738 resultados para Social support
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Background<br/>Low patient adherence to treatment is associated with poorer health outcomes in bronchiectasis. We sought to use the Theoretical Domains Framework (TDF) (a framework derived from 33 psychological theories) and behavioural change techniques (BCTs) to define the content of an intervention to change patients adherence in bronchiectasis (Stage 1 and 2) and stakeholder expert panels to define its delivery (Stage 3).<br/><br/>Methods<br/>We conducted semi-structured interviews with patients with bronchiectasis about barriers and motivators to adherence to treatment and focus groups or interviews with bronchiectasis healthcare professionals (HCPs) about their ability to change patients adherence to treatment. We coded these data to the 12 domain TDF to identify relevant domains for patients and HCPs (Stage 1). Three researchers independently mapped relevant domains for patients and HCPs to a list of 35 BCTs to identify two lists (patient and HCP) of potential BCTs for inclusion (Stage 2). We presented these lists to three expert panels (two with patients and one with HCPs/academics from across the UK). We asked panels who the intervention should target, who should deliver it, at what intensity, in what format and setting, and using which outcome measures (Stage 3).<br/><br/>Results<br/>Eight TDF domains were perceived to influence patients and HCPs behaviours: Knowledge, Skills, Beliefs about capability, Beliefs about consequences, Motivation, Social influences, Behavioural regulation and Nature of behaviours (Stage 1). Twelve BCTs common to patients and HCPs were included in the intervention: Monitoring, Self-monitoring, Feedback, Action planning, Problem solving, Persuasive communication, Goal/target specified:behaviour/outcome, Information regarding behaviour/outcome, Role play, Social support and Cognitive restructuring (Stage 2). Participants thought that an individualised combination of these BCTs should be delivered to all patients, by a member of staff, over several one-to-one and/or group visits in secondary care. Efficacy should be measured using pulmonary exacerbations, hospital admissions and quality of life (Stage 3).<br/><br/>Conclusions<br/>Twelve BCTs form the intervention content. An individualised selection from these 12 BCTs will be delivered to all patients over several face-to-face visits in secondary care. Future research should focus on developing physical materials to aid delivery of the intervention prior to feasibility and pilot testing. If effective, this intervention may improve adherence and health outcomes for those with bronchiectasis in the future.
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Death of a spouse is associated with increased mortality risk for the surviving partner (the widowhood effect), although the mechanisms driving the effect are poorly understood. After acute stress and grief have dissipated, mortality risk may be increased by loss of emotional and instrumental support for daily living and so we investigated whether social support at both the household and community levels moderated the influence of spousal bereavement on mortality risk. <br/><br/>We assembled death records from the Northern Ireland Mortality Study spanning almost nine years for a prospective cohort of 296,125 married couples enumerated in the 2001 Census. Presence of other adults within the household and urban/rural residence were used as measures of support at the household and community levels, with informal social support perceived to be strongest in rural areas. We used Cox proportional hazards models to estimate the effects of widowhood, sex, household composition and urban/intermediate/rural residence on all-cause mortality.<br/><br/>Elevated mortality risk during the first six months of widowhood was found in all areas and for both sexes (range of hazard ratios 1.24, 1.57). After more than six months the effect among men was attenuated in rural but not urban areas (HRs and 95%CIs 1.09 [0.99, 1.21] and 1.35 [1.26, 1.44] respectively). Among women the effect was attenuated in both rural and urban areas (HRs 1.06 [0.96, 1.17] and 1.09 [1.01, 1.17]). Mortality risk post bereavement was not associated with presence of other adults in the household.<br/><br/>We found some support for the hypothesis that informal social support is beneficial for reducing the impacts of spousal loss. Rural residence had a positive effect especially among men but presence of other adults in the household had no effect. The reasons for this discrepancy require further investigation and we identify men in urban areas as being at greatest risk in the long term.<br/>
