Browsing by Author "Coelho, Anabela"
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- Biopsychosocial factors that influence the purpose in life among working adults and retireesPublication . Coelho, Anabela; Lopes, Manuel; Barata, Marta; Sousa, Sofia; Goes, Margarida; Bia, Florbela; Dias, Ana; João, Ana; Lusquinhos, Leonel; Oliveira, Henrique; Gaspar, TâniaThis study aimed to identify and characterize biopsychosocial factors that impact the purpose in life (PIL) among adults that are working or already retired. This cross-sectional study includes a sample of 1330 participants, of whom 62.2% were female, with ages ranging from 55 and 84 years, with a mean of 61.93 years and a standard deviation of 7.65. Results suggest that the education level, stress, spirituality (religion) and optimism, social support from friends, and quality of life-related to physical health seem to contribute positively to the PIL for both groups. However, some variables such as age, marital status and environmental quality of life help explain the PIL of retired people, and the quality of life-related to social support helps explain the PIL of working adults. Overall, the reported findings suggest that the purpose in life is strongly related to physical, psychological, social, and environmental health factors. It is highlighted that working adults and retired people have their purpose in life-related to similar factors and others specific to each life stage, suggesting the need for crucial interventions to promote a healthier and more positive aging process.
- Healthcare equity and commissioning: a four-year national analysis of Portuguese primary healthcare unitsPublication . Pereira, António; Biscaia, André; Calado, Isis; Freitas, Alberto; Costa, Andreia; Coelho, AnabelaEqual and adequate access to healthcare is one of the pillars of Portuguese health policy. Despite the controversy over the commissioning processes' contribution to equity in health, this article aims to clarify the relationship between socio-economic factors and the results of primary healthcare (PHC) commissioning indicators through an analysis of four years of data from all PHC units in Portugal. The factor that presents a statistically significant relationship with a greater number of indicators is the organizational model. Since the reform of PHC services in 2005, a new type of unit was introduced: the family health unit (USF). At the time of the study, these units covered 58.1% of the population and achieved better indicator results. In most cases, the evolution of the results achieved by commissioning seems to be similar in different analyzed contexts. Nevertheless, the percentage of patients of a non-Portuguese nationality and the population density were analyzed, and a widening of discrepancies was observed in 23.3% of the cases. The commissioning indicators were statistically related to the studied context factors, and some of these, such as the nurse home visits indicator, are more sensitive to context than others. There is no evidence that the best results were achieved at the expense of worse healthcare being offered to vulnerable populations, and there was no association with a reduction in inequalities in healthcare. It would be valuable if the Portuguese Government could stimulate the increase in the number of working USFs, especially in low-density areas, considering that they can achieve better results with lower costs for medicines and diagnostic tests.
- Measuring health outcomes and experiences from a patient’s perspectivePublication . Coelho, Anabela; Barrenho, Eliana; Gaspar, TâniaThe primary objective of health systems is to improve people's health and well-being. Yet, health systems today face significant challenges, ranging from delivering high-quality care to tackling inequalities in health outcomes, getting rid of ineffective care, and investing more in health systems' resilience. Faced with those challenges, the ability to assess whether health systems are successful in delivering good health outcomes and experiences for the people they serve is critical. Health systems are awash with data. There are good measures of what providers can do and the resources this takes – think of the many administrative data about healthcare activities, costs, inputs, outcomes measuring mortality, and incidence and prevalence of diseases. Yet far too little is known about how healthcare impacts the lives of people. This makes it difficult to gain insight into the effectiveness of the healthcare and assess how policy change contributes to improvement in health outcomes.
- Mental health patient-reported outcomes and experiences assessment in PortugalPublication . Coelho, Anabela; de Bienassis, Katherine; Klazinga, Niek; Santo, Susan; Frade, Patrícia; Costa, Andreia; Gaspar, TâniaMental ill-health is increasingly recognized by policymakers for its significant human and economic toll. The main objective of this study is to capture patient-reported outcomes and experiences on mental health care in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 397 participants, 247 (62.2%) women, divided into four age groups: ages 16-24 years, ages 25-44 years, ages 45-65 years, and ages 66 years or older. The data collection procedure and analysis followed the OECD PaRIS Mental Health Working Group 2021 protocol allowing subsequent comparability with data from other OECD member countries. Findings on the WHO-5 Well-Being Index showed that women manifest a lower score in well-being following mental health care services use. This finding may be, at least in part, explained by the study population (mental health services users), including individuals with clinical depression which is more frequently observed in women. In terms of the level of satisfaction with treatment (provided by nurses, doctors, phycologists, etc.) the response "Yes, definitely" varied from 67% of answers regarding "time spent by care providers", to 76.3% "involvement in decisions" to 79.7% regarding "clarity of explanations" and 84.4% regarding the item courtesy and respect. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in mental health services in Portugal. The study results generate useful clinical information to help meet the expectations and needs of patients, contributing to a continuous improvement of mental health community services.
