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- Functional capacity and quality of life of older person with hip fracture at hospital discharge: a cross sectional studyPublication . Rocha, Paula; Marques, Andréa; Matos, Luís; Costa, Andreia; Henriques, Maria Adriana; Baixinho, Cristina Lavareda; Jester, RebeccaBackground: In older adults, a hip fracture, leads to functional decline, resulting in dependence in activities of daily living, with a negative impact on quality of life. Objective: Characterize the functional capacity and quality of life of older person with hip fracture on returning home. Methods: Exploratory-descriptive, cross-sectional, quantitative study, with a sample of 102 individuals aged 65 years or older with hip fracture admitted to an orthopedic service in a hospital in a central region of Portugal. Was used a questionnaire that included sociodemographic and clinical characteristics, instruments to assess functional independence, ADL performance, and quality of life. Descriptive and inferential statistical analysis was performed using SPSS software, version 29. Results: The results indicate severe dependence in performing activities of daily living (Barthel: 61.08); severe gait impairment (speed and quality) (Time Up and Go Test: 85.58 s); difficulties in functional exercises (10-m Walk Test: 77.74 s); and high risk of falls (Morse: 66.53). There is a negative correlation between gait and the Barthel index (r = 0.263; p = 0.007) and the Berg Scale (r = 0.420; p < 0.001); and a positive correlation between the Berg scale and the Barthel scale (r = 0.452; p < 0.001). Individuals with a history of falls had worse scores on the Berg Scale (U = 835.5; p = 0.002), and those who had less dependence had better quality of life scores in the General Health Status (p = 0.002); Physical Function (p = 0.003) and Mental Health (p = 0.005). Conclusions: Results obtained at hospital discharge are predictors of functional loss in older adults with hip fracture on returning home. Individuals with previous falls and who are more dependent are at greater risk of loss of quality of life.
- Inflammatory Biomarkers in Diabetic Macular EdemaPublication . Campos, António; Furtado, Maria João; Carneiro, Ângela; Meireles, Angelina; Neves, Carlos; Ambrósio, António Francisco; Leal, Inês; Figueira João; Marques, João Pedro; Henriques, José; Falcão, Manuel; Gomes, Nuno; Flores, Rita; Silva, Rufino; Pessoa, BernardeteDiabetic retinopathy (DR) is a major complication of both Type 1 and Type 2 diabetes mellitus (T1DM and T2DM). Disease progression can result in visual impairment, primarily due to diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR). Although several ocular treatments are available for DME, a subset of patients fails to respond, reflecting the multifactorial, complex, and systemic nature of DR. Inflammatory biomarkers can be classified according to different characteristics, including imaging biomarkers—most commonly assessed using optical coherence tomography (OCT)—and molecular biomarkers, which are defined by their biochemical and biophysical properties. Pro- and anti-inflammatory cytokines, chemokines, adipokines, and inflammation-related enzymes are recognized as key inflammatory biomarkers and can be detected in the vitreous humour, aqueous humour, tears, serum, and other biological tissues. The identification and characterization of reliable biomarkers may help determine disease severity, monitor disease progression, and predict the risk of specific outcomes, thereby aiding in the prevention of end-stage disease (prognostic biomarkers). In addition, biomarkers may serve as predictive tools for therapeutic response, guiding personalized treatment strategies and enabling ongoing monitoring. This review provides a comprehensive overview of the role of inflammatory biomarkers in the diagnosis and management of DR and DME.
