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Papers by António José Feliciano Barbosa
It may be concluded that the sample includes all HC users willing to participate and following th... more It may be concluded that the sample includes all HC users willing to participate and following the inclusion and exclusion criteria. In can be considered a simple random sample and it was expected to represent the adult population of a primary care services unit in Portugal with roughly the same size (11,000 registered persons) with no severe mental disorder aged at least 18 years. The question of randomness is addressed in line 4 of the Results section, comparing the age and sex distributions of the sample elements with that of the population registered.
Escola Anna Nery, 2013
OBJETIVO: Avaliar o efeito do programa Parar Para Pensar na prevenção do uso/abuso de bebidas alc... more OBJETIVO: Avaliar o efeito do programa Parar Para Pensar na prevenção do uso/abuso de bebidas alcoólicas de adolescentes em contexto escolar. MÉTODO: Realizou-se estudo quasi-experimental, com pré e pós-teste, com 178 participantes, estudantes no 7º ano escolar; o grupo experimental (n = 70) foi sujeito à intervenção durante um ano, e o grupo de controle (n = 108) não sofreu intervenção. Foram utilizados o Questionário de Conhecimentos Acerca do Álcool; Questionário de caracterização dos consumos; Escala de Expectativas Acerca do álcool e Escala de Aptidões Sociais. RESULTADOS: Constatou-se que os adolescentes submetidos ao programa apresentaram evolução positiva nas seguintes variáveis: frequência do consumo e ocorrência de episódios de embriaguez; e, ainda, melhorou os conhecimentos, as expectativas acerca do álcool e a percepção do consumo pelos pares (p < 05). CONCLUSÃO: O programa foi eficaz na estabilização do consumo, no aumento dos conhecimentos, na estabilização das expe...
Revista Latino-Americana de Enfermagem, 2009
This study aimed to evaluate the alcohol consumption phenomenon in public schools in Coimbra, Por... more This study aimed to evaluate the alcohol consumption phenomenon in public schools in Coimbra, Portugal (7th, 8th and 9th grades) for the implementation of a preventive program of alcohol use/abuse. This is a quantitative, descriptive and correlational study. The sample included 654 students (51.5% female) between 12 and 18 years of age. The Alcohol Expectancy Questionnaire - Adolescent form (AEQ-A) and the Questionnaire of Knowledge on Alcohol were used for data collection. Results show that positive expectancy on alcohol is discriminative of consumption and occurrence of intoxication. Positive expectancy exists even before adolescents have significant experiences with alcohol consumption and increases with age, which reinforces the need for early preventive effort. These results permitted to improve the prevention program included in the school curriculum of the 7th grade students.
Clinical Rheumatology, 2008
The objective of this study was to cross-culturally adapt and validate the Portuguese version of ... more The objective of this study was to cross-culturally adapt and validate the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS). This version was obtained with forward/backward translations, consensus panels and pre-testing. The Portuguese KOS-ADLS and Medical Outcomes Study, 36-item Short Form (SF-36) questionnaires, visual analogue scales (VAS) of pain, disability and discomfort, and a form for patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s characteristics were administered to 168 subjects with knee osteoarthritis (OA). Reliability was acceptable (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha = 0.91; ICC = 0.97). There were significant correlations with SF-36 physical component subscales, all VAS, and duration of knee OA. The subjects with bilateral knee OA and that need walking aids obtained lower scores (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). No floor/ceiling effects were detected. Responsiveness to physical therapy was showed (standardized effect size = 0.62; standardized response mean = 1.02). The Portuguese KOS-ADLS evidenced acceptable reliability, validity, floor/ceiling effects, and responsiveness.
BMC Psychiatry, 2010
Background: To investigate the validity and stability of a Portuguese version for the Screening f... more Background: To investigate the validity and stability of a Portuguese version for the Screening for Somatoform Symptoms-2 (SOMS-2) in primary care (PC) settings. Methods: An adapted version of the SOMS-2 was filled in by persons attending a PC unit. All medically unexplained symptoms were further ascertained in a clinical interview and by contacting the patient's physicians and examining medical records, attaining a final clinical symptom evaluation (FCSE). An interview yielded the diagnosis of Clinical Somatization (CS) and the diagnosis of current depressive and anxiety disorders. Results: From the eligible subjects, 167 agreed to participate and 34.1% of them were diagnosed with somatization. The correlation between the number of self-reported and FCSE symptoms was 0.63. After excluding symptoms with low frequency, low discriminative power and not correlated with the overall scale, 29 were retained in the final version. A cutoff of 4 symptoms gave a sensitivity of 86.0% and a specificity of 95.5% on the FCSE and 56.1% and 93.6% at selfreport. Stability in the number of symptoms after 6 months was good (k = 0.57). Conclusions: The 29 symptoms version of the SOMS-2 with a cutoff of 4 showed a high specificity and sensitivity, being reliable as a referral tool for further specialized diagnosis.
