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Cano F, Alves E, João A, Oliveira H, Pinho LG, Fonseca C. A rapid literature review on the health-related outcomes of long-term person-centered care models in adults with chronic illness. Front Public Health 2023; 11:1213816. [PMID: 37670836 PMCID: PMC10477001 DOI: 10.3389/fpubh.2023.1213816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/07/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction The strong association between age and the increasing prevalence of chronic diseases, makes it imperative to promote self-care throughout life. Systematic knowledge on the health findings of person-centered care models may contribute to designing effective healthcare strategies to promote empowerment for self-care in long-term care. Objective To assess the association between the implementation of person-centered care models that promote self-care training in long-term care and health-related outcomes, among adults with chronic illness. Methods A rapid review of the literature was performed following the Cochrane rapid review methodology. The electronic databases CINAHL, MedicLatina, MEDLINE, and Psychology and Behavioral Sciences Collection were searched for randomized experimental studies, published between 2017 and 2022, that implemented interventions based on person-centered models to promote self-care in adults aged ≥18 years with chronic diseases and needing long-term health care. Verification of the eligibility of the articles and the extraction of data were performed by two independent investigators. Quantitative data on the health-related variables assessed were collected and, through narrative synthesis, health outcomes were grouped into individual, institutional and societal levels. Results Eight studies, mostly conducted in European countries, were included. All satisfied more than 60% of the methodological quality score. A large variability among studies was found regarding the number of participants, the data collection period and duration of the intervention, the samples selected and the care model implemented. A high number of health-related outcomes (n = 17) were analyzed in the studies, using 52 different instruments. The main health-related outcomes were multidimensional, with implications at the individual, institutional and societal levels. The promotion of overall health and wellbeing (n = 4), the implementation of patient-centered care models (n = 1), the positive and more frequent interactions with health professionals (2), the decrease on staff psychosocial distress (n = 1), and the absence of added costs (n = 1), while improving family caregivers' skills (n = 1) were the main health-related outcomes described. Conclusion There is a need to develop robust experimental studies focused on the views and experiences of all stakeholders and conducted in different countries and cultures. Short-, medium- and long-term health outcomes should be measured using internationally accepted and validated scales for chronic patients.
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Affiliation(s)
- Fátima Cano
- Local Health Unit of Baixo Alentejo, Beja, Portugal
| | - Elisabete Alves
- São João de Deus School of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
| | - Ana João
- São João de Deus School of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
| | - Henrique Oliveira
- Instituto de Telecomunicações, Lisbon, Portugal
- Polytechnic Institute of Beja, Beja, Portugal
| | - Lara Guedes Pinho
- São João de Deus School of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
| | - César Fonseca
- São João de Deus School of Nursing, University of Évora, Évora, Portugal
- Comprehensive Health Research Center (CHRC), University of Évora, Évora, Portugal
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Schneider BC, Veckenstedt R, Karamatskos E, Pinho LG, Morgado B, Fonseca C, Moritz S, Jelinek L. Negative cognitive beliefs, positive metacognitive beliefs, and rumination as mediators of metacognitive training for depression in older adults (MCT-Silver). Front Psychol 2023; 14:1153377. [PMID: 37034960 PMCID: PMC10074596 DOI: 10.3389/fpsyg.2023.1153377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/02/2023] [Indexed: 04/11/2023] Open
Abstract
Background Metacognitive Training for Depression in older adults (MCT-Silver; www.uke.de/mct-silver) is a cognitive-behavioral based group intervention that aims at reducing depression by targeting (meta)cognitive beliefs and rumination. In the present study, it was examined whether negative cognitive beliefs, positive metacognitive beliefs and/or rumination may be implicated as mediators of MCT-Silver's effects on depression. Materials and methods We conducted a secondary analysis of a randomized controlled trial comparing MCT-Silver to an active control intervention (cognitive remediation) including 66 older adults (60 years and older) with complete baseline data. Clinician-rated (Hamilton Depression Rating Scale) and self-reported (Beck Depression Inventory-II) depression, negative cognitive beliefs (Dysfunctional Attitudes Scale-18B), positive metacognitive beliefs (positive beliefs subscale; Metacognition Questionnaire-30) and rumination (10-item Ruminative Response Scale) were assessed before (pre) and after 8 weeks of treatment (post), as well as 3 months later (follow-up). It was examined whether change in depression (pre- to follow-up) was mediated by change in negative cognitive beliefs, positive metacognitive beliefs and/or rumination (pre- to post-assessment). Results Mediation results differed for self-reported vs. clinician-rated depression. The effect of MCT-Silver on reduction in clinician-rated depression was mediated by a reduction in self-reported rumination, whereas reduction in self-reported depression was mediated by a reduction in negative cognitive beliefs. Positive metacognitive beliefs were not a significant mediator for either outcome. Conclusion The current study provides initial evidence for the roles of negative cognitive beliefs and rumination in the treatment of depression in later life with MCT-Silver. Given the divergence of findings and lack of causal precedence, mechanisms of change for MCT-Silver cannot yet be equivocally identified.
