Gina Tomé

A influência da comunicação com a família e grupo de pares no bem-estar e nos comportamentos de risco nos adolescentes Portugueses

The purpose of this study was to analyze the influence of parents and peer group on health and risky behaviors of Portuguese adolescents. It was studied the type of communication that adolescents have with their parents and with peers. The sample consisted of subjects who participated in a study performed in Portugal, which incorporates the European HBSC-Health Behavior in School-aged Children study. The study included a total of 4.877 students in 6th, 8th and 10th grades of public school in Portugal, with an average age of 14 years old. The overall results revealed that good communication with parents has a more protective effect on adolescents risky behavior than good communication with friends. Adolescents with closer and better communication with their parents and friends have also revealed to have a happier and more pleased life. The results highlight the importance of communication and positive relationship simultaneously with parents and peers.

Living conditions and quality of care in residential units for people with long-term mental illness in Portugal--a cross-sectional study.

BackgroundAs in most European countries, mental health care has shifted from large hospitals to smaller community based settings in Portugal. Our study objectives were to determine: a) the characteristics of users of mental health residential facilities in Portugal; b) the quality of care provided comparing community and hospital units; and c) to investigate associations between quality of care, service and service users’ characteristics and experiences of care.MethodsAll longer term mental health units in Portugal providing on-site staffed support for at least 12xa0h per day were assessed with the Quality Indicator for Rehabilitative Care (QuIRC), a standardised tool completed by the unit manager. The QuIRC rates seven domains of care (Living Environment, Therapeutic Environment, Treatments and Interventions, Self/Management and Autonomy, Recovery Based Practice, Social Inclusion, and Human Rights). A random sample of service users were interviewed using standardised measures of autonomy, experiences of care and quality of life.ResultsMost (60xa0%) of the 42 units were in Lisbon and surrounding districts with 50xa0% based in the community and 50xa0% in hospital settings. They had a mean of 11.5 beds. Service users (nu2009=u2009278) were mainly men (66.2xa0%), with a diagnosis of schizophrenia (72.7xa0%), and a mean age of 49.4xa0years. Community units scored higher than hospital units on the Living Environment, Treatments and Interventions, and Self-Management and Autonomy domains of the QuIRC. Increased service user age was negatively associated with all but one domain. All QuIRC domains were positively associated with service users’ autonomy and experiences of care.ConclusionsInvesting in better quality, community based mental health facilities is associated with better outcomes for service users who require longer term support.

Depressão e coping em crianças e adolescentes portugueses

The goal of this study was to analyze the relation of depression and coping strategies between themselves and according to age and gender. The sample was constituted of 916 children and adolescents, of both genders, with an average age of 14.4 years (DP=2.62), enlisted randomly in public schools from different regions of Portugal (Trás-os-Montes and Alto Douro, Beira Interior, Estremadura and Ribatejo and Region of Lisbon). In each chosen school two groups where drafted, each group belonging to a different school year, between 5o to 12o grades, correspondent in Portugal to a school passage between 10 and 18 years old. The used measures of evaluation were the Children’s Depression Inventory CDI (Kovacs, 1992) and the Coping Responses Inventory Youth Form CRI-Y (Moos, 1993). The results suggest that the group of young adults (18-22 years) and girls presented higher levels of depression and use of coping strategies, comparatively to the groups of pre-adolescents (10-13 years), adolescents (14-17 years) and boys. A negative relation between depression and coping was observed, therefore when depressive symptoms increased, the use of coping strategies decreased. These results were confirmed when we observed differences between depression symptoms and coping, where the groups that had demonstrated less depression symptoms or an average level of symptoms presented higher values of coping strategies. In general, the study suggested that girls and older adolescents are more depressed and use less efficient coping strategies to deal with stressful events.

