José Cunha Machado

Parent education interventions: Results from a national study in Portugal

Parenting education programmes are becoming widespread practices and are being recognized by the scientific community as promising interventions for preventing child maltreatment. However, a diversity of programme objectives and implementation conditions can be related to different outcomes in parental competencies and child adjustment. In this paper we present data concerning the effects of different parent education interventions developed in Portugal. Five hundred one participants participating in 56 interventions were evaluated using a pre- and post-test design. Analyses were designed to determine the participant and programme characteristics that were associated with intervention outcomes, as indicated by univariate and covariate test results and respective effect sizes. After controlling for pre-test results, significant and positive intervention effects were found for parental stress, effective parenting attitudes (i.e., empathic responding, use of punitive discipline, and endorsement of parental roles), perception of the informal social support network and child behavioural and emotional difficulties. These positive outcomes are associated with some parental characteristics (educational level and child protection referrals) as well as with a number of programme characteristics (e.g., length of programme, existence of a manual, transportation, specific training in the programme). Discussion is focused on the positive effects of interventions and the role of the identified moderating factors as well as their implications for the development of parent education programmes.

Portuguese children's exposure to second-hand tobacco smoke in the family car

OBJECTIVES To assess the prevalence of childrens exposure to second-hand smoke in the family car; to compare exposure among children with smoking and non-smoking parents. METHODS In 2011, a self-administered questionnaire was applied to a 4th grade Portuguese children national sample (N=3187, mean age 9.5 ± 0.7, 51.1% boys). Prevalence rates and chi-square tests were computed. RESULTS Of the participants, 52.0% reported having, at least, one smoking parent. Overall exposure in the car was 28.9% (95% CI 27.3-30.5). Childrens exposure among those reporting smoking parents was 46.9% (95% CI 44.4-49.4); and 8.6% (95% CI 7.1-10.1) among those reporting non-smoking parents (p<.001). Therefore, children with smoking parents were 5.44 times more likely to be exposed. CONCLUSIONS Childrens exposure to second-hand smoke in the family car is frequent, especially if one or both parents smoke. This highlights the need for effective tobacco control measures to prevent this severe health hazard.

Quality of life in patients with skin tumors: the mediator role of body image and social support

This study analyzed the relationships between illness representations, psychological morbidity, family stress, and quality of life and whether these variables were mediated by body image and social support.

Partners’ representations of diabetes as mediators between patients’ representations and adherence to self-care behaviors, in type 2 diabetes

Abstract The purpose of this study was to analyze partners’ representations of diabetes as mediators between patients’ illness representations and adherence to all self-care behaviors, in recently diagnosed type 2 diabetes (T2DM) patients. The sample included 340 patients and their respective partners. The instruments used were: Revised Summary of Diabetes Self-Care Activities (RSDSCA); Medication Adherence Report Scale (MARS); and the Brief Illness Perception Questionnaire (Brief-IPQ). A mediational effect of partners’ representation of diabetes consequences was found between the same patients’ representations and exercise, foot care, and self-monitoring of blood glucose. Partners’ representations of personal and treatment control, were mediators between the same partners’ representations and self-monitoring of blood glucose. No partners’ representations mediated patients’ representation and adherence to medication or diet . This study emphasized partners’ representations on patient’s adherence to exercise, foot care and monitoring of blood glucose, in recent diagnosed T2DM patients. Interventions to promote adherence in T2DM should promote convergence between patients and partners’ diabetes representations. This study provides some evidence for the need to treat T2DM within the dyad to improve adherence, starting after the diagnosis.

Patients' and Spouses' Contribution Toward Adherence to Self-Care Behaviors in Type 2 Diabetes.

This article focuses on patients’ and partners’ variables regarding adherence to self-care, in recently diagnosed patients with Type 2 diabetes. One hundred four patients and partners were included. Instruments answered were Family Inventory of Life Events and Changes (family stress), Family Crisis Oriented Personal Evaluation Scales (family coping), Revised Dyadic Adjustment Scale (dyadic adjustment), Multidimensional Diabetes Questionnaire (partner support) and Hospital Anxiety and Depression Scale (psychological morbidity). Results showed adherence to diet to be positively predicted by patient dyadic adjustment and patient positive support and negatively by partner depression and partner negative support. Adherence to exercise was predicted by patient’s family stress and negatively by partner anxiety. Adherence to glucose monitoring was predicted by partner positive support. Psychological variables were not associated with adherence to foot care. Finally, positive partner support moderated the relationship between family stress and dyadic adjustment in patients. The results emphasize the need to treat the patient in the context of the dyad. Future research should focus on partners’ specific instrumental behaviors that promote patients’ self-care behaviors.

Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study.

OBJECTIVE To compare secondhand smoke exposure (SHSe) prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children. MATERIALS AND METHODS This is a cross-sectional study that assessed childrens SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios. RESULTS The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students). Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children). SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children. CONCLUSIONS Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management.

Coping and quality of life in patients with skin tumors in the follow-up stage: The mediating role of body image and psychological morbidity

ABSTRACT This study examined the relationships between coping style, body image, psychological morbidity, and quality of life. A total of 58 patients who were diagnosed with skin tumors, had been submitted to surgery, and were in the follow-up phase answered the following instruments: dermatology life quality index (DLQI), hospital anxiety and depression scales (HADS), body image scale (BIS), and the mini mental adjustment to cancer scale (Mini-MAC). The results showed that patients with a higher use of the coping styles of helplessness/hopelessness, anxious preoccupation, and cognitive avoidance reported a worse quality of life. Body image mediated the relationship between the coping styles of anxious preoccupation, helplessness/hopelessness, and quality of life. Psychological morbidity mediated the relationship between helplessness/hopelessness and quality of life. Therefore, even in the follow-up phase, it is important that health professionals are aware of the patients emotional distress and body image to identify those at a higher risk of having a poorer quality of life.

A study of a couple with type 2 diabetes: dyadic adjustment and psychological morbidity

OBJECTIVE this study assessed dyadic adjustment and psychological morbidity in type 2 diabetic patients and their partners, focusing on the role of gender. METHODS 214 diabetic patients and their partners participated in the cross-sectional study and were assessed on psychological morbidity (HADS) and marital adjustment (RDAS). Data was analyzed using dyadic analysis, a statistical process that studies the patient/partner dyads simultaneously. RESULTS results revealed that the negative relationship between dyadic adjustment and psychological morbidity in female patients was stronger than in male diabetic patients or in partners of male diabetic patients. On the other hand, the relationship between dyadic adjustment and psychological morbidity in partners of diabetic men was stronger than the same relationship in partners of diabetic women. CONCLUSION since gender is a moderator, it is important to attend to the different needs of female and male patients and the education of diabetic patients should be centered on the patient/partner dyad.

Human Resource Management and the Internet: Challenge and/or Threat to Workplace Productivity?

Throughout the last few years, the Internet has become a common tool at the workplace. Companies, from different activity sectors, were quick to embrace the opportunities and potential given by the Internet and put them to good use to achieve their goals. However, despite having contributed to the efficiency of employees, by allowing them to have immediate access to information on a variety of topics and facilitating communication all over the world, it also contributed to never before encountered concerns to employers. Initial research into the use of the Internet for personal reasons during working hours stated that such use had a negative impact on productivity. The reasoning for such was that employees would be wasting time which could be used to further their work, thus possibly making them unproductive. On the other hand, recent research has shown the Internet to be quite valuable to productivity. Studies have shown that not only is the Internet a priceless tool which aids workers to accomplish their designated tasks, but also when used reasonably, allows those who are working to have moments of relaxation. This contributes to improvements in concentration and ultimately in productivity. Due to this ambiguity and the absence of works on this theme in Portugal, a decision was made to base this study on the impact of the Internet usage on productivity.

Differences, predictors, and moderators of therapeutic adherence in patients recently diagnosed with type 2 diabetes:

This study analyzed the differences over time in newly diagnosed type 2 diabetes patients on reported adherence. A longitudinal design with two assessment moments was used with 268 patients who were assessed on adherence to self-care behaviors and medication, beliefs about medicines, psychological distress, trust in the physician, and satisfaction with care. HbA1c and general beliefs about medicines decreased from T1 to T2 while adherence to foot care, the needs of medicines, and psychological distress increased. Beliefs about medicines, satisfaction with communication/information, and trust in physician predicted adherence. Intervention should consider these variables when promoting adherence.