Medo e ansiedade dentária: uma realidade

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina DentáriaIntrodução: O medo e a ansiedade dentária emergem como principais fatores condicionantes do tratamento dentário de alguns pacientes e que interferem também na sua condição psicológica. Os pacientes ansiosos, medrosos ou fóbicos adiam a consulta de Medicina Dentária, evitam os tratamentos e só recorrem ao Médico Dentista quando surgem os sintomas dolorosos. As deteriorações consecutivas agravam o estado de saúde da cavidade oral e o tratamento tardio será mais invasivo, provocando no paciente desconforto psicológico adicional, potenciando a ansiedade dentária e formando, deste modo, um ciclo vicioso, que estará na base de problemas individuais de saúde, assim como de problemas de saúde pública de difícil solução. Objetivos: Com este estudo pretende-se avaliar a prevalência de ansiedade dentária nos inquiridos e comparar a prevalência obtida com estudos realizados anteriormente, procurando contribuir para a compreensão dos fatores etiológicos que eventualmente levam ao surgimento deste distúrbio. Metodologia: Aplicou-se um questionário constituído por quatro partes, a 150 pacientes que frequentaram as Clínicas de Terapia da Fala, Fisioterapia e Psicologia da Faculdade de Ciências da Saúde da Universidade Fernando Pessoa (FCS-UFP). A primeira parte do questionário corresponde a um conjunto de informações acerca de alguns aspetos de ordem sociocultural no sentido de caraterizar a amostra, a parte seguinte diz respeito ao comportamento individual do inquirido face ao tratamento dentário, na terceira parte diz respeito à Escala Modificada de Ansiedade Dentária, da autoria de Humphris – Modified Dental Anxiety Scale (MDAS), adaptada para a população portuguesa por Lopes e Ponciano (2004) e, por fim, a última parte constituída pelo Dental Fear Survey (DFS), da autoria de Kleinknecht et al. e adaptada para a população portuguesa por Lopes e Ponciano, (2004). Resultados: Neste estudo, salienta-se que entre os 150 inquiridos, segundo a MDAS, 14,7% (n=22) são “muito ansiosos” e 11,3% (n=17) são “ansiosos”. Relativamente à DFS 23,3% (n=35) apresentam “ansiedade elevada” e 76,7% (n=115) detem “ansiedade moderada”. Conclusão: Os indivíduos que apresentam valores mais elevados de ansiedade assumem ter sido alvo de experiência anterior de trauma, faltam frequentemente à consulta movidos pelo medo, são os que mais conhecem acidentes em consultório, os que mais se sentem influenciados por relatos de tais factos e que, mais conhecem e convivem com pessoas próximas, que exteriorizam medo perante a consulta. Estes expressaram ainda que sentiam mais temor perante os estímulos: agulha e broca. Introduction: The dental anxiety and fear rise like the most important factors responsible for some patient’s dental treatments. Also, these interfere with their psychological condition. Anxious, fearful or phobic patients are able to delay the dental medicine visit, to avoid those treatments and they only look for a dentist when painful symptoms arise. The consequent damage worsens the oral health and the next treatment will be more invasive. This will cause additional psychological problems and consequently it will enhance dental anxiety. In this way, a vicious cycle will be on the base of individual and public health problems of hard solution. Objectives: With this study, it’s supposed to evaluate the prevalence of dental anxiety in respondents and after that compare with the prevalence obtained on previous studies. The main aim is to understand the etiological factors which eventually can cause this disorder. Methodology: We applied a questionnaire with four parts, to 150 patients who attended the Speech Therapy, Physical Therapy and Psychology clinics of Health Sciences Faculty of Fernando Pessoa University. The first part has a set of sociocultural informations in order to characterize the sample; the second part talks about the individual behavior of each respondent against the dental treatment; the third one concerns with the Modified Dental Anxiety Scale (MDAS), authored by Humphris, adapted for the portuguese population by Ponciano and Lopes (2004) , and finally, the last part is formed by Dental Fear Survey (DFS), authored by Kleinknecht et al. and adapted for portuguese populations by Lopes and Ponciano, (2004). Results: In this study, it is underlined that among the 150 respondents, according to the MDAS, 14.7% (n = 22) are "very anxious" and 11.3% (n = 17) are "anxious". Regarding DFS 23.3% (n = 35) have "high anxiety" and 76.7% (n = 115) have "moderate anxiety." Conclusion: People who have higher levels of anxiety admit a previous traumatic experience. They say that they don’t go to the dentist because of frightening reasons. They admit that they are the ones who know more accidents related with dental medicine, the ones who feel more influenced by those reports and the ones who know and live more with fearful patients. Furthermore, they tell that they feel more scared with some stimulus: needle and drill

