Objectives To evaluate differences in empathy between the Integrated Master's degree in Medicine ... more Objectives To evaluate differences in empathy between the Integrated Master's degree in Medicine (MIM)
BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support me... more BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self‐report and physician assessment.MethodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number ...
Background Compassion, one of the items of empathy, is crucial in health care professions. So, th... more Background Compassion, one of the items of empathy, is crucial in health care professions. So, the evaluation of the levels of compassion of Medicine, Dentistry and Pharmaceutical Sciences Master Degrees’ (M.D.) students of the public Colleges in Portugal according to the type of Master Degree and the participation in extracurricular activities (E.A.) was a task to be performed. Methods Cross-sectional study in 2020, applying an on-line questionnaire including the “Compassion” items of the Jefferson Medical Empathy Scale – Students’ version and questions about the participation in E.A. Results A sample of 901 students was studied. Its distribution by participation in E.A. did not differ significantly between M.D. (p = 0,854), most of the students participating in E.A. Using quartile distribution of compassion, the distribution of compassion levels was different among the three I.M. (p < 0.001), between Colleges (p < 0.001), and between curricular years (p < 0.001), with not...
The Patient Enablement Instrument (PEI) is a 6 questions indicator of effectiveness of the primar... more The Patient Enablement Instrument (PEI) is a 6 questions indicator of effectiveness of the primary care consultation measuring the patient's feelings about the consultation with his family physician. The underlying reasons for each answer are yet to be fully comprehended. Research questions: Investigate the explanations of PEI answers, especially regarding the "equal or worse" and "equal or less". Method: Observational study in triangulation methodology with PEI application complemented with a qualitative questionnaire of pre-established justifications and an open option response. Convenience sample yet size representative in randomized days of consultation in Primary Healthcare Centres, Central Portugal. After consultation patients were invited and gave written consent and doctors were unware of the study. Results: A sample of n=190 was studied, 62,6% female, 14,2% <35 years, 41,1% >65 years, 84,7% consulting in a previously scheduled appointment and 74,7% are under regular medication. 47,9% have low studies and 56,3% no professional activity. Main reasons for equal or worst: "Because my illness is boring and there is no improvement", n=8 (4,2%), "Because there is no explanation for my illness", n=7 (3,7%), "Because they cannot solve my illness", n=11 (5,8%), "Because I feel my illness is never going to be solved", n=9 (4,7%), "Because I drop off as I came in with no resolution for my problem", n=12 (6,3%), "Because I don't have total confidence on my Doctor", n=3 (1,35%). Conclusions: The explanations of PEIs answers clearly are in the domain of the doctor/patient communication skills. Two aspects have been established: the perpetuation of incomprehension and doubts, and the feeling of irresolution and inability to solve the problems. The communication skills have a direct relationship with the capacity that the patients acquire to improve their well-being and increase their quality of life.
Revista Portuguesa de Cardiologia (English Edition), 2019
Objectives: To compare clinical characteristics, medical activity, and family and social characte... more Objectives: To compare clinical characteristics, medical activity, and family and social characteristics of individuals with controlled and uncontrolled hypertension. Methods: This was an observational study on an alphabetically organized randomized sample of individuals suffering from hypertension in a primary care setting followed by 25 general practitioners at three clinics in the Central region of Portugal in mid-2018. Electronic medical records of individuals with an ICPC-2 classification of hypertension were analyzed. Epidemiologic, family, social and therapeutic data were gathered for descriptive and inferential analysis. Results: From a total population of 8750 patients classified as having hypertension, a representative sample of 387 individuals (n=369 required for a 95% confidence interval and 5% error margin) was studied. The incidence of uncontrolled hypertension was 56.1%, significantly higher among those living alone (p=00.24) or in a nuclear family (p=0.011), in lower socioeconomic classes (p=0.018), and prescribed anti-inflammatory drugs (p=0.018). The calculated cardiovascular risk was no higher for uncontrolled hypertension (p=0.116). Therapeutic inertia was not found either in number of medicines or in their association (p=0.274). No other studied ଝ Please cite this article as: Martins RdS, et al. Pessoas que sofrem de hipertensão arterial: implicações na atividade médica das diferenças entre os controlados e os não controlados. Rev Port Cardiol. 2019.