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Background<br/>The use of multiple medicines (polypharmacy) is increasingly common in older people. Ensuring that patients receive the most appropriate combinations of medications (appropriate polypharmacy) is a significant challenge. The quality of evidence to support the effectiveness of interventions to improve appropriate polypharmacy is low. Systematic identification of mediators of behaviour change, using the Theoretical Domains Framework (TDF), provides a theoretically robust evidence base to inform intervention design. This study aimed to (1) identify key theoretical domains that were perceived to influence the prescribing and dispensing of appropriate polypharmacy to older patients by general practitioners (GPs) and community pharmacists, and (2) map domains to associated behaviour change techniques (BCTs) to include as components of an intervention to improve appropriate polypharmacy in older people in primary care.<br/><br/>Methods<br/>Semi-structured interviews were conducted with members of each healthcare professional (HCP) group using tailored topic guides based on TDF version 1 (12 domains). Questions covering each domain explored HCPs perceptions of barriers and facilitators to ensuring the prescribing and dispensing of appropriate polypharmacy to older people. Interviews were audio-recorded and transcribed verbatim. Data analysis involved the framework method and content analysis. Key domains were identified and mapped to BCTs based on established methods and discussion within the research team.<br/><br/>Results<br/>Thirty HCPs were interviewed (15 GPs, 15 pharmacists). Eight key domains were identified, perceived to influence prescribing and dispensing of appropriate polypharmacy: Skills, Beliefs about capabilities, Beliefs about consequences, Environmental context and resources, Memory, attention and decision processes, Social/professional role and identity, Social influences and Behavioural regulation. Following mapping, four BCTs were selected for inclusion in an intervention for GPs or pharmacists: Action planning, Prompts/cues, Modelling or demonstrating of behaviour and Salience of consequences. An additional BCT (Social support or encouragement) was selected for inclusion in a community pharmacy-based intervention in order to address barriers relating to interprofessional working that were encountered by pharmacists.<br/><br/>Conclusions<br/>Selected BCTs will be operationalised in a theory-based intervention to improve appropriate polypharmacy for older people, to be delivered in GP practice and community pharmacy settings. Future research will involve development and feasibility testing of this intervention.
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<p>BACKGROUND: The transtheoretical model has been successful in promoting health behavior change in general and clinical populations. However, there is little knowledge about the application of the transtheoretical model to explain physical activity behavior in individuals with non-cystic fibrosis bronchiectasis. The aim was to examine patterns of (1) physical activity and (2) mediators of behavior change (self-efficacy, decisional balance, and processes of change) across stages of change in individuals with non-cystic fibrosis bronchiectasis.</p><p>METHODS: Fifty-five subjects with non-cystic fibrosis bronchiectasis (mean age SD = 63 10 y) had physical activity assessed over 7 d using an accelerometer. Each component of the transtheoretical model was assessed using validated questionnaires. Subjects were divided into groups depending on stage of change: Group 1 (pre-contemplation and contemplation; n = 10), Group 2 (preparation; n = 20), and Group 3 (action and maintenance; n = 25). Statistical analyses included one-way analysis of variance and Tukey-Kramer post hoc tests.</p><p>RESULTS: Physical activity variables were significantly (P < .05) higher in Group 3 (action and maintenance) compared with Group 2 (preparation) and Group 1 (pre-contemplation and contemplation). For self-efficacy, there were no significant differences between groups for mean scores (P = .14). Decisional balance cons (barriers to being physically active) were significantly lower in Group 3 versus Group 2 (P = .032). For processes of change, substituting alternatives (substituting inactive options for active options) was significantly higher in Group 3 versus Group 1 (P = .01), and enlisting social support (seeking out social support to increase and maintain physical activity) was significantly lower in Group 3 versus Group 2 (P = .038).</p><p>CONCLUSIONS: The pattern of physical activity across stages of change is consistent with the theoretical predictions of the transtheoretical model. Constructs of the transtheoretical model that appear to be important at different stages of change include decisional balance cons, substituting alternatives, and enlisting social support. This study provides support to explore transtheoretical model-based physical activity interventions in individuals with non-cystic fibrosis bronchiectasis.</p>
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Online help-seeking is an emerging trend within the 21st century. Yet despite some movement towards developing online services, little is known about how young people locate, access and receive support online. This study aims to conceptualise the process of online help-seeking among adolescent males. Modified photo-elicitation techniques were employed within eight semi-structured focus group sessions with adolescent males aged 14 15 years (n= 56) across seven schools in Northern Ireland. Thematic analyses was conducted within an ontological framework of critical realism and an epistemological framework of contextualism. Informal online help-seeking pathways increased opportunity for social support and reduced stigma but also included loss of control and reduced anonymity. Formal pathways offered increased anonymity but concerns were raised regarding participants ability to locate and appraise the quality of information online. A conceptual model of online help-seeking has been developed to highlight the key help seeking pathways taken by adolescent males.
