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Carvalho, Ana Sofia

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6410-E2E3-9D74
0000-0003-1132-8880

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  • Between scientists and public: reframing public participation in science through bioethics
    Publication . Carvalho, Mónica; Carvalho, Ana Sofia; Araújo, Joana; Brites, Marta
    Discourses and techniques about the relationship between science and the public have remarkably developed in the past four decades. Science communication has become an important issue for the scientific governance. Public confidence in science, decision-making and support to democracy have changed the predominance of a top-down communication model, from scientists to public, to a more participative one – the Public Engagement with Science (PES). The Institute of Bioethics at Portuguese Catholic University, in Oporto, is doing research in the role of science in society issues and the aim of this paper is to discuss the relevance of Bioethics to improve PES. The bioethical issues seem to draw people‟s attention to certain scientific facts, confronting them with the consequences of science and improving their skills in deliberating on scientific issues. Moreover, ethics influences the way one understands public engagement, „scientific citizenship‟ or „science governance‟. The role of ethics is not to re-edit the old fashionable deficit perspective which usually focuses on the impact of science and technology from the perspective of non-experts. Ethics is a theoretical and practical reference for changing the science-making in the near future, and it makes us consider the public as playing a more important role than that of mere spectators with lack of scientific knowledge or with emotional concerns. The ethical reflection could redefine the non-experts place in the context of science, involving people with science, making them not simply aware of scientific issues but also involved in the process of decision-making. On the other hand, bioethics can also contribute to the participation of scientists in the ethical reflection that takes place outside the labs, broadening their role as citizen scientists.
    2010Conference object Open access Show more
  • Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre study
    Publication . Teixeira, Carla; Ribeiro, Orquídea; Fonseca, António Manuel; Carvalho, Ana Sofia
    Background: 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.
    2013Journal article Open access Show more
  • A água e a ética
    Publication . Araújo, Joana; Carvalho, Ana Sofia; Renaud, Michel
    2009Book part Open access Show more
  • Burnout in nurses working in Portuguese palliative care teams: a mixed methods study
    Publication . Pereira, Sandra M.; Fonseca, António M.; Carvalho, Ana Sofia
    2012Journal article Restricted access Show more
  • Compared to palliative care, working in intensive care more than doubles the chances of burnout: results from a nationwide comparative study
    Publication . Pereira, Sandra Martins; Teixeira, Carla Margarida; Carvalho, Ana Sofia; Hernández-Marrero, Pablo
    Introduction: Professionals working in intensive and palliative care units, hence caring for patients at the end-of-life, are at risk of developing burnout. Workplace conditions are determinant factors to develop this syndrome among professionals providing end-of-life care. Objectives: To identify and compare burnout levels between professionals working in intensive and palliative care units; and to assess which workplace experiences are associated with burnout. Methods: A nationwide, multicentre quantitative comparative survey study was conducted in Portugal using the following instruments: Maslach Burnout Inventory–Human Services Survey, Questionnaire of workplace experiences and ethical decisions, and Questionnaire of socio-demographic and professional characteristics. A total of 355 professionals from 10 intensive care and 9 palliative care units participated in the survey. A series of univariate and multivariate logistic regression analyses were performed; odds ratio sidelong with 95% confidence intervals were calculated. Results: 27% of the professionals exhibited burnout. This was more frequent in intensive care units (OR = 2.525, 95% CI: 1.025–6.221, p = .006). Univariate regression analyses showed that higher burnout levels were significantly associated with conflicts, decisions to withhold/withdraw treatment, and implementing palliative sedation. When controlling for socio-demographic and educational characteristics, and setting (intensive care units versus palliative care units), higher burnout levels were significantly and positively associated with experiencing conflicts in the workplace. Having post-graduate education in intensive/palliative care was significantly but inversely associated to higher burnout levels. Conclusions: Compared to palliative care, working in intensive care units more than doubled the likelihood of exhibiting burnout. Experiencing conflicts (e.g., with patients and/or families, intra and/or inter-teams) was the most significant determinant of burnout and having post-graduate education in intensive/palliative care protected professionals from developing this syndrome. This highlights the need for promoting empowering workplace conditions, such as team empowerment and conflict management. Moreover, findings suggest the need for implementing quality improvement strategies and organizational redesign strategies aimed at integrating the philosophy, principles and practices of palliative care in intensive care units.
    2016Journal article Open access Show more
  • Burnout in palliative care: a systematic review
    Publication . Pereira, Sandra Martins; Fonseca, António M.; Carvalho, Ana Sofia
    Burnout is a phenomenon characterized by fatigue and frustration, usually related to work stress and dedication to a cause, a way of life that does not match the person’s expectations. Although it seems to be associated with risk factors stemming from a professional environment, this problem may affect any person. Palliative care is provided in a challenging environment, where professionals often have to make demanding ethical decisions and deal with death and dying. This article reports on the findings of a systematic review aimed at identifying described burnout levels in palliative care nurses and physicians, and the related risks and protective factors. The main findings indicate that burnout levels in palliative care, or in health care settings related to this field, do not seem to be higher than in other contexts.