- Functional Dependence in Brazilian Adults One Year After COVID-19 Infection: Prevalence and Risk Factors in a Cross-Sectional StudyPublication . Milan, Natália; Laranjeira, Carlos; Rossoni, Stéfane Lele; Ali, Amira Mohammed; Fekih-Romdhane, Feten; Baccon, Wanessa; Carreira, Lígia; Salci, Maria AparecidaOne of the challenges post-COVID-19 is reducing the negative impacts on quality of life, performance, and independence in activities of daily living. Assessing functional dependence in adults one year after acute infection can help to understand the long-term consequences, evaluate the impact on quality of life, plan rehabilitation and healthcare, identify the most vulnerable groups, measure the socioeconomic impact, and support public policies and clinical decisions. Objectives: The objectives of this study are as follows: (a) to assess the prevalence of functional dependence in Brazilian adults with COVID-19; (b) to analyze the association between the study variables; and (c) to determine the factors associated with functional dependence. Methods: This was an observational, cross-sectional study with 987 adults (18 to 59 years old) living in the State of Paraná (Brazil) hospitalized for COVID-19 between March and December 2020. Data were collected by telephone 12 months after the acute infection using an instrument to retrieve sociodemographic and health information, and a functional dependence scale to assess dependence before COVID-19 retrospectively (using participant recall information) and at the time of the interview. Data were analyzed using penalized logistic regression after imputing missing data. Data were analyzed using penalized logistic regression after imputing missing data. Results: Functional dependence after COVID-19 was 5.0% and was associated with low levels of education, not having a partner, living with someone, not owning a home, experiencing job changes, requiring care, obesity, smoking, multimorbidity, ICU admission in the acute phase, use of invasive ventilation, or having Long COVID. Individuals who required care or used invasive ventilation support were, respectively, 9.3 and 6.5 times more likely to develop dependence after COVID-19. Despite adjustment for multiple factors, the magnitude of the observed effects warrants cautious interpretation, as unmeasured or residual confounding effects may still be present. Sample recall bias due to collection after 12 months and the presence of the alpha variant without COVID-19 vaccination coverage may limit data generalization. Conclusions: The results highlight the need to emphasize the public health implications of identifying functional dependence. In this vein, it is necessary to implement preventive measures, identify and monitor more vulnerable groups, plan rehabilitation programs, and develop public health policies.
- Nurses' Perceptions of Fundamental Care in Preventing Venous Ulcer Recurrence: A Qualitative Focus Group StudyPublication . Gomes, Filipe José Paulo; Baixinho, Cristina Lavareda; Monteiro, Ana Isabel Cabral; Costa, Andreia Silva da; Henriques, Maria Adriana PereiraVenous ulcers are the most prevalent among those affecting the lower limbs, with high economic and quality of life impact. Due to the chronicity of venous disease, healing and recurrence cycles are common. Patient adherence to self-care activities to prevent recurrence is very low, so it is crucial to reflect on nurses' experiences with this phenomenon. A qualitative and descriptive study was developed to analyse nurses' perceptions about preventing venous ulcer recurrence. According to the inclusion criteria, focus groups with nurses were implemented. Three focus groups were conducted through the Colibri platform, ensuring all ethical assumptions. Content analysis was performed according to thematic criteria, using the WebQda software. Three main themes emerged: integration of care, context of care, and relationship. The participants emphasised the importance of holistic assessment and the establishment of common goals to promote adherence to fundamental recurrence prevention care. Understanding and respecting individual values, empathy and active listening, considering the established relationship, anticipating the person's needs, and trust are essential to overcoming barriers to implementing recurrence prevention care and to its continuity. Taking these aspects into consideration implies that the professional is part of the process of preventing the recurrence of venous ulcers.
- Movimentos de profissionalização histórica: a relação entre as catástrofes sociais e a enfermagem modernaPublication . Santos, Paulo Alexandre Figueiredo dos; Rabiais, Isabel Cristina Mascarenhas; Amendoeira, José Joaquim Penedos; Figueiredo, Amélia Simões; Berenguer, Sílvia Maria Alves Caldeira; Pereira, Maria Cristina Queiroz VazContexto: É em contexto de catástrofes sociais que a afirmação socioprofissional do enfermeiro se constitui uma referência. Objetivo: Dimensionar a relação entre as catástrofes sociais e a relevância do trabalho realizado por determinadas enfermeiras, no final do século XIX, com contributo para a construção/evolução da enfermagem enquanto profissão. Metodologia: Embora as opções metodológicas na validação do caráter científico deste estudo histórico assentem na historiografia, os factos narrados e interpretados foram contextualizados em função da época histórica, permitindo o emergir de novos significados que possibilitem definir no próprio tecido documental, unidades, conjuntos, séries, relações inovadoras. Resultados: Foram várias as enfermeiras que contribuíram para a evolução da enfermagem enquanto ciência. Experienciaram a sua profissão em contextos com um denominador comum: os conflitos armados que se traduziram num cenário de catástrofe social, onde imperava a necessidade de cuidar do Outro. Conclusão: É inegável que os contextos de catástrofes sociais permitiram um campo de atuação que conferiu visibilidade à enfermagem moderna e possibilitou um caminho, traçado no sentido de construir a enfermagem enquanto disciplina.
