Browsing by Author "Castro, Luísa"
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- Advantages and Disadvantages, Concerns, and Solutions for Emergency Remote Teaching During COVID-19: Portuguese Lecturers’ PerspectivesPublication . Marques dos Santos, José Paulo; Serrão, Carla; Amorim-Lopes, Teresa Sofia; Rodrigues, Ana Rita; Marina, Silvia; Teixeira, Andreia; Castro, Luísa; Duarte, IvoneCOVID-19 pandemic impacted the world dramatically and how communities and societies behaved. The purpose of this study was to explore lecturers’ perspectives on emergency remote teaching, not only from technology-prone lecturers but encompassing contributions from disparate academic fields, which brought assorted experiences into the data. The qualitative study analyses the perspectives of 344 lecturers from 35 higher education institutions in Portugal instigated by the COVID-19 outbreak. The thematic analysis revealed three themes related to the advantages and disadvantages: the lecturing process, learning process, and life and society. Regarding the concerns, four themes emerged: learning process, self-regulation and compromising the future, resources, the assessment process, and well-being. Finally, solutions encompass three themes: pedagogy and innovation, normative framework, and digital literacy. With a special focus on the solutions, all these themes contribute to designing the structure of a training program for the 21st-century higher education lecturer, emphasizing the digital domain. The themes cluster in digital-based innovative pedagogies (mastering digital education software, active pedagogies for digital environments, lecturer posture in digital environments, ‘‘for-digital’’ studying material production, e-proctoring, and transferable competences besides the digital), and digital competences (transgenerational digital-base communication, webcam behavior, well-being in digital settings, and general digital competences).
- Burnout among physicians working in palliative care during the COVID-19 Pandemic in Portugal: a cross-sectional studyPublication . Gonçalves, José Vítor; Castro, Luísa; Nunes, Rui; Rêgo, Guilhermina; Castro Guedes, Maria LuísaPhysicians working in palliative care have a greater risk of burnout. Burnout has three dimensions: emotional exhaustion, depersonaliza-tion and reduction of personal accomplishments. Burnout is associated with different consequences for the professionals like less professional satisfac-tion and increase of overall levels of exhaustion. Burnout in healthcare professionals has an impact in the patients with increased probability of clinical erros. In order to monitor the quality of the care it is mandatory to assess overall levels of burnout. This study aimed to determine burnout levels and associated variables of physicians working in the Portuguese national network of palliative care. A cross-sectional, exploratory and quantitative design was employed and participants were sampled using convenience and snowball technique. The Copenhagen Burnout Inventory was used to determine burnout levels of physicians working in the Portuguese National Network of Palliative Care. The contributions of personal, work and COVID-19 variables were evaluated in three subclasses: work, personal and patient-related burnout. The results obtained enabled the identification of healthcare professionals at risk, comparison with previous results published and to assess the impact of COVID-19 in their non COVID-19 activity. Seventy-five physicians participated. Socio-demographic characterization was conducted and the levels of burnout and determinants were ex-plored. High levels of personal, work and patient-related burnout were present in 32 (43%), 39 (52%) and 16 (21%) physicians, respectively. The majority agreed that COVID-19 had an impact on their activities. Exclusive dedication to palliative care and type of palliative care unit were associated with lower levels of patient and work-related burnout. Weekly physical activity was associated with lower levels of work and personal burnout. Self-perceived health status was associated with lower levels of burnout for all subclasses. There was a high level of burnout among physicians working in the Portuguese National Network of Palliative Care. Measures to identify and prevent burnout are necessary in order to protect these professionals.
- Burnout among Portuguese healthcare workers during the COVID-19 pandemicPublication . Duarte, Ivone; Teixeira, Andreia; Castro, Luísa; Marina, Sílvia; Ribeiro, Carla; Jácome, Cristina; Martins, Vera; Ribeiro-Vaz, Inês; Pinheiro, Hugo Celso; Silva, Andreia Rodrigues; Ricou, Miguel; Sousa, Bruno; Alves, Cristiana; Oliveira, Andreia; Silva, Paula; Nunes, Rui; Serrão, CarlaDuring COVID-19 pandemic, healthcare workers (HCWs) have had high workload and have been exposed to multiple psychosocial stressors. The aim of this study was to evaluate HCWs in terms of the relative contributions of socio-demographic and mental health variables on three burnout dimensions: personal, work- related, and client-related burnout.
- Burnout and depression in Portuguese healthcare workers during the COVID-19 pandemicPublication . Serrão, Carla; Duarte, Ivone; Castro, Luísa; Teixeira, AndreiaDuring the COVID-19 pandemic, healthcare workers (HCW) have been exposed to multiple psychosocial stressors. Resilience might protect employees from the negative consequences of chronic stress. The aim of this study was to explore the mediating role of resilience in the relationship between depression and burnout (personal, work-related, and client-related). A cross-sectional study was performed using an online questionnaire distributed via social networks. A survey was conducted comprising standardized measures of resilience (Resilience Scale-25 items), depression (subscale of Depression Anxiety Stress Scales-21 items), and burnout (Copenhagen Burnout Inventory Scale-19 items). A total of 2008 subjects completed the survey, and a hierarchical regression model was estimated for each burnout dimension. The results revealed that depression had not only a directed effect on personal, work- and client-related burnout, but also an indirect small effect on it through resilience. Psychological resilience played a partial mediating role between depression and all burnout dimensions. This partial mediation suggests that there may be other possible variables (e.g., social connection, self-compassion, gratitude, sense of purpose) that further explain the associations.
