCaring for a relative with COPD influences multiple dimensions of carers' lives. Several instruments have been used to assess the caregiving experience in COPD,1 e.g. the Zarit Burden Interview (ZBI). This instrument was originally developed for use in carers of people with dementia, however, its applicability in COPD has not been tested. This study explored the content validity of the ZBI in carers of patients with COPD. Ten carers (68.2±6.9yrs, all female) of patients with COPD (74.7±5.3yrs, all male, FEV1=49.2±19.0%pred) participated in cognitive debriefing interviews. They were asked to complete the ZBI and verbalise their thinking process to assess the adequacy of its content and instructions. Interviews were recorded and transcribed for further analysis using the qualitative data analysis software (WebQDA). Responses to the ZBI were also analysed to explore floor/ceiling effects. From the 22 items of the ZBI, 6 items were relevant for all carers and 11 items were not relevant for at least one participant. Five of these 11 items were not relevant for ≥40% of the sample and were related to stress for providing care, embarrassment about patient’s behaviour and impacts on social/leisure time. The remaining 5 items were not consensual. Overall, the ZBI was well-understood although 8 items were less clear for some carers. They suggested: improving questions (n=1) and scoring (n=5); eliminating item 4 (n=2); including 2 questions about the caregiving context (n=1). Responses were mostly distributed in the option ‘Never/Not at all’. The ZBI in its current form should not be used to assess carer experience among those caring for patients with COPD. 1Cruz, J et al. Resp Med 2017;128:13-27
- Avaliação de sistemas posturais da pélvis numa pessoa com Distrofia Muscular do tipo Cinturas: resultados da análise a três almofadas na promoção do equilíbrio dinâmicoPublication . Marques, Cíntia; Matos, Carolina; Cavaleiro, Joana; Simões, Juliana; Fonseca-Pinto, Rui; Lopes, Nuno; Ribeiro, Jaime MoreiraIntrodução: As almofadas anti-escaras são dispositivos especializados para a redistribuição de pressão e gestão da carga sobre os tecidos e do microclima. Devem manter o alinhamento postural, facilitar o movimento, criar uma base estável, aliviar a dor e serem confortáveis. Podem ser compostas exclusivamente por um material como espuma, gel, ar e fluido, ou pela combinação de dois ou mais destes materiais. As investigações concretizadas focam-se na distribuição do peso e negligenciam o comportamento dinâmico da almofada durante as atividades quotidianas. Objetivos: Avaliar a eficácia na manutenção do equilíbrio dinâmico de três tipos de almofadas de gama média-alta com diferentes composições. Métodos: Estudo com uma pessoa do sexo feminino com Distrofia Muscular do tipo Cinturas, utilizando-se: uma almofada de espuma e ar (A), uma almofada de espuma e bolsa de fluido (B) e uma de ar (C). A recolha de dados foi realizada em dois momentos: 1)recolha dados antropométricos, cinemáticos e dinâmicos, através de medição direta do alcance, videogravação e acelerómetro, e pressões exercidas sobre as almofadas, mediante um protocolo de movimentos e randomização de almofadas; 2)avaliação da perceção do utilizador com questionário e escala visual analógica de dor, após quatro horas de permanência na almofada. Resultados: A almofada A revelou melhores resultados ao nível do alcance máximo, do pico de pressão na posição inicial, do coeficiente de variação e da pressão média na flexão frontal do tronco. A almofada B apresentou resultados mais positivos na área de contacto, coeficiente de variação e na pressão média na posição inicial, no pico de pressão da flexão frontal do tronco, na variação da aceleração e na análise subjetiva. Conclusão: As almofadas anti-escaras que, na sua composição, combinam dois materiais, são mais eficazes na promoção do equilíbrio dinâmico, observando-se vantagem na utilização da almofada composta por espuma e fluido.
- A Board Game Performance Index – a disruptive innovation to assess people with dementia with different apathy levelsPublication . Rosa, Marlene; Lopes, Susana; Martins, Natália; Lacomba-Arnau, ElenaTraditional observation scales could be subjective and less sensitive to behavioural changes in people with dementia with different levels of apathy. This pilot study aims to explore if there is a difference in a comprehensive game index between people with dementia with different levels of apathy. Patients with dementia were recruited and thirteen were selected for this study. Sociodemographic data, apathy levels (APADEM) and a game performance index were collected. Patients were divided into two groups according to the percentile 50 in APADEM and the game performance index was compared. Results demonstrated that patients with different levels of apathy have significant differences in the Board Game Performance Index. Future studies should explore other dimensions in a comprehensive game index and strengthen the methodology with a more representative sample of people with dementia.
- 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.
- 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).
- O Burnout nos terapeutas ocupacionais em Portugal : comparação da sua prevalência em diferentes contextos de práticaPublication . Vale, Catarina; Camacho, Catarina; Estrela, Cátia; Dixe, Maria dos Anjos; Reis, Helena