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<p>BACKGROUND: Behavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits.</p><p>PURPOSE: These analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality.</p><p>METHODS: Data from the PRIME Study (N=6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support.</p><p>RESULTS: Following initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR=1.24, p<0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR=1.14, p=0.04). Of the behaviors included, the most significant contribution to outcomes was found for smoking, but a role was also found for fruit and vegetable intakes and high alcohol consumption.</p><p>CONCLUSIONS: These findings demonstrate well-known associations between depression, hostility, and mortality and suggest the potential importance of behaviors in explaining these relationships.</p>
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Objective: Research indicates that parents of twins have poorer psychosocial outcomes than parents of singletons. Parents who have conceived using assisted reproductive technology (ART) have been found to be at higher risk of negative psychosocial outcomes compared to parents who have conceived spontaneously. The current study aimed to model the factors associated with parenting stress of newly-born twins, using the Transactional Model of Stress.<br/><br/>Methods: Data were collected using a cross-sectional survey design with participants identified from delivery records across Northern Ireland. Mothers and fathers (n=104) of twins aged between 1 and 12 months old returned a questionnaire pack containing the Parenting Stress Index, Impact on the Family Scale-Financial Burden, Coping Orientation to Problems Experienced Brief Version, Multidimensional Scale of Perceived Social Support, General Health Questionnaire and a demographic questionnaire.<br/><br/>Results: There were no differences on psychological outcomes between parents who had conceived via ART and those who conceived spontaneously. Regression analyses found that social interaction and support is an important variable in terms of the psychological outcomes experienced by parents of twins.<br/><br/>Conclusion: Parents of newly-born twins regardless of the mode of conception should be considered an at risk group for parental distress. Support groups such as the Twins and Multiple Births Association could be important in providing that crucial social interaction and support that seems to be important in the emotional well-being of parents of twins.
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Current scientific evidence supports the recommendation to initiate or continue the practice of physical exercise in healthy pregnant women. Group exercise programs have positive effects in improving health and well-being, as well as social support. In order to understand the scientific evidence in this field, and the outcomes in maternal health, it has generated wide interest in exploring the studies carried out with more relevant group exercise programs. The aim of this systematic review was to evaluate the available evidence on the effectiveness of group exercise programs in improving womens and newborns health outcomes during pregnancy. Three databases were used to conduct literature searches and strict inclusion and exclusion criteria were employed. Seventeen studies were selected for analysis. All studies were randomized control trials conducted with pregnant women that evaluated the effect of group exercise programs on the health outcomes of mother and newborn. Most studies followed a supervised structured exercise program including a main aerobic part, resistance training, pelvic floor training and stretching and relaxation sections. The significant effects of the programs are related with improved maternal perception of health status, lower maternal weight gain, improved levels of maternal glucose tolerance, improved aerobic fitness and muscular strength, lower frequency of urinary incontinence, improved sick leave due to lumbopelvic pain, fewer cesarean and instrumental deliveries, higher newborn Apgar score and faster postpartum recovery. Exercise and health professionals should advise pregnant women that aerobic group exercise during pregnancy improves a wide range of health outcomes for the women and newborn
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A sexualidade estando presente desde o nascimento, na adolescncia assume novo significado. Descobre-se o primeiro amor atravs de uma relao de intimidade e partilha de afectos, o corpo adquire um novo sentido, o grupo torna-se importante enquanto fonte de suporte, partilha de angstias e confiana, contribuindo para o desenvolvimento do adolescente. Na adolescncia, perscrutam alguns factores de risco, nomeadamente a vivncia da sexualidade de forma no informada e responsvel, com repercusses para a sade fsica e psicolgica, pelo que imperioso intervir atravs de programas formativos no mbito da sexualidade que promovam vivncia desta de forma responsvel. So objectivos do estudo: Promover um modelo de interveno formativa baseado no debate e reflexo crtica sobre sexualidade em contexto de sala de aula; Construir e validar instrumentos que permitam avaliar as atitudes face sexualidade e ainda os conhecimentos dos adolescentes sobre reproduo, planeamento familiar e infeces de transmisso sexual; Testar a eficcia de um programa de interveno formativo a nvel dos conhecimentos sobre planeamento familiar, infeces de transmisso sexual, reproduo e atitudes