Browsing by Author "Costa, Nilza"
Now showing 1 - 10 of 10
Results Per Page
Sort Options
- Cuidar de cuidadores informais de pessoas idosas dependentes: Concepção de um programa de intervençãoPublication . Abreu, Margarida; Leite, Alcione; Costa, NilzaIntrodução: O envelhecimento da população e as políticas de contenção de custos em Portugal estão a provocar mudanças na prestação de cuidados de saúde, nomeadamente, às pessoas idosas. Quando estas adoecem, face a imperativos económicos, legais, culturais e religiosos as famílias são responsabilizadas pela prestação de cuidados no domicilío. É frequente os cuidadores informais que assumiram os cuidados às pessoas idosas, por instinto, vontade, disponibilidade ou capacidade, manifestarem desespero, cansaço e ansiedade. Assim, surgiu o interesse em construir, implementar e avaliar um programa psicoeducacional destinado aos cuidadores informais de pessoas idosas dependentes. Este trabalho tem como objectivo descrever o processo de elaboração de um programa de intervenção, em articulação com os profissionais de saúde e a população de cuidadores. Metodologia: Estudo de investigação acção, em que participaram 55 cuidadores de pessoas idosas depentendes, inscritas numa USF da Trofa. Como instrumento de avaliação inicial utilizamos o COPE Index (McKee et al., 2003). Análise dos resultados: Os participantes neste estudo tinham idades compreendidas entre os 51 e os 71 anos; eram maioritariamente mulheres (91%), casadas ou a viver em união de facto (82%), possuíam o primeiro ciclo do ensino básico (67,3%). Em termos de necessidades sentidas, 28,4% dos cuidadores manifestaram desejo de apoio emocional e psicológico; 25,7% formação na área da prestação de cuidados e apoio para a prestação de cuidados. Discussão dos resultados: Segundo a literatura a partir dos nossos resultados poderemos construir um programa com as pessoas cuidadoras e com os profissionais de saúde, encorajando-os a discutir os seus planos. Conclusões: Face aos resultados do nosso estudo prévio e em articulação com os cuidadores e com profissionais de saúde da USF foi elaborado um programa psicoeducacional. Com o programa pretendemos oferecer às pessoas cuidadoras inform
- Family Caregivers of Terminally Ill Patients at Home: Contributions for a Supervision ModelPublication . Teixeira, Maria; Abreu, Wilson; Costa, NilzaBackground: Nowadays, family caregivers play a critical role in the support of terminally ill at home. However, there are relatively few supervision models to help nurses in make decisions. Objectives: Contribute to a caregiver supervision model. Methodology In a prior study, the needs of 10 terminally ill and their caregivers were identified. In the present study, based on a focus group, 8 expert nurses analysed the needs and validated both the functions and the focus of supervision. Results Data on terminally ill pacients confirm the normative function of supervision through the diagnostic criteria ffor sel-care deficit and risks. The formative function of supervision is evident when family caregivers have no knowledge/skill to provide care or are not aware of aproblem. Finally, the restorative function concerns the assessment of the caregivers’ physical, emotional and relational capacity, as well as their time and resources available to provide care. Conclusion The contribuctions of our study emphasises a 3 function model that covers the needs of terminally il patients and their family caregivers
- Perceção dos familiares cuidadores de pessoas com esquizofrenia no âmbito de um programa de intervenção em educação para a saúdePublication . Lomeo, Roselane; Costa, Nilza; Abreu, Wilson
- Perception of caregivers of persons with schizophrenia about a health education programPublication . Lomeo, Roselane; Costa, Nilza; Abreu, WilsonThe mental health policy of Brazil has been guided by the search for citizenship, social equality and autonomy of the individuals with mental disorders and it started with the deinstitutionalization process. On the other hand, this paradigm shift contributed to making the patients stay in the family environment and thus the need for family members to play the role of caregivers. The attributions of these care functions have contributed to a physical and emotional overload. Using a psychoeducational approach focused on the family member/caregiver of people with schizophrenia, this study proposed to check the caregivers' perception about the importance of the practice of relaxation activities for the promotion of selfcare. The intervention was performed during a six-month period. Participants were 31 family caregivers of mental health cohabitation centers in the city of Belo Horizonte, Brazil. Using the relatives’ reports about the perception of the intervention, categories were listed and treated with the support of the software webQDA. The results revealed through the family members' perception, that the intervention program provided them with contributions such as wellbeing, self-control over impulses, increased self-esteem, and encouragement for self-care. The literature reinforces that the educational practice in health is composed of educational activities aimed at the development of individual and collective capacities aimed at improving the health and quality of life of people. The intervention program with relaxation exercises contributed to an improved physical and mental health for family caregivers, awakening them to self-care