A importância dos espaços verdes para a promoção de Guimarães a capital verde da Europa

Relatório de estágio de mestrado em Geografia (área de especialização em Planeamento e Gestão do Território)O presente relatório de estágio resulta do trabalho desenvolvido sobre as temáticas das cidades sustentáveis, o papel dos espaços verdes públicos urbanos (EVPU) para a sustentabilidade ambiental urbana e a distinção do desempenho ambiental de certas áreas urbanas pela União Europeia. Com efeito, a Comissão Europeia instituiu, em 2006, o Prémio Capital Verde da Europa (CVE) que avalia as cidades com uma população ≥100 000 habitantes em doze componentes ambientais, incluindo as áreas verdes urbanas (e uso sustentável do solo). A Câmara Municipal de Guimarães demonstrou, já em 2013, interesse no prémio CVE, tendo em 2015 formalizado esta intenção, iniciando o processo de candidatura para 2020. Desta forma, a possibilidade de usufruir de um estágio curricular no Departamento de Serviços Urbanos e Ambiente (DSUA), na Divisão de Espaços Verdes (DEV), da Câmara Municipal de Guimarães, entre julho e setembro de 2015, foi essencial para a prossecução da parte empírica deste trabalho. No âmbito deste estágio, a base de dados da DEV relativa aos EVPU de Guimarães foi atualizada, implementando-se uma nova tipologia, com um conjunto de 16 categorias que interrelacionam características como dimensão, localização, uso e função. Concluído o estágio, a oferta de EVPU em Guimarães foi analisada, tanto no município como no perímetro urbano, em função da distribuição espacial das diferentes tipologias, da capitação (m2/hab) para as tipologias englobadas na Estrutura Verde Principal e Secundária, a população residente (por grupo etário) no raio de influência de 300m de EVPU≥0,5ha e a relação espacial com o edificado. A avaliação da carência de EVPU foi efetuada ao nível da freguesia, cruzando a análise da necessidade potencial (definida a partir da densidade populacional, representatividade de moradias uni e bifamiliares e do uso do solo agrícola e florestal) com a da escassez eventual (dada pela área total de EVPU). Os resultados mostram um défice no município de 7,1m2/hab para a Estrutura Verde Principal e de 4,1m2/hab para a Estrutura Verde Secundária, tendo em conta os valores de referência de 20m2/hab e 10m2/hab, respetivamente. Tal não se verifica quanto à capitação de EVPU no perímetro urbano, dado que 57% destes espaços se localiza nesta área. Aqui, 69% dos residentes encontra-se na área de influência de um EVPU≥0,5ha, valor que baixa para 35% em todo o município. Finalmente, concluiu-se que as maiores carências se verificam nas áreas de extensão-agregação urbana atual. Estes valores são bastante baixos comparativamente aos apresentados pelas cidades vencedoras do prémio CVE, implicando um grande esforço futuro de Guimarães nesta componente da candidatura.The present internship report results from the work developed on the themes of sustainable cities, the role of urban public green spaces (UPGS) for urban environmental sustainability and the reward by the European Union of certain urban areas for their environmental performance. Indeed, the European Commission established in 2006 the European Green Capital (EGC) Award that assesses cities which have more than 100,000 inhabitants on the basis of twelve environmental components, including green urban areas (and sustainable land use). The municipality of Guimarães showed, already in 2013, an interest in the EGC award, and in 2015 formalized its intention by starting the application process for 2020. Thus, the possibility to develop a curricular internship at the Department of Urban Services and Environment (DSUA), Green Spaces Division (DEV), of the Municipality of Guimarães, between July and September 2015, was essential for pursuing the empirical part of this work. Under this internship, DEV database concerning the UPGS of Guimarães was updated, by implementing a new typology with a set of 16 categories that relate features such as size, location, use and function. Completed the internship, the UPGS supply of Guimarães was analyzed, in both the municipality and the urban perimeter, based on the spatial distribution of each UPGS type, green space capitation (m2/person) for typologies included in the Main and Secondary Green Structures, resident population (by age group) in the 300m radius of influence of each UPGS≥0,5ha, and spatial relationship with buildings. The evaluation of the lack of UPGS was made at the parish level, crossing the analysis of potential need (based on population density, representativeness of one-or-two-families house type and of agricultural and forestry lands) with the estimation of possible scarcity (given by total area of UPGS). Results show a deficit in the municipality of 7,1m2/person for the Main Green Structure and of 4,1m2/person for the Secondary Green Structure, taking into account the reference values of 20m2/person and 10m2/person, respectively. This does not apply to the urban perimeter, given that 57% of public green spaces are located in this area. Here, 69% of the residents are found in the area of influence of a UPGS ≥0,5ha, a value that lowers to only 35% for the entire municipality. Finally, it was concluded that the greatest lack in UPGS is found in areas of current urban sprawl. These values are quite low comparatively to those presented by the EGC award winning cities, implying a major future effort by Guimarães in respect to this application component