face sexualidade; Testar a efectividade do programa de interveno formativo numa amostra alargada de adolescentes, analisando tambm o papel das variveis sociodemogrficas, sociopsicolgicas e sexuais. O trabalho de campo desenvolveu-se em trs estudos distintos, no primeiro e terceiro participaram 840 adolescentes e no segundo 90. No primeiro estudo construmos e validamos os instrumentos para colheita de dados, no segundo, experimental de campo, validamos o modelo da interveno formativa no mbito da sexualidade e no terceiro, descritivo e correlacional, testamos a efectividade de um programa de interveno numa amostra mais alargada. O protocolo de recolha de informao incluiu quatro escalas construdas para o efeito com o intuito de avaliar as atitudes face sexualidade, os conhecimentos sobre planeamento familiar, infeces de transmisso sexual e reproduo e ainda a escala de insatisfao com a imagem corporal em adolescentes e a escala de satisfao com o suporte social. As raparigas e residentes na zona urbana so as que tm mais conhecimentos sobre planeamento familiar e possuem atitudes face sexualidade mais favorveis. Os interlocutores preferenciais sobre sexualidade so os amigos, seguidos da me. So os adolescentes com pouca ou moderada prtica religiosa que j iniciaram a actividade sexual. So as raparigas que tm maior satisfao com o suporte social nas dimenses, satisfao com as amizades, intimidade, actividades sociais e suporte social total. Os adolescentes que j iniciaram a actividade sexual, revelam maior percepo de suporte social na dimenso satisfao com a amizade. O modelo de formao construdo e aplicado influenciou as atitudes face sexualidade, conhecimentos sobre reproduo, sobre infeces de transmisso sexual e sobre planeamento familiar. Do nosso ponto de vista, pensamos ser urgente a aplicao de programas de interveno formativos em contexto escolar, ou outro, que integrem de uma forma harmoniosa as vrias facetas da sexualidade humana, promovendo a aquisio de uma postura responsvel, flexvel e gratificante nos adolescentes enquanto seres sexuados.
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A formao inicial de professores possui caratersticas muito prprias e a complexidade envolta sobre o perodo de estgio na prtica pedaggica, requer um olhar aprofundado sobre as questes subjacentes ao stress tanto no estagirio, como no supervisor e orientador. A presente investigao inter e multicultural, pretende conhecer junto a estes trs atores as principais fontes indutoras de stress e seus sintomas no decorrer do perodo de estgio pedaggico, as estratgias de coping e a satisfao com o suporte social. Desenvolvemos trs estudos de cariz comparativo entre Portugal e Brasil, em oito Instituies de Ensino Superior (4 de Portugal e 4 do Brasil) numa amostra total de 1.194 indivduos. O primeiro de ndole qualitativa envolveu 24 professores supervisores e orientadores de estgio, os quais identificaram as principais causas de stress que permitiram a construo do questionrio Avaliao do stress do professor/orientador de Estgio Pedaggico (ASPOEP). Contamos no segundo estudo com uma amostra de 204 docentes (122 orientadores e 82 supervisores) no exerccio da superviso pedaggica e no terceiro estudo com 966 estagirios (476 Portugal e 490 Brasil). Nestes dois ltimos estudos, para a identificao dos fatores de stress, os supervisores responderam ao questionrio ASPOEP e os estagirios ao questionrio ASAE (Avaliao do stress do aluno estagirio). Foram ainda utilizados os questionrios de Avaliao dos sintomas de stress, o de Estratgias de coping e para a anlise do suporte social fizemos uso da Escala de satisfao com o suporte social. Na anlise dos dados foi utilizado o SPSS, tendo sido realizadas as estatsticas descritivas e inferenciais. Os resultados globais evidenciam o estgio pedaggico como uma fonte indutora de stress. Nos supervisores de estgio, a sobrecarga de trabalho, as relaes interpessoais, o desempenho do estagirio e sobretudo a estrutura e acompanhamento do estgio, marcaram os fatores de maior stress, que foi mais evidente no gnero feminino e na populao brasileira. Entre estagirios, a insegurana e a indisciplina so os fatores de maior stress, sobretudo no gnero feminino de Portugal. O stress apesar de moderado para a maioria da amostra, evidencia ndices de stress elevado em 10,7% dos docentes e 19,1% dos estagirios portugueses e 23,8% dos docentes e 12,7% dos estagirios brasileiros. Os sintomas cognitivos so os mais evidentes nestas duas populaes estudadas, porm nos casados e com filhos existe evidncia significativa de sintoma comportamental. A estratgia de coping centrada no indivduo foi mais prevalente, porm evidencia-se que os brasileiros e tambm os pais com filhos apresentam significativo coping centrado no outro. O suporte social da amizade e da intimidade foram os que demonstraram maior satisfao, sendo assim eficaz na manuteno de um stress moderado. Os portugueses apresentam maior satisfao com o suporte social que os brasileiros. Ficou evidente que a satisfao e as estratgias de coping contribuem de forma positiva na diminuio dos sintomas de stress, bem como a satisfao com estgio diminui os nveis de stress. Sugere-se que na formao de professores sejam integrados programas de formao sobre gesto e controlo do stress para supervisor, orientador e estagirio, bem como devem ser propostas mudanas a nvel curricular, ligado estrutura e acompanhamento do estgio, para que este possa ser um perodo de desenvolvimento de competncias profissionais, aliceradas no bem-estar para todos os intervenientes.
