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- Ética e deontologia nas tecnologias da saúdePublication . Cruz, Agostinho; Lopes, Paula; Amorim, Manuela; Cabral, Ana Paula; Curado, Henrique; Faria, Isabel; Gonçalves, Maria João; Machado, Alberto; Sousa, Helena; Monteiro, Pedro; Tavares, DianaMuitas são as Instituições de Ensino Superior (IES) que ministram cursos na área da saúde e onde são desenvolvidos estudos de cariz clínico, sendo necessário garantir a salvaguarda dos padrões de (bio)ética, por forma a proteger e garantir a dignidade e integridade humana e a proteção/segurança dos seus dados pessoais. O Decreto-Lei n.º 80/2018 (15 /outubro), veio estabelecer princípios e regras aplicáveis ao funcionamento das comissões de ética integradas em IES, que realizem investigação clínica. A Comissão de Ética da Escola Superior de Saúde (CE da ESS) do Politécnico do Porto tem 10 anos de existência, desenvolvendo atividade de apoio aos projetos de investigação integrados em cursos de graduação e/ou dos seus Centros de Investigação, ou de entidades externas. Assim, para além da análise e emissão de pareceres relativos à investigação realizada, a CE da ESS tem intervém ainda no eixo da formação, objetivando padrões conduta (bio)ética, proteção e garantia da dignidade/integridade humana e proteção/segurança dos dados pessoais e/ou sensíveis, segundo os Códigos Deontológicos e de Conduta das Tecnologias da Saúde. Nestas áreas da saúde, os dilemas surgem no dia-a-dia dos profissionais e são devidos tanto às diferentes patologias, como aos procedimentos de diagnóstico e terapêutica utilizados. Existe ainda a problemática da confidencialidade e registo, que tem vindo a assumir cada vez maior importância, com o incremento da autonomia do paciente / utente. O respeito pelos direitos do utente, nas questões relativas ao controlo e acesso à informação clínica e terapêutica, pressupõe conhecimento e experiência do profissional quanto aos limites ético-deontológicos, dada a gestão constante do risco inerente à intervenção, tendo em vista o objetivo último da mesma: o bem-estar de quem procura estes profissionais.
- Utilização de substâncias psicadélicas para o tratamento da perturbação obsessivo-compulsiva: uma análise de escopoPublication . Monteiro, Pedro; Simões de Almeida, Raquel; Marques, AntónioA utilização de substâncias psicadélicas ou psicoativas para tratar doenças mentais, como a Perturbação Obsessivo-Compulsiva (POC), é cada vez mais procurada. Há relatos de que opções alternativas de tratamento têm sido usadas para reduzir a sintomatologia, embora a investigação realizada seja escassa e dispersa, sendo necessário o mapeamento e identificação dos estudos realizados.
- Assessing the efficacy of the ‘Bicho De 7 Cabeças’ B-learning school-based program in enhancing mental health literacy and reducing stigmaPublication . Meilsmeidth, Gislene; Trigueiro, Maria João; Simões-Silva, Vítor; Simões de Almeida, Raquel; Portugal, Paula; Gomes, Paulo Veloso; Sousa, Sara; Campos, Filipa; Monteiro, Pedro; Soutelo, Ana Paula; Marques, AntónioThe prevalence of mental disorders in adolescents has a considerable impact on daily life, restricting tasks and diminishing overall quality of life while potentially leading to stigmatization. This study aims to measure the impact of a mental health literacy intervention program, called “Bicho de 7 Cabeças” project, in b-learning format, on the increase of knowledge and the decrease of stigma in young people from Póvoa de Varzim, in Portugal. A quasi-experimental study was conducted, from November 2022 to May 2023, involving an experimental group (“Bicho de 7 Cabeças” protocol) and an active control group (informational brochures), utilizing a pre-test/post-test design. Mental Health Literacy Measure-MHLM, Mental Health Promoting Knowledge Scale-MHPK-10, Mental Illness Knowledge Schedule-MAKS, Reported and Intended Behaviour Scale-RIBS, and Community Attitudes toward People with Mental Illness-CAMI were used. A total of 504 young students from the 9th grade enroll in this study, with a mean age around 14 years old. There is a significant difference between stigma (p <.001) and knowledge (p <.001) scores at baseline and follow-up. The results of this study shows that interventions aimed at young people for the promotion of mental health literacy and stigma reduction are needed and more initiatives should be implemented in schools to address these problems.