Epigenetic mechanisms underlying prostate cancer radioresistance

Radiotherapy (RT) is one of the mainstay treatments for prostate cancer (PCa), a highly prevalent neoplasm among males worldwide. About 30% of newly diagnosed PCa patients receive RT with a curative intent. However, biochemical relapse occurs in 20-40% of advanced PCa treated with RT either alone or in combination with adjuvant-hormonal therapy. Epigenetic alterations, frequently associated with molecular variations in PCa, contribute to the acquisition of a radioresistant phenotype. Increased DNA damage repair and cell cycle deregulation decreases radio-response in PCa patients. Moreover, the interplay between epigenome and cell growth pathways is extensively described in published literature. Importantly, as the clinical pattern of PCa ranges from an indolent tumor to an aggressive disease, discovering specific targetable epigenetic molecules able to overcome and predict PCa radioresistance is urgently needed. Currently, histone-deacetylase and DNA-methyltransferase inhibitors are the most studied classes of chromatin-modifying drugs (so-called 'epidrugs') within cancer radiosensitization context. Nonetheless, the lack of reliable validation trials is a foremost drawback. This review summarizes the major epigenetically induced changes in radioresistant-like PCa cells and describes recently reported targeted epigenetic therapies in pre-clinical and clinical settings

Natural Products for the Prevention and Treatment of Oral Mucositis—A Review

Cancer, a major world public health problem, is associated with chemotherapy treatments whose administration leads to secondary concerns, such as oral mucositis (OM). The OM disorder is characterized by the presence of ulcers in the oral mucosa that cause pain, bleeding, and difficulty in ingesting fluids and solids, or speaking. Bioactive compounds from natural sources have arisen as an effective approach for OM. This review aims to summarize the new potential application of different natural products in the prevention and treatment of OM in comparison to conventional ones, also providing a deep insight into the most recent clinical studies. Natural products, such as Aloe vera, Glycyrrhiza glabra, Camellia sinensis, Calendula officinalis, or honeybee crops, constitute examples of sources of bioactive compounds with pharmacological interest due to their well-reported activities (e.g., antimicrobial, antiviral, anti-inflammatory, analgesic, or wound healing). These activities are associated with the bioactive compounds present in their matrix (such as flavonoids), which are associated with in vivo biological activities and minimal or absent toxicity. Finally, encapsulation has arisen as a future opportunity to preserve the chemical stability and the drug bioa vailability of bioactive compounds and, most importantly, to improve the buccal retention period and the therapeutic effectsThis research was funded by the project EXPL/BAA-GR/0663/2021—Kiwi4Health—Exploring the