Aan de start

REDE gehouden op 7 oktober 1966 ter gelegenheid van de opening van de Medische Faculteit Rotterdam door prof. dr. A. QUERID

Issues around vulnerability among people attended by a Portuguese community-based association: a qualitative secondary analysis

European Psychiatry, Volume 67, Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry, April 2024 , pp. S818.Introduction: Despite vulnerability being a poorly understood concept is a key concept in health and social care disparities. Typically, vulnerable groups include individuals with physical and/or mental disabilities, children, the elderly, members of the lower social classes, and refugees. In Portugal, the pandemic was responsible for worsening inequalities in access to health and social care for the most vulnerable. To the best of our knowledge, there is a dearth of qualitative research on vulnerability from the viewpoint of those who are vulnerable or work with the most vulnerable. Objectives As expressions of vulnerability are strongly influenced by cultural factors, this study aims to examine issues of vulnerability among people who attend and work in a Portuguese community-based association. Methods Secondary analysis of qualitative data from twelve vulnerable people and fifteen professionals who attended these people. The manifestations of the vulnerability reported by participants included being homeless, being a migrant, having an infectious disease, being drug dependent, living with socioeconomic difficulties (unemployment), and experiencing a process of loss and grief. They also reported having a mental or physical health problem, or both. Depression and anxiety were the most often reported mental health disorders. Regarding the academic background of professionals, most of them (n = 12) are from social sciences (e.g., social workers, social mediators, and psychologists). Results Three main themes emerged from the study: (1) meanings of human vulnerability; (2) barriers to vulnerability mitigation; and (3) approaches to addressing vulnerability. Our findings revealed that vulnerability is a very dynamic process of openness to conditions that impact individual outcomes. However, there is a conceptual gap: being vulnerable is perceived as something negative, but vulnerability also has the potential to change priorities in life for the better. Some participants emphasized the importance of self-care to avoid becoming vulnerable themselves, particularly in terms of mental health. Conclusions Understanding the social determinants of vulnerability is necessary to achieve satisfactory care for human groups. Practitioners need to be aware of these larger societal dynamics, understand them, and make sure their services are responsive to cultural differences. In order to develop interventions that promote social and health outcomes, practitioners should be encouraged to share knowledge on best practices.info:eu-repo/semantics/publishedVersio

Addressing spiritual needs, facilities and barriers in portuguese palliative care: a cross-sectional survey

Background: Spiritual care is an essential component of Palliative Care (PC) and a dimension of holistic care that preserves dignity and helps sick people to find meaning in suffering and in life. The knowledge about its implementation is still scarce in the Portuguese context. This study aimed to evaluate the facilities, barriers and needs for spiritual care in PC. Method: We conducted a descriptive cross-sectional survey of 180 health professionals in the period November 2018 to September 2019 at PC units. The data were collected through an online questionnaire published on social networks, after approval by an Ethics Committee. Sociodemographic and professional data, spiritual beliefs and knowledge about the objectives and purposes of PCs were collected. These were evaluated using an instrument consisting of 26 statements of dichotomous response (true/false). Results: The average age of participants was 42.42 years (SD=11.35), most are female (82.2%), nurses (43.9%), and 70% work in the health field. The total sample has worked on average for 15.67 ± 10.28 years and more than half (58.9%) perform functions in palliative care. Most identify with a religious belief (87.8%), attaching great importance to spiritual/religious conviction (45% of participants). The results suggest that empathy and the therapeutic use of silence (82.2%) are facilitators of spiritual care. The key barriers refer to the lack of expert professionals and the organization of care (36.1%). The results also highlight the need for specific training in the area of spirituality, hope and intervention strategies (53.9%). Conclusion: This study has provided insight into spiritual care in PC in Portugal. Future studies are necessary to investigate the effects of spiritual care more fully, and to develop outcome measurements that appropriately capture the effects of the variety of spiritual care practices.info:eu-repo/semantics/publishedVersio

Evidence-based practice a relevant piece to update knowledge in mental health nursing

