Adaptação cultural e contributo para a validação da pain attitudes and believes scale for physiotherapists (PABS-PT) para a população de fisioterapeutas portugueses

RESUMO: Introdução: Vários estudos têm encontrado evidência para a relação entre as crenças e atitudes dos profissionais de saúde, a sua abordagem de tratamento, referida como orientada segundo o modelo biomédico ou modelo biopsicossocial (Bishop, 2008; Mutsaers, 2012), e os resultados obtidos. É sugerido que, no tratamento da dor lombar crónica, os profissionais que orientam o seu raciocínio e prática segundo o modelo biomédico, tendem a obter piores resultados quando comparados com os obtidos pelos profissionais que orientam o seu raciocínio e prática segundo uma abordagem biopsicossocial. Esta área de estudo tem salientado a importância de desenhar instrumentos capazes de identificar a orientação preferencial dos profissionais de saúde no tratamento da dor crónica de natureza músculo-esquelética, entre os quais se encontra a “Pain Attitudes and Beliefs Scale for Physiotherapists” (PABS-PT). Objetivo: Adaptar culturalmente a PABS-PT para a população de fisioterapeutas portugueses que intervêm em utentes com dor (lombar) crónica, e contribuir para a sua validação Metodologia: A versão original (língua inglesa) do PABS-PT foi adaptada para a língua e cultura portuguesas, através das etapas definidas nas normas orientadoras estabelecidas para este processo (Beaton et al., 2002; MAPI Institute, 2001). A avaliação das propriedades psicométricas da versão portuguesa foi realizada com recurso a uma amostra de 202 fisioterapeutas e estudantes finalistas do curso de licenciatura em Fisioterapia. Inicialmente foi realizada a análise fatorial exploratória da escala através do método das componentes principais. Posteriormente avaliou-se a consistência interna das componentes obtidas com recurso ao alpha de Cronbach (α). Para analisar a validade de constructo foram correlacionadas as componentes obtidas com a versão portuguesa da “Health Care Providers’ Pain and Impairment Relationship Scale” (HC-PAIRS), recorrendo ao cálculo do coeficiente de Spearman. Resultados: O processo de adaptação cultural não revelou dificuldades importantes sendo considerado que a versão portuguesa da PABS-PT é de fácil compreensão e preenchimento, e os seus itens adequados para avaliar as crenças e atitudes dos fisioterapeutas portugueses relativas à intervenção na dor crónica músculo-esquelética. Os resultados revelaram uma estrutura fatorial de duas componentes, identificadas com as componentes da escala original que explicam 30,96% da variância total. A consistência interna encontrada é boa, para a componente biomédica (α de Cronbach = 0,826), mas muito fraca para a componente biopsicossocial (α de Cronbach= 0,589). Relativamente à validade convergente e discriminativa, foi encontrada uma associação estatisticamente significativa e positiva, entre as componentes 1 (biomédica) da versão nportuguesa da PABS e a HC-PAIRS (Rs = 0,481, p≤ 0,005), e negativa, fraca e significativa entre a pontuação total da componente 2 (biopsicossocial) e a HC-PAIRS (Rs = -0,038, p=0,612). Conclusão: A versão portuguesa do PABS-PT é de fácil compreensão e aparenta ser um instrumento válido para a medição da orientação preferencial dos fisioterapeutas, relativamente às suas atitudes e crenças na avaliação e tratamento de utentes com dor crónica de natureza músculo-esquelética. No entanto, a componente biopsicossocial requer uma análise mais aprofundada para que possa, com rigor, ser utilizada na definição de uma orientação preferencialmente biopsicossocial.--------------ABSTRACT: Introduction: Previous studies have found a relation between the beliefs and attitudes of health professionals, their treatment approach, which can follows a biomedical or a biopsychosocial orientation (Bishop, 2008; Mutsaers, 2012), and the outcomes obtained. Therefore, is suggested that the professionals who tend to approach chronic low back pain patients according to the biomedical model have worse outcomes than professionals who use a biopsychosocial approach in there clinical reasoning. This research field has highlighted the importance of developing measures capable of identifying the preferred orientation of health professionals in the treatment of chronic pain of musculoskeletal nature, including the “Pain Attitudes and Beliefs Scale for Physiotherapists” (PABS-PT). Objective: To cross culturally adapt and validate the PABS-PT for the Portuguese population of physiotherapists. Methodology: The original version (English version) of the PABS-PT was adapted to the Portuguese language and culture, through the guidelines established for these processes (Beaton et al., 2002; MAPI Institute, 2001). The psychometric evaluation of the Portuguese version was carried out on a sample of 202 p physiotherapist and final year students of the physiotherapy course. Initially, an exploratory factorial analysis was performed through the method of the main components. Then, the internal consistence of the main components was evaluated using the Cronbach’s alpha (α). The convergent construct validity was analysed through the correlation between the obtained components of PABS-PT and the Health Care Provider’s Pain and Impairment Relationship Scale (HC-PAIRS), using the Spearmen correlation coefficient. Results: No major difficulties were found during the cultural adaptation process of PABS-PT to Portugal, which means that the Portuguese version is easy to understand and fulfill, and items are appropriated to evaluate the beliefs and attitudes of the Portuguese physiotherapists who treat chronic pain of musculoskeletal origins. The results revealed a factorial structure of two components, as the original scale, explaining 30,96% of the total variance. Internal consistence results were good, for the biomedical component (Cronbach’s α = 0,826), but very weak for the biopsychosocial componente (Cronbach’s α = 0,589). Relatively to convergent and discriminative validity, a statistically significant association was found, between the components 1 (biomedical) of the Portuguese version of PABS-PT and the HC-PAIRS (Rs= 0,481, p≤ 0,005) and negative, weak and significant between the total score of component 2 (biopsychosocial) and the HC-PAIRS (Rs = -0,038, p=0,612). Conclusion: The Portuguese Version of PABS-PT is easy to understand and seems to be a valid instrument to measure the attitudes and beliefs of physiotherapists in the management of patients with chronic low back pain. However, the biopsychosocial component requires a further deep analysis to examine a preferable biopsychosocial orientation.