- Burnout and depression in portuguese healthcare workers during the COVID-19 pandemic—The mediating role of psychological resiliencePublication . Serrão, Carla; Duarte, Ivone; Castro, Luísa; Teixeira, AndreiaDuring the COVID-19 pandemic, healthcare workers (HCW) have been exposed to multiple psychosocial stressors. Resilience might protect employees from the negative consequences of chronic stress. The aim of this study was to explore the mediating role of resilience in the relationship between depression and burnout (personal, work-related, and client-related). A cross-sectional study was performed using an online questionnaire distributed via social networks. A survey was conducted comprising standardized measures of resilience (Resilience Scale-25 items), depression (subscale of Depression Anxiety Stress Scales-21 items), and burnout (Copenhagen Burnout Inventory Scale 19 items). A total of 2008 subjects completed the survey, and a hierarchical regression model was estimated for each burnout dimension. The results revealed that depression had not only a directed effect on personal, work- and client-related burnout, but also an indirect small effect on it through resilience. Psychological resilience played a partial mediating role between depression and all burnout dimensions. This partial mediation suggests that there may be other possible variables (e.g., social connection, self-compassion, gratitude, sense of purpose) that further explain the associations.
- Burnout in Portuguese physiotherapists during COVID-19 pandemicPublication . Jácome, Cristina; Seixas, Adérito; Serrão, Carla; Teixeira, Andreia; Castro, Luísa; Duarte, IvoneThis study described the burnout experienced by physiotherapists during the COVID-19 pandemic and analysed the role of possible factors of this occupational phenomenon. Cross-sectional study based on a web-based survey applied to physiotherapists living in Portugal. The survey included sociodemographic, health status and clinical practice questions. The Copenhagen Burnout Inventory (personal, work- and patient-related burnout), the Resilience Scale, the Depression Anxiety and Stress Scales and the Satisfaction with Life Scale were used. A total of 511 physiotherapists (median 33 years old, 82% females) completed the survey. The participants worked mainly in private practice (50%) and wards (35%). During COVID-19, 52% were working directly with patients, but only 18% were working with COVID-19 patients. Personal (42%), work- (42%) and patient-related burnout (25%) was observed. Three significant models explained personal- (R2 = 51%), work- (R2 = 31%) and patient-related burnout (R2 = 16%). Lower levels of resilience and higher levels of depression and stress were significantly associated with personal, work- and patient-related burnout. Being female and working directly with patients were additionally associated with both personal and work-related burnout. Having health problems and working with COVID-19 patients were only associated with personal burnout. More than 40% of physiotherapists experienced personal and work-related burnout and 25% patient-related burnout, with resilience, depression and stress having a relevant role in the three burnout dimensions. Early detection and management strategies need to be implemented to address physiotherapists' physical and psychological fatigue and exhaustion.
- Burnout, resilience, and subjective well-being among Portuguese lecturers’ during the COVID-19 pandemicPublication . Castro, Luísa; Serrão, Carla; Rodrigues, Ana Rita; Marina, Sílvia; dos Santos, José Paulo Marques; Amorim-Lopes, Teresa Sofia; Miguel, Carla; Teixeira, Andreia; Duarte, IvoneBackground: Lecturers face a large wide of occupational stressors. If the prolonged stress and the symptomatology associated with the working conditions to which lecturers were exposed were already a concern before the pandemic, the pandemic may have exacerbated this psychosocial vulnerability. Burnout is a psychological syndrome that develops in response to chronic work stress. This study aims to describe burnout amongst lecturers working in Portugal and to analyse potential determinants of burnout during the COVID-19 pandemic. Methods: A cross-sectional study was performed using an online questionnaire distributed via social networks. The survey collected sociodemographic and sleep patterns data in addition to applying the Copenhagen Burnout Inventory (personal, work- and student-related burnout), the Resilience Scale, the Depression Anxiety and Stress Scales, and the Satisfaction with Life Scale. Results: The sample included 331 lecturers from 35 different colleges and faculties. Three significant models explained personal (R2 = 54%), work- (R2 = 47%) and student- (R2 = 19%) related burnout. Lower levels of resilience and higher levels of depression and stress were significantly associated with personal and work-related burnout. Changes in sleep patterns were additionally associated with both personal and work-related burnout. Conclusion: Higher education institutions must recognize the impact of the work environment and organizational culture on faculty mental health and take proactive measures to improve this environment. These institutions can implement support strategies such as educational technology training, professional development programmes, emotional support resources, and workload flexibility. Implementing measures to enhance lecturers’ resilience and overall life satisfaction could potentially help mitigate burnout and improve the well-being of educators, ultimately contributing to the overall quality of education.