BMC Gastroenterology, 2009
Background: It has been demonstrated in many studies that quality of life can be improved after l... more Background: It has been demonstrated in many studies that quality of life can be improved after liver transplantation in patients with liver disease. Nevertherless quality of life improvement in specific groups of transplantated patients such as those with Familial Amyloid Polineuropathy hasn't yet been explored. The present study aimed to compare the change in quality of life following liver transplantation between patients with Familial Amyloid Polineuropathy (FAP) and patients with liver disease. Results: Patient's mental quality of life showed an improvement in all liver disease patients, and a worsening in FAP patients, resulting in a significant difference between the two groups. Regarding physical quality of life, although a similar improvement was seen in both groups, FAP patients had significantly less improvement than the subgroup of decompensated liver disease (Child-Pugh B and C). Conclusion: It is concluded that liver transplantation has a less beneficial impact in FAP patient's physical quality of life, probably because they are not so much disabled by their disease at the moment of liver transplantation. The lesser improvement in mental quality of life of FAP patients may be due to their particular psychological profile and greater expectations towards transplantation.
Introdução e objectivos: O presente estudo teve como objectivos traduzir e validar para a cultura... more Introdução e objectivos: O presente estudo teve como objectivos traduzir e validar para a cultura portuguesa o "Herth Hope Index"; determinar o nível de esperança dos doentes em Cuidados Paliativos e identificar as suas características sócio-demográficas e clínicas. Metodologia Partindo do "Herth Hope Index" (Kaye Herth, 1992) procedeu-se a um estudo de investigação metodológica. O instrumento foi validado numa amostra de 117 doentes, maioritariamente do sexo feminino (56, 4%) com uma média de idades de 67,3 anos (D.P.= 12, 2). Na validação seguiu-se a mesma metodologia da autora da escala original a quem foi solicitada a autorização assim como às direcções das instituições onde foram recolhidos os dados (Equipas de Cuidados Paliativos). Obtivemos também o consentimento informado dos doentes. Resultados: Após a análise da homogeneidade dos itens, suprimiram-se 3 da escala original, ficando a Escala de Esperança de Herth-HHI-PT constituída por 9 itens que permite a obtenção de uma pontuação global (pontuações mais elevadas maior nível de esperança) organizados apenas numa dimensão que explica 50,3% de variância explicada. O coeficiente de alfa de Cronbach (0,873) permite igualmente afirmar que o instrumento apresenta uma boa consistência interna. Os doentes apresentam índices de esperança bons (média de 3,2; D.P.= 0,52). Conclusão: Os resultados indiciaram estarmos perante uma escala fiável e válida para a avaliação da esperança em cuidados paliativos, embora se sugira a necessidade de novos estudos de revalidação.
Advances in Psychosomatic Medicine, 2011
The main ethical perspective in the clinical relationship takes into consideration the vulnerabil... more The main ethical perspective in the clinical relationship takes into consideration the vulnerability of the clinical condition before threats and risks that can undermine the integrity and dignity of the person. Psychosomatic medicine faces complex cases whose ethical problems cannot only be solved by applying top-down deontological or utilitarian approaches, principlism, which is limited mainly to easing ethical tensions, or a bottom-up approach, the casuistic model, case-based reasoning. In introducing vulnerability as the core of ethical questioning as a principle ontological priority over other principles, relational ethics refers to the appreciation of the responsibility of health professionals through which a health care professional and the patient 'together' can construct more reasonable and prudential courses of action with, for, and by the patient. The model of relational ethics is based on three main aspects, clinically integrated approach, science/philosophy partnership, and deliberative process, that when taken together, form an intermediate model that ensures prudent and reasonable decision-making. The three structural elements and characteristics of relational ethics create and maintain a responsible relationship between the professional and the patient being aware that the mutual vulnerability of health professional and the patient has a moral value and recognizing that their relationship will allow for personal development of each. I conceptualized the model of relational ethics as one that embraces the meta-ethical principles of vulnerability, dignity, responsibility, and respect for autonomy as they are considered by many international declarations or conventions. This model integrates three key polarities: ensure conditions of authenticity, facilitate a process of cooperative mutuality, and promote opportunities for growth and development. Relational ethics can be used to solve major ethical problems in psychosomatic medicine, capacity, informed consent, and confidentiality.
