Qualidade de vida, percepção de saúde, resiliência, auto-regulação e suporte social nos adolescentes portugueses com a doencça crónica

Tese de Doutoramento em Psicologia na área de especialidade Psicologia da Saúde

Contextual factors related to chronic condition in portuguese adolescents: Highlights from the HBSC/WHO study

Adolescence’s changes may become more pronounced when living with a chronic condition (CC). This study aims to examined the differences in satisfaction with family life, perception of school competence and “pressure with homework” of Portuguese adolescents’ 1) living with CC; 2) how living with CC affects school participation; taking into account age, gender and family socioeconomic status (SES). Five thousand fifty Portuguese adolescents (mean age 14 ± 1.85) of the Health Behaviour in School-aged Children (HBSC/WHO) were included. Results showed increased vulnerability in adolescents living with CC, presenting a lower satisfaction with family life and poor school outcomes. Younger boys, having a higher SES and not having CC are significantly associated with satisfaction with family life. Older girls, having a lower SES and living with CC were associated with more stress related to school work. Future interventions should include these features combined with ‘listening’ to adolescents and their needs, allowing their participation in the promotion of personal health.

Young people's well-being and the economic crisis: How does parental unemployment and family wealth affect the downturn experience?

Background: Portugal is among the European countriesmost severely hit by the economic recession and the fifth with the highest unemployment rate. Given that adolescents' development is highly influenced by their living contexts, monitoring the repercussions of the economic recession is essential for the evaluation and improvement of their current and future public health. Objective: To investigate youth perceived repercussions of the economic recession, its association with life satisfaction, as well as to assess differences across parental employment status and family perceived wealth. Methods: Data were drawn from the Portuguese 2014 Health Behaviour in School-aged children survey, aWHO collaborative cross-national study, with a nationally representative sample of 2748 students (Mage = 14.7 years ± 1.2; 48% boys). Descriptive statistics and linear regression models were performed. Results: Levels of life satisfaction are lower when young people perceive that the economic recession generated negative lifestyle changes. Having unemployed parents was found to be significantly associated with perceiving such repercussions and family wealth to decrease the perception of repercussions of the recession. Conclusions: Findings enhance our understanding of how Portuguese youth are being affected by the socioeconomic conditions surrounding them. Such information contributes to improve future research and also allow some considerations about the policies aimed at protecting young people'swellbeing during a period of high unemployment and socioeconomic downturn.

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.