- The Arabic Control Attitudes Scale-Revised: Method Effect (Negatively Worded Items) and Measurement Invariance as Threats to Its Construct Validity Are Remedied in a 5-Item Version With Improved PerformancePublication . Ali, Amira Mohammed; Al-Dossary, Saeed A.; Alharrasi, Maryam; Laranjeira, Carlos; Ayed, Ahmad; El-Gazar, Heba Emad; Zoromba, Mohamed Ali; Atalla, Amal Diab Ghanem; Alamer, Rasmieh; Al-Abri, Khalood; Subih, Maha; Pakai, AnnamariaBackground: The Control Attitudes Scale-Revised (CAS-R) is widely used to explore cardiac patients’ beliefs about their ability to manage illness. The CAS-R’s construct validity may be questionable in different cultural contexts. Conclusions/applications based on inaccurate construct validity can be misleading and incorrect. Objective: In this study, we aimed to evaluate the psychometric properties of the Arabic version of the CAS-R. Methods: Within a cross-sectional design involving 180 Omani patients with heart failure (mean age = 70.3 ± 9.8 years, 51.7% females), exploratory/confirmatory factor analysis (CFA) and multigroup CFA were used to evaluate the construct validity and measurement invariance of the CAS-R across gender and marital groups. Results: In exploratory factor analysis, 2 factors with eigenvalues >1 explained 37.9% of the variance. Despite the poor fit of the unidimensional CAS-R, CFA revealed an excellent fit of a 2-factor structure. Negative (5 and 8) and cross-loading items (1) contributed to scale variance at the configural level. Eliminating negative items and item 6 improved model fit, reliability (Cronbach’s α = 0.66 vs. 0.56), and invariance at all levels. In support of its convergent and criterion validity, the CAS-R 5 correlated with the CAS-R and depression (r = 0.953, −0.268; P values <.01). Conclusions: Negative items comprised a minor weak factor (helplessness) that was not stable across groups. Eliminating items 5, 6, and 8 resulted in a clean invariant short form (CAS-R 5) with superior properties that may implicate nursing decisions and interventions concerning perceived control.
- Linking Critical Thinking Dispositions to Well-Being in Higher Education: A Cross-Sectional StudyPublication . Valentim, Olga; Almeida, Raquel Simões de; Marques, Rita; Lucas, Isabel; Sales, Leila; Payan-Carreira, Rita; Lopes, JoséBackground/Objectives: Mental health challenges are increasingly prevalent among higher education students, with significant implications for academic success and personal development. Emerging research suggests that critical thinking dispositions may support psychological well-being by enhancing resilience and adaptive coping. This study aimed to investigate the relationship between critical thinking dispositions and psychological well-being and to identify key sociodemographic predictors in this context. Methods: A cross-sectional design was employed from December 2024 to May 2025, recruiting 429 students from Portuguese higher education institutions via convenience sampling. Participants completed validated self-report measures: the Critical Thinking Dispositions Scale (CTDS) and the Psychological Well-Being Scale (PWBS), assessing seven critical thinking dispositions and six well-being dimensions, respectively. Sociodemographic data were also collected. Descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlations, and hierarchical multiple regression were used for data analysis. Results: Students demonstrated moderate to high levels of critical thinking and psychological well-being, with higher scores associated with increased age and academic progression. Significant positive correlations were identified between critical thinking dispositions and all well-being dimensions; personal growth, purpose in life, and autonomy exhibited the strongest associations. Regression analysis revealed that confidence in reasoning, cognitive maturity, and open-mindedness were significant predictors of psychological well-being, explaining 28.7% of the variance. Conversely, inquisitiveness showed a negative association with psychological well-being in the multivariate model, an unexpected finding that warrants cautious interpretation and further investigation. Conclusions: Critical thinking dispositions reflect affective tendencies and habitual ways of engaging with thinking. These dispositions appear to protect psychological well-being in higher education students. Integrating the development of emotional awareness and reflective thinking into curricula may therefore foster resilience and academic success. Further longitudinal research is needed to explore causal mechanisms and intervention efficacy in broader academic contexts.
