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- Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre studyPublication . Teixeira, Carla; Ribeiro, Orquídea; Fonseca, António Manuel; Carvalho, Ana SofiaBackground: The provision of Intensive Care (IC) can lead to a health care provider's physical, psychological and emotional exhaustion, which may develop into burnout. We notice the absence of specific studies regarding this syndrome in Portuguese Intensive Care Units (ICUs). Our main objective is to study the incidence and risk factors of burnout in Portuguese ICUs. Methods: A self-fulfilment questionnaire containing 3 items: (i) socio-demographic data of the study population; (ii) experiences in the workplace; (iii) Maslach Burnout Inventory (MBI) - was applied to evaluate the influence of distinct factors on the prevalence of burnout among physicians and nurses working in ICUs. Results: Three hundred professionals (82 physicians and 218 nurses) from ten ICUs were included in the study, out of a total of 445 who were eligible. There was a high rate of burnout among professionals working in Portuguese ICUs, with 31% having a high level of burnout. However, when burnout levels among nurses and physicians were compared, no significant difference was found. Using multivariate analysis, we identified gender as being a risk factor, where female status increases the risk of burnout. In addition, higher levels of burnout were associated with conflicts and ethical decision making regarding withdrawing treatments. Having a temporary work contract was also identified as a risk factor. Conversely, working for another service of the same health care institution acts as a protective factor. Conclusions: A high rate of burnout was identified among professionals working in Portuguese ICUs. This study highlights some new risk factors for burnout (ethical decision making, temporary work contracts), and also protective ones (maintaining activity in other settings outside the ICU) that were not previously reported. Preventive and interventive programmes to avoid and reduce burnout syndrome are of paramount importance in the future organization of ICUs and should take the above results into account.
- A public health approach on health and retirement: what do we know about their relationship?Publication . Uva, Mafalda Sousa; Fonseca, António Manuel; Nunes, Baltazar; Dias, Carlos MatiasThe exit from active life and the ingress into a life stage in which labour activities andrelations do not exist, or could be of a different nature, is a feature of retirement.Several studies have investigated the effects of changes in health upon retirement. Severalothers have investigated the effects of retirement on health. If retirement is responsible foraffecting health, then the implementation of public health policies, aimed at improving olderindividual’s health, should take this matter into account. Similarly, the implementation ofpolitical changes in retirement age such as those that we are witnessing in Portugal shouldbe carefully planned.The aim of this work is to describe and discuss the international and national studiesconducted to improve the understanding of the relationship between health and retirement,especially between chronic diseases (and self-perceived health) and retirement, and also tohighlight the importance of studying this subject from a public health point of view inPortugal.Regarding the effects of health on retirement, self-perceived health seems to have a rel-evant effect on retirement, as well as chronic diseases, although there is less agreement inthe latter case. Findings on the impact of retirement in health are not consensual and it isthought that the nature of the analysis (cross-sectional or longitudinal), the timing and thereason for retirement, the circumstances of an individual before and after retirement andthe health measure under research could be primarily responsible for the lack of consistencyamong studies.Concerning the Portuguese population, the few studies found about health and retire-ment are focused in different health status indicators, making it difficult to reach a general conclusion. Thus the need remains for the establishment of more methodologically valid research studies in Portugal, mainly epidemiologic studies involving the quantification of association and impact measures.
- Social Network: CommentsPublication . Fonseca, António M.
- Building a model to analyse and compare social policies on ageingPublication . Bárrios, Maria João; Fernandes, Ana Alexandre; Fonseca, António M.Demographic ageing results in issues both for individuals and for organizations, with regards to social, economic and health issues. The challenge for public policies is to create the adequate resources and to adapt devices, in order to facilitate and allow an ageing process with well-being. The WHO’s proposal of Active Ageing has a great potential in guiding ageing policies, in particular local interventions. In this research we aimed to convert the active ageing concept into a practical instrument, built for use by policy-makers, researchers and stakeholders to evaluate and compare different social policies on ageing. We have proceeded to the validation of both the content and the design of the instrument, using the Delphi technique. Through the instrument created, it will be possible to analyse ageing policies from the active ageing point of view, to compare programmes and communities/organizations, to share the best policy practices and identify the least appropriate policy actions as the intervention priorities, adjusting and improving them.
- Sexualidade e envelhecimento: uma revisão de perspectivasPublication . Fonseca, António M.
- L'invecchiamento: una lettura psicologicaPublication . Fonseca, António M.
- Burnout em médicos e enfermeiros: estudo quantitativo e multicêntrico em unidades de cuidados paliativos em PortugalPublication . Pereira, Sandra Martins; Teixeira, Carla Margarida; Ribeiro, Orquídea; Hernández-Marrero, Pablo; Fonseca, António M.; Carvalho, Ana SofiaTheoretical Framework: Systematic contact with death is considered a risk factor for burnout in health, particularly for doctors and nurses who develop their professional activity in palliative care. Objectives: To study the syndrome of burnout in these professionals in Portugal. Methodology: A multicenter quantitative survey study. Results: Out of 142 professionals, 88 returned the completed questionnaire; of these, only 3% were in burnout and 13% at high risk of developing this syndrome. Professing a religion (p=.005) and having post-graduate education/training in palliative care (p=.011) were significantly and inversely associated with burnout. Conflicts with other professionals (p=.012) were significantly associated with developing this syndrome. Conclusion: Although the percentage of professionals with high levels of burnout in palliative care is low, there are risk factors that can be optimized to promote a higher well-being state among professionals.
- A experiência de bem-estar no envelhecimento patológico e no envelhecimento bem-sucedidoPublication . Fonseca, Antonio; Blom, Carolina; Morais, Mafalda; Medeiros, Sofia
- Sexualidade e envelhecimento: uma revisão de perspectivasPublication . Fonseca, António M.
- Promoção do desenvolvimento psicológico no envelhecimentoPublication . Fonseca, António M.O objetivo deste texto é apresentar as principais bases teóricas e empíricas no âmbito da promoção do desenvolvimento psicológico em pessoas idosas. A orientação da psicologia do desenvolvimento para a população idosa deve-se ao interesse partilhado por um número crescente de psicólogos no uso de abordagens desenvolvimentais do comportamento humano. Através delas tem sido possível entender melhor a plasticidade do processo de envelhecimento e a importância das relações entre os indivíduos e os seus contextos de referência para a compreensão da diversidade no decurso do desenvolvimento humano, na segunda metade da vida. A emergência de uma perspectiva desenvolvimental aplicada ao indivíduo idoso fez-se acompanhar do aparecimento de intervenções simultaneamente dirigidas ao próprio indivíduo e aos contextos comunitários a que ele pertence, tendo como elemento comum a preocupação com o respectivo desenvolvimento. As bases conceituais e empíricas mais importantes subjacentes à promoção do desenvolvimento psicológico no envelhecimento são apresentadas neste artigo, discutindo-se igualmente as implicações desta perspectiva para o desenho de programas de intervenção e para a ciência desenvolvimental, realçando a sua pertinência para a compreensão e promoção da vida das pessoas idosas.