- Os programas psicoeducacionais e a promoção do autocuidado dos cuidadores familiares de pessoas com demênciaPublication . Abreu, Margarida; Luzio, Diana; Castro, Lisneti; Bartolo, Ana; Freitas, Susana; Pereira, Anabela; Abreu, Wilson; Costa, Nilza
- Psychoeducational programs for informal caregivers of dependent older adults: Barriers to participationPublication . Abreu, Margarida; Silva, Alcione Leite; Costa, Nilza; Abreu, WilsonPsychoeducational programs (PEP) are recommended to provide support to informal caregivers. Evidences show low levels of participation in such programs. Removing barriers is necessary to promote effective programs. The research questions were as follows: what are the barriers to the participation of caregivers of dependent older adults in a PEP? What are the factors that motivate caregivers to participate in a PEP? The main purpose of this study was to analyze the barriers to the participation of informal caregivers of dependent older adults in a PEP and to identify the factors that promote the participation of informal caregivers of dependent older adults in a PEP. A qualitative approach was used for this study, conducted with twenty-four informal caregivers of dependent older adults registered at a Family Health Unit in Trofa County, Portugal. Data were collected using semi-structured interviews. For the analysis of empirical material, the content analysis technique proposed by Bardin was used. The “situational” barriers to the participation were most prevalent (need to escort the care recipient to medical visits, cost of transportation, lack of time due to caregiving tasks, or professional activity). The factors that favored participation mostly corresponded to the “psychosocial” (interest in acquiring additional knowledge and skills) and “institutional” categories (interest in the program content). The results demonstrate that inclusion of the participants in the design, implementation, and assessment of the program, as was the case, did not suffice to facilitate the program participation - the multiple barriers to their participation should also have been taken into account. Only by recognizing such barriers will the program become more effective and efficient for the caregivers.
- Response of non-motor symptoms to levodopa in late-stage Parkinson's disease: results of a levodopa challenge testPublication . Fabbri, Margherita; Coelho, Miguel; Guedes, Leonor Correia; Chendo, Inês; Sousa, Catarina; Rosa, Mario M.; Abreu, Daisy; Costa, Nilza; Godinho, Catarina; Antonini, Angelo; Ferreira, Joaquim J."BACKGROUND: Non-motor symptoms (NMS) are extremely common among late-stage Parkinson's disease (LSPD) patients. Levodopa (L-dopa) responsiveness seems to decrease with disease progression but its effect on NMS in LSPD still needs to be investigated. OBJECTIVE: To assess the response of blood pressure (BP), pain, fatigue and anxiety to L-dopa in LSPD patients. METHODS: 20 LSPD patients, defined as Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 (MED ON) and 22 PD patients treated with subthalamic deep brain stimulation (advanced PD group) underwent an L-dopa challenge. BP and orthostatic hypotension (OH) assessment, a visual analogue scale (VAS) for pain and fatigue and the Strait Trait Anxiety (STAI) were evaluated before and after the L-dopa challenge. RESULTS: Systolic BP dropped significantly after L-dopa intake (p < 0.05) in LSPD patients, while there was no change in pain, fatigue or anxiety. L-dopa significantly improved (p < 0.05) pain and anxiety in the advanced PD group, whereas it had no effect on BP or fatigue. L-dopa-related adverse effects (AEs), namely OH and sleepiness, were more common among LSPD patients. 40% and 65% of LSPD patients were not able to fill out the VAS and the STAI, respectively, while measurement of orthostatic BP was not possible in four LSPD patients. CONCLUSIONS: This exploratory study concludes that some non-motor variables in LSPD do not benefit from the acute action of L-dopa while it can still induce disabling AEs. There is a need for assessment tools of NMS adapted to these disabled LSPD patients."
- The relationship between frailty, functional dependence, and healthcare needs among community‐dwelling people with moderate to severe dementiaPublication . Abreu, Wilson; Tolson, Debbie; Jackson, Graham A.; Staines, Harry; Costa, NilzaThis paper examines the healthcare needs of community-dwelling older people living in Porto, Portugal, diagnosed with moderate or severe dementia, linked to functional dependency, cognitive decline, limitations in the activities of daily life, and frailty levels. A sample of 83 participants was recruited. Data were collected between 2013 and 2017. A sociodemographic questionnaire, the Clinical Dementia Rating (CDR), the Barthel Index (BI), the Lawton and Brody Instrumental Activities of Daily Living (IADL) Scale, and the Edmonton Frail Scale (EFS) were used. A set of 26 healthcare needs was defined to support the assessment. The Pearson chi-square or Fisher's exact test (as appