Portuguese Health Professionals Research Articles

Music in Dementia Assessment Scales (MiDAS) portuguese version: Translation, cultural adaptation and psychometric study

AbstractBackgroundMusic in Dementia Assessment Scales (MiDAS) is an observational, dementia‐specific, visual analogue scale, developed to measure musical experiences of patients with dementia (PwD). Derived from qualitative data of focus groups and interviews with PwD, carers, care home staff, and music therapists, it revealed acceptable to good psychometric properties in a preliminary study. We aim to describe the translation and cultural adaptation of MiDAS to European Portuguese, and the results of a preliminary psychometric evaluation.MethodA rigorous ten step approach, suggested by the authors of MiDAS, was followed, for translation and cultural adaptation. It included: two forward translations and a back translation by a bilingual professional translator; harmonization with versions in different languages; testing and debriefing the final version with health professionals.For the psychometric study, care home residents with dementia attended a bi‐weekly group music‐based intervention (Mbi), for up to ten sessions. Intervention coordinators and care home staff completed MiDAS ratings at every session and the Quality‐of‐Life Scale (QoL‐AD) was completed at three time‐points. Inter‐rater and test‐retest reliability, internal consistency, concurrent and construct validity of MiDAS were evaluated.ResultNo major changes have been made to the actual content of MiDAS. Minor adjustments were made in wording and additional instruction details were added, to increase clarity and adequacy to the Portuguese setting.A total of 529 MiDAS‐PT forms (Staff = 235, Therapist = 294) were completed during the psychometric study. Our analysis indicated low therapist inter‐rater and test‐retest reliability, good internal consistency, low concurrent validity, and good construct validity. High factor loadings between the five MiDAS items (Interest, Response, Initiation, Involvement, and Enjoyment) were found.ConclusionOverall, Portuguese health professionals considered MIDAS‐PT user friendly and intuitive in terms of content and structure. More research is needed, with a larger sample, providing a more in‐depth psychometric characterization.

On the reception of biomedical translation: comparing and contrasting health professionals’ evaluation of translation options and expectations about the safe use of medical devices in Portuguese

ABSTRACT Little is known about health professionals’ evaluation of translation options and expectations about communicating risks concerning the use of medical devices. Since translators’ decisions are (at least partially) based on what they believe readers expect from the translated product, investigating health professionals’ reception of translated medical texts is particularly useful. Adopting a cross-disciplinary approach to the study of translation norms, this article reports on a questionnaire involving 34 Portuguese health professionals who were asked to evaluate translated instructions for a medical device. This evaluation was followed by questions on the health professionals’ expectations. The results suggest that readers’ expectations about how translators should translate do not coincide with their evaluation of translation options. In other words, the findings point to a contradiction between what health professionals say translators should do when translating biomedical texts and what are their preferred translation options when evaluating translated excerpts. We believe these findings can contribute to the awareness of health professionals’ dominating discourses of faithfulness and fidelity towards the original in the translation of biomedical texts and their influence on perceptions of quality. These discourses, as the findings suggest, can have implications on how readers perceive how translators should translate.

Impact of Covid-19 on mental health of Portuguese health professionals – longitudinal study, phase I

IntroductionThe Covid-19 pandemic brought enormous challenges for health professionals. As in past epidemics, the uncertainty, danger and fear of contamination and an excessive load of work under dramatic conditions may contribute to aggravate the mental health of health professionals.ObjectivesExplore how the Covid-19 crisis impacted the mental health of healthcare workers and how their mental status relates with perspectives on the recent past and near future.MethodsA longitudinal study will be applied in two phases, Q1 and Q2, one year apart, to evaluate depression, anxiety and post-traumatic stress among health professionals from a healthcare center in Portugal. Phase Q1 is concluded and comprised the Depression, Anxiety and Stress Scale (DASS-21), the Impact of Event Scale – Revised (IES-R) and a questionnaire about the past and the future.ResultsThe IES-R scale revealed that nurses are at a higher risk of developing post-traumatic stress disorder (PTSD) than other professionals. The levels of depression and anxiety in the DASS-21 show no significant differences. Interestingly, professionals who worked almost exclusively at inpatient wards show higher levels of depression, anxiety and stress than those who worked at several hospital units (emergency, inpatient and outpatient units). A positive correlation was found between depression and anxiety and negative perspectives about the past and the future.ConclusionsCovid-19 posed a terrible challenge for health professionals. Its impact on the mental health of healthcare workers may be significant even after the pandemic is under control.DisclosureNo significant relationships.