Objectives To evaluate differences in empathy between the Integrated Master’s degree in Medicine ... more Objectives To evaluate differences in empathy between the Integrated Master’s degree in Medicine (MIM) students from the Faculty of Medicine - University of Coimbra (FMUC) and the Faculty of Health Sciences - University of Beira Interior (FCS-UBI).Methodology Cross-sectional observational study with the Jefferson Scale of Physician Empathy – students’ Portuguese version (JSPE – spv) to 1st, 3rd and 6th year students of the 2017/2018 academic year with descriptive and inferential statistical analysis (p<0.05).Results Size representative sample of 795 students. Higher total empathy score (TES) (p=0.008) and "Perspective taking" (p=0.001) in FCS-UBI were found. JSPE-TES was higher in FCS-UBI, 3rd year (p=0.038). Higher FCS-UBI "Perspective taking" in the 1st year (p=0.030) and 6th year (p=0.044), for "Compassionate care" in the 3rd (p=0.019) and for "Standing in the patient’s shoes" in the 1st year (p=0.018) and in FMUC for "Compassionate...
Introduction: This article describes the views of European rural general practitioners regarding ... more Introduction: This article describes the views of European rural general practitioners regarding the strengths, weaknesses, opportunities and threats (SWOT) of the implementation of a chronic care model (CCM) in European rural primary care. Methods: This was a mixed-methods online survey. Data were collected from 227 general practitioners between May and December 2017. Categorical data were analysed using descriptive methods while free-text responses were analysed using qualitative methods. The setting was rural primary care in nine European countries (including Central and Eastern Europe). Main outcomes
PURPOSE To compare the final score of the scale to the levels of HbA1c. MATERIAL AND METHODS Cros... more PURPOSE To compare the final score of the scale to the levels of HbA1c. MATERIAL AND METHODS Cross-sectional observational study by applying the Diabetes Empowerment Scale-Short Form to diabetics at three primary care units in the central region of Portugal. The test-retest (in writing first and, five minutes later, orally) was performed to access Cronbach's alpha in 20 patients not studied in the next phase. Then, the scale was applied to diabetic patients after nursing consultation and prior to entering the medical consultation. Descriptive and inferential statistics after checking for the normality of the data were performed. RESULTS In the first phase Cronbach's alpha was 0.90 to 1.00 in all of eight scale items. The average result obtained in the written phase was 3.78 ± 0.71 and in the oral 3.79 ± 0.64, p = 0.629. The sample of the second stage was of 81 diabetic patients, 55.6% male. Sample's mean age was 68.5 ± 1.1 years, mean HbA1c of 6.8 ± 0.2 and mean time fro...
Na atualidade não é simples falar de moral, embora a ética esteja na moda, contudo parece que pou... more Na atualidade não é simples falar de moral, embora a ética esteja na moda, contudo parece que poucos acreditam que seja uma disciplina importante para a vida em geral. Considerando que existem poucos estudos sobre as bases que influenciam as decisões éticas dos profissionais de saúde, o objetivo deste estudo foi analisar as atitudes éticas dos profissionais de saúde nas relações com os pacientes.
Background: Diabetes is known as a major cause of morbidity and mortality worldwide. Portugal is ... more Background: Diabetes is known as a major cause of morbidity and mortality worldwide. Portugal is known as the European country with the highest prevalence of this disease. While diabetes prevalence data is updated annually in Portugal, the General Practitioner's (GP) Sentinel Network represents the only data source on diabetes incidence. This study describes the trends in Diabetes incidence, between 1992 and 2015, and estimate projections for the future incidence rates in Portugal until 2024. Methods: An ecological time-series study was conducted using data from GP Sentinel Network between 1992 and 2015. Family doctors reported all new cases of Diabetes in their patients' lists. Annual trends were estimated through Poisson regression models as well as the future incidence rates (until 2024), sex and age group stratified. Incidence rate projections were adjusted to the distribution of the resident Portuguese population given Statistics Portugal projections.
