Browsing by Author "Santos, Osvaldo"
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- COVID-19, wellness and life satisfaction in adolescence: individual and contextual issuesPublication . Matos, Margarida Gaspar de; Carvalho, Marina; Branquinho, Cátia; Noronha, Catarina; Moraes, Bárbara; Gaspar, Tania; Guedes, Fábio Botelho; Cerqueira, Ana; Santos, Osvaldo; Rodrigues, Nuno NetoDuring and in the aftermath of the COVID-19 pandemic, several works reflected on young people’s physical and psychological health. The Dual Factor Model, which we refer to as the quadripartite model, is useful for understanding children’s and adolescents’ psychological health and differentiating them regarding their attitude toward the effects of the COVID-19 pandemic. In this investigation, students from the fifth to twelfth year of schooling enrolled in the DGEEC study “Psychological Health and Wellbeing in Portuguese schools” were considered. Four groups were created based on life satisfaction (low or high) and psychological distress (with or without symptoms). The study included 4444 students (M = 13.39 years ± 2.41), of whom 47.8% were male. Of the participants, 27.2% were in the second cycle of primary education, and 72.8% were in lower and upper secondary education. Differences in gender and education level (as a proxy for age) were observed. Additionally, when considering students’ perceptions of changes in their lives following the COVID-19 pandemic (stayed the same, became worse, became better), these three groups were compared concerning personal and contextual variables, revealing significant differences at both the individual and contextual levels. Finally, the study discusses the influence of education and health professionals and the need for friendly public policies.
- Effectiveness of social prescribing programs in the primary health-care context: a systematic literature reviewPublication . Costa, Andreia; Sousa, C. Joana; Seabra, Paulo Rosário Carvalho; Virgolino, Ana; Santos, Osvaldo; Lopes, Joaquim; Henriques, Adriana; Nogueira, Paulo; Alarcão, VioletaSocial prescribing (SP) is an approach that promotes the use of local non-clinical activities by people. The referral is usually made by primary health-care professionals, in a process wherein local providers play a pivotal role. The main objective of this study was to identify domains of intervention and evidence about the effectiveness of SP programs regarding health-related outcomes. A systematic literature review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in PubMed, CINHAL, and SCOPUS. Inclusion criteria of the reviewed papers were as follows: (i) effectiveness studies of interventions designated as SP or interventions entailing SP conceptual components; (ii) interventions with adults. Quality assessment was performed with the Cochrane tool for assessing risk of bias in randomized trials; an assessment tool developed by the US National Heart, Lung and Blood Institute was applied to observational studies. Overall, 13 articles were included for analysis, with a total of 4603 patients. Although three studies comprised a control group, only two followed a randomized controlled trials (RCT) design. Nine principal domains of intervention within SP were identified, with three categories of outcome measures: Physical and psychological wellbeing; Health behaviors and self-efficacy; and Health care resources end economic evaluation. SP is an emergent and promising health-care intervention, and it has been used to promote different health behaviors. Evidence of SP effectiveness on patient’s health and wellbeing is not strong. Further research is needed for understanding how SP can be applied efficiently.
- Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approachPublication . Alarcão, Violeta; Candeias, Pedro; Stefanovska-Petkovska, Miodraga; Neves, Júlia; Pintassilgo, Sónia; Machado, Fernando Luís; Santos, Osvaldo; Virgolino, Ana; Santos, Ricardo R.; Heitor, Maria João; Costa, AndreiaBackground: The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people’s lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. Methods: To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. Results: The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals’ resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. Conclusions: Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.
- Mental health of healthcare professionals: two years of the COVID-19 pandemic in PortugalPublication . Costa, Alexandra; Almeida, Teresa Caldas de; Fialho, Mónica; Rasga, Célia; Martiniano, Hugo; Santos, Osvaldo; Virgolino, Ana; Vicente, Astrid Moura; Heitor, Maria JoãoThe COVID-19 pandemic increased psychosocial risk factors among healthcare professionals (HCPs). Objective: To characterize Portuguese HCPs mental health (MH), estimate anxiety, depression, post-traumatic stress disorder (PTSD) and burnout symptoms, and identify risk/protective factors. A cross-sectional online survey and a longitudinal assessment were conducted in 2020 (T0) and 2021 (T1). Sociodemographic and occupational variables, COVID-19-related experiences and protective behavior data were collected from a non-probabilistic sample of HCPs in Portugal. Symptoms of anxiety, depression, PTSD, burnout and resilience were assessed using the Portuguese versions of the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-9), the Post-traumatic Stress Disorder Checklist (PCL-5), the Shirom-Melamed Burnout Measure (MBSM) and the Connor-Davidson Resilience Scale (CD-RISC-10), respectively. Risk and protective factors were identified through simple and multiple logistic regression models. Overall, 2027 participants answered the survey in T0 and 1843 in T1. The percentage of moderate-to-severe symptoms decreased from T0 to T1; however, a considerable proportion of HCPs reported symptoms of distress in both years. Being a woman, working in a COVID-19-treatment frontline position and work-life balance increased the odds of distress. High resilience, good social/family support, and hobbies/lifestyle maintenance were found to be protective factors. Globally, our results show that performing as a HCP during the pandemic may result in long-term effects on MH.
- Nutritional counselling in adults promoting adherence to the Mediterranean diet as adjuvant in the treatment of major depressive disorder (INDEPT): a randomized open controlled trial study protocolPublication . Sousa-Santos, Nuno; Fialho, Mónica; Madeira, Teresa; Clara, Cátia; Veiga, Sofia; Martins, Raquel; Barros, Neuza; Santos, Gabriela; Santos, Osvaldo; Almeida, Carolina; Ganança, Licínia; Campos, Rui C.; Camolas, José; Silva, Alda Pereira da; Guarino, Maria Pedro Sucena; Heitor, Maria JoãoBackground: Major Depressive Disorder (MDD) is a leading cause of disability worldwide. Approximately one-third of patients with MDD do not respond to treatment, and often exhibit elevated inflammation biomarkers, which are associated with worse prognosis. Previous research has linked healthier dietary patterns, such as the Mediterranean Diet (MedDiet), with a lower risk of MDD and symptoms of depression, potentially due to their anti-inflammatory properties. The aim of this study is to evaluate the effectiveness of a nutritional counselling intervention promoting MedDiet to alleviate symptoms of depression in adults recently diagnosed with MDD and presenting with elevated inflammation biomarkers. Methods: This study is a randomized controlled trial (RCT) that will recruit adults from outpatient clinics, between the ages of 18 and 70 years who have been diagnosed with MDD and are currently receiving treatment with the first prescribed antidepressant, and who exhibit elevated inflammation biomarkers (interleukin-6 and/or C-reactive protein). The control group will receive treatment-as-usual (TAU) only. The primary outcome of the study will be the change in symptoms of depression, as measured by the Beck Depression Inventory 2 (BDI-II), after 12 weeks of intervention. Data analysis will follow an intention-to-treat approach. Secondary outcomes will include changes in inflammation biomarkers, quality of life, adherence to the MedDiet, and cost-effectiveness of nutritional counselling. All outcomes will be assessed at baseline, after the 12-week intervention, and at 6- and 12-months post-baseline. Discussion: This study will be the first RCT to evaluate the effect of a nutritional intervention with anti-inflammatory properties, as an adjuvant in the treatment of MDD, in individuals diagnosed with MDD and elevated inflammation biomarkers. The results of this study may contribute to the development of more effective and personalized interventions for MDD patients with elevated inflammation biomarkers.