What determines health professionals' COVID-19 vaccine hesitancy? A nationwide study.

IntroductionTo contain the COVID‐19 pandemic, higher vaccination rates are essential. However, as vaccine hesitancy is a reality, it is important to understand what drives health professionals to refuse getting vaccinated against COVID‐19, who have been in the frontline of this pandemic since its beginning and may be key actors to improve vaccine coverage among their patients.PurposeThis study aims to assess the factors associated with vaccine hesitancy (VH) among health professionals (physicians, nurses, pharmacists and dentists).MethodsA nationwide cross‐sectional study was conducted through an online survey, with 890 Portuguese health professionals. A logistic regression analysis was used to determine the adjusted odds ratio (OR) of the independent variables (perceptions, knowledge and attitudes) per 1‐point increase in the Likert scale and VH.ResultsComplacency, communications, confidence and convenience were strongly associated with VH probability. Concerns about vaccines’ efficacy (ORPhysicians = 8.33, 95% CI: 4.51–15.36) and safety (ORNurses = 11.07, 95% CI: 4.12–29.77) increase the risk of VH on all health professional groups. A reduction of VH probability is associated with higher risk perceptions of getting infected (1/ORNurses = 2.76, 95% CI: 1.52–5.02) and suffering complications (1/ORNurses = 33.72, 95% CI: 8.48–134.13), higher confidence in the effectiveness of COVID‐19 vaccines (1/ORDentists = 12.29, 95% CI: 2.91–51.89), risk perception of getting infected if vaccinated (1/ORPhysicians = 14.92, 95% CI: 6.85–32.50), risk of suffering from complications after getting vaccinated, and higher trust levels on the information transmitted by competent authorities (1/ORDentists = 17.76, 95% CI: 3.83–82.22).ConclusionsTo reduce COVID‐19 VH, which appears to be highly influenced by perceptions, knowledge and attitudes, it is essential to promote interventions directed to transforming these potentially modifiable determinants.

Portuguese translation and cultural adaptation of the Music in Dementia Assessment Scales (MiDAS)

ABSTRACT Introduction Music in Dementia Assessment Scales (MiDAS) is an observational, dementia-specific, visual analogue scale, developed to measure musical experiences of patients with dementia (PwD). It was derived from qualitative data from focus groups and interviews with PwD, carers, care home staff, and music therapists. Since its publication, there has been great interest in using MiDAS in several European countries, including Portugal. However, no adaptation to Portuguese language and culture is yet available. In this manuscript, we aim to describe the process of translation and cultural adaptation of MiDAS to European Portuguese, presenting the final MiDAS-PT version. Method We have followed a rigorous 10-step approach, consisting of: a preparation stage; elaboration of two forward translations; synthesis of the latter versions; back-translation by a bilingual professional translator; revision of that version by the original author of MiDAS; harmonization with other versions of MiDAS in different languages; testing and debriefing of the final version with volunteer health professionals; consensus meetings; proofreading; and, finally, the reporting of the process. Results No major changes have been made to the actual content text of MiDAS. Some minor adjustments were made to the wording, and additional instruction details were added in order to increase clarity and adequacy in the Portuguese setting. Discussion Overall, Portuguese health professionals considered the instrument to be user-friendly and intuitive in terms of content, structure and layout. To allow the use of MiDAS-PT for research and clinical purposes, the next step will be a study of its psychometric properties.

The breastfeeding self-efficacy scale-short form: Psychometric characteristics in Portuguese pregnant women