It may be concluded that the sample includes all HC users willing to participate and following th... more It may be concluded that the sample includes all HC users willing to participate and following the inclusion and exclusion criteria. In can be considered a simple random sample and it was expected to represent the adult population of a primary care services unit in Portugal with roughly the same size (11,000 registered persons) with no severe mental disorder aged at least 18 years. The question of randomness is addressed in line 4 of the Results section, comparing the age and sex distributions of the sample elements with that of the population registered.
Escola Anna Nery, 2013
OBJETIVO: Avaliar o efeito do programa Parar Para Pensar na prevenção do uso/abuso de bebidas alc... more OBJETIVO: Avaliar o efeito do programa Parar Para Pensar na prevenção do uso/abuso de bebidas alcoólicas de adolescentes em contexto escolar. MÉTODO: Realizou-se estudo quasi-experimental, com pré e pós-teste, com 178 participantes, estudantes no 7º ano escolar; o grupo experimental (n = 70) foi sujeito à intervenção durante um ano, e o grupo de controle (n = 108) não sofreu intervenção. Foram utilizados o Questionário de Conhecimentos Acerca do Álcool; Questionário de caracterização dos consumos; Escala de Expectativas Acerca do álcool e Escala de Aptidões Sociais. RESULTADOS: Constatou-se que os adolescentes submetidos ao programa apresentaram evolução positiva nas seguintes variáveis: frequência do consumo e ocorrência de episódios de embriaguez; e, ainda, melhorou os conhecimentos, as expectativas acerca do álcool e a percepção do consumo pelos pares (p < 05). CONCLUSÃO: O programa foi eficaz na estabilização do consumo, no aumento dos conhecimentos, na estabilização das expe...
Revista Latino-Americana de Enfermagem, 2009
This study aimed to evaluate the alcohol consumption phenomenon in public schools in Coimbra, Por... more This study aimed to evaluate the alcohol consumption phenomenon in public schools in Coimbra, Portugal (7th, 8th and 9th grades) for the implementation of a preventive program of alcohol use/abuse. This is a quantitative, descriptive and correlational study. The sample included 654 students (51.5% female) between 12 and 18 years of age. The Alcohol Expectancy Questionnaire - Adolescent form (AEQ-A) and the Questionnaire of Knowledge on Alcohol were used for data collection. Results show that positive expectancy on alcohol is discriminative of consumption and occurrence of intoxication. Positive expectancy exists even before adolescents have significant experiences with alcohol consumption and increases with age, which reinforces the need for early preventive effort. These results permitted to improve the prevention program included in the school curriculum of the 7th grade students.
Clinical Rheumatology, 2008
The objective of this study was to cross-culturally adapt and validate the Portuguese version of ... more The objective of this study was to cross-culturally adapt and validate the Portuguese version of the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS). This version was obtained with forward/backward translations, consensus panels and pre-testing. The Portuguese KOS-ADLS and Medical Outcomes Study, 36-item Short Form (SF-36) questionnaires, visual analogue scales (VAS) of pain, disability and discomfort, and a form for patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s characteristics were administered to 168 subjects with knee osteoarthritis (OA). Reliability was acceptable (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha = 0.91; ICC = 0.97). There were significant correlations with SF-36 physical component subscales, all VAS, and duration of knee OA. The subjects with bilateral knee OA and that need walking aids obtained lower scores (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). No floor/ceiling effects were detected. Responsiveness to physical therapy was showed (standardized effect size = 0.62; standardized response mean = 1.02). The Portuguese KOS-ADLS evidenced acceptable reliability, validity, floor/ceiling effects, and responsiveness.
BMC Psychiatry, 2010
Background: To investigate the validity and stability of a Portuguese version for the Screening f... more Background: To investigate the validity and stability of a Portuguese version for the Screening for Somatoform Symptoms-2 (SOMS-2) in primary care (PC) settings. Methods: An adapted version of the SOMS-2 was filled in by persons attending a PC unit. All medically unexplained symptoms were further ascertained in a clinical interview and by contacting the patient's physicians and examining medical records, attaining a final clinical symptom evaluation (FCSE). An interview yielded the diagnosis of Clinical Somatization (CS) and the diagnosis of current depressive and anxiety disorders. Results: From the eligible subjects, 167 agreed to participate and 34.1% of them were diagnosed with somatization. The correlation between the number of self-reported and FCSE symptoms was 0.63. After excluding symptoms with low frequency, low discriminative power and not correlated with the overall scale, 29 were retained in the final version. A cutoff of 4 symptoms gave a sensitivity of 86.0% and a specificity of 95.5% on the FCSE and 56.1% and 93.6% at selfreport. Stability in the number of symptoms after 6 months was good (k = 0.57). Conclusions: The 29 symptoms version of the SOMS-2 with a cutoff of 4 showed a high specificity and sensitivity, being reliable as a referral tool for further specialized diagnosis.