Estratégias de Auto-Regulação em Pré-Adolescentes e Adolescentes: Versão Portuguesa do TESQ-E

Self-regulation plays a key role in the eating behavior of children and adolescents, while facing the environment temptations. The Tempest Self-Regulation Questionnaire (TESQ-E; www.tempestproject.eu) is an instrument for measuring cross-cultural self-regulation. It has been constructed, adapted and translated into nine European Countries within the TEMPEST project. This article aims to study the validation of the Portuguese version of the instrument. The sample includes 1200 Portuguese pre-adolescents and adolescents, of average age 12.5 years (SD = 1.61) between nine and 17 years of age, 48.3% boys, from different educational grades: 5th grade (16.8%), 6th grade (19.8%), 7th grade (30.8%), 8th grade (17.8%) and 9th grade (14.9%). The Portuguese version of the instrument demonstrated good psychometric properties and kept the factor structure of the original version: three dimensions, which include six strategies for self -regulation, two in each dimension. The most popular dimension was Maintaining healthy eating objectives, and the less popular Change the meaning of temptation. The study concluded that the TESQ-E is a reliable instrument to estimate the self-regulation strategies in children and adolescents. Psychometric guidelines are presented to the Portuguese population aged nine to 17 years old.A auto-regulacao tem um papel fundamental no comportamento alimentar em criancas e adolescentes face as tentacoes do ambiente. O Tempest Self-Regulation Questionnaire for Eating (TESQ-E; www.tempestproject.eu) e um instrumento de medida da auto-regulacao transcultural que foi construido, traduzido e adaptado em nove paises europeus, no âmbito do Projeto TEMPEST. Este artigo tem como objetivo o estudo da validacao da versao Portuguesa do instrumento. Participaram da amostra 1200 pre-adolescentes e adolescentes Portugueses, com media de idades de 12,5 anos (DP=1,61), entre os nove e os 17 anos de idade, 48,3% rapazes, de diferentes niveis de escolaridade 5o ano (16,8%), 6o ano (19,8%), 7o ano (30,8%), 8o ano (17,8%) e 9o ano (14,9%). A versao portuguesa do instrumento demonstrou boas propriedades metricas, e confirmou a estrutura factorial da versao original: tres dimensoes, que incluem seis estrategias de auto-regulacao, duas em cada dimensao. A dimensao mais popular foi a Manutencao de objectivos de alimentacao saudavel, e a menos popular, Mudanca do sentido atribuido as tentacoes. Conclui-se que o TESQ-E e um instrumento confiavel para estimar as estrategias de auto-regulacao em criancas e adolescentes. Orientacoes psicometricas sao apresentadas para a populacao portuguesa entre os nove e os 17 anos.

Depressão, rendimento escolar e estratégias de coping em adolescentes

The present study’s main objective is to verify if low school success adolescents possess greater incidence of depression symptoms and use less coping strategies than higher school success adolescents. Two hundred and forty two adolescents from four Odivelas schools, ages between 10 and 16 years old, constituted the sample. To operacionalizate variables two measures of evaluation were used, the Children‘s Depression Inventory CDI (Kovacs, 1992) and Coping Responses Inventory Youth Form – CRIY (Moos, 1993). The final results confirmed that low success adolescents had more depression symptoms, however it did not confirm that these adolescents used fewer coping strategies than higher school success adolescents.

Trends in Portuguese Adolescents’ Sexual Behavior from 2002 to 2014: HBSC Portuguese Study

This study examined trends in adolescent sexual behaviors from 2002 to 2014 in Portugal. Data were collected using self-reported questionnaires from 8th and 10th graders in classrooms during 2002, 2006, 2010, and 2014. Overall, the prevalence of sexual intercourse, age of sexual initiation, pill use, and sexual intercourse under the influence of alcohol or drugs decreased in Portugal between 2002 and 2014, while condom use increased. Boys and 10th graders more frequently reported having ever had sexual intercourse, boys and 8th graders more frequently reported having had sexual intercourse under the influence of alcohol or drugs, girls and 10th graders more frequently reported having had their first sexual intercourse at 14 years or older (except in 2014, where boys and girls reported more frequently having initiated at 12–13 years), and girls and 10th graders reported more frequently having used condoms and the pill (except in 2014) at the last sexual intercourse. Eighth graders more frequently reported having had their first sexual experience at 12–13 years (except in 2006).

