Será que valeu a pena? A avaliação da experiência do tratamento de procriação medicamente assistida pelos casais inférteis e ajustamento psicossocial um ano após o tratamento

Undergoing Assisted Reproductive Technology (ART) can be a demanding experience. We aimed to describe changes in psychosocial adjustment from ART treatment to one year after and couples’ evaluation of the treatment’s experience. The study used a longitudinal design, with 33 infertile couples who were assessed during their ART treatment and one year after treatment regarding their emotional reactivity, emotional distress and quality of life; additionally, participants were asked to evaluate their treatment experience. Results indicated that from the ART cycle to one year after, couples who have achieved pregnancy showed an increase in positive emotions and a decrease in negative emotions. However, all couples evaluated the experience of ART in a positive way, regardless of treatment outcome, although more positive ratings were found in couples who have achieved pregnancy. It can be concluded that the emotional reactivity and the evaluation of the experience one year after treatment is affected by the treatment outcome.O recurso a técnicas de procriação medicamente assistida (PMA) tem sido descrito como um acontecimento exigente física e psicologicamente. No presente estudo, e utilizando um desenho longitudinal., pretendemos descrever as mudanças no ajustamento psicossocial desde o momento do tratamento até um ano após o tratamento, em 33 casais inférteis portugueses, bem como avaliar, de forma retrospetiva, a experiência do tratamento. Os resultados mostraram que, quando comparado o momento tratamento com um ano mais tarde, os casais cujos tratamentos tinham sido bem- sucedidos tiveram um aumento das emoções positivas e diminuição das negativas. No entanto, de um modo geral, todos os casais avaliaram de forma positiva o tratamento de PMA, independentemente do seu resultado, apesar de os casais que alcançaram uma gravidez terem avaliado a experiência de forma mais positiva. Pode concluir-se que a reatividade emocional e a avaliação da experiência são em parte influenciadas pelo resultado do tratamento

The indirect effect of contextual factors on the emotional distress of infertile couples

Few studies were dedicated to study the role of contextual factors, such as the socioeconomic status and urban or rural residence in emotional distress of infertile couples. This study aimed to explore the impact of contextual factors on emotional distress, either directly or by affecting the importance of parenthood in one's life, which in turn affects emotional distress. In this cross-sectional study, 70 couples recruited during hormonal stimulation phase prior to in vitro fertilisation completed clinical and sociodemographic forms and self-report questionnaires assessing representations about the importance of parenthood and emotional distress. Path analysis using structural equation modelling was used to examine direct and indirect effects among variables. Results indicated that socioeconomic status and place of residence had an impact in emotional distress by affecting the representations about the importance of parenthood in one's life. Gender differences were found regarding model paths, suggesting that the social context may have a stronger influence on women's emotional distress than on their partners’ distress. When delineating psychological interventions, health care providers should consider that cultural values about children and parenthood contribute to shape the infertility experience

Psychosocial adjustment infertility: A comparision study of infertile couples, couples undergoing assisted reproductive technologies and presumed fertile couples

The aim of the present study was to investigate psychosocial adjustment and infertility related stress of infertile couples and couples undergoing Assisted Reproductive Technologies (ART). In a cross sectional study, 148 couples were recruited: 79 couples undergoing ART, 25 infertile couples in their first medical appointment in an infertility centre and no previous ART treatments and 44 childless couples in reproductive age without infertility history. Measures assessed emotional adjustment, quality of life, marital relationship and infertility stress. Couples were the focus of the analysis. Results indicated that couples undergoing ART presented more adjustment difficulties, especially women. No significant differences were found in marital adjustment, althoughART couples idealized their marital relationship to a higher degree. Results are discussed in terms of clinical implications and future research directions. ------ RESUMO ------ O objectivo deste estudo foi investigar o ajustamento psicossocial e o stress associado à infertilidade em casais inférteis e casais que recorreram à Reprodução Medicamente Assistida (RMA). Neste estudo transversal, a amostra foi constituída por 148 casais: 79 casais a realizar tratamento de RMA, 25 casais inférteis, sem tratamentos de RMA anteriores, na sua primeira visita a um serviço de infertilidade e 44 casais em idade reprodutiva, sem filhos e sem história de infertilidade. Foi avaliado o ajustamento emocional, a qualidade de vida, a relação conjugal e o stress associado à infertilidade. Os resultados indicaram que os casais, principalmente as mulheres, que estão a realizar um tratamento de RMA apresentam maiores dificuldades de ajustamento. No que se refere ao relacionamento conjugal, de um modo geral não foram encontradas diferenças, apesar de os casais que recorreram à RMA tenderem a idealizar mais o seu relacionamento conjugal. As implicações clínicas e futuras áreas de investigação são discutidas