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Affiliation(s)
- Brooke C. Schneider
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Brooke C. Schneider,
| | - Ruth Veckenstedt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Evangelos Karamatskos
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lara Guedes Pinho
- Nursing Department, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | | | - César Fonseca
- Nursing Department, University of Évora, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Oliveira AP, Nobre JR, Luis H, Luis LS, Pinho LG, Albacar-Riobóo N, Sequeira C. Social Media Use and Its Association with Mental Health and Internet Addiction among Portuguese Higher Education Students during COVID-19 Confinement. Int J Environ Res Public Health 2022; 20:664. [PMID: 36612991 PMCID: PMC9819961 DOI: 10.3390/ijerph20010664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
The use of social media was one of the most common way to keep in touch with friends and family during confinement. For higher education students, the fact that their universities were closed was a major change in their lives. The aim of this study is to relate the prevalence and type of social media with Internet addiction and mental health of university students in a district of Portugal during COVID-19 confinement. Mental health was studied by applying the reduced version of the Mental Health Inventory (MHI-5) and to measure the Internet use and dependence, the Internet Addiction Test (IAT) was used. The study (cross-sectional, descriptive, and correlational) used an online questionnaire, conducted on Google® Forms and the link was sent to 4450 students, in the months of April to June 2020, during the confinement. A total of 329 valid questionnaires were obtained. We can conclude that regarding mental health, students in the 18-24 age group, single or divorced and who are not in a relationship, and with worse academic results, show worse levels of mental health. It is noteworthy that the students with the same characteristics also have the highest levels of addiction to internet.
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Affiliation(s)
- Ana Paula Oliveira
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal
- Faculty of Nursing, University of Rovira e Virgili, 43003 Tarragona, Spain
| | - Joana Rita Nobre
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal
- Faculty of Nursing, University of Rovira e Virgili, 43003 Tarragona, Spain
| | - Henrique Luis
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Teresa Ambrósio, 1600-277 Lisbon, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | - Luis Soares Luis
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | - Lara Guedes Pinho
- Nursing School, University of Évora, 7000-811 Évora, Portugal
- Comprehensive Health Research Center, 7002-554 Évora, Portugal
| | | | - Carlos Sequeira
- Nursing School of Porto, 4200-072 Porto, Portugal
- Group Inovation and Development in Nursing (NursID), Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), 4200-450 Porto, Portugal
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Nascimento V, Fonseca C, Pinho LG, Lopes MJ. Person-Centered Health Intervention Programs, Provided at Home to Older Adults with Multimorbidity and Their Caregivers: Protocol for a Systematic Review. J Pers Med 2022; 13:27. [PMID: 36675688 PMCID: PMC9861220 DOI: 10.3390/jpm13010027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/09/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022] Open
Abstract
The WHO has been promoting the paradigm shift in health care towards person-centered care, considering this strategy as fundamental for the personalization of care, but globally, the implementation of person-centered health intervention programs is still in an early stage. Older adults have high morbidity rates, which are often precursors to functional dependence on informal caregivers. Person-centered health intervention programs may answer the vulnerability of older adults and their caregivers, but they are not yet intensively implemented. This systematic literature review aims to identify which person-centered health programs exist in-home settings for this population and show the health gains. Methods: A systematic review of the literature will be conducted in the following databases: PubMed, CINAHL, MedicLatina, Scopus, and MEDLINE. The search strategy will contain the following MesH terms or similar: "older adults", "caregivers", "home care", and "patient-centered care." Criteria inclusion: Person-centered health intervention programs performed to older adults and their caregivers' in-home context; scientific articles from 2017 to 2022. For the extraction and synthesis, two independent reviewers will quality analyze the inclusion and exclusion criteria and the data quality analysis. Disagreements will be resolved by a third reviewer.