Brothers and Sisters—“More” is Better? Effects on School, Violence and Health

Aims: The aim of this study was to understand the differences between adolescents with and without brothers and sisters, in what concerns to risk behaviours, health and the relationship with their peers and family. Sample: The Portuguese HBSC (Health Behaviour in School-Aged Children) survey included a total of 6026 students where 47.7% were boys. Results: Male adolescents with three or more brothers drink and smoke more, feel sadder, are more nervous and angrier, have more worries, and more frequently act as bullies. Boys who are only child are more satisfied with life and report more frequently that they like school. Boys with more than three sisters practice more physical activity. Girls with one brother are less victimized and have better relationships with their friends.

A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial

PurposeThis study aimed to assess the efficacy of a staff-training intervention to improve service users’ engagement in activities and quality of care, by means of a cluster randomised controlled trial.MethodAll residential units with at least 12-h a day staff support (nxa0=xa023) were invited to participate. Quality of care was assessed with the Quality Indicator for Rehabilitative Care (QuIRC) filled online by the unit’s manager. Half the units (nxa0=xa012) were randomly assigned to continue providing treatment as usual, and half (nxa0=xa011) received a staff-training intervention that focused on skills for engaging service users in activities, with trainers working alongside staff to embed this learning in the service. The primary outcome was service users’ level of activity (measured with the Time Use Diary), reassessed at 4 and 8 months. Secondary outcomes were the quality of care provided (QuIRC), and service users’ quality of life (Manchester Short Assessment of Quality of Life) reassessed at 8 months. Generalized linear mixed effect models were used to assess the difference in outcomes between units in the two trial arms. The trial was registered with Current Controlled Trials (Ref NCT02366117).ResultsKnowledge acquired by the staff during the initial workshops increased significantly (pxa0≤xa00.01). However, the intervention and comparison units did not differ significantly in primary and secondary outcomes at either follow-up.ConclusionsThe intervention increased the level of knowledge of staff without leading to an improvement in service users’ engagement in activities, quality of life, or quality of care in the units.

Characteristics and Quality of Care of Residential Units for People with Long-term Mental Illness in Portugal

Introduction In Portugal, following the National Mental Health Plan (2008-2017), an increasing number of residential units for people with severe mental illness has been developed. There are no studies assessing their functioning. Objectives To characterize the Portuguese residential units with high and medium support levels, their users, and the quality of care provided. Methods Portuguese residential units for the long-term mentally ill were assessed with the Quality Instrument for Rehabilitative Care (QuIRC) filled on-line by the managers. A random sample of service users was interviewed face-to-face with the Service User Interview. Results Forty-two units (100%) were included. The majority (54.8%) was in the community, single-sex (54.8%), staffed 24 hours a day (54.8%), and had 10 or less beds (61.9%), no limit in the LOS (88.1%), and no service users in involuntary commitment (93%). All units provided access to psychologists and social workers, the majority to psychiatrists and nurses (95.2% each), auxiliaries (88.1%), and occupational therapists (73.8%). Users assessed (n=278) had a mean age of 50±11 years, and were mainly men (66.2%), with a diagnosis of schizophrenia (72.7%), a mean GAF score of 64.3±15.1, and were living in the unit for a median of 4 years. Quality of care assessed by the QuIRC was significantly higher in community versus hospital units in the following dimensions: Living Environment (p=0.030), Treatments and Interventions (p=0.035), and Self-Management and Autonomy (p=0.019). Conclusions Residential facilities for people with severe mental illness provide better quality of care in some dimensions in community versus hospital units.