Cross-cultural adaptation of Hypertension Knowledge Test into European Portuguese

We aim to validate a European-Portuguese version of the Hypertension Knowledge Test (HKT) questionnaire and examine its factorial structure with a confirmatory factor analysis (CFA). A process of translation and back-translation was performed. A cross-sectional study was developed in which all adult patients taking at least one antihypertensive drug were invited to participate. Data on personal and family history were collected, and the HKT, Strelec, and the Batalla questionnaires were administered. We enrolled 304 patients with a mean age of 68.12±10.83 years. The mean score of HKT was 15.33±2.79. CFA indicated that the construct being tested was unidimensional, and Cronbach’s alpha (α=0.65) showed that the instrument had an acceptable internal consistency. When evaluating concurrent validity, HKT was significantly correlated with the Batalla and Strelec scores. Thus, the Portuguese version of HKT (HKT-pt-PT) can be used either in research or in clinical practice. With this version, a potential standard exists to evaluate knowledge about hypertension, which could avoid the practice of using non-validated questionnaires in Portugal and allow the cross-sectional and longitudinal comparability of studies

time to go public with insulin resistance?

BACKGROUND: It is estimated that around 70% of Type 2 Diabetes Mellitus patients (T2DM) have Non-Alcoholic Fatty Liver Disease (NAFLD). Awareness and education are amongst the major shortcomings of the public health response to the increasing threat of NAFLD. Characterizing the specific NAFLD-related information needs of particular high-risk metabolic communities, for instance, T2DM patients, might aid in the development of evidence-based health promotion strategies, ultimately promoting NAFLD-awareness, treatment adherence and therapeutic success rates. METHODS: Semi-structured interviews with T2DM patients were conducted to gain insight into their awareness of NAFLD, including its relationship with insulin resistance and T2DM. RESULTS: Awareness of NAFLD as a disease entity, as well as its progression to end-stage liver disease or its relationship with other metabolic conditions, including insulin resistance and T2DM was low. Surveillance behaviours were also suboptimal and perceptions on the self-management knowledge and praxis regarding lifestyle intervention components of T2DM treatment seemed detached from those of NAFLD. CONCLUSIONS: Our findings could inform the integration of NAFLD-related content in T2DM health promotion strategies. Rising awareness on NAFLD progression and its relationship with T2DM using culturally and community-relevant constructs might facilitate the development of primary and secondary prevention programmes to promote the adherence to lifestyle interventions by influencing NAFLD threat perceptions.publishersversionpublishe

Abordagem do tabagismo nos grupos de sala de espera como estratégia de promoção à saúde / Approach to smoking in waiting room groups as a health promotion strategy

Objetivo: Relatar a experiência de estudantes de Enfermagem em uma ação educativa sobre o combate ao tabagismo, salientando a necessidade de uma abordagem direcionada, respeitando as particularidades de cada indivíduo e o convidando para uma conversa aberta. Métodos: O estudo consiste em um relato de experiência, de natureza descritiva, e o seu desenvolvimento ocorreu no período de março a maio de 2019.  Resultado: No início da ação houve desinteresse e distanciamento dos participantes, foi preciso que os executores mudassem sua abordagem para atingir seu público. A atividade finalizou com sucesso e com interessados no plano de cessação. Conclusão: Em tempos que o tabagismo é responsável por uma grande parcela de óbitos e fator de risco para doenças crônicas, deve se unir esforços para orientação da população, uma vez que essa dependência é algo evitável e de grande impacto na saúde.