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- New taxonomy for prolonged disorders of consciousness may help with decisions on withdrawal of clinically assisted nutrition and hydration: A proposed decision-making pathwayPublication . Teixeira, Liliana da Conceição; Rocha, Nuno; Nunes, RuiThe number of patients surviving severe brain injury is increasing; however, many are left in a prolonged disorder of consciousness. With appropriate treatment, these patients can survive for years. Unless a living will exists; the doctors can authorize withdrawal of artificial nutrition and hydration for these patients, based on best interests. There is an urge to revise the current terminology used in prolonged disorders of consciousness (vegetative state and minimally conscious state) to better reflect our understanding of these conditions, which will, in turn, ease the challenges faced when making a decision about withdrawal of artificial nutrition and hydration of these patients. A decision-making pathway based on a new taxonomy is proposed. The importance of reassessment is reinforced to clarify diagnosis and help with prognosis. Adopting a new classification for prolonged disorders of consciousness would clarify how we think about these patients
- Repeated Clinical Assessment Using Sensory Modality Assessment and Rehabilitation Technique for Diagnosis in Prolonged Disorders of ConsciousnessPublication . da Conceição Teixeira, Liliana; Blacker, Danielle; Campos, Carlos; Garrett, Carolina; Duport, Sophie; Rocha, NunoThe recommended way to assess consciousness in prolonged disorders of consciousness is to observe the patient’s responses to sensory stimulation. Multiple assessment sessions have to be completed in order to reach a correct diagnosis. There is, however, a lack of data on how many sessions are sufficient for validity and reliability. The aim of this study was to identify the number of Sensory Modality Assessment and Rehabilitation Technique (SMART) assessment sessions needed to reach a reliable diagnosis. A secondary objective was to identify which sensory stimulation modalities are more useful to reach a diagnosis.
- Dependent person in self-care: analysis of care needsPublication . Dixe, Maria dos Anjos; Frontini, Roberta; Miguel Lopes de Sousa, Pedro; Peralta, Teresa; Teixeira, Liliana; Querido, AnaBackground: The aim of this study was to assess the selfcare dependency levels of the dependent person at the time of home discharge and its relationship between (1) the degree of dependency of each self-care domain; (2) the previous dependency levels; and (3) the gender of the dependent person. It also aims to assess the relationship between the degree of dependency of each self-care domain, the length of admission, the length of dependency and the age of the dependent person at the time of discharge. Methods: A cross-sectional study was conducted. The sample comprised hospitalised adults and elderly in the medical services of a Portuguese hospital during the months of March, April and May of 2018. The data were collected by an interview conducted at the time of home discharge from the hospital medical ward. Results: The average age of dependent people of the sample is 80.7 years ( 10.1) with the majority being women (51.7%), with no statistical difference in the mean age according to gender (U = 2205.500; p > 0.05). They were hospitalised on average 11.4 days ( 33.2), most of them (44.0%) due to respiratory problems (85% of which were due to pneumonia). There were no statistically significant differences between the length of the hospital stay, the length of dependency and the participants’ gender (U = 2200.500, p > 0.05; U = 1688.000, p > 0.05). Medication intake was the highest dependency domain amongst participants (41.3%), followed by instrumental activities of daily living (40.6%) and bathing (39.9%). Conclusion: The amount of support required may vary according to the domain that the person is dependent. Thus, it is important to use a robust and reliable assessment tool that will be able to assess the degree of dependency on the various domains of self-care.
- Enquadramento da Prática da Terapia Ocupacional: Domínio & Processo 4ª EdiçãoPublication . Gomes, Maria Dulce; Teixeira, Liliana; Ribeiro, Jaime
- Exploring the associations between early maladaptive schemas and impulsive and compulsive buying tendenciesPublication . Rocha, Susana; Fernández, Xosé Manuel; Castro, Yolanda Rodríguez; Ferreira, Simão; da Conceição Teixeira, Liliana; Campos, Carlos; Rocha, Nuno BarbosaThe main purpose of this preliminary study was to investigate a potential relationship between early maladaptive schemas (EMSs) and impulsive and compulsive buying tendencies in a sample of young adults (college students). This research adds to the cognitive perspective of consumer behavior that the cognitive schemas putatively associated with early experiences may have a strong impact on impulsive and compulsive buying. Data was obtained from 365 participants in a cross-sectional study design. Participants completed an online survey with the following instruments: Young Schema Questionnaire; Impulsive Buying Tendency Measurement Scale; Richmond Compulsive Buying Scale; and Hospital Anxiety and Depression Scale. Using multiple linear hierarchical regressions, we confirmed that the domain of over vigilance and inhibition schemas was positively associated with impulsive and compulsive buying tendencies, while an opposite association was found for the domain of impaired limits. Being a female was also a predictor of impulsive buying and compulsive buying. The results were discussed in terms of the coping mechanisms to deal with negative emotions, as a way to obtain rewards, or as a way to escape painful self-awareness. Other mechanisms related to the internalization of perfectionist expectations and the propensity to shame were also explored. Copyright © 2023 Rocha, Fernández, Castro, Ferreira, Teixeira, Campos and Rocha.
