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Browsing ESEP - Artigos e Conference Proceedings by Author "Abreu, Wilson"
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- Achieving Prudent Dementia Care (Palliare): An International Policy and Practice ImperativePublication . Tolson, Debbie; Fleming, Anne; Hanson, Elizabeth; Abreu, Wilson; Crespo, Manuel Lillo; Macrae, Rhoda; Jackson, Graham; Hvalič-Touzery, Simona; Holmerová, Iva; Routasalo, PirkkoThis paper examines the provision of integrated advanced dementia care within seven European countries and critically reviews the potential contribution of the Prudent Healthcare perspective as a starting point for reform. Progressive efforts to innovate, promote quality and integrate care are tempered with the reality of resource constraints. Some policy makers in Europe and North America have turned their attention to the principles of Prudent Healthcare as a potential mechanism to maximise benefits for patients within available resources. As dementia progresses, living well requires increasing levels of support and care, people living with advanced dementia have complex health and social care needs, are highly dependent on others but are not yet at the terminal end stage of the condition. People with advanced dementia can benefit from a dementia specific palliative approach to care (Palliare), that helps them to live the best life possible for the months and often years they live with advanced dementia. It is also highly desirable to align policy innovations with integrated palliative care practice models and the education of the dementia workforce to accelerate informed improvements in advanced dementia care. There may be some coherence, at least superficially between Prudent Healthcare and integrated palliative care models such as Palliare. It is argued that for successful implementation, both require practitioners to be equipped with knowledge and skills and be empowered to deliver high quality care often within impoverished care environments. Adoption of the prudent perspective will however require development of a repertoire of approaches to hear the voice or proxy voice of people living with advanced dementia and to commit to the development and implementation of new evidence for advanced dementia practice. Evidence informing this policy debate draws upon contemporary literature and policy and the findings from research activities undertaken by the Palliare project supported through the Erasmus+ K2 Strategic Partnerships funding programme.
- An Intelligent Multicriteria Model for Diagnosing Dementia in People Infected with Human Immunodeficiency VirusPublication . Pinheiro, Luana I. C. C.; Pereira, Maria Lúcia D.; Andrade, Evandro C. de; Nunes, Luciano C.; Abreu, Wilson; Pinheiro, Pedro Gabriel Calíope D.; Holanda Filho, Raimir; Pinheiro, Plácido RogerioHybrid models to detect dementia based on Machine Learning can provide accurate diagnoses in individuals with neurological disorders and cognitive complications caused by Human Immunodeficiency Virus (HIV) infection. This study proposes a hybrid approach, using Machine Learning algorithms associated with the multicriteria method of Verbal Decision Analysis (VDA). Dementia, which affects many HIV-infected individuals, refers to neurodevelopmental and mental disorders. Some manuals standardize the information used in the correct detection of neurological disorders with cognitive complications. Among the most common manuals used are the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) of the American Psychiatric Association and the International Classification of Diseases, 10th edition (ICD-10)—both published byWorld Health Organization (WHO). The model is designed to explore the predictive of specific data. Furthermore, a well-defined database data set improves and optimizes the diagnostic models sought in the research.
- Application of Data Mining Algorithms for Dementia in People with HIV/AIDSPublication . Pinheiro, Luana Ibiapina Cordeiro Calíope; Pereira, Maria Lúcia Duarte; Fernandez, Marcial Porto; Filho, Francisco Mardônio Vieira; Abreu, Wilson; Pinheiro, Pedro Gabriel Calíope DantasDementia interferes with the individual’s motor, behavioural, and intellectual functions, causing him to be unable to perform instrumental activities of daily living. This study is aimed at identifying the best performing algorithm and the most relevant characteristics to categorise individuals with HIV/AIDS at high risk of dementia from the application of data mining. Principal component analysis (PCA) algorithm was used and tested comparatively between the following machine learning algorithms: logistic regression, decision tree, neural network, KNN, and random forest. The database used for this study was built from the data collection of 270 individuals infected with HIV/AIDS and followed up at the outpatient clinic of a reference hospital for infectious and parasitic diseases in the State of Ceará, Brazil, from January to April 2019. Also, the performance of the algorithms was analysed for the 104 characteristics available in the database; then, with the reduction of dimensionality, there was an improvement in the quality of the machine learning algorithms and identified that during the tests, even losing about 30% of the variation. Besides, when considering only 23 characteristics, the precision of the algorithms was 86% in random forest, 56% logistic regression, 68% decision tree, 60% KNN, and 59% neural network. The random forest algorithm proved to be more effective than the others, obtaining 84% precision and 86% accuracy
- Assessment of the attitude towards childbirth in health sciences students - development and validation of the questionnaire Cave-StPublication . González-Mesa, Ernesto; Rengel-Díaz, Cristóbal; Riklikiene, Olga; Thomson, Gilliam; Cazorla-Granados, Olga; Abreu, Wilson; Morgado-Neves, Dulce; Gökçe Isbir, Gözde; Jonsdottir, Sigríður Sia; Karlsdóttir, Sigfríður Inga; Lalor, JoanAbstract The purpose of this study is to report on the validation process of a questionnaire that explores health science students’ attitudes towards women’s childbirth experiences. This questionnaire can help inform education programs to enhance the quality of woman-professional interactions, and to improve women’s experiences of childbirth. A standardized procedure for the development and validation of the questionnaire included: item development and psychometric pre-validation, Cronbach’s Alpha coefficient calculation, test–retest and item-total correlation for the reliability analysis. Content validitywas undertaken by Delphi method with sixteen panelists over two rounds. We determined the factor structure and refined and validated the questionnaire according to the responses of a cohort of 560 students using principal components factor analysis with varimax rotation. Confirmatory factor analysis was undertaken. A 52-items questionnaire CAVE-st: (acronym for cuestionario de actitudes sobre vivencias y experiencias en el parto) was developed and validated. The results of the factor analysis finally revealed four latent dimensions. The questionnaire CAVE-st is a valid and reliable tool to assess health science students’ attitude towards women’s childbirth experiences. Further work to translate and adapt the instrument in other cultures and languages will be undertaken.