Objetivo: Avaliar a correlação entre o valor obtido pelo instrumento de medição Diabetes Empowerm... more Objetivo: Avaliar a correlação entre o valor obtido pelo instrumento de medição Diabetes Empowerment Scale - Short Form e o controlo da pessoa com diabetes medido pelo valor da hemoglobina glicada A1c.Material e Métodos: Estudo observacional transversal pela aplicação do Diabetes Empowerment Scale - Short Form a pessoas com diabetes de três Unidades de Saúde Familiar da Região Centro de Portugal após realização de teste e reteste (primeiro por escrito e, passados cinco minutos, oralmente) para determinação da coerência interna através do valor de alfa de Cronbach em 20 elementos que não foram depois estudados. A aplicação a pacientes diabéticos foi feita após a consulta de enfermagem e antes da entrada na consulta médica. Foi realizada estatística descritiva e inferencial apos verificação da normalidade dos dados.Resultados: Na primeira fase o valor de alfa de Cronbach de 0,90 a 1,00 relativamente aos oito itens da escala. Na aplicação escrita, a média de resultados foi de 3,78 ± 0,...
Doutoramento em Ciências e Tecnologias da SaúdeAtendendo a que existem poucos estudos sobre as de... more Doutoramento em Ciências e Tecnologias da SaúdeAtendendo a que existem poucos estudos sobre as determinantes e as bases que influenciam as decisões éticas dos profissionais de saúde, os objetivos deste estudo são identificar e comparar as atitudes éticas dos profissionais de saúde bem como as justificações para essas tomadas de decisão. Tratase de um estudo transversal quantitativo e qualitativo, de tipo descritivo, no qual foram inquiridos 163 profissionais de saúde, 77 médicos e 86 enfermeiros, dos centros de saúde da região centro de Portugal, com o objetivo de analisar e comparar as atitudes éticas dos profissionais de saúde, assim como as categorias das justificações para a tomada de decisão face a problemas éticos. Foi utilizado um questionário sociodemográfico, uma escala de atitudes perante os direitos à informação e ao consentimento, para avaliação das atitudes éticas dos profissionais de saúde, e foi solicitado aos participantes que listassem problemas éticos, a partir da ...
Background Empathy is the capacity to understand and resonate with the experiences of other peopl... more Background Empathy is the capacity to understand and resonate with the experiences of other people. Patient enablement is the degree to which a patient feels strengthened in terms of being able to deal with, understand and manage their disease. Methods Secondary cross-sectional analysis of existing data from 2 independent datasets (456 primary health care patients), with the application of two validated questionnaires, Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and Patient Enablement Instrument (PEI). Objective Evaluate medical empathy and patients’ enablement after consultation with their family doctors and to verify if there was an association between these two concepts. Results The median value of JSPPPE-VP score was 6.60 (interquartile range 1.00) and of PEI/ICC score was of 1.83 (interquartile range 0.67). Regarding empathy (JSPPPE-VP), patients taking chronic medication had a slight but significantly higher median score than patients not taking them (...
Background: Multimorbidity brings several difficulties and challenges to the daily work of primar... more Background: Multimorbidity brings several difficulties and challenges to the daily work of primary care teams. Team meetings are opportunities to discuss approaches and solutions on how to best manage multimorbid patients. Objective: This qualitative study aimed to collect a consensus, from general practitioners that deal with multimorbid patients, about their perspectives regarding multimorbidity team meetings in primary care. Methods: The study followed a modified Delphi method with 15 Portuguese general practitioners. After every round of responses, results were analyzed, and justifications for nonconsensual items were aggregated by the investigators, and then a new Delphi round with the revised questionnaire was again initiated. This process was repeated until consensus has been reached. Results: Overall, a list of 10 key themes associated with the ideal meeting was agreed: (a) definition; (b) setting; (c) duration; (d) frequency; (e) number of participants; (f) attendance; (g) requirement of patient's presence; (h) number of patients/clinical cases; (i) structure of the meeting; and (j) sharing meeting results. The consensus was achieved after two Delphi rounds with a mean score between 7.9 and 8.7 (maximum score of 9.0 per key theme). Conclusion: The complexity of multimorbidity affects meetings' periodicity, duration, and participants. Ideally, it should be an interprofessional primary care team meeting. Further research exploring meeting outcomes (organizational effectiveness and healthcare quality) of the proposed factors is needed before they can be recommended for general use.
