Browsing by Author "Nunes, Rui"
Now showing 1 - 7 of 7
Results Per Page
Sort Options
- 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.
- 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.
- Impact of COVID-19 pandemic on the mental health of healthcare workers during the first wave in Portugal: a cross-sectional and correlational studyPublication . Duarte, Ivone; Pinho, Rita; Teixeira, Andreia; Martins, Vera; Nunes, Rui; Morgado, Helder; Castro, Luísa; Serrão, CarlaObjectives The COVID-19 pandemic has had a negative impact on the mental health of healthcare workers (HCWs) worldwide. This study aims to identify the degree to which sociodemographic variables and indicators of subjective well-being and psychological resilience are associated, positively and negatively, with the outcomes of burnout, stress, depression and anxiety among Portuguese HCWs observed during the first wave. It also aims to evaluate the strength of association of these variables and indicators with each outcome. Design Cross-sectional quantitative study. The statistical methods used are simple logistic model, multiple logistic regression model and −2*log-likelihood statistic. Setting Portuguese HCWs living in Portugal and working in the Portuguese healthcare system. Participants The study included 1535 professionals, with a mean age of 38 years. Primary and secondary outcomes measures Psychological variables were measured by Copenhagen Burnout Inventory, the Resilience Scale, the Depression, Anxiety and Stress Scales and the Satisfaction with Life Scale. Results High levels of personal (55%; n=844), work-related (55.1%; n=846) and client-related burnout (35.4%; n=543) were found. Additionally, participants expressed substantial levels of depression (28.7%; n=441), stress (36.4%; n=558) and anxiety (33.1%; n=508). About 1202 participants (78.3%) demonstrated moderate-to-high levels of resilience. Profession, work regime during the pandemic, having a health problem, resilience and satisfaction with life are independent variables significantly associated with the outcomes of burnout, stress, depression and anxiety. Satisfaction with life was the independent variable that had a major association with all outcomes. Conclusions Governments and hospital administrations should take action to promote resilience and satisfaction with life as these variables are protective relating to mental health problems. Interventions as educational sessions, psychological support at work, programmes promoting resilience and coping mechanisms and better work conditions may improve mental health. The implementation of measures to protect healthcare students from developing prejudicial outcomes seams very adequate and important.
- New taxonomy for prolonged disorders of consciousness may help with decisions on withdrawal of clinically assisted nutrition and hydration: A proposed decision-making pathwayPublication . Teixeira, Liliana da Conceição; Rocha, Nuno; Nunes, RuiThe number of patients surviving severe brain injury is increasing; however, many are left in a prolonged disorder of consciousness. With appropriate treatment, patients with prolonged disorders of consciousness can survive for years. Unless an advance directive exists, the treating clinicians can authorize withdrawal of clinically assisted nutrition and hydration for these patients, based on best interests. The classic terminology used in prolonged disorders of consciousness ranges from coma, vegetative state to minimally conscious state. However, a new group of patients with covert cognition has been identified in the last decade, making it necessary to revise the current taxonomy to better reflect our understanding of these conditions. With the introduction of a less ambiguous terminology, the challenges when it comes to withdrawal of clinically assisted nutrition and hydration of these patients may ease. A decision- making pathway for withdrawal of clinically assisted nutrition and hydration for patients with prolonged disorders of consciousness, based on a new taxonomy is proposed. These decisions should be based primarily on best interests. The adoption of a new classification for impairments of consciousness would clarify and improve how we think about these patients. Moreover, the development of accurate prognostic predictors would be a major step in the decision-making process, as it would influence the beneficent pathway towards the best clinical outcome.
- What young people know about human trafficking?Publication . Rodrigues, Bárbara; Nunes, Rui; Santos, Cristina; Serrão, Carla; Duarte, IvoneO Tráfico de Seres Humanos (TSH) afeta grande parte da população mundial, incluindo crianças. A necessidade de (in)formar jovens sobre este crime acentua a emergência do papel das escolas e das famílias como maior fonte de transmissão de conhecimentos. O estudo visa avaliar o conhecimento em TSH e identificar as fontes de informação deste fenómeno de uma amostra de jovens de 14 escolas públicas do município do Porto, 7 das quais estão abrangidas pelo programa TEIP (Territórios Educativos de Intervenção Prioritária). Foi aplicado um questionário de autorrelato na sala de aula. Tornou-se evidente que a (in)formação neste tema é escassa. A este respeito, sugerimos que seja dada mais visibilidade a este fenómeno, através da integração da temática em projetos de educação para a saúde/ sexual nas escolas. Ações que abranjam intervenções preventivas de carácter universal, mas também intervenções mais específicas, em grupos identificados como prioritários e mais vulneráveis.