- Current practices in home mechanical ventilation for chronic obstructive pulmonary disease: A real-life cross-sectional multicentric studyPublication . Ribeiro, C.; Vieira, A. L.; Pamplona, P.; Drummond, M.; Seabra, B.; Ferreira, D.; Liberato, H.; Carreiro, A.; Vicente, I.; Castro, Luísa; Costa, P.; Carriço, F.; Martim, T.; Cravo, J.; Teixiera, N.; Grafino, M.; Conde, S.; Windisch, W.; Nunes, R.Home mechanical ventilation (HMV) use in chronic obstructive pulmonary disease (COPD) is becoming increasingly widespread. The aim of this study was to provide an accurate description of the current practices and clinical characteristics of COPD patients on HMV in Portugal. The study was designed as a cross-sectional, multicenter real-life study of COPD patients established on HMV for at least 30 days. Data related to clinical characteristics, adaptation and ventilatory settings were collected. The study included 569 COPD patients on HMV from 15 centers. The majority were male, with a median age of 72 years and a high prevalence of obesity (43.2%) and sleep apnea (45.8%). A high treatment compliance was observed (median 8h/day), 48.7% with inspiratory positive airway pressure ≥ 20 cmH2O and oronasal masks were the preferred interface (91.7%). There was an equal distribution of patients starting HMV during chronic stable condition and following an exacerbation. Patients in stable condition were initiated in the outpatient setting in 92.3%. Despite the differences in criteria and setting of adaptation and a slightly lower BMI in patients starting HMV following an exacerbation, we found no significant differences regarding age, gender, ventilation pressures, time on HMV, usage, severity of airflow obstruction or current arterial blood gas analysis (ABGs) in relation to patients adapted in stable condition. Patients were highly compliant with the therapy. In agreement with most recent studies and recommendations, there seems to be a move towards higher ventilation pressures, increased use of oronasal masks and an intent to obtain normocapnia. This study shows that chronic hypercapnic and post exacerbation patients do not differ significantly regarding patient characteristics, physiological parameters or ventilatory settings with one exception: chronic hypercapnic patients are more often obese and, subsequently, more frequently present OSA.
- Do surrogates predict patient preferences more accurately after a physician-led discussion about advance directives? A randomized controlled trialPublication . Martins, Catarina Sampaio; Sousa, Iva; Barros, Cláudia; Pires, Alexandra; Castro, Luísa; Santos, Cristina da Costa; Nunes, RuiCaregivers frequently assume the role of surrogate decision-makers but often are unable to accurately predict patients’ preferences. This trial aims to find if the use of the Advance Directives documents as a communication tool, improves the agreement between patients and caregivers. This trial occurred in a palliative care service of a Portuguese hospital center. A prospective, single-blinded, controlled, randomized trial, enrolling patients and caregivers as a dyad was conducted. Participants individually fulfilled an Advance Directive document, in which patients reported their end-of-life preferences and caregivers reported their decisions as patients’ health surrogates. Dyads were randomly assigned to the Intervention or the Control group, in which the physician respectively promoted an open discussion about patients’ Advance Directives or evaluated patients’ clinical condition. Caregivers’ Advance Directives as surrogates were collected one month later. Proportions of agreement and Cohen’s κ were used to access agreement and reliability, respectively, between the dyads. Results from 58 dyads were analyzed. We observed an improvement in agreement between the caregivers’ answers and the patients’ wishes on two-thirds (8/12) of the answers, in the Intervention group, contrasting to one-quarter (3/12) of the answers, in the Control group, despite statistical significance in differences wasn´t obtained. Although not reaching statistical significance, the results suggest that discussions of advance directives with physicians may lead to better prepared surrogates.
- Equity in the access of chinese immigrants to healthcare services in PortugalPublication . Nunes, Rui; Aparício, Sandra Lopes; Castro, Luísa; Duarte, IvoneThe aim of this study was to identify the barriers that Chinese immigrants face when accessing the Portuguese National Health Service. An observational, cross-sectional and quantitative study was carried out via a bilingual Portuguese/Mandarin self-completed paper questionnaire was applied. The study population consisted of individuals with Chinese nationality who were residing in mainland Portugal for at least one year and aged 18 years or over. A total of 304 individuals answered the questionnaire. The results show that 284 (93.4%) of the participants had already sought healthcare in Portugal. The participants identified language difficulties and health professionals’ lack of knowledge of Chinese cultural habits as the most significant barriers to accessing healthcare in Portugal. Of a total of 165 participants who sought healthcare in China, confidence in treatment outcomes and health professionals’ knowledge of Chinese cultural habits were the reasons given by 151 (91.5%) individuals. This study reveals the existence of linguistic and cultural barriers that can condition the access of the Chinese immigrant population to healthcare systems.
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