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- Lived Experiences of Physiotherapists in Caring for People with Advanced Amyotrophic Lateral Sclerosis in Portugal: A Phenomenological StudyPublication . Monteiro, Andreia; Ali, Amira Mohammed; Laranjeira, CarlosAmyotrophic lateral sclerosis (ALS) is a disease that has a multidimensional impact on a person’s life, with symptoms associated with a significant loss of autonomy. Specialized palliative care (PC) should be provided early and throughout the course of the disease. Indeed, physiotherapists should be understood as integral members of the multidisciplinary team in PC, in the care and improvement of the quality of life of these people. This study aimed to describe the lived experience of physiotherapists in the context of intervention in people with advanced ALS and their families. Descriptive phenomenology was employed as a framework for conducting semi-structured interviews to reveal experiences. Sixteen physiotherapists who performed interventions on at least one person with advanced ALS in the last 2 years were included in the study. The study involved conducting semi-structured individual interviews, through the Zoom® videoconferencing platform (version 6.4.3). Data were analyzed according to Giorgi’s five-stage approach and managed using webQDA software (Version 3.0, University of Aveiro, Aveiro, Portugal). The COREQ checklist was applied in the study. Participants were mostly female (n = 12) and aged between 26 and 55 years (M = 36.81; SD = 6.75). Four constituents were identified: (1) undulating course of a complex disease; (2) barriers to person-centered care; (3) enablers of person-centered care; (4) transition between curative and palliative care. The findings illustrate the multidimensional impact of the disease trajectory on the person and their family. This study highlights the need to invest in specialized training for physiotherapists, contributing to a person-centered PC practice with an impact on promoting comfort and quality of life.
- Efeito anti-placa de bochechos no crescimento de placa bacteriana supra-gengival: um ensaio clínico aleatórioPublication . Tarlattini, Giovanna; Ribeiro, Sandra; Albuquerque, Teresa; Luis, HenriqueObjetivo: O objetivo deste estudo foi o de avaliar o efeito antiplaca de um bochecho com óleos essenciais (EO) sem álcool e de um bochecho de cloreto de cetilpiridínio (CPC) em comparação com um controlo positivo de clorohexidina (CHX), utilizando um modelo in vivo de crescimento de placa bacteriana durante três dias. Métodos: Este estudo foi desenvolvido como um ensaio clínico cruzado, cego e aleatorizado, que envolveu 16 voluntários. Após receberem a profilaxia profissional, durante os três dias seguintes, cada voluntário deixou de utilizar qualquer outro meio de higiene oral e realizou dois bochechos diários com 20 ml de um dos colutórios em teste. O bochecho de clorohexidina a 0,2% foi utilizado como controlo positivo. Após os três dias, o índice de placa foi avaliado e os participantes preencheram um questionário para manifestar a opinião em relação ao produto utilizado. Cada voluntário passou por um período de washout de 14 dias entre cada fase do estudo. Resultados: O grupo que utilizou o CPC mostrou um melhor efeito na inibição do crescimento da placa bacteriana, quando comparado com o grupo EO. De facto, a média global do índice de placa bacteriana foi menor com a utilização do CPC (1,30) do que com o uso do EO (1,73) e da CHX (1,54). Todos estes valores foram estatisticamente significativos (P<0,031). Conclusão: O CPC apresentou melhores resultados na redução da placa bacteriana quando comparado com o EO e com a CHX.
- I am with you: a netnographic analysis of the Instagram opinion leaders on eating behavior changePublication . Saboia, Inga; Almeida, Ana Margarida Pisco; Lopes de Sousa, Pedro Miguel; Pernencar, CláudiaCurrently we are strongly influenced by the changes provided by Web 2.0. The number of users consuming and sharing online information about health and wellbeing is increasing. This is a new scenario and a fertile field to study, in which social networks and eHealth applications are powerful tools to support behavior change. This article explores the influence processes of online opinion leaders, such as health professionals and non-professional, on the food behavioral change of their followers on online social networks. We use a netnography observation method following user profiles on Instagram. Some groups and its characteristics and practices were identified. This paper focuses only on three opinion leaders categories: nutritionists, POLs and healthy lifestyle in Portugal and Brazil. Results show different opinion leaders acting as partners, but with different characteristics and practices.
- CBView: Merging Data in Metabolic DiagnosisPublication . Correia-Brito, Gabriel; Fonseca-Pinto, Rui; Guarino, Maria Pedro; Lajes, Marlene; Vieira Lopes, NunoThe metabolic syndrome is a set of risk factors associated with increased cardiovascular risk. These changes to the standard metabolic functions are associated with increased blood insulin and with insulin resistance, which is the common feature of disease pathophysiology. Although with admissible genetic inheritance, the metabolic syndrome symptoms increase with age, sedentarism, weight gain, tobacco, and poor dietetic habits. Due to their characteristics, clinical manifestations of metabolic diseases are perceived by the patient at advanced stages of metabolic dysfunction, when the risk of an acute cardiovascular event is high. Early detection of disturbed glucose homeostatic mechanisms, by recording efferent responses to stimuli like meal ingestion, is, therefore, a methodology with diagnostic potential acting as a predictive measure of metabolic dysfunction. This work presents a novel software (CBView) that analyses the records of physiological responses mediated by the carotid bodies to provocation tests, obtained by a new medical device (CBMeter) aiming to the early tracking of changes in autonomic responses that control metabolism, and thus providing quantitative metrics to assess metabolic dysfunction.