- Perspective of clients and healthcare professionals about occupational therapy intervention in vocational rehabilitation: A descriptive-exploratory study at a professional rehabilitation centre in PortugalPublication . Ribeiro, Jaime; Inácio, Andreia; Teixeira, Liliana; Pereira, Inês; Lopes, Inês; Gonçalves, IolandaVocational rehabilitation (VR) allows individuals to enter, return and/or maintain employment. After literature review, no evidence of VR in individuals with acquired injuries, in Portugal was found. This paper aims to explore and describe the Occupational Therapy (OT) approach in VR and the client’s and the healthcare professionals’ perspectives, at Centro de Reabilitação Profissional de Gaia. A case study research was carried out with individuals aged 18 to 65 years old, with physical and neurological injuries, and receiving OT intervention; Occupational Therapists and other healthcare professionals working with those clients. To collect and analyse the data, a semi structured interview, focus group and subsequent content analysis by Bardin method were done. Participants’ perspectives were that OT promotes autonomy in occupations, assesses and recommends assistive products and performs functional assessments. Comparing results with literature, the clients and health professionals’ perspective of the OT intervention was consistent with the Occupational Therapist skills and intervention in VR.
- Apoiar no autocuidado de utentes e cuidadores informaisPublication . Dixe, Maria dos Anjos; Querido, Ana; Soares, Elsa; Gomes, José Carlos; Pereira, Cidália; Teixeira, Liliana; Sousa, Pedro; Amado, Sandra; Peralta, Teresa
- Alteração no desempenho ocupacional após internamento em UCI por Covid-19: A perceção dos utentes do Hospital de LeiriaPublication . Ferreira, Ana Rita; Rodrigues, Mariana; Cardoso, Raquel; Sabino, Inês; Teixeira, LilianaA Covid-19 é uma doença provocada pelo vírus SARS-CoV-2 que afetou de forma significativamente negativa a saúde pública e a economia mundial, originando assim uma pandemia global, tendo provocado até ao dia 8 de abril de 2021, segundo os dados fornecidos pelo Serviço Nacional de Saúde (2021), 825 633 casos confirmados de infeção por SARS-CoV-2 e 16 899 mortes, em Portugal. A Covid-19 pode causar algumas consequências, como, fadiga, perturbação do ciclo do sono, ansiedade e/ou depressão e fraqueza muscular, podendo levar a alterações no desempenho ocupacional. Assim, perante o referido anteriormente e o facto de até à data não existir literatura suficiente que sustente as alterações do desempenho ocupacional, consequentes da Covid-19 e do internamento, surgiu a necessidade de investigar “Qual a perceção dos utentes internados em Unidade de Cuidados Intensivos, no Centro Hospitalar de Leiria, por Covid-19 na alteração do desempenho ocupacional”, pelo que se irá aplicar uma entrevista semiestruturada aos participantes, de forma a recolher dados que auxiliem na resposta à questão de investigação. Com esta investigação prevê-se que os utentes do Centro Hospitalar de Leiria, internados por Covid-19, reportem défices no desempenho ocupacional, principalmente devido às alterações físicas e respiratórias, sendo expectável que cause alterações nas atividades de vida diária e instrumentais, no descanso e sono e no trabalho/educação.
- What names for covert awareness? A systematic reviewPublication . Schnakers, Caroline; Bauer, Chase; Formisano, Rita; Noé, Enrique; Llorens, Roberto; Lejeune, Nicolas; Farisco, Michele; Teixeira, Liliana; Morrissey, Ann-Marie; De Marco, Sabrina; Veeramuthu, Vigneswaran; Ilina, Kseniya; Edlow, Brian L.; Gosseries, Olivia; Zandalasini, Matteo; De Bellis, Francesco; Thibaut, Aurore; Estraneo, AnnaAfter a severe brain injury, some patients do not fully recover consciousness and remain in a prolonged Disorder of Consciousness (DoC) such as the vegetative state/unresponsive wakefulness syndrome (VS/UWS) or the minimally conscious state (MCS). Patients in a VS/UWS open their eyes and present preserved autonomic functions, but they are not conscious and show only reflexive behaviors while the MCS is being characterized by the presence of inconsistent but clearly discernible behavioral signs of consciousness (e.g., visual tracking, command following) (The Multi-Society Task Force on Persistent Vegetative State, 1994; Giacino et al., 2002). More recently, the MCS has been subdivided in two clinical entities, MCS+ and MCS– (characterized by the presence/absence of command-following, intelligible verbalization, and intentional communication) supported by metabolic differences in areas associated with both consciousness and language (e.g., lower metabolism in the precuneus and thalamus and in the left middle temporal cortex in MCS-) (Thibaut et al., 2020). Prolonged DoCs are a relatively rare condition (estimated prevalence of 5,000–42,000 and 112,000–280,000 for VS/UWS and MCS, respectively, in the US) implying severe disability and complete dependence, which can last from 28 days to decades (Giacino et al., 2018)
- Needs and skills of informal caregivers to care for a dependent person: a crosssectional studyPublication . Dixe, Maria dos Anjos; Teixeira, Liliana Fernanda da Conceição; Areosa, Timóteo João Teixeira Camacho Coelho; Frontini, Roberta; Peralta, Teresa de Jesus de Almeida; Querido, Ana Isabel FernandesThe world is facing many socio-demographic changes, such as an increased average life expectancy and the presence of chronic and non-communicable diseases, which in turn, leads to an enhanced dependency on others. Consequently, the demand for informal caregivers has significantly increased during the past few years. Caring for a dependent person is linked to a series of burdens that often leads to physical, psychological and emotional difficulties. Taking into consideration the difficulties faced by informal caregivers, knowing in which areas of functioning they need more guidance may help to relieve their burden. Therefore, the main goal of this study is to better understand the needs and competencies of the informal caregiver when caring for a dependent person in the different self-care domains.