- A national e-Delphi towards the measurement of safe medication practices in Portuguese hospitalsPublication . Guerreiro, Mara Pereira; Plácido, Madalena; Barros, Carla Teixeira; Coelho, Anabela; Graça, Anabela; Gaspar, Maria João; Martins, Sofia de OliveiraObjectives - To determine the face and content validity of items for measuring safe medication practices in Portuguese hospitals. Methods - 128 items were drafted from content analysis of existing questionnaires and the literature, employing preferred terms of the WHO International Classification for Patient Safety (Portuguese version). A two-round e-Delphi was convened, using a purposive multidisciplinary panel. Hospital-based experts were asked to rate the relevance of items on a 7-point Likert scale and to comment on their clarity and completeness. Results - The response rate was similar in both rounds (70.3% and 73.4%, respectively). In the first round 91/128 (71.1%) items reached the predefined level of positive consensus. In the second round 23 additional items reached positive consensus, as well as seven items newly derived by the panel. Conclusions - Most items have face and content validity, indicating relevance and clarity, and can be included in a future questionnaire for measuring safe medication practices in Portuguese hospitals.
- Patient-reported outcomes and experiences assessment in women with breast cancer: Portuguese case studyPublication . Coelho, Anabela; Kendir, Candan; Barrenho, Eliana; Klazinga, Niek; Paiva, Cláudia; Sousa, Joaquim Abreu de; Gonçalves-Monteiro, Salomé; Redondo, Patrícia; Bastos, Ana; Nogueira, Armanda; Guedes, Fábio Botelho; Costa, Andreia Silva; Gaspar, TâniaIn 2020, female breast cancer was the most commonly diagnosed cancer worldwide, representing the type of cancer with the highest incidence among women and the second most common cause of cancer death among women in all OECD countries. The conventional measures addressing the burden of breast cancer by measuring mortality, incidence, and survival do not entirely reflect the quality of life and patients' experience when receiving breast cancer care. The main objective of this study is to capture patient-reported outcomes and experiences in women with breast cancer in Portugal using methods developed for international benchmarking purposes, such as the OECD Patient-reported Indicators Surveys. The study included 378 women with breast cancer, with the age distribution being 19.8% aged 15 to 49 years and 80.2% aged 50 years and over. The data collection procedure and analysis followed the "OECD Breast Cancer Patient Reported Outcomes Working Group" protocol, allowing subsequent comparability with data from other OECD member countries. Most women were satisfied with the treatment outcome regarding the shape of their lumpectomy breasts when wearing a bra (96.1%) and with the equal size of both breasts (78.3%). Findings on the WHO QOL-BREF showed that women manifest a lower score in well-being when compared with the general population or populations living with chronic diseases. This study shows the feasibility of implementing and using patient-reported metrics (PROM and PREM) in breast cancer services in Portugal. Measuring PROMs and PREMs from Portuguese women receiving breast cancer care provides insightful evidence of the quality and value of cancer care.
- Sexually transmitted infections and health literacy: a community-based preventive programPublication . Sul, Susana; Ferreira, Liliana; Maia, Ana Catarina; Coelho, Anabela; Costa, AndreiaBackground: Sexually transmitted infections (STIs) are a public health problem with a high risk of morbidity and community transmissibility. Evidence points to their continuous increase. This study describes the design, development, and implementation of a community-based STI prevention program for community healthcare users. Methods: Based on the Health Planning Process design method, a structured, community-based intervention program on STI counseling and detection was conducted in a primary health care unit in Lisbon. Two data collection instruments were applied in the diagnosis of the situation, namely the Health Literacy Survey Portugal (ILS-PT) and the STD Attitude Scale, to 47 patients who attended the health consultation on STI counseling and detection in a primary care unit in Lisbon. Two interventions were implemented, the health education session and the provision of an educational poster. In the evaluation of the project, the acceptance and satisfaction of the patients with the implemented interventions were considered outcome indicators. A descriptive statistical analysis of the data was performed. Results: The participants show considerably low levels of health literacy and high-risk behaviors for acquiring STIs. After an intervention, a high percentage of the participants point out the project as exciting and valuable and reveal having acquired knowledge that allowed them to improve their health. Furthermore, the patients were very satisfied with the implemented health education session and the educational poster. Conclusion: This project revealed the urgent and important need to implement community intervention projects to prevent STIs and promote health literacy among the most vulnerable groups.