- Planning a health promotion program: Mobile app gamification as a tool to engage adolescentsPublication . Pernencar, Cláudia ; Sousa, Pedro; Frontini, Roberta; Martinho, Ricardo; Runte, Daniel; Mendes, Denis; Carvalho, MiguelOver the past decade, the World Health Organization (WHO) has been alerting about the existing overweight prevailing among the adolescents’ group. This group is considered a nutritional risk group mainly because of less correct eating patterns and misbehaviors towards physical activity. To prevent obesity within this risk group, we are working on a mobile application involving gamification techniques. This article presents the preliminary results of a design study for this app, and explores possible design guidelines and processes based on results achieved in preliminary user interface and experience tests.
- Estudo preliminar da saúde oral de desportistas praticantes de boxePublication . Caciones, Adriana; Antunes, Margarida; Assunção, Victor; Albuquerque, Teresa; Luis, HenriqueObjetivos Caracterizar o estado de saúde oral de praticantes de boxe; conhecer a frequência de utilização de protetores bucais e os efeitos na saúde oral dos praticantes desta modalidade desportiva; comparar o uso de protetores bucais e de efeitos na saúde oral entre praticantes de boxe de manutenção e de competição. Métodos: A população-alvo foi constituída por uma amostra de conveniência dos praticantes de boxe amador na Escola de Boxe de Lisboa. A recolha de dados foi realizada através de questionário, observação da cavidade oral avaliando os índices CPO-D, gengival (IG) e higiene oral simplificado (IHO-S), e palpação da articulação temporo-mandibular. Os dados foram analisados com teste de V de Cramer (α=0,05). Resultados: Amostra constituída por 36 indivíduos (18-65 anos), maioritariamente do sexo masculino. A maioria utiliza protetores bucais (89%), sendo as “Boil and Bite” os mais populares. As alterações provocadas na cavidade oral verificaram-se, maioritariamente, ao nível da ATM, com 33% dos praticantes referindo dor na articulação e 25% dificuldade em abrir a boca. Nos hábitos de higiene oral, a maioria indicou escovar 2 a 3 vezes ao dia, utilizar meios de remoção interdentária e realizar consultas de saúde oral regularmente. Na observação intraoral, obtiveram-se os seguintes valores médios: 5,66 no CPO, 2,59 no IHO-S e 0,59 no IG.
- Physical therapy provision in multiple sclerosis across Europe: a regional lottery?Publication . Rasova, K; Martinkova, P; Pavlikoma, M; Cattaneo, D; Jonsdottir, J; Henze, T; Baert, I; Van Asch, P; Santovo, C; Smedal, T; Beiske, A G; Stachowiak, M; Kovalewski, M; Nedeljkovic, U; Bakalidou, D; Alves-Guerreiro, José; Nilsagård, Y; Dimitrova, E N; Habek, M; Armutlu, K; Donzé, C; Ross, E; Ilie, A M; Martić, AThis paper provides information about an ongoing multi-staged online web questionnaire survey established by a core group within the Special Interest Group in Mobility, Rehabilitation in Multiple Sclerosis (www.eurims.org). The aims of the survey were to document the following across Europe: the availability and setting in which physical therapy for multiple sclerosis (MS) is delivered; the level of awareness and knowledge of different physical therapy approaches; the actual content of physical therapy and applied evaluation tools.
- Is food insecurity related to health-care use, access and absenteeism?Publication . Dias, Sara; Gregório, Maria João; Melo, António; Matias, Maria Ana; Rodrigues , Ana M; Sousa, Rute Dinis de; Canhão,Helena; Perelman, JulianFood insecurity (FI) is defined as uncertain access to healthy food in quantity and quality. We hypothesize that FI may be associated with greater health-care use and absenteeism because it may amplify the effect of diseases; also, FI may be associated with reduced health-care access because it reflects economic vulnerability. The present study estimates the association between FI and health-care use and access, and absenteeism.Design: Cross-sectional data collected in 2015-2016. Health-care use was measured as the number of consultations, taking any drug and having been hospitalized in the past year. Health-care access was measured by the suspension of medication and having fewer consultations due to financial constraints. Absenteeism was measured by the weeks of sickness leave. Binary variables were modelled as a function of FI using logistic regressions; continuous variables were modelled as a function of FI using negative binomial and zero-inflated negative binomial regressions. Covariates were included sequentially.Setting: Portugal.Participants: Non-institutionalized adults from the EpiDoc3 cohort (n 5648).Results: FI was significantly associated with health-care use before controlling for socio-economic conditions and quality of life. Moderate/severe FI was positively related to the suspension of medicines (adjusted OR = 4·68; 95 % CI 3·11, 6·82) and to having fewer consultations (adjusted OR = 3·98; 95 % CI 2·42, 6·37). FI and absenteeism were not significantly associated.Conclusions: Our results support the hypothesis that FI reflects precariousness, which hinders access to health care. The greater use of health care among food-insecure people is explained by their worse quality of life and lower socio-economic condition, so that the specific role of poor nutrition is unclear.