BackgroundThe Breastfeeding Self-Efficacy Scale-Short Form is a reliable instrument to measure mother's confidence in her ability to breastfeed. The Breastfeeding Self-Efficacy Scale-Short Form has traditionally been used postnatally, but evidence suggests that it can be used antenatally to identify mothers at-risk of requiring additional support to improve breastfeeding outcomes. ObjectiveThe aim of this study was to examine the psychometric characteristics of an antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form, among pregnant Portuguese women. DesignMethodological prospective study to examine the psychometric characteristics of the antenatal Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form. SettingsTwo public hospital units in the Northern Portugal. ParticipantsThe sample was comprised of 373 pregnant women recruited at 30–34 gestational weeks. MethodsThe original English version of the antenatal Breastfeeding Self-Efficacy Scale-Short Form was translated into Portuguese and the Portuguese antenatal version of the scale was tested in a sample of 373 pregnant women. To examine the psychometric characteristics of the Portuguese antenatal version of the scale, the maternal demographic variables and the depressive and anxiety symptomatology of the participants were examined. The predictive validity of the Portuguese antenatal version of the scale was studied according to infant feeding method at one, three, and six months postpartum. ResultsThe Cronbach's alpha coefficient was 0.92. The antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form scores were found to be associated with women's parity, educational level, occupational status, time they intend to breastfeed, and previous breastfeeding experience. Also, the antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form scores significantly predicted exclusive breastfeeding at 1 month postpartum. ConclusionsResults provided evidence that the antenatal Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form is a valid and reliable measure to assess breastfeeding self-efficacy in pregnant women. The antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form could be a useful tool to assist Portuguese health professionals during routine prenatal care appointments to screen women with lower antenatal breastfeeding self-efficacy and, consequently, those that could be at risk for not initiating or early breastfeeding cessation.

Justifying treatment bias: The legitimizing role of threat perception and immigrant–provider contact in healthcare.

Immigrants tend to receive a lower quality of healthcare, which can be a sign of healthcare bias. We examined whether this bias in medical care is associated with a legitimizing process involving two psychosocial factors: threat perception and level of intergroup contact. One hundred eighty six Portuguese health professionals (55.6% clinicians; 44.4% nurses; 78.5% female; Mage = 45.83, range = 23 and 71) completed a questionnaire on prejudiced attitudes toward immigrants, perceptions of health-specific threats, bias in medical practice and level of contact with immigrant patients. For healthcare providers who have more contact with immigrant patients, the perceived health threat mediated the relationship between prejudiced attitudes and treatment bias. In contrast, for healthcare providers with less contact with immigrant patients, the perceived threat was not associated with treatment bias. These findings help to understand the persistence of lower quality medical treatment among immigrants, providing guidelines for future research. In particular, they suggest that perceiving immigrants as a threat to public health is indicative of the providers' engagement in a legitimizing process of self-reported biased treatment, making this engagement necessary only for providers with greater levels of contact with immigrant patients. (PsycINFO Database Record

Health Support Directed at Lesbian, Gay and Bisexuals: Socio-demographic Context and Education

Abstract Introduction: Promoting the dignity of people and equality of access to care are two fundamental pillars of good healthcare practice. Thus, producing evidence on educating and investigating competencies and practices aimed at lesbian, gay and bisexual (LGB) clients and their determinants constitute synergetic strategies which are necessary to ensure excellent health care for this particular group. Objective: To analyse the effects of the socio-demographic conditions and training in the care competence and practices carried out by health professionals for lesbian, gay and bisexual clients. Methodology: Descriptive study carried out on a sample of 119 Portuguese health professionals, the majority of whom are female with an average age of 37.90 years. Instruments:Sexual Orientation Counselor Competency Scale Citation (Bidell,2005) Correlates of Homophobia and Gay Affirmative Practice in Rural Practitioners (Crisp,2002), adapted by Pereira & Cunha (2014) . Results: Health professionals with an age ≤ 31years and with specific training in psychological intervention were shown to have greater affirmative competence. 47.1% were shown to be competent professionals, 26.9% being highly competent and 26% incompetent. The health professionals with the highest competence were also the ones with the best health practices (66.7%). Conclusion: The results show the existence of a significant association between the socio-demographic variables and healthcare practices. They also show that the health professionals with the least competence also used inadequate healthcare practices for LGB clients. Training in affirmative competencies should provide for ethically guided therapeutic interventions which are culturally accessible and socially inclusive and thus ensuring the effectiveness of health systems.