Eco-Innovative Re-Use of Kiwiberry, supported by national funds from Fundação para a Ciência e a Tecnologia (Portugal), as well as the project MTS/SAS/0077/2020-Honey+-New reasons to care honey from the Natural Park of Montesinho: A bioindicator of environmental quality & its therapeutic potential. Ana Sofia Ferreira (SFRH/BD/7519/2020) and Ana Margarida Silva (SFRH/BD/144994/2019) are thankful for their Ph.D. grants financed by POPH-QREN and subsidized by the European Science Foundation and Ministério da Ciência, Tecnologia e Ensino Superior. Catarina Macedo is thankful for her scholarship from the project EXPL/BAA-GR/0663/2021. Francisca Rodrigues (CEECIND/01886/2020) is thankful for her contract financed by FCT/MCTES—CEEC Individual Program Contract. This work was financially supported by Portuguese national funds through projects UIDB/50006/2020, UIDP/50006/2020, and LA/P/0008/2020, from the Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES). This work was also financed by national funds from FCT—Fundação para a Ciência e a Tecnologia, I.P., in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences—UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy—i4HBinfo:eu-repo/semantics/publishedVersio

Admission severity of atrial-fibrillation-related acute ischemic stroke in patients under anticoagulation treatment: a systematic review and meta-analysis

In non-valvular-associated atrial fibrillation (AF), direct oral anticoagulants (DOAC) are as effective as vitamin K antagonists (VKA) for the prevention of acute ischemic stroke (AIS). DOAC are associated with decreased risk and severity of intracranial hemorrhage. It is unknown if different pre-admission anticoagulants impact the prognosis of AF related AIS (AF-AIS). We sought to analyze the literature to assess the association between pre-admission anticoagulation (VKA or DOAC) and admission severity of AF-AIS. Methods: A Systematic literature search (PubMed and ScienceDirect) between January 2011 to April 2021 was undertaken to identify studies describing the outcome of AF-AIS. Results: A total of 128 articles were identified. Of 9493 patients, 1767 were on DOAC, 919 were on therapeutical VKA, 792 were on non-therapeutical VKA and 6015 were not anticoagulated. In comparison to patients without anticoagulation, patients with therapeutical VKA and under DOAC presented with less severe stroke (MD −1.69; 95% CI [−2.71, −0.66], p = 0.001 and MD −2.96; 95% Cl [−3.75, −2.18], p < 0.00001, respectively). Patients with non-therapeutical VKA presented with more severe stroke (MD 1.28; 95% Cl [0.45, 2.12], p = 0.003). Conclusions: In AF-AIS, patients under therapeutical VKA or DOAC have reduced stroke severity on admission in comparison to patients without any anticoagulation, with higher magnitude of protection for DOAC.info:eu-repo/semantics/publishedVersio

Microwave- and Ultrasound-Assisted Extraction of Cucurbita pepo Seeds: A Comparison Study of Antioxidant Activity, Phenolic Profile, and In-Vitro Cells Effects