The transformation of work? A quantitative evaluation of changes in work in Portugal

This report is made for the Work Package 15 of WORKS project and tries to develop more information on the Portuguese situation in the work structures changes in the recent years. It starts with an analysis of socio- economical indicators (Macro economical indicators, Employment indicators, Consumption, Technology at the workplace, Productivity), and then approaches the situation in terms of work flexibility in its dimensions of time use and New forms of work organisation. It traces employment in business functions with a sectoral and occupational approach, and analyses the occupational change in South Europe with particular relevance to Portugal (skill utilisation and job satisfaction, occupational and industrial mobility, quantitative evaluation of the shape of employment in Europe. Finaly are analysed the globalisation indicators.

Evaluation of the potential of translocated common cockle for ecological risk assessment studies: bioaccumulation and biomarkers test

Thesis submitted to the Faculdade de Ciências e Tecnologia to obtain the Master’s degree in Environmental Engineering, profile in Ecological Engineering

2,4,6- Ttrichloroanisol:a consumer panel evaluation

“Cork taint” is a major problem in wine industry and is caused by contamination of wines. This contamination is usually attributed to wine cork stoppers and 2,4,6-trichloroanisole (2,4,6-TCA) is one of the compounds mostly associated to this off-flavour. In this work, a consumer panel performed “forced choice” triangular tests in order to measure Odour Detection Thresholds (ODT) and Taste Detection Thresholds (TDT) of 2,4,6-TCA in water, hydro-alcoholic solutions (11.5% and 18% ethanol) and white and red wines. A paired preference test was also performed by the panel in order to measure Odour Rejection Threshold (ORT) in white and red wine spiked with 2,4,6-TCA. Results obtained show that the ODT and the TDT for 2,4,6-TCA in water were 0.2 and 0.3 ng/L, respectively. In hydro-alcoholic solutions with 11.5% and 18% ethanol the ODT were 4 and 10 ng/L respectively. In red wine the ODT and the TDT were 0.9 and 1.7 ng/L and in white wine were 1.5 and 1.0 ng/L respectively. ORT for white was 10.4 ng/L and for red wines 16.0 ng/L. These results suggest that although this group of consumers detected very low concentrations of 2,4,6-TCA in wines, they did not reject the wine at these low concentration values.

Anatase as an alternative application for preventing biodeterioration of mortars: evaluation and comparison with other biocides

International Biodeterioration & Biodegradation 64(2010)388 e 396

Software languages engineering: experimental evaluation

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do grau de Mestre em Engenharia Informática

Design and performance evaluation of turbo FDE receivers

Dissertação apresentada na Faculdade de Ciências e Tecnologia da Universidade Nova de Lisboa para obtenção do Grau de Mestre em Engenharia Electrotécnica e de Computadores

The state of environmental performance evaluation in the public sector: the case of the Portuguese defence sector

Journal of Cleaner Production, nº 17, p. 36-52

The Vasco da Gama Bridge on the Tagus Estuary: A paradigm of bad decision making, but good post-evaluation

World Transport Policy & Practice, Vol.6, nº2, (2000)

Evaluation of Opuntia spp. bioactive products as promising natural chemotherapeutical agents- an in vitro approach

Dissertation to obtain a Master Degree in Biotechnology

Models for pheromone evaluation in Ant Systems for Mobile Ad-hoc networks

On a mobile ad-hoc network environment, where the resources are scarce, the knowledge about the network's link state is essential to optimize the routing procedures. This paper presents a study about different pheromone evaluation models and how they react to possible changes in traffic rate. Observing how the pheromone value on a link changes, it could be possible to identify certain patterns which can indicate the path status. For this study, the behavior of the Ant System evaluation model was compared with a Temporal Active Pheromone model (a biological approach) and a Progressive Pheromone Reduction model with and without a maximum pheromone limit.