- Development and validation of a Portuguese psychologist's empathy scale: A pilot studyPublication . Cruz, Márcia; Grilo, Ana; Custódio, Susana; Dores, Artemisa R.; Silva, Carina; Alves, PauloThe systematic assessment of empathy is essential for identifying psychologists' competencies and developmental needs, ultimately contributing to more effective clinical practice. Given the multidimensional nature of empathy, comprehensive evaluation requires consideration of its cognitive, affective, and behavioural dimensions. However, no existing instrument is specifically validated to assess psychologists' self-perceived empathy in clinical contexts. To address this limitation, the present pilot study aimed to develop and undertake a preliminarily validation of the Portuguese Psychologists' Empathy Scale (PPES), a self-report instrument designed to assess empathy among psychologists working in Portuguese-speaking contexts across these three components. The study proceeded in two phases: item construction and initial psychometric testing. A total of 106 Portuguese psychologists completed a 57-item Likert-type instrument. Bartlett's test of sphericity was significant ( χ 2 (45) = 811.56, p < .001), and the KMO index (0.73) indicated moderate adequacy for factor analysis. Exploratory factor analysis revealed three core factors explaining 48% of the total variance, with strong internal consistency. A subsequent confirmatory factor analysis supported model refinement, leading to the removal of items with low factor loadings. The final PPES comprises 43 items distributed across cognitive (16), affective (16), and behavioural (11) dimensions. The findings provide encouraging preliminary evidence for the PPES, demonstrating robust internal consistency and acceptable initial factorial validity. Nevertheless, further studies using independent samples and external validation procedures are required to fully establish its psychometric soundness and clinical applicability with Portuguese-speaking psychologists.
- The Fenix reborn: Occupational therapy in the first humanitarian mission in PortugalPublication . Roldão, ElisabeteIn Portugal, June 2017, there was a large fire, which was considered a national disaster. It led to changes in people's daily routines, affecting their occupational performance and making them vulnerable. At the time, the non-governmental organisation, Doctors of the World, implemented the first humanitarian mission in Portugal–The Hope Mission. This mission, which was made up of a nurse, a community mediator, two occupational therapists, four occupational therapy students and a clinical educator, intervened with the population of the entire affected region. Their main objective was to meet the needs of the people; involving them in significant activities, re-organising their roles and routines, re-structuring their daily lives, increasing their quality of life and their wellbeing and avoiding social isolation. Home visits, group activities and projects were implemented in partnership with community institutions. One of the projects was the (Re)Start Project. An initial assessment was made by the occupational therapists in order to plan the intervention. The project consisted of home visits (where an evaluation of the home context was made), group sessions (cognitive stimulation, motion sessions and group dynamics) and individual sessions (focusing on the performance issue and difficulties experienced by each person undertaking their daily routines). To understand the degree of satisfaction of the participants, specifically in relation to the (Re)Start project, a questionnaire was given to all who participated for more than one month. From analysis of the questionnaires, the conclusion was drawn that participants were satisfied with the activities developed in the project and found them meaningful. The presence of occupational therapy in this scenario was found to be important and made a difference. It would be useful to repeat this type of intervention at a national level, if a further humanitarian crisis occurs, especially in areas with ageing population or which are geographically isolated.
- The experiences of mothers in caring for children with complex health conditions during hospitalization in Brazil: a grounded theory analysisPublication . Harmuch, Camila; Laranjeira, Carlos; Lima, Ana Luísa Serrano; Higarashi, Ieda Harumi; Jaques, André Estevam; Paiano, MarcellePurpose Children with Complex Health Conditions (CCHC) require prolonged, specialized, and multidisciplinary care, often demanding prolonged hospitalizations. In this context, mothers generally assume the role of primary caregivers, facing emotional, physical and social overload. However, their experiences during hospitalization remain little explored. This study aimed to understand the experiences and needs of mothers caring for CCHC during hospitalization. Design and methods This qualitative study used an inductive approach based on the Straussian Grounded Theory principles. Data collection took place between September 2024 and March 2025, through individual, in-person, semi-structured interviews, conducted with mothers of CCHC admitted to a Brazilian university hospital. Data analysis followed the constant comparison method, occurring simultaneously with collection, enabling the construction of categories and conceptual refinement. Results Sixteen mothers aged between 23 and 46 years (34.75 ± 7.55) were recruited. Data analysis generated the core category “Care experiences: balancing between light and shadow” around which three categories are anchored: 1) Dealing with the complexity of the disease and hospitalization; 2) Barriers to care dynamics during hospitalization; and 3) Enablers of care for children with complex health conditions. Conclusions The analysis of maternal experiences highlights the urgent need for care practices based on family-centered care models that recognize mothers as protagonists in the care process. Practice implications Findings support the implementation of institutional protocols that ensure effective communication, continuous support and qualification of professionals to promote a welcoming, safe and humanized environment, reducing the emotional and structural vulnerabilities faced by mothers who care for CCHC.