- Rural rehabilitation disparities and strengthening strategies: umbrella reviewPublication . Ayres, Stephanie Nicole; Monteiro, Pedro C.; Doyle, Nancy; Morrow, Corey; Jesus, Tiago S.; Costa Monteiro, Pedro"Rural residents with disabilities often experience healthcare disparities versus urban counterparts. To meta-synthesize the rural rehabilitation disparities, including access barriers, and the strategies for improving rehabilitation access for rural underserved populations. Methods: Umbrella review of the contemporary (2015-2024), English-language reviews focused on rural rehabilitation service-delivery gaps or strategies for adults or children with disabilities, with no country restrictions. Six scientific databases (Medline/PubMed, Scopus, CINAHL, Cochrane Library, PDQ-Evidence, REHABdata) were searched, supplemented by snowballing. Two independent reviewers performed full-text assessments and quality appraisals of the systematic reviews on intervention effects, using the Measurement Tool to Assess Systematic Reviews-2. Of the 530 records identified, 366 were unique references and 16 reviews were finally included, including 8 systematic reviews, two of them with meta-analyses. The 16 reviews included collectively synthesized information from 484 studies. Rural rehabilitation-access disparities were identified. For instance, those derived from supply shortages in low-density markets, workforce recruiting and retention issues, long travel requirements and costs, waiting times or low intervention intensity, and generalist versus specialist skills of the therapist workforce. Rural rehabilitation strengthening strategies were also identified. These include telehealth service options – benefits and challenges; outreach, home and community-centered approaches; navigator programs; and finally, task-sharing with (remote) specialist support. This umbrella review provides a meta-synthesis of the issues affecting equitable access to rehabilitation by rural populations and of the strengthening strategies to address those disparities. Alone or combined, these strategies might be tailored to and with local communities and interested parties for effective co-implementation."
- Barriers and facilitators for the practice of occupational therapy in mental health: findings from a global practitioner survey of the World Federation of Occupational TherapistsPublication . Jesus, Tiago S.; Monteiro, Pedro C.; Ledgerd, Ritchard; Zweck, Claudia von; Costa Monteiro, PedroOccupational therapists are health professionals with knowledge and capacity to address mental health (MH) needs and reduce MH workforce shortages worldwide. However, occupational therapists working in MH are often underrepresented within the MH and occupational therapy workforce. Using the perspective of occupational therapists with MH practice, the study aimed to: identify barriers and facilitators for occupational therapy practice in MH, and analyze differences in respondent or country level characteristics. The study involved secondary ecological analysis of survey responses. The survey was developed and disseminated by the World Federation of Occupational Therapists. Ordinal logistic regressions were used to determine whether individual- and country-level variables (e.g., demographic, socio-economic factors) significantly affected the survey responses. Survey responses (n = 1102) were obtained from 67 countries or territories. Of the nine surveyed factors, six (66%) were rated more often as barriers for practice, including “waiting times”, “services funding”, “intervention costs”, and “therapists availability”. “Screening & referral” and having “education /preparation for MH” were practice facilitators. Responses did not substantially vary by respondent or country-related factors, except for the Socio-Demographic Index which substantially and significantly affected the response pattern for “safety concerns” (estimate: 11.08; 95% CI:7.09-15.07; p<.0001). The results of this large worldwide survey of occupational therapists on the facilitators and barriers for practice in MH can help inform strategies to strengthen practice in this field. While referral and screening mechanisms should be reinforced to facilitate access to occupational therapy, such actions need to be complemented with adequate service funding, career attractiveness, and therapist availability; otherwise, increased service demands may result in unmet needs and service constraints. Further research is needed to investigate why “safety concerns” was a reported barrier particularly for countries with a lower Socio Demographic Index.
- Education of occupational therapists in mental health: A global survey of educators regarding perceived facilitators and barriersPublication . Jesus, Tiago S.; Monteiro, Pedro C.; Ledgerd, Ritchard; Zweck, Claudia von; Costa Monteiro, PedroOccupational therapists can address worldwide mental health (MH) needs and workforce shortages. Ways to advance occupational therapy education to build occupational therapist workforce capacity in MH require further investigation. This study aimed to identify perceived barriers to and facilitators for advancing MH occupational therapy education, as rated by occupational therapy educators from across the world, stratified into groups of high-income countries (HICs) and low- and middle-income countries (LMICs). Global survey, Likert-type, created and distributed by the World Federation of Occupational Therapists. Data were subject to a secondary weighted and subgroup analysis. A total of 155 responses were obtained from occupational therapy educators from 45 countries or territories; 69% of the respondents were from HICs. The weighted analysis showed that educational standards and student interest were large facilitators for both HICs and LMICs. Faculty expertise stood out as a facilitator and the lack thereof as a barrier, both across HICs and LMICs. For HICs, regulation issues, lack of recognition, lack of supervised/fieldwork practice, and lack of workforce demand were frequently reported barriers, whereas lack of teaching resources and practice evidence were often perceived as barriers in LMICs. Capacity building approaches are required to advance MH occupational therapy education, with tailored approaches for HICs and LMICs.