    2011Journal article Restricted access Show more
  • Children’s understanding of informed assents in research studies
    Publication . Cotrim, Hortense; Granja, Cristina; Carvalho, Ana Sofia; Cotrim, Carlos; Martins, Rui
    The assent procedure reflects an effort to enable the minor to understand, to the degree they are capable of, what their participation in the decision making process would involve. Aims: To evaluate the minors’ ability to understand the information provided to them when obtaining assent and to evaluate the opinion of the parents regarding the importance of asking the child’s assent. Methods: The sample included a total of 52 minors aged between 10 and 17 years who underwent exercise echocardiogram. The Quality of Informed Consent is divided into two parts: Part A was used to measure objective understanding and part B to measure subjective understanding. Results: The results show that the minors have a high capacity to understand the information given to them when asking for assent. A positive relationship was found between the two parts of the questionnaire. No statistically significant relationship was found between age and sex and part A and part B or between both age groups (<14 years old and ≥14 years old) and the measure. In the case of the parents, 96.6% of parents consider assent as an advantage for the child’s acceptance of health care. The opinion of the parents is not related to the age, sex or level of schooling. Conclusion: Minors showed a substantial level of understanding regarding the information provided to them. The parents considered the implementation of assent fundamental to the child’s acceptance of health care.
    2021-07Journal article Open access Show more
  • Ciência e ética em Portugal
    Publication . Carvalho, Mónica; Morais, Diogo; Magalhães, Susana; Carvalho, Ana Sofia; Teixeira, Luis Miguel Lopes
    O objectivo é apresentar o projecto "Ciência e ética em Portugal" que tem por finalidade promover a discussão sobre o desenvolvimento a dual da área da Ciência da Saúde junto da Sociedade, através das implicações éticas. Para este fim estão a ser produzidos documentários para a TV sobre ciência e questões bioéticas relacionadas. Cada documentário deve conter: informações científicas consideradas fundamentais para o entendimento dos temas; o actual cenário das investigações na área em Portugal; entrevistas a profissionais portugueses da área; Legislações vigentes ou ainda em discussão; discussões acerca dos aspectos éticos relacionados que também podem envolver entrevistas a bioeticistas. O projecto é uma iniciativa do Instituto de Bioética e do Centro de Investigação em Ciência e Tecnologia das Artes - CITAR que têm desenvolvido actividades e projectos que visam o entendimento e a divulgação da ciência a partir das suas implicações éticas. Particularmente no contexto das actividades de educação do IB, tem-se observado que as questões bioéticas parecem chamar significativamente a atenção das pessoas para determinados factos científicos. A partir desta experiência, supõe-se que a Bioética, ao confrontar os cidadãos com as consequências da ciência, poderia desenvolver as competências dos diversos públicos para a deliberação acerca das questões científicas. Como afirma Sheila Jasanoff 12005, 188), a bioética tornou-se um instrumento poderoso no planeamento das políticas em biotecnologia. Nesse sentido, parece relevante que os média, ao veicularem muitos dos temas científicos actuais, também sejam capazes de proporcionar a discussão destes temas a partir do ponto de vista ético, de modo a promover a reflexão e não apenas informar acerca dos factos científicos. Esta reflexão, aliás, parece de crucial importância para os cidadãos, estejam eles directa ou indirectamente envolvidos nos processos decisórios em torno das biotecnologias, actualmente em curso na nossa sociedade. Os temas dos documentários devem ser os mais actuais e que mais directamente podem implicar em processos de deliberação no meio político e entre os cidadãos, tais como: Procriação Medicamente Assistida, Investigação em Células Estaminais, Diagnóstico Genético de Pré-Implantação e Clonagem. Destaca-se que já foi realizado um documentário sobre a Procriação Medicamente Assistida em Portugal com o título "O desejo de ter um filho: a PMA em Portugal". Actualmente está em fase de produção o segundo documentário, sobre Células Estaminais.
    2013-05Conference object Open access Show more
  • Knowledge and behavior among health professionals in relation to cadaveric organ donation and transplantation: a questionnaire-based analysis in Portuguese Hospitals
    Publication . Melo, J.; Batista, A.; Teixeira, A.; Figueiredo, E.; Ribeiro, O.; Lopes, P.; Pina, J.; Granja, C.; Carvalho, A. S.
    Objective. To assess knowledge and behavior relative to cadaveric organ donation and transplantation among physicians and nurses working at nine Portuguese hospitals. Methods. This prospective study between May and October 2009 included 495 questionnaires that were returned among 840 that were delivered, a 59% response rate. The transplant questionnaire comprised three main sections: section 1, sociodemographic-professional variables of the participants with nine questions; section 2, generic questions on organ donation and transplantation with 12 questions; and section 3 evaluated knowledge with 20 specific questions on organ donation and transplantation. Results. Sixty-one percent of the participants were females, with 40% of the overall cohort between 31 and 40 years old; 62% married; 63% working in the emergency department; and 78% nurses. Although 78% of the participants stated that they had undergone specific training on organ donation and transplantation, 62% felt that they needed more training. The reasons evoked for the low rate of donation included difficulties in initiating the process of organ donation, in diagnosing cerebral death and in obtaining necessary human resources. There were no significant differences in knowledge between physicians and nurses concerning specific organ donation and transplantation issues. Having had specific training on organ donation and transplantation was significantly associated with correct answers to several questions, including those pertaining to knowledge of the national legislation on organ donation and transplantation. Conclusions. The present study showed a lack of specific knowledge and training on organ donation and transplantation issue. It also suggested that for hospital staff to successfully act as initiators of the organ procurement process, more information and education are necessary. This effort could significantly increase the rate of organ donation and transplantation in Portugal.
    2011Journal article Restricted access Show more
  • 2011Journal article Open access Show more