Nowadays there is a growing demand for nutraceuticals to prevent diseases related to redox imbalances, such as atherosclerosis and diabetes, being crucial to search for new matrixes rich in bioactive compounds. This work aims to characterize the value-added compounds extracted from Curcubita pepo seeds using green methodologies, namely microwave-assisted extraction (MAE) and ultrasound-assisted extraction (UAE), employing water as an extracting solvent for two ratios (condition 1: 1 mg/20 mL; condition 2: 2.5 mg/20 mL). The extract with the best antioxidant/antiradical activity in FRAP (71.09 μmol FSE/g DW) and DPPH (5.08 mg TE/g DW) assays was MAE condition 1, while MAE condition 2 exhibited the highest activity in the ABTS assay (13.29 mg AAE/g DW) and TPC (16.89 mg GAE/g DW). A remarkable scavenging capacity was observed, particularly for HOCl, with IC50 values ranging from 1.88–13.50 μg/mL. A total of 21 phenolic compounds were identified, being catechin (4.567–7.354 mg/g DW), caffeine (1.147–2.401 mg/g DW) and gallic acid (0.945–1.337 mg/g DW) predominant. No adverse effects were observed on Caco-2 viability after exposure to MAE extracts, while the other conditions led to a slight viability decrease in NSC-34. These results highlighted that the extract from MAE condition 2 is the most promising as a potential nutraceutical ingredient.This research was funded by UIDB/50006/2020 and UIDP/50006/2020 by the Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES) through national funds. Ana Margarida Silva (SFRH/BD/144994/2019) and Ana Sofia Ferreira (2020.07519.BD) are thankful for the Ph.D. grants financed by POPH‐QREN and subsidized by the European Science Foundation and Ministério da Ciência, Tecnologia e Ensino Superior. Manuela M. Moreira (CEECIND/02702/2017) and Francisca Rodrigues (CEECIND/01886/2020) are thankful for their contracts financed by FCT/MCTES—CEEC Individual Program Contract.info:eu-repo/semantics/publishedVersio

Development and Optimization of a Topical Formulation with Castanea sativa Shells Extract Based on the Concept “Quality by Design”

The proposed study aims to develop and optimize a topical formulation with Castanea sativa shells extract considering the concept of Quality by Design, focusing on a planned development that consider the vulnerabilities of the entire process through risk analysis tools and design of experiments (DoE). A Box–Behnken design with three factors and three levels was used as a statistical tool for the execution of the DoE and the analysis of the response surface methodology responses. The independent variables studied were the quantity of sodium lauryl sulfate (%) (X1), beeswax (%) (X2) and macadamia oil (%) (X3); the dependent variables were pH (Y1), viscosity (Y2) and adhesiveness (Y3). According to the mathematical model, the optimal formulation contains 0.93% of sodium lauryl sulfate, 5.00% of beeswax and 10.00% of macadamia oil. The optimal formulation with the extract was prepared and characterized over the time, regarding organoleptic and technological characteristics, allowing conclusions to be reached regarding its stability. The formulation presented a pleasant odor and was light brown in color, it also demonstrated pseudoplastic-thixotropic behavior and a small reduction in the formulation consistency after 30 days of storage. This study demonstrated the efficiency of the Quality by Design methodology to understand the product variability, supporting that this approach favors a better understanding of the whole process and enables to design a robust development stage, reducing costs and generating high-quality productsThis research was supported by project PTDC/ASP-AGR/29277/2017—Castanea sativa shells as a new source of active ingredients for functional food and cosmetic applications: a sustainable approach, financially supported by national funds by FCT/MCTES and co-supported by Fundo Europeu de Desenvolvimento Regional (FEDER) throughout COMPETE 2020—Programa Operacional Competitividade e Internacionalização (POCI-01-0145-FEDER-029277). The authors are thankful to Sortegel for the samples. Ana Margarida Silva is thankful for her Ph.D. grant (SFRH/BD/144994/2019) financed by POPH-QREN and subsidized by the European Science Foundation and Ministério da Ciência, Tecnologia e Ensino Superior. Francisca Rodrigues (CEECIND/01886/2020) is thankful for her contract financed by FCT/MCTES—CEEC Individual Program Contract. This work was also financed by national funds from FCT - Fundação para a Ciência e a Tecnologia, I.P., in the scope of the project UIDB/50006/2020. This work was also supported by national funds from FCT - Fundação para a Ciência e a Tecnologia, I.P., in the scope of the projects UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences – UCIBIO and project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy - i4HBinfo:eu-repo/semantics/publishedVersio

A efetividade do oxigénio nasal de alto fluxo na insuficiência respiratória: revisão sistemática

Background: respiratory insufficiency is a syndrome with a great impact on hospital admissions, morbidity and mortality. The applicability of High-flow nasal oxygen has been the subject of interest in critically ill patients. Objective: to know the effectiveness of High-flow nasal oxygen as a treatment for respiratory insufficiency in adult patients admitted to the intensive care units. Methods: systematic reviews of effectiveness using the PICO strategy and recommendations from the Joanna Briggs Institute. The survey was carried out in august 2021 using the PubMed and EBSCOhost access platforms. Results: 583 results were identified. Six randomized clinical trials were analyzed. The selection was made after elimination of duplicates; title reading, abstract reading and full text reading according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram. Conclusion: high-flow nasal oxygen proved to be comfortable, tolerable and effective in the treatment of hypoxemic and hypercapnic respiratory insufficiency. It was effective when compared with conventional oxygen therapy in the post-extubation of hypoxemic patients and in reducing partial pressure of carbon dioxide when compared with Non-Invasive Ventilation in hypercapnic patients.Marco contextual: la insuficiencia respiratoria es un síndrome que tiene un gran impacto en los ingresos hospitalarios, la morbilidad y mortalidad. La aplicabilidad del oxígeno nasal de alto flujo ha sido objeto de interés en pacientes críticos. Objetivo: conocer la efectividad del oxígeno nasal de alto flujo en el tratamiento de la insuficiencia respiratoria en adultos en unidades de cuidados intensivos. Métodos: revision sistemática de efectividad utilizando la estrategia PICO y recomendaciones del Instituto Joanna Briggs. La búsqueda se llevó a cabo en agosto de 2021 utilizando las plataformas de acceso PubMed y EBSCOhost. Resultados: se identificaron 583 resultados. Se analizaron seis ensayos clínicos aleatorios. La selección se realizó después de la eliminación de duplicados; lectura de títulos, de resúmenes y de texto completo siguiendo el diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Conclusión: el Oxígeno nasal de alto flujo demostró ser cómodo, tolerable y eficaz en el tratamiento de la insuficiencia respiratoria hipoxémica e hipercápnica. Fue eficaz en comparación con la oxigenoterapia convencional en la postextubación de pacientes hipoxémicos y en la reducción de la presión parcial de dióxido de carbono en comparación con la Ventilación No Invasiva en pacientes hipercápnicos.Enquadramento: a insuficiência respiratória é uma síndrome com grande impacto nos internamentos, na morbilidade e mortalidade. A aplicabilidade do oxigénio nasal de alto fluxo tem sido alvo de interesse no doente crítico. Objetivo: conhecer a efetividade do oxigénio nasal de alto fluxo no tratamento da insuficiência respiratória no adulto em unidades de cuidados intensivos. Métodos: revisão sistemática de efetividade que utiliza a estratégia PICO e recomendações do Joanna Briggs Institute. A pesquisa foi realizada em agosto de 2021 com recurso às plataformas de acesso PubMed e EBSCOhost. Resultados: identificaram-se 583 resultados. Foram analisados seis ensaios clínicos randomizados. A seleção foi feita após eliminação de duplicados; leitura do título, resumos e textos integrais de acordo com o diagrama Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Conclusão: o oxigénio nasal de alto fluxo revelou-se confortável, tolerável e eficaz no tratamento da insuficiência respiratória hipoxémica e hipercápnica. Foi eficaz quando comparado com oxigenoterapia convencional na pós-extubação de doentes hipoxémicos e na redução da pressão parcial de dióxido de carbono quando comparado com a Ventilação Não Invasiva nos doentes hipercápnicos