- Assessment of the attitude towards childbirth in health sciences students - development and validation of the questionnaire Cave-StPublication . González-Mesa, Ernesto; Rengel-Díaz, Cristóbal; Riklikiene, Olga; Thomson, Gilliam; Cazorla-Granados, Olga; Abreu, Wilson; Morgado-Neves, Dulce; Gökçe Isbir, Gözde; Jonsdottir, Sigríður Sia; Karlsdóttir, Sigfríður Inga; Lalor, JoanThe purpose of this study is to report on the validation process of a questionnaire that explores health science students’ attitudes towards women’s childbirth experiences. This questionnaire can help inform education programs to enhance the quality of woman-professional interactions, and to improve women’s experiences of childbirth. A standardized procedure for the development and validation of the questionnaire included: item development and psychometric pre-validation, Cronbach’s Alpha coefficient calculation, test–retest and item-total correlation for the reliability analysis. Content validity was undertaken by Delphi method with sixteen panelists over two rounds. We determined the factor structure and refined and validated the questionnaire according to the responses of a cohort of 560 students using principal components factor analysis with varimax rotation. Confirmatory factor analysis was undertaken. A 52-items questionnaire CAVE-st: (acronym for cuestionario de actitudes sobre vivencias y experiencias en el parto) was developed and validated. The results of the factor analysis finally revealed four latent dimensions. The questionnaire CAVE-st is a valid and reliable tool to assess health science students’ attitude towards women’s childbirth experiences. Further work to translate and adapt the instrument in other cultures and languages will be undertaken.
- Birth-related PTSD symptoms and related factors following preterm childbirth in TurkeyPublication . Gökçe İsbir, Gözde; İnci, Figen; Kömürcü Akik, Burcu; Abreu, Wilson; Thomson, GillAbstract Objective: To examine factors associated with birth-related post-traumatic stress disorder (PTSD) among women who had preterm birth in their last pregnancy in Turkey.Methods: 304 women were asked to report sociodemographic factors, perinatal factors, birth-related factors, preterm birth/premature infant characteristics, and social support factors and PTSD symptoms. Data were collected using online surveys between November 2020 and February 2021. Hierarchical multiple linear regression was used. Results: The prevalence of birth-related PTSD symptoms following preterm birth was 71.1%. Older age, the woman being positively affected by her own mother’s birth experience, not having traumatic experience in pregnancy and in the postnatal period, lower stress level after traumatic events experienced during birth, not feeling that their life/physical integrity was at risk during birth, having amniotomy, feeling psychologically well after childbirth, not being negatively affected by witnessing other parents’ happy moments with their babies in friend/family groups, the absence of infant illness and mother’s reporting higher positive interactions with healthcare team were associated with decreased likelihood of birth-related PTSD. Except for age and traumatic event in the postnatal period, all the variables explained 43% of the variance with a small effect size (f2 = 0.04). Stress level after the traumatic events experienced during labor was the strongest predictor of birth-related PTSD symptoms (β = 0.33). Conclusion: Wellbeing of mother and baby, facilitating interventions at labor, and positive communication with the healthcare team was associated with lower birth-related PTSD symptoms. The study findings highlighted on birth-related PTSD symptoms in mothers of preterm infants in Turkey.