Faculty of medicine, university of coimbra, Portugal 2 university clinic of general and Family me... more Faculty of medicine, university of coimbra, Portugal 2 university clinic of general and Family medicine, Faculty of medicine, university of coimbra, Portugal 3 Faculty of health sciences, university of beira interior, covilhã, Portugal 4 cintesis-centre for research in health technologies and service, oporto, Portugal
The untranslatable word desenrascanço, a Portuguese construct related to people's ability to skil... more The untranslatable word desenrascanço, a Portuguese construct related to people's ability to skilfully negotiate complex issues and to solve them with originality and creativity, was studied using a common medical complex scenario-multimorbidity. An online qualitative survey was carried out in the last trimester of 2018. A total of 117 general practitioners (GPs) completed the full survey. Ninety-one (77.8%) were familiar with the concept of desenrascanço. Responses were coded using thematic analysis. Desenrascanço is commonly used by GPs; 77 out of 91 GPs use desenrascanço in at least half of the appointments with multimorbid patients. Three components of desenrascanço were identified: adaptive response; creativity and art; and positivity. It could conceivably be hypothesised that the positive drive of desenrascanço (e.g. creativity) are used by GPs collectively to adapt to multimorbidity-a medical complex situation. Nonetheless, one should not forget that it may not be the ideal solution, as stated by participant GPs.
This study examined the relationship between the frequency of coffee consumption and blood pressu... more This study examined the relationship between the frequency of coffee consumption and blood pressure over a two year follow up of a cohort of elderly people. Healthy, older people (N = 205) were examined at baseline and at two years. Participants completed physical and behavioural assessments, which included body composition, current pharmacological treatment, and frequency of coffee consumption grouped into three categories: “never to a few times per month”, “once a week to a few times per week”, and “every day”. Blood pressure (systolic (sBP), diastolic (dBP), mean (mBP), and pulse pressure (PP)) was measured at baseline and after two years. After adjusting for body composition, smoking status, age, sex, heart rate, and number of antihypertensive agents taken, participants who drank coffee everyday had a significant increase in sBP, with a mean of 8.63 (1.27; 15.77) and an mBP, with a mean of 5.55 mmHg (0.52; 10.37) after two years (t = 2.37, p = 0.02 and t = 2.17, p = 0.03, respec...
Objectives To evaluate differences in empathy between the Integrated Master's degree in Medicine ... more Objectives To evaluate differences in empathy between the Integrated Master's degree in Medicine (MIM)
BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support me... more BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self‐report and physician assessment.MethodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number ...
Background Compassion, one of the items of empathy, is crucial in health care professions. So, th... more Background Compassion, one of the items of empathy, is crucial in health care professions. So, the evaluation of the levels of compassion of Medicine, Dentistry and Pharmaceutical Sciences Master Degrees’ (M.D.) students of the public Colleges in Portugal according to the type of Master Degree and the participation in extracurricular activities (E.A.) was a task to be performed. Methods Cross-sectional study in 2020, applying an on-line questionnaire including the “Compassion” items of the Jefferson Medical Empathy Scale – Students’ version and questions about the participation in E.A. Results A sample of 901 students was studied. Its distribution by participation in E.A. did not differ significantly between M.D. (p = 0,854), most of the students participating in E.A. Using quartile distribution of compassion, the distribution of compassion levels was different among the three I.M. (p < 0.001), between Colleges (p < 0.001), and between curricular years (p < 0.001), with not...
The Patient Enablement Instrument (PEI) is a 6 questions indicator of effectiveness of the primar... more The Patient Enablement Instrument (PEI) is a 6 questions indicator of effectiveness of the primary care consultation measuring the patient's feelings about the consultation with his family physician. The underlying reasons for each answer are yet to be fully comprehended. Research questions: Investigate the explanations of PEI answers, especially regarding the "equal or worse" and "equal or less". Method: Observational study in triangulation methodology with PEI application complemented with a qualitative questionnaire of pre-established justifications and an open option response. Convenience sample yet size representative in randomized days of consultation in Primary Healthcare Centres, Central Portugal. After consultation patients were invited and gave written consent and doctors were unware of the study. Results: A sample of n=190 was studied, 62,6% female, 14,2% <35 years, 41,1% >65 years, 84,7% consulting in a previously scheduled appointment and 74,7% are under regular medication. 47,9% have low studies and 56,3% no professional activity. Main reasons for equal or worst: "Because my illness is boring and there is no improvement", n=8 (4,2%), "Because there is no explanation for my illness", n=7 (3,7%), "Because they cannot solve my illness", n=11 (5,8%), "Because I feel my illness is never going to be solved", n=9 (4,7%), "Because I drop off as I came in with no resolution for my problem", n=12 (6,3%), "Because I don't have total confidence on my Doctor", n=3 (1,35%). Conclusions: The explanations of PEIs answers clearly are in the domain of the doctor/patient communication skills. Two aspects have been established: the perpetuation of incomprehension and doubts, and the feeling of irresolution and inability to solve the problems. The communication skills have a direct relationship with the capacity that the patients acquire to improve their well-being and increase their quality of life.