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Pretendemos com este estudo caracterizar os sem abrigo, as suas redes e relaes sociais, bem como os modelos de interveno, de forma a que se possa ter um maior conhecimento acerca desta problemtica. Para a consecuo destes propsitos, foram delineados os seguintes objectivos: caracterizar a populao sem abrigo em termos de variveis scio-demogrficas; identificar a sua rede social de apoio; caracterizar as dimenses sociais associadas vinculao adulta nos sem abrigo; caracterizar a incidncia de psicopatologia nesta populao; analisar o seu bem estar psicolgico; caracterizar os acontecimentos de vida stressantes que contribuem para a emergncia desta problemtica. Para atingir estes objectivos foram realizados dois estudos, um de carcter quantitativo e um segundo de carcter qualitativo. Participaram 225 indivduos (105 sem abrigo e 120 pessoas carenciadas) garantindo a homogeneidade nas variveis sexo e idade. A mdia de idades da amostra total (n= 225) de 38 anos, sendo que a maioria dos sujeitos desta investigao pertence ao sexo masculino (78,5%). O grupo dos sem abrigo foi recolhido em duas comunidades de insero, na zona centro do pas, sendo importante destacar que todos nesta fase tm apoio residencial, satisfao das necessidades bsicas, acompanhamento social e psicolgico, bem como, projectos de insero em curso. O protocolo de recolha de informao inclui dados pessoais, a verso portuguesa da (ASQ)-Questionrio de Estilos de Vinculao nos Sem Abrigo (QEVSA), da escala de ocorrncia de acontecimentos de vida stressantes relacionados com o surgimento do primeiro episdio de sem abrigo (EAVSSA), do Questionrio de Morbilidade Psiquitrica em Adultos (QMPA), do Medical Outcomes Studys social support scale (MOS-SSS-P), a escala de medida de manifestao de bem-estar psicolgico (EMMBEP), o programa de interveno da CINO e uma entrevista estruturada utilizada no estudo qualitativo. Os principais resultados so: a) o perfil de sem abrigo encontrado maioritariamente homem, em mdia com 39 anos, solteiro ou divorciado, com 1 filho, 2. ciclo de escolaridade, desempregado e portugus; b) maioria viveu na rua mais de um ano, est na instituio h menos de meio ano, no teve nos ltimos seis meses consumo de substncias (lcool e drogas), frequenta consultas (sade mental e toxicodependncia), toma medicao (teraputica de substituio e neurolpticos), afirma no ter comportamentos de risco, e na maioria tm patologia infecciosa (HIV ou hepatite c), tendo cerca de 40% estado detidos; c) a problemtica dos sem abrigo um fenmeno multicausal apontando como principais factores o conflito familiar, o desemprego e problemas de sade; d) em termos de vinculao populao sem abrigo parece corresponder a indivduos com vinculao insegura, denotando uma falta de confiana generalizada; e) em termos de bem estar psicolgico a mdia foi significativamente superior no grupo de pessoas carenciadas, quando comparado com o grupo dos sem abrigo; f) no que toca sade mental constatamos que 80% dos sem abrigo e 42.5% das pessoas carenciadas so portadores de transtorno mental; g) no que concerne ao apoio social os sem abrigo referem menor suporte social (apoio emocional, afectivo, instrumental e menor interaco social positiva) que as pessoas carenciadas; h) os sem abrigo tm menos familiares e amigos ntimos; i) os resultados do estudo qualitativo indicam que o programa de interveno da CINO, parece contribuir para a emergncia de uma rede social estvel, activa, acessvel e integrada que se constitui como um sistema salutognico para o indivduo, diminuindo o uso dos servios. Parece ainda eficaz aos olhos dos prprios e destacam como factor fundamental a sua participao activa no mesmo, a importncia de rotinas organizadoras, de espaos de terapia de grupo e a existncia de equipa multidisciplinar. Destacam ainda como positivo o facto de existir um primeiro perodo de regime fechado como estratgia de preveno de recada, um programa faseado de aquisio de responsabilidades e autonomia, acesso a emprego no exterior da comunidade e o follow-up ps autonomizao. Como implicao deste trabalho salienta-se a produo de conhecimentos acerca da realidade dos sem abrigo na regio centro do pas e de estratgias de interveno.