BMC Gastroenterology, 2009
Background: It has been demonstrated in many studies that quality of life can be improved after l... more Background: It has been demonstrated in many studies that quality of life can be improved after liver transplantation in patients with liver disease. Nevertherless quality of life improvement in specific groups of transplantated patients such as those with Familial Amyloid Polineuropathy hasn't yet been explored. The present study aimed to compare the change in quality of life following liver transplantation between patients with Familial Amyloid Polineuropathy (FAP) and patients with liver disease. Results: Patient's mental quality of life showed an improvement in all liver disease patients, and a worsening in FAP patients, resulting in a significant difference between the two groups. Regarding physical quality of life, although a similar improvement was seen in both groups, FAP patients had significantly less improvement than the subgroup of decompensated liver disease (Child-Pugh B and C). Conclusion: It is concluded that liver transplantation has a less beneficial impact in FAP patient's physical quality of life, probably because they are not so much disabled by their disease at the moment of liver transplantation. The lesser improvement in mental quality of life of FAP patients may be due to their particular psychological profile and greater expectations towards transplantation.
Introdução e objectivos: O presente estudo teve como objectivos traduzir e validar para a cultura... more Introdução e objectivos: O presente estudo teve como objectivos traduzir e validar para a cultura portuguesa o "Herth Hope Index"; determinar o nível de esperança dos doentes em Cuidados Paliativos e identificar as suas características sócio-demográficas e clínicas. Metodologia Partindo do "Herth Hope Index" (Kaye Herth, 1992) procedeu-se a um estudo de investigação metodológica. O instrumento foi validado numa amostra de 117 doentes, maioritariamente do sexo feminino (56, 4%) com uma média de idades de 67,3 anos (D.P.= 12, 2). Na validação seguiu-se a mesma metodologia da autora da escala original a quem foi solicitada a autorização assim como às direcções das instituições onde foram recolhidos os dados (Equipas de Cuidados Paliativos). Obtivemos também o consentimento informado dos doentes. Resultados: Após a análise da homogeneidade dos itens, suprimiram-se 3 da escala original, ficando a Escala de Esperança de Herth-HHI-PT constituída por 9 itens que permite a obtenção de uma pontuação global (pontuações mais elevadas maior nível de esperança) organizados apenas numa dimensão que explica 50,3% de variância explicada. O coeficiente de alfa de Cronbach (0,873) permite igualmente afirmar que o instrumento apresenta uma boa consistência interna. Os doentes apresentam índices de esperança bons (média de 3,2; D.P.= 0,52). Conclusão: Os resultados indiciaram estarmos perante uma escala fiável e válida para a avaliação da esperança em cuidados paliativos, embora se sugira a necessidade de novos estudos de revalidação.
Advances in Psychosomatic Medicine, 2011
The main ethical perspective in the clinical relationship takes into consideration the vulnerabil... more The main ethical perspective in the clinical relationship takes into consideration the vulnerability of the clinical condition before threats and risks that can undermine the integrity and dignity of the person. Psychosomatic medicine faces complex cases whose ethical problems cannot only be solved by applying top-down deontological or utilitarian approaches, principlism, which is limited mainly to easing ethical tensions, or a bottom-up approach, the casuistic model, case-based reasoning. In introducing vulnerability as the core of ethical questioning as a principle ontological priority over other principles, relational ethics refers to the appreciation of the responsibility of health professionals through which a health care professional and the patient 'together' can construct more reasonable and prudential courses of action with, for, and by the patient. The model of relational ethics is based on three main aspects, clinically integrated approach, science/philosophy partnership, and deliberative process, that when taken together, form an intermediate model that ensures prudent and reasonable decision-making. The three structural elements and characteristics of relational ethics create and maintain a responsible relationship between the professional and the patient being aware that the mutual vulnerability of health professional and the patient has a moral value and recognizing that their relationship will allow for personal development of each. I conceptualized the model of relational ethics as one that embraces the meta-ethical principles of vulnerability, dignity, responsibility, and respect for autonomy as they are considered by many international declarations or conventions. This model integrates three key polarities: ensure conditions of authenticity, facilitate a process of cooperative mutuality, and promote opportunities for growth and development. Relational ethics can be used to solve major ethical problems in psychosomatic medicine, capacity, informed consent, and confidentiality.