Revista Portuguesa de Cardiologia (English Edition), 2019
Objectives: To compare clinical characteristics, medical activity, and family and social characte... more Objectives: To compare clinical characteristics, medical activity, and family and social characteristics of individuals with controlled and uncontrolled hypertension. Methods: This was an observational study on an alphabetically organized randomized sample of individuals suffering from hypertension in a primary care setting followed by 25 general practitioners at three clinics in the Central region of Portugal in mid-2018. Electronic medical records of individuals with an ICPC-2 classification of hypertension were analyzed. Epidemiologic, family, social and therapeutic data were gathered for descriptive and inferential analysis. Results: From a total population of 8750 patients classified as having hypertension, a representative sample of 387 individuals (n=369 required for a 95% confidence interval and 5% error margin) was studied. The incidence of uncontrolled hypertension was 56.1%, significantly higher among those living alone (p=00.24) or in a nuclear family (p=0.011), in lower socioeconomic classes (p=0.018), and prescribed anti-inflammatory drugs (p=0.018). The calculated cardiovascular risk was no higher for uncontrolled hypertension (p=0.116). Therapeutic inertia was not found either in number of medicines or in their association (p=0.274). No other studied ଝ Please cite this article as: Martins RdS, et al. Pessoas que sofrem de hipertensão arterial: implicações na atividade médica das diferenças entre os controlados e os não controlados. Rev Port Cardiol. 2019.
Objectives To evaluate differences in empathy between the Integrated Master’s degree in Medicine ... more Objectives To evaluate differences in empathy between the Integrated Master’s degree in Medicine (MIM) students from the Faculty of Medicine - University of Coimbra (FMUC) and the Faculty of Health Sciences - University of Beira Interior (FCS-UBI).Methodology Cross-sectional observational study with the Jefferson Scale of Physician Empathy – students’ Portuguese version (JSPE – spv) to 1st, 3rd and 6th year students of the 2017/2018 academic year with descriptive and inferential statistical analysis (p<0.05).Results Size representative sample of 795 students. Higher total empathy score (TES) (p=0.008) and "Perspective taking" (p=0.001) in FCS-UBI were found. JSPE-TES was higher in FCS-UBI, 3rd year (p=0.038). Higher FCS-UBI "Perspective taking" in the 1st year (p=0.030) and 6th year (p=0.044), for "Compassionate care" in the 3rd (p=0.019) and for "Standing in the patient’s shoes" in the 1st year (p=0.018) and in FMUC for "Compassionate...
Introduction: This article describes the views of European rural general practitioners regarding ... more Introduction: This article describes the views of European rural general practitioners regarding the strengths, weaknesses, opportunities and threats (SWOT) of the implementation of a chronic care model (CCM) in European rural primary care. Methods: This was a mixed-methods online survey. Data were collected from 227 general practitioners between May and December 2017. Categorical data were analysed using descriptive methods while free-text responses were analysed using qualitative methods. The setting was rural primary care in nine European countries (including Central and Eastern Europe). Main outcomes
PURPOSE To compare the final score of the scale to the levels of HbA1c. MATERIAL AND METHODS Cros... more PURPOSE To compare the final score of the scale to the levels of HbA1c. MATERIAL AND METHODS Cross-sectional observational study by applying the Diabetes Empowerment Scale-Short Form to diabetics at three primary care units in the central region of Portugal. The test-retest (in writing first and, five minutes later, orally) was performed to access Cronbach's alpha in 20 patients not studied in the next phase. Then, the scale was applied to diabetic patients after nursing consultation and prior to entering the medical consultation. Descriptive and inferential statistics after checking for the normality of the data were performed. RESULTS In the first phase Cronbach's alpha was 0.90 to 1.00 in all of eight scale items. The average result obtained in the written phase was 3.78 ± 0.71 and in the oral 3.79 ± 0.64, p = 0.629. The sample of the second stage was of 81 diabetic patients, 55.6% male. Sample's mean age was 68.5 ± 1.1 years, mean HbA1c of 6.8 ± 0.2 and mean time fro...