E-Poster Presentation.Introduction Web Journal Club as a collaborative learning method, is an effective method to enhance the knowledge base of nursing students, their presentation skills, problem-solving skills and ability to critically appraise literature. Objectives To describe the experience of a online journal club on education of MHN undergraduate students. Methods We implemented a journal club in the online classroom with a total of 24 portuguese undergraduate students enrolled in clinical training of MHN (sixth semester). Over a two-week period, five 2-hour online journal club sessions were conducted in April 2020. During each session, five journal articles were presented synchronously to a live online audience via the Zoom Classroom technology. After all sessions, students were invited by e-mail to complete an anonymous and voluntary online questionnaire via Google Forms. Results All students were all very positive about the journal club sessions and found the opportunity to discuss and reflect on practice issues in depth very helpful. They found the sessions supportive, they helped to bond the group, they learnt a great deal from each others experiences, and they felt that they gained in confidence as a group. Survey results also indicated that few participants experienced technical difficulties during sessions. Conclusions This pedagogical practice enhances gains in the various actors involved: 1) in students, contributing to their learning process and acquisition of competences, articulating research and clinical practice; and 2) lastly, even more indirectly, in people receiving care, since a evidence-based practice ensures safe and quality of nursing care delivery.info:eu-repo/semantics/publishedVersio

Psychometric Properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) in a Portuguese Sample during the early stage of the COVID-19 pandemic

European Psychiatry , Volume 67 , Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry , April 2024 , pp. S149.Introduction The COVID-19 global crisis has resulted in significant disruptions in the lives of students in higher education, leading to negative consequences for their academic achievements and general psychological well-being. Objectives In this study, we sought to examine the psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) among students in Portuguese higher education institutions during the initial phase of the COVID-19 pandemic and its efficacy in capturing mental health symptoms due to a global health crisis. Methods In this cross-sectional study, a convenience sampling method was used to enlist a total of 1522 participants. The sample consisted of 75.1% women and 79.2% undergraduate students. Participants completed an electronic survey that was designed using the Depression Anxiety Stress Scale-21 (DASS-21) — a self-report instrument measuring anxiety, depression, and stress. Results The findings of the study indicated a significant occurrence of depressive symptoms [≥10] (N = 434, 28.5%), anxiety symptoms [≥7] (N = 551, 36.2%), and stress symptoms [≥11] (N = 544, 35.7%). Based on the collected data, a Confirmatory Factor Analysis (CFA) was conducted in order to examine the factor structure of the scale. The analysis revealed a three-factor solution that corresponded to the three subscales of the DASS-21. The Heterotrait-Monotrait (HTMT) correlation ratio was then used to assess the discriminant validity, with good results. Results showed that the DASS21 has satisfactory reliability indexes (Cronbach’s α > 0.90). Conclusions In light of the notable changes in living conditions brought by the COVID-19 pandemic, the present study has shown that the DASS-21 instrument has maintained its reliability and validity. Consequently, this finding supports the appropriateness of using the DASS-21 as a screening tool for assessing mental health among students in Portugal. Moreover, it is recommended that academics and healthcare practitioners use the DASS-21 as a tool for assessing the levels of psychological distress experienced by students. Additional validation studies of this scale are required, using bigger and more representative populationsinfo:eu-repo/semantics/publishedVersio

Identifying predictors of resilient coping in students during COVID-19 lockdown

European Psychiatry, Volume 67, Special Issue S1: Abstracts of the 32nd European Congress of Psychiatry, April 2024, pp. S105 - S106.Introduction Although increasing resilient coping throughout life is beneficial, it is particularly important in young people. To prevent the development of mental health problems, it is crucial to understand the factors associated with resilience. However, among university students, the characteristics considered conducive to resiliency have not been sufficiently studied, particularly during pandemic times. Objectives The present study examined factors associated with resilient coping in Portuguese higher education students during the COVID-19 pandemic. Methods Data were collected from an opportunity large sample of participants during the academic year 2020/2021. Four self-report measures were utilized within the study: Herth Hope Index, Brief Resilient Coping Scale, Depression Anxiety and Stress Scale – 21 items, and Impact of Event Scale-Revised. Additionally, a demographic questionnaire was used to collect data including age, gender, have children, education level, and study area. Ethics clearance was obtained. In order to test the research question, a multiple regression was conducted (using SPSS 28), with resilient coping as the dependent variable and the other variables entered as potential predictor variables. Results A total of 1522 students (75.1% women and 24.9% men) took part in this study. Most participants were single (91.2%), had no children (93%), and the ages ranged from 18 to 59, with a mean age of 22.88±6.93 years. In terms of study level, the majority of students (73.7%) are at the undergraduate level and are not working (76.6%). Among the participants, 35.7%, 36.2%, and 28.5% had symptoms of stress, anxiety, and depression above the normal range, respectively. High resilience scores were found in 215 participants (14.1%). The mean hope (HHI) was 35.53 (SD = 5.92). Our results also demonstrated that hope is the only predictor of resilient coping (p<0.001). A higher level of hope is expected to affect people’s psychological adjustment by influencing both their appraisal of, and their coping with, the stressors confronted by them. Conclusions Establishing and improving protective factors should increase the likelihood of the individual successfully avoiding negative outcomes and increase their ability to function normally, thus promoting resilient outcomes. We were able to draw practical implications for developing resilience-promoting methods in a university context. These results can be used to help students build resilience by preparing for future problems.info:eu-repo/semantics/publishedVersio