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Affiliation(s)
- Vânia Nascimento
- Nursing Department, University of Évora, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-811 Évora, Portugal
| | - César Fonseca
- Nursing Department, University of Évora, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-811 Évora, Portugal
| | - Lara Guedes Pinho
- Nursing Department, University of Évora, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-811 Évora, Portugal
| | - Manuel José Lopes
- Nursing Department, University of Évora, 7000-811 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-811 Évora, Portugal
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Fonseca C, Ramos A, Pinho LG, Morgado B, Oliveira H, Lopes M. Functional Profile of Older Adults Hospitalized in Rehabilitation Units of the National Network of Integrated Continuous Care of Portugal: A Longitudinal Study. J Pers Med 2022; 12:1937. [PMID: 36422113 PMCID: PMC9697554 DOI: 10.3390/jpm12111937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The success of healthy aging depends on the ability of countries to study and act on frailty in the elderly, control chronic diseases, improve functional capacity and prevent cognitive decline and social interaction. AIM (1) to evaluate the functional profile of older adults hospitalized in a Unit of the National Network of Integrated Continuous Care of Portugal; and (2) to assess the relationship between functional profile and age, gender, level of education and emotional state. METHODS Longitudinal study with a population of 59,013 older adults (65 years or older) hospitalized in Medium-Term Care and Rehabilitation Units in Portugal. RESULTS Older age (≥85 years), no school attendance, low body mass index and presence of sad or depressed mood were predictive factors for a deficit in functional capacity. We identified significant improvements in rehabilitation, but after 210 days of hospitalization, older people incurred a loss of functionality. Total compensation needs were typified by severe deficits in self-care and functional capacity: 47.1%. A moderate deficit was present in 43.1%, and a slight self-care and functional deficit occurred in 9.8% of the individuals. CONCLUSIONS Knowing the determinants of functional capacity and self-care needs will make it possible to define priority intervention groups and implement quality and financing models based on gains in functionality.
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Affiliation(s)
- César Fonseca
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Ana Ramos
- Hospital Center of Medium Tejo, 2304-909 Tomar, Portugal
| | - Lara Guedes Pinho
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
| | - Bruno Morgado
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Hospital Garcia de Orta, 2805-267 Almada, Portugal
| | - Henrique Oliveira
- Institute of Telecommunications, 1049-001 Lisbon, Portugal
- Polytechnic Institute of Beja, 7800-295 Beja, Portugal
| | - Manuel Lopes
- Nursing Department, University of Évora, 7000-801 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801 Évora, Portugal
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Oliveira AP, Nobre JR, Luis H, Luis LS, Albacar-Riobóo N, Pinho LG, Sequeira C. Literacy and Mental Health of Portuguese Higher Education Students and Their Use of Health Promotion Strategies during Confinement in the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:14393. [PMID: 36361270 PMCID: PMC9658650 DOI: 10.3390/ijerph192114393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The pandemic of COVID-19 caused significant changes in economies and societies with a major impact on the entire education process. However, these changes did not invalidate a constant effort of adaptation. This cross-sectional, descriptive, and correlational study used an online questionnaire administered to students from various study cycles at higher education institutions in Portugal, with the aim of exploring the influence of literacy and mental health on the use of mental health promotion strategies during COVID-19 confinement. A total of 329 students from higher education institutions participated in this study, mostly from the age group 18-24 years (n = 272; 82.7%) and female (n = 265, 80.5%). The most mentioned health promotion strategies during this period included studying (n = 170; 51.7%); physical activities (n = 151, 45.9%); social networking (n = 124, 37.7%); cooking activities (n = 120, 36.5%); and listening to music (n = 118, 35.9%). Academic success is self-reported, and it is weakly correlated with the MHI5 (r = 0.103, p = 0.063). Students in the pre-graduate programs studied more during the times of the pandemic and used this activity as a mental-health-promoting strategy with a statistically significant difference (p = 0.033). Although it was difficult to improve health literacy related to COVID-19 in such a short period of time, there was a very strong motivation to access, understand, evaluate, communicate, synthesize, and apply information and knowledge to maintain mental health through self-care using health promotion strategies.
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Affiliation(s)
- Ana Paula Oliveira
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal
- Faculty of Nursing, University of Rovira e Virgili, 43003 Tarragona, Spain
| | - Joana Rita Nobre
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal
- Faculty of Nursing, University of Rovira e Virgili, 43003 Tarragona, Spain
| | - Henrique Luis
- Health School, Polytechnic Institute of Portalegre, 7300-555 Portalegre, Portugal
- Unidade de Investigação em Ciências Orais e Biomédicas (UICOB), RHODes-Rede de Higienistas Orais para o Desenvolvimento da Ciência Faculdade de Medicina Dentária, Universidade de Lisboa, Rua Teresa Ambrósio, 1600-277 Lisbon, Portugal
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | - Luis Soares Luis
- Center for Innovative Care and Health Technology (ciTechcare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | | | - Lara Guedes Pinho
- Nursing School, University of Evora, 7000-811 Evora, Portugal
- Comprehensive Health Research Center, 7002-554 Evora, Portugal
| | - Carlos Sequeira
- Nursing School of Porto, 4200-072 Porto, Portugal
- Group Inovation and Development in Nursing (NursID), Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), 4200-450 Porto, Portugal
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