Na atualidade não é simples falar de moral, embora a ética esteja na moda, contudo parece que pou... more Na atualidade não é simples falar de moral, embora a ética esteja na moda, contudo parece que poucos acreditam que seja uma disciplina importante para a vida em geral. Considerando que existem poucos estudos sobre as bases que influenciam as decisões éticas dos profissionais de saúde, o objetivo deste estudo foi analisar as atitudes éticas dos profissionais de saúde nas relações com os pacientes.
Background: Diabetes is known as a major cause of morbidity and mortality worldwide. Portugal is ... more Background: Diabetes is known as a major cause of morbidity and mortality worldwide. Portugal is known as the European country with the highest prevalence of this disease. While diabetes prevalence data is updated annually in Portugal, the General Practitioner's (GP) Sentinel Network represents the only data source on diabetes incidence. This study describes the trends in Diabetes incidence, between 1992 and 2015, and estimate projections for the future incidence rates in Portugal until 2024. Methods: An ecological time-series study was conducted using data from GP Sentinel Network between 1992 and 2015. Family doctors reported all new cases of Diabetes in their patients' lists. Annual trends were estimated through Poisson regression models as well as the future incidence rates (until 2024), sex and age group stratified. Incidence rate projections were adjusted to the distribution of the resident Portuguese population given Statistics Portugal projections.
Objetivo: Avaliar a correlação entre o valor obtido pelo instrumento de medição Diabetes Empowerm... more Objetivo: Avaliar a correlação entre o valor obtido pelo instrumento de medição Diabetes Empowerment Scale - Short Form e o controlo da pessoa com diabetes medido pelo valor da hemoglobina glicada A1c.Material e Métodos: Estudo observacional transversal pela aplicação do Diabetes Empowerment Scale - Short Form a pessoas com diabetes de três Unidades de Saúde Familiar da Região Centro de Portugal após realização de teste e reteste (primeiro por escrito e, passados cinco minutos, oralmente) para determinação da coerência interna através do valor de alfa de Cronbach em 20 elementos que não foram depois estudados. A aplicação a pacientes diabéticos foi feita após a consulta de enfermagem e antes da entrada na consulta médica. Foi realizada estatística descritiva e inferencial apos verificação da normalidade dos dados.Resultados: Na primeira fase o valor de alfa de Cronbach de 0,90 a 1,00 relativamente aos oito itens da escala. Na aplicação escrita, a média de resultados foi de 3,78 ± 0,...
Doutoramento em Ciências e Tecnologias da SaúdeAtendendo a que existem poucos estudos sobre as de... more Doutoramento em Ciências e Tecnologias da SaúdeAtendendo a que existem poucos estudos sobre as determinantes e as bases que influenciam as decisões éticas dos profissionais de saúde, os objetivos deste estudo são identificar e comparar as atitudes éticas dos profissionais de saúde bem como as justificações para essas tomadas de decisão. Tratase de um estudo transversal quantitativo e qualitativo, de tipo descritivo, no qual foram inquiridos 163 profissionais de saúde, 77 médicos e 86 enfermeiros, dos centros de saúde da região centro de Portugal, com o objetivo de analisar e comparar as atitudes éticas dos profissionais de saúde, assim como as categorias das justificações para a tomada de decisão face a problemas éticos. Foi utilizado um questionário sociodemográfico, uma escala de atitudes perante os direitos à informação e ao consentimento, para avaliação das atitudes éticas dos profissionais de saúde, e foi solicitado aos participantes que listassem problemas éticos, a partir da ...