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As pessoas idosas so hospitalizadas com mais frequncia e por perodos superiores por comparao com pessoas mais novas. A literatura indica que a interao entre idade, patologia e cuidados durante o internamento influencia a perceo de Qualidade de Vida (QV) pela pessoa idosa. Esta investigao analisa a influncia da hospitalizao na QV e espiritualidade das pessoas idosas e pretende contribuir para melhor compreender a hospitalizao na velhice, ajudando a desenvolver medidas que promovam a qualidade dos cuidados a pessoas idosas durante a hospitalizao. A amostra compreende 250 participantes (65 anos). Administrou-se o EASYcare (Sistema de Avaliao de Pessoas Idosas) e a Escala da Espiritualidade em 3 momentos: admisso, alta e follow-up (6 a 12 meses aps a alta). Os principais resultados indicam: i) na admisso, as pessoas idosas mais dependentes tendem a ser vivas, no praticar exerccio fsico, sentir-se sozinhas e deprimidas; os independentes tendem a estar mais satisfeitos com a sua habitao e a gerir de forma autnoma as suas finanas, apresentando maior escolaridade e sendo mais novos; ii) na alta, as pessoas idosas diminuem a perceo da qualidade de vida, principalmente com aumento da dependncia, diminuio da sade mental e bem-estar, diminuio da mobilidade e capacidade de cuidar de si; iii) no follow-up, os participantes tendem a ser mais dependentes comparativamente com a admisso; o risco de queda menor comparativamente com os outros momentos. O modelo preditivo de bitos indica como principais resultados: falecimento entre admisso e alta tem como fatores protetores rendimentos suficientes e ausncia de apoio social; falecimento entre alta e follow-up tem como fatores de risco idade e risco de queda elevado; falecimento entre admisso e follow-up tem como fator protetor antecedentes clnicos do foro cardaco. As concluses gerais sustentam a importncia do aprofundamento da pesquisa sobre a influncia da hospitalizao na pessoa idosa na sua qualidade de vida, e a adoo de medidas e estratgias para a promoo da QV durante e aps o internamento hospitalar. Estes resultados tm implicaes na prtica e na elaborao de polticas institucionais, pois permite compreender o impacto da hospitalizao nas pessoas idosas, permitindo desenvolver medidas para melhorar os cuidados antes, durante e aps o internamento hospitalar. Este estudo permite conhecer as necessidades das pessoas idosas durante o internamento e delinear estratgias para o follow-up, sendo adaptado s especificidades da populao idosa Portuguesa.
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Surviving childhood cancer has multiple implications on both physical and psychological domains of the individual. However, its study and possible effects on health-related quality of life (HRQoL) outcomes of adolescent survivors has been understudied. The objective of this study was twofold; to assess positive and negative cancer-related consequences (psychosocial and physical) in a sample of adolescent cancer survivors and to explore their relationship with HRQoL outcomes. Forty-one participants answered two questions about positive and negative consequences in the aftermath of cancer and filled in the KIDSCREEN-52 self-reported version. Data were analysed using mixed methods approach. 87.8% of the sample identified positive consequences and 63.4% negative consequences in survivorship. Four positive categories and five negative categories with regard to cancer-related consequences were found. Changed perspectives in life narratives seem to be the positive consequence more related to HRQoL (physical well-being, mood & emotions, autonomy, social support & peers), followed by useful life experience (physical well-being, autonomy, social support & peers). Psychological impact was the most referred negative consequence with a significant detrimental effect on social support and peers HRQoL dimension. Even if the majority of survivors reported benefit finding in the aftermath of cancer, concomitant positive and negative consequences have been found. However, findings only reveal a significant relationship between positive narratives and HRQoL, and negative consequences do not seem to have a significant influence on overall HRQoL in survivorship.
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Tese de mestrado em Bioestatstica, apresentada Universidade de Lisboa, atravs da Faculdade de Cincias, 2013
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Tese de doutoramento, Psicologia da Educao, Universidade de Lisboa, Instituto de Educao, 2015