Burnout em Profissionais da Saúde Portugueses: Uma Análise a Nível Nacional

<p><strong>Introduction:</strong> Burnout is a psychological syndrome, characterized by a state of high emotional exhaustion, high depersonalization and low personal accomplishment, which leads to erosion of personal, professional and health values. This study reports the incidence of burnout in Portuguese Healthcare professionals.<br /><strong>Material and Methods:</strong> Burnout in Portugal’s health professionals was assessed with the Maslach Burnout Inventory - Human Services Survey, using a zero (never) to six (always) ordinal scale, on a sample of 1 262 nurses and 466 physicians with mean age of 36.8 year (SD = 12.2) and 38.7 (SD = 11.0), respectively. Participants came from all national districts (35% Lisbon, 18% Oporto, 6% Aveiro, 6% Setúbal, 5% Coimbra, 5% Azores and Madeira), working in hospitals (54%), Families’ Health Units (30%), Personalized Health Units (8%) and other public or private institutions (8%).<br /><strong>Results:</strong> Analysis of MBI-HSS scores, stratified by district, revealed that both types of professionals had moderate to high levels of burnout (M = 3.0, SD = 1.7) with no significant differences between the two groups. Vila Real (M = 3.8, SD = 1.7) and Madeira (M = 2.5, SD = 1.5) were the regions where burnout levels were higher and lower, respectively. Burnout levels did not differ significantly between Hospital, Personalized Health Units and Families’ Health Centers. Professionals with more years in the function were less affected by Burnout (r = -0.15). No significant association was observed with the duration of the working day (r = 0.04). The strongest predictor of burnout was the perceived quality of working conditions (r = -0.35).<br /><strong>Discussion:</strong> The occurrence of the burnout syndrome in Portuguese health professionals is frequent, being associated with a poor working conditions perception and reduced professional experience. The incidence of the burnout syndrome shows regional differences which may be associated with different and suboptimal conditions for health care delivery. Results suggest the need for interventions aimed at improving working conditions and initial job training of health professionals, as requisites for a good professional practice and personal well-being.<br /><strong>Conclusions:</strong> At the national level, between 2011 and 2013, 21.6% of healthcare professionals showed moderate burnout and 47.8% showed high burnout. The perception of poor working conditions was the main predictor of burnout occurrence among the Portuguese health professionals.</p>

Burnout in Portuguese Healthcare Professionals: An Analysis at the National Level

Burnout is a psychological syndrome, characterized by a state of high emotional exhaustion, high depersonalization and low personal accomplishment, which leads to erosion of personal, professional and health values. This study reports the incidence of burnout in Portuguese Healthcare professionals. Burnout in Portugal's health professionals was assessed with the Maslach Burnout Inventory - Human Services Survey, using a zero (never) to six (always) ordinal scale, on a sample of 1 262 nurses and 466 physicians with mean age of 36.8 year (SD = 12.2) and 38.7 (SD = 11.0), respectively. Participants came from all national districts (35% Lisbon, 18% Oporto, 6% Aveiro, 6% Setúbal, 5% Coimbra, 5% Azores and Madeira), working in hospitals (54%), Families' Health Units (30%), Personalized Health Units (8%) and other public or private institutions (8%). Analysis of MBI-HSS scores, stratified by district, revealed that both types of professionals had moderate to high levels of burnout (M = 3.0, SD = 1.7) with no significant differences between the two groups. Vila Real (M = 3.8, SD = 1.7) and Madeira (M = 2.5, SD = 1.5) were the regions where burnout levels were higher and lower, respectively. Burnout levels did not differ significantly between Hospital, Personalized Health Units and Families' Health Centers. Professionals with more years in the function were less affected by Burnout (r = -0.15). No significant association was observed with the duration of the working day (r = 0.04). The strongest predictor of burnout was the perceived quality of working conditions (r = -0.35). The occurrence of the burnout syndrome in Portuguese health professionals is frequent, being associated with a poor working conditions perception and reduced professional experience. The incidence of the burnout syndrome shows regional differences which may be associated with different and suboptimal conditions for health care delivery. Results suggest the need for interventions aimed at improving working conditions and initial job training of health professionals, as requisites for a good professional practice and personal well-being. At the national level, between 2011 and 2013, 21.6% of healthcare professionals showed moderate burnout and 47.8% showed high burnout. The perception of poor working conditions was the main predictor of burnout occurrence among the Portuguese health professionals.

A survey of spontaneous reporting of adverse drug reactions in 10 years of activity in a pharmacovigilance centre in Portugal