Background Empathy is the capacity to understand and resonate with the experiences of other peopl... more Background Empathy is the capacity to understand and resonate with the experiences of other people. Patient enablement is the degree to which a patient feels strengthened in terms of being able to deal with, understand and manage their disease. Methods Secondary cross-sectional analysis of existing data from 2 independent datasets (456 primary health care patients), with the application of two validated questionnaires, Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE) and Patient Enablement Instrument (PEI). Objective Evaluate medical empathy and patients’ enablement after consultation with their family doctors and to verify if there was an association between these two concepts. Results The median value of JSPPPE-VP score was 6.60 (interquartile range 1.00) and of PEI/ICC score was of 1.83 (interquartile range 0.67). Regarding empathy (JSPPPE-VP), patients taking chronic medication had a slight but significantly higher median score than patients not taking them (...
Background: Multimorbidity brings several difficulties and challenges to the daily work of primar... more Background: Multimorbidity brings several difficulties and challenges to the daily work of primary care teams. Team meetings are opportunities to discuss approaches and solutions on how to best manage multimorbid patients. Objective: This qualitative study aimed to collect a consensus, from general practitioners that deal with multimorbid patients, about their perspectives regarding multimorbidity team meetings in primary care. Methods: The study followed a modified Delphi method with 15 Portuguese general practitioners. After every round of responses, results were analyzed, and justifications for nonconsensual items were aggregated by the investigators, and then a new Delphi round with the revised questionnaire was again initiated. This process was repeated until consensus has been reached. Results: Overall, a list of 10 key themes associated with the ideal meeting was agreed: (a) definition; (b) setting; (c) duration; (d) frequency; (e) number of participants; (f) attendance; (g) requirement of patient's presence; (h) number of patients/clinical cases; (i) structure of the meeting; and (j) sharing meeting results. The consensus was achieved after two Delphi rounds with a mean score between 7.9 and 8.7 (maximum score of 9.0 per key theme). Conclusion: The complexity of multimorbidity affects meetings' periodicity, duration, and participants. Ideally, it should be an interprofessional primary care team meeting. Further research exploring meeting outcomes (organizational effectiveness and healthcare quality) of the proposed factors is needed before they can be recommended for general use.
Faculty of medicine, university of coimbra, Portugal 2 university clinic of general and Family me... more Faculty of medicine, university of coimbra, Portugal 2 university clinic of general and Family medicine, Faculty of medicine, university of coimbra, Portugal 3 Faculty of health sciences, university of beira interior, covilhã, Portugal 4 cintesis-centre for research in health technologies and service, oporto, Portugal
The untranslatable word desenrascanço, a Portuguese construct related to people's ability to skil... more The untranslatable word desenrascanço, a Portuguese construct related to people's ability to skilfully negotiate complex issues and to solve them with originality and creativity, was studied using a common medical complex scenario-multimorbidity. An online qualitative survey was carried out in the last trimester of 2018. A total of 117 general practitioners (GPs) completed the full survey. Ninety-one (77.8%) were familiar with the concept of desenrascanço. Responses were coded using thematic analysis. Desenrascanço is commonly used by GPs; 77 out of 91 GPs use desenrascanço in at least half of the appointments with multimorbid patients. Three components of desenrascanço were identified: adaptive response; creativity and art; and positivity. It could conceivably be hypothesised that the positive drive of desenrascanço (e.g. creativity) are used by GPs collectively to adapt to multimorbidity-a medical complex situation. Nonetheless, one should not forget that it may not be the ideal solution, as stated by participant GPs.
This study examined the relationship between the frequency of coffee consumption and blood pressu... more This study examined the relationship between the frequency of coffee consumption and blood pressure over a two year follow up of a cohort of elderly people. Healthy, older people (N = 205) were examined at baseline and at two years. Participants completed physical and behavioural assessments, which included body composition, current pharmacological treatment, and frequency of coffee consumption grouped into three categories: “never to a few times per month”, “once a week to a few times per week”, and “every day”. Blood pressure (systolic (sBP), diastolic (dBP), mean (mBP), and pulse pressure (PP)) was measured at baseline and after two years. After adjusting for body composition, smoking status, age, sex, heart rate, and number of antihypertensive agents taken, participants who drank coffee everyday had a significant increase in sBP, with a mean of 8.63 (1.27; 15.77) and an mBP, with a mean of 5.55 mmHg (0.52; 10.37) after two years (t = 2.37, p = 0.02 and t = 2.17, p = 0.03, respec...
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