Needs of patients with mental illness in a community context

Taking into account the different circumstances that make up the community, it becomes a privileged context for the development of interventions in the field of health. It is expected that the person with mental illness, who is integrated in his community, develops skills that allow him an effective recovery, taking into account the importance of promoting recovery in this way. Knowing the perspectives of health professionals about the needs of these people is important for the development of intervention programs in the community and, thus, contribute to the promotion of recovery. MATERIAL & METHODS This paper aims to explore and describe the perspective of health professionals on the needs of people with mental illness. It is a qualitative and exploratory study, based on symbolic interactionism. A convenience sample of 7 health professionals from different areas of training and intervention was used. We chose a semi-structured interview as a data collection instrument. Data analysis was performed using content analysis according to Blumer's assumptions. RESULTS From the analysis of the narratives emerged four dimensions, which include subdimensions. In the Social Relations dimension, two sub-dimensions emerged: relationship with the family and relation with the environment; in the Disease dimension, five sub-dimensions were highlighted: therapeutic intervention with the family, therapeutic intervention with the person, therapeutic regimen, stigma and difficulties caused by the disease; in the Environment dimension, three sub-dimensions were distinguished: knowledge about resources in the community and accessibility, social integration and resources in the community; in the fourth dimension Health Services emerged three subdimensions: continuity of care, articulation between health services and communication between technicians / teams. CONCLUSIONS These results allow a broad understanding of the perspectives of health professionals on the needs of the person with mental illness. We can conclude that these needs are related to the different domains of people's lives, the difficulties being demonstrated in terms of family dynamics, work environment and social relations, and the difficulties in adherence and management of the therapeutic regime are also highlighted, such as difficulties in accessing support networks such as health centers or other outreach, or the inability of people to mobilize means of access to such networks. These results constitute a contribution to the implementation of intervention programs, which should also take into account the needs expressed by the people themselves, which is being studied in a parallel study.This article is a result of the project (NORTE-01-0145-FEDER-023855), supported by Norte Portugal Regional Operational Programme (NORTE 2020), under the PORTUGAL 2020 Partnership Agreement, through the European Regional Development Fund (ERDF).info:eu-repo/semantics/publishedVersio

Necessidades da pessoa com doença mental após alta hospitalar na voz dos profissionais de saúde

Introdução: tendo como referência os valores implícitos no Plano Nacional de Saúde Mental e a importância dos cuidados continuados e integrados, o recovery da pessoa com doença mental torna-se um forte objeto de estudo nesta área de intervenção. O recovery é um processo subjetivo, tendo como filosofia a recuperação clínica e pessoal. Neste sentido, saber quais as necessidades da pessoa com doença mental torna-se um objetivo primordial para se poderem desenhar programas de intervenção assentes nessa subjetividade. Objetivos: explorar a perspetiva dos profissionais de saúde sobre necessidades da pessoa com doença mental após a alta hospitalar. Material e Métodos: estudo qualitativo e exploratório, com base no interacionismo simbólico. Recorreu-se a uma amostra de conveniência de 7 profissionais de saúde de diferentes áreas de formação e intervenção. Optou-se por uma entrevista semiestruturada como instrumento de recolha de dados. A análise dos dados foi efetuada recorrendo à análise de conteúdo segundo os pressupostos de Blumer. Resultados: da análise das narrativas emergiram quatro dimensões, as quais incluem subdimensões. Na dimensão Relações Sociais sobressaíram duas subdimensões: relação com a família e relação com o ambiente; na dimensão Doença, destacaram-se cinco subdimensões: intervenção terapêutica junto da família, intervenção terapêutica junto da pessoa, regime terapêutico, estigma e dificuldades causadas pela doença; na dimensão Ambiente distinguiram-se três subdimensões: conhecimento sobre recursos na comunidade e acessibilidade, integração social e recursos na comunidade; na quarta dimensão Serviços de Saúde emergiram três subdimensões: continuidade de cuidados, articulação entre os serviços de saúde e, comunicação entre técnicos/equipas. Conclusões: estes resultados permitem uma compreensão alargada das perspetivas dos profissionais de saúde sobre as necessidades da pessoa com doença mental. Podemos concluir que estas necessidades estão relacionadas com os diferentes domínios da vida das pessoas. Constituem um aporte para a implementação de programas de intervenção, os quais devem ainda ter em atenção as necessidades expressas pelas próprias pessoas, aspeto que está a ser trabalhado num estudo paralelo.info:eu-repo/semantics/publishedVersio