- Clinical supervision in nuring practice: a comparative study in Portugal and the United KingdomPublication . Abreu, Wilson; Marrow, Carol ElizabethThis research examines the practice of clinical supervision in nursing in both The United Kingdom and Portugal, one important pilar of safety care. The study was funded by the British Council under the Treaty of Windsor scheme. Forty five nurses from both countries completed questionnaires. One focus group interview was held in both countries involving three participants, six in total (only three volunteered) who had also completed the questionnaire. The quantitative data from the questionnaires were analysed using the Statistical Package for the Social Sciences and the qualitative data from both the questionnaires and the focus groups were analysed using Colaizzi’s (1978) framework. The findings suggest that clinical supervision has positive benefits for professional development of nurses and their clinical practice. Constraints are evident, particularly in The United Kingdom and these included lack of time, lack of understanding of clinical supervision and lack of commitment.Implications for Nursing Management: Managers need to support clinical supervision for it is important for quality care and evidence based practice. Protocols for clinical supervision practice would enable managers to lead and support staff’s professional development and help to ensure quality care within the organisation.
- Community education matters: representations of female genital mutilation in Guineans immigrant womenPublication . Abreu, Wilson; Abreu, MargaridaFemale Genital Mutilation is a cultural tradition, recognized as a violation of human rights and dignity of girls. Many countries develop educational programs that offer alternatives to the ritual. The research questions to which we are seeking answers are: what was the meaning of the practice to the populations? In the community educational programs, what does the alternative ritual consist of? The aims of the study were: to explore the experiences of Guineans immigrant women that lived in communities where the practice was performed, to describe how, where, and who was usually involved, to identify the effects of the mutilation, and to evaluate the effectiveness of the educational programs developed to eradicate the practice. A qualitative design was chosen. Data were collected by a semi-structure interview from eight immigrant women from Guinea Bissau living in the North of Portugal. Participants were never invited to answer if they had undergone the practice in the past. A religious leader was invited to mediate the relationship with them. Findings show that Type II is the most common form of mutilation. It was shaped by a complex interplay of cultural factors related to the initiation into womanhood, the status of woman and the need to be accepted by men. We did not find a direct relation between religion and mutilation. Educational programs offer an alternative to the ritual (“symbolic fanado”). The educational programs are in general inclusive and culturally-sensitive. They contribute to the reduction of the prevalence of female mutilation, involving the community and respecting the local culture. Instead of imposition, the programs develop a cultural action for freedom. As a result, in these programs emerges an alternative to the cutting, well accepted by the population.
- Cross-cultural conceptualization of a good end of life with dementia: a qualitative studyPublication . Nishimura, Mayumi; Dening, Karen Harrison; Sampson, Elizabeth L.; de Oliveira Vidal, Edison Iglesias; Abreu, Wilson; Kaasalainen, Sharon; Eisenmann, Yvonne; Dempsey, Laura; Moore, Kirsten J.; Davies, Nathan; Bolt, Sascha R.; Meijers, Judith M. M.; Dekker, Natashe Lemos; Miyashita, Mitsunori; Nakanishi, Miharu; Nakayama, Takeo; van der Steen, Jenny T.Background: Research on the nature of a “good death” has mostly focused on dying with cancer and other life-limiting diseases, but less so on dementia. Conceptualizing common cross-cultural themes regarding a good end of life in dementia will enable developing international care models. Methods: We combined published qualitative studies about end of life with dementia, focus group and individual interviews with the researchers, and video-conferencing and continuous email discussions. The interviews were audio-recorded and transcribed verbatim. The data were analyzed thematically, and the researchers developed common themes referring to their original studies. Results: Fourteen qualitative researchers representing 14 cross-cultural studies covering qualitative data of 121 people with dementia and 292 family caregivers. The researchers and data were from eight countries UK, The Netherlands, Japan, Portugal, Germany, Canada, Brazil, and Ireland. Three focus groups, five individual interviews, and video-conferencing were conducted and feedback on multiple iterations was gained by 190 emails between May 2019 and April 2020 until consensus was achieved. Nine cross-culturally common themes emerged from the discussions and shared interpretation of the data of persons with dementia and family caregivers. Three represent basic needs: “Pain and Symptoms Controlled,” “Being Provided Basic Care,” and “A Place like Home.” Other themes were “Having Preferences Met,” “Receiving Respect as a Person,” “Care for Caregivers,” “Identity Being Preserved,” “Being Connected,” and “Satisfaction with Life and Spiritual Well-being.” “Care for Caregivers” showed the greatest difference in emphasis across cultures. Good relationships were essential in all themes. Conclusions: The common cross-cultural themes comprise a framework underpinned by value placed on personhood and dignity, emphasizing that interdependency through relationships is essential to promote a good end of life with dementia. These themes and valuing the importance of relationships as central to connecting the themes could support care planning and further development of a dementia palliative care model.