- Informal Palliative Care at Home: A Focus Group Study Among Professionals Working in Palliative Care in PortugalPublication . Vanessa Marrazes; Laura Gonçalves; Ana Querido; Carlos Laranjeira; Laranjeira, Carlos; Querido, AnaInformal caregivers (ICs) are the backbone of homebased palliative care (PC) because they play a vital role in offering more seamless and timely support, preventing suffering and fostering comfort and dignity. Specialized home-based PCteams must recognize ICs’ unmet needs in fulfilling daily responsibilities and enhance their preparedness for caring. In this vein, this study aimed to carry out the following: (a) explore how PC professionals perceive the preparedness of ICs to provide PC at home and (b) determine what barriers and enablers they consider essential for the delivery of high-quality PC at home. Methods: Using purposeful sampling, thirty-four professionals from four disciplines who worked in specialized PC teams were recruited for a descriptive qualitative research study. Four focus group discussions were conducted from September 2024 to January 2025. This was followed by a thematic analysis according to Braun and Clarke’s framework. The findings are reported following the COREQ checklist. Results: Most of the participants were female nurses (n = 22) with a mean age of 41.8 ± 8.62 years. AcademicEditor: JosepVidal-Alaball Received: 30March2025 Revised: 19April2025 Accepted: 22April2025 Published: 23 April2025 Citation: Marrazes,V.; Gonçalves, L.; Querido, A.; Laranjeira, C. Informal Palliative Care at Home: AFocus GroupStudyAmongProfessionals WorkinginPalliative CareinPortugal. Healthcare 2025, 13, 978. https:// doi.org/10.3390/healthcare13090978 Copyright: ©2025bytheauthors. Licensee MDPI,Basel,Switzerland. This article is an open access article distributed under the termsand conditions of the Creative Commons Attribution (CC BY)license (https://creativecommons.org/ licenses/by/4.0/). Three overarching themes were identified: (1) IC needs and motivations for providing care; (2) perceived barriers to good-quality palliative home care; and (3) perceived enablers of good-quality palliative home care. The IC’s preparedness depends on personal characteristics, health status, the scope of tasks, and the ramifications stemming from the complexity of the illness trajectory. Conclusions: Professionals deemed it essential for PC staff to be experienced, accessible, person-centered, and proactive. Furthermore, effective communication and a well-defined network for requesting certain community resources or services were deemed crucial for delivering high-quality PC at home.
- Psychometric evaluation of the Arabic version of the Eight-item Center for Epidemiological Studies Depression Scale (CESD-8): Specific cultural considerations for the assessment of depressionPublication . Ali, Amira M.; Al-Dossary, Saeed A.; Fekih-Romdhane, Feten; Alameri, Rana Ali; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alkhamees, Abdulmajeed A.; Aljaberi, Musheer A.; Pakai, Annamaria; El-Gazar, Heba EmadBackground Despite extensive evaluations of the Center for Epidemiological Studies Depression Scale (CESD), its shortest version, the Eight-Item version (CESD-8), is less investigated, with absolute lack of information on its psychometric properties in the Arab world. Methods To fill the gap, data collected via an anonymous online survey from Saudi samples of students (N = 979, 422) and employees (N = 314), were analyzed through exploratory factor analysis, confirmatory factor analysis, and multigroup analysis to examine the structure and measurement invariance of the CESD-8. Convergent validity and internal consistency tests involved correlating the CESD-8 with its subscales, item analysis measures, and intra class correlations. Criterion validity tests involved correlating the CESD-8 and its subscales with a single-item measure of happiness. Results Exploratory factor analysis produced two factors (negative affect and positive affect) with eigen values >1, which explained 86.4 % of the variance. In confirmatory factor analysis, the crude exploratory factor analysis model had good fit while the fit of the unidimensional CESD-8 and another two-factor structure (depressed affect and somatic complaints) was improved by correlating the residuals of the items of positive affect (CESD4 and CESD6). A three-factor model (depressed affect, somatic complaints, and positive affect) expressed the best fit in the absence of error correlations. This model was invariant across groups of students and employees, gender, and age. The scale and its three dimensions demonstrated adequate internal consistency (alpha coefficient range = 0.65–0.89), convergent validity (item total correlation range = 0.43–0.80 and range of correlations with the CESD-8 = -0.68–0.92), and criterion validity (range of correlations with happiness scores = -0.40–0.60). Conclusions The CESD-8 is a valid short scale for quick identification of people with depressive psychopathologies. Using the CESD-8 to detect heterogenous depressive symptoms, rather than assessing depression as a whole condition, may influence our understanding of the dynamics and treatments of depression in specific groups/cultures, with emphasis on absence of positive affect in the definition of depression among Arabs. Replications of the three-factor structure in different cultures are needed.