Reporting of adverse drug reactions (ADRs) may differ between countries. In a retrospective descriptive study we analysed the potential causative drugs and clinical situations related to spontaneously reported ADRs over 10 years to a regional pharmacovigilance centre in Portugal. We collected 3165 cases (36% of all national reports) of ADRs reported by doctors (54%), pharmacists (31%), and nurses (15%), 56% of which were classified as serious, 22% as unexpected and 13% as both serious and unexpected. According to World Health Organization causality criteria of ADRs related to drugs, 67% where probable, 20% possible, 7% conditional, 6% certain and 1% unclassifiable or unlikely. There was a predominance of females (66%, P < 0.005) both for total and serious ADRs. Physicians, while working in hospitals, reported more (68%) and more serious ADRs (75%) than those working in primary care (29%). Pharmacists working outside hospitals reported more (90%) than those working in hospitals. Drugs more frequently associated with ADRs were antibiotics (22%), followed by vaccines (16%), drugs acting on the nervous system (15%), non-steroidal anti-inflammatory drugs (14%) and those working on the cardiovascular system (11%). The most common systems, organs or disorders affected by ADRs were skin manifestations (21%), followed by general disorders (20%), gastrointestinal/hepatobiliary disorders (15%), nervous system disorders (11%) and immune system disorders (6%). Our study shows a general commitment of Portuguese health professionals to ADR reporting with a clear predominance of serious rather than non-serious ADRs. This study may help to improve the recognition of the general aspects of ADRs occurring in Portugal.

Suicídio de um paciente: a experiência de médicos e psicólogos portugueses

ObjectiveTo describe the impact of a patient suicide on Portuguese health professionals (psychologists, psychiatrists and general physicians). MethodA self-report questionnaire, which assessed the characteristics, experience and impact of a patient suicide, was used. Results242 health professionals filled the questionnaire and 64 professionals had been confronted with at least one patient suicide. Emotional suffering (47%), concerns, doubts and fear (35%), frustration (28%) and shock and surprise (23%) were the most common feelings reported by health professionals. Increased attention, vigilance and accuracy in assessment and intervention were the most frequent reaction after the patient suicide (80%). Increased insecurity and anxiety were also reported (28%). Colleagues, contact with patient's family and case review were the sources of help more frequently used, and supervisor, team case review and colleagues were rated as the most useful. There were no differences according to gender, age or professional group in the experience of this event. ConclusionThe results show that the suicide of a patient has a considerable professional and emotional impact. However, this difficult event can also be an opportunity for learning and professional growth leading to positive and adequate changes in clinical practice with regard to the management of suicide risk and its aftermath.

Attitudes of Portuguese health professionals toward adverse drug reaction reporting

Adverse drug reactions are a major public health problem. Underreporting is an important limitation of all reporting systems, partially due to attitudes of health professionals. This study sought: (1) to evaluate the reproducibility of a questionnaire on attitudes to and knowledge of adverse drug reaction (ADR) reporting among physicians, nurses and pharmacists: and (2) to compare the attitudes and knowledge of these three groups of health professionals. This study targeted a sample of physicians (n = 30), nurses (n = 30) and pharmacists (n = 20) in the central region of Portugal. A structured questionnaire was administered to each health professional twice, at an interval of 2-4 weeks. Most attitudes were based on Inman's 'seven deadly sins' and measured using a continuous visual analog scale (VAS), with answers scored from 0 (total disagreement) to 10 (total agreement). Questionnaire reproducibility was determined using the intraclass correlation coefficient (ICC). The response rate was 100 %. Attitudes that registered the highest ICCs were Complacency (the belief that really serious ADRs are well documented by the time a drug is marketed) (physicians, ICC 0.84; nurses, ICC 0.70; pharmacists, ICC 0.99), and Diffidence (the belief that one would only report an ADR if one were sure that it was related to the use of a particular drug) (physicians, ICC 0.73; nurses, ICC 0.65; pharmacists, ICC 0.98). In most cases, there were no differences among the three groups of professionals in terms of attitudes and knowledge. The Horizontal continuous VAS is reliable to detect the knowledge and attitudes about ADRs.

Measuring Job Satisfaction in Portuguese Health Professionals: Correlates and validation of the job descriptive index and the job in general scale

This paper presents the psychometric properties of the job descriptive index (JDI) and job in general (JIG) instruments in a Portuguese sample of health professionals from hospitals and health centers. Demographic and professional correlates of job satisfaction are also investigated. The sample consists of 1,314 health professionals including physicians, nurses, administrators, and diagnostic technicians. The results show high internal consistency coefficients for the scores on the JDI subscales and the JIG scale, ranging from .75 to .90. The data supported the 5‐factor structure of the JDI scales. The factor analyses and the correlation coefficients did not support the distinction between an overall job satisfaction measure and the evaluation of the satisfaction with the present work. The results offer empirical support for the Portuguese adaptation of the JDI and JIG scales. Level of education emerged as the most important demographic correlate of job satisfaction facets and global satisfaction, and supervisory role as the most significant professional correlate.