Adjustment strategies adopted by higher education students during COVID-19 pandemic: focus group discussions

Introduction: With the closure of higher education institutions during the COVID-19 sanitary crisis, students have experienced problems such as interruptions to their education, loss of peer support networks, and mental health issues. Objectives: This study aimed to explore adjustment patterns used by students to overcome the impact of the COVID-19 pandemic. Methods:A qualitative descriptive study was developed by carrying out Focus Group Discussions (FGDs). Portuguese students enrolled in education levels above high school, including undergraduate and graduate programs, were considered eligible. Participants were recruited using convenience sampling. Each FGD took approximately 60–90 min. Results: Twelve students were participated in 2 FGDs, each one with 6 participants. Mostly were undergraduate students (Bachelor’s degree), in the field of health area. The thematic analysis revealed three main themes. The first theme was related to the personal sphere and included most of adjustment strategies used, namely: pandemic as a “window of opportunity” to be involved in new academic and professional projects; work-life balance by organizing and separating work from private life; selfcare through the adoption of healthy lifestyles; being compassionate with others and compliance with sanitary measures. In the social sphere, students evoked new ways of communicating via digital networking to compensate for the lack of physical proximity and stay in safe contact with friends and relatives. In the contextual sphere, students talked about the importance of adapting the “teaching/learning” environment. Tailored teaching support was a significant strategy, especially in maintaining their motivation. Conclusions: Several strategies were pointed by students to stay mentally healthy and mitigate delayed-onset post-traumatic stress disorder during the COVID-19 pandemic. Besides, positive coping and hope should be integrated into the standard training of students across all study areas.info:eu-repo/semantics/publishedVersio

Improving rainwater-use in Cabo Verde drylands by reducing runoff

Dryland agriculture in Cabo Verde copes with steep slopes, inadequate practices, irregular intense rain, recurrent droughts, high runoff rates, severe soil erosion and declining fertility, leading to the inefficient use of rainwater. Maize and beans occupy N80% of the arable land in low-input, low-yielding subsistence farming. Three collaborative field trialswere conducted in different agroecological zones to evaluate the effects ofwater-conservation techniques (mulching of crop residue, a soil surfactant and pigeon-pea hedges) combinedwith organic amendments (compost and animal or green manure) on runoff and soil loss. During the 2011 and 2012 rainy seasons, three treatments and one control (traditional practice) were applied to 44- and 24-m2 field plots. A local maize variety and two types of beanswere planted. Runoff and suspended sedimentswere collected and quantified after each daily erosive rainfall. Runoff occurred for rainfalls≥50mm(slope b10%, loamy Kastanozem),≥60mm(slope≤23%, silt–clay–loam Regosol) and≥40mm(slope≤37%, sandy loam Cambisol). Runoffwas significantly reduced only with themulch treatment on the slope N10% and in the treatment of surfactant with organic amendment on the slope b10%. Soil loss reached 16.6, 5.1, 6.6 and 0.4 Mg ha−1 on the Regosol (≤23% slope) for the control, surfactant, pigeon-pea and mulch/pigeon-pea (with organic amendment) treatments, respectively; 3.2, 0.9, 1.3 and 0.1 Mg ha−1 on the Cambisol (≤37% slope) and b0. 2Mg ha−1 for all treatments and control on the Kastanozem(b10% slope). Erosion was highly positively correlated with runoff. Mulch with pigeon-pea combinedwith an organic amendment significantly reduced runoff and erosion fromagricultural fields on steep slopes, contributing to improved use of rainwater at the plot level. Sustainable land management techniques, such as mulching with pigeon-pea hedges and an organic amendment, should be advocated and promoted for the semiarid hillsides of Cabo Verde prone to erosion to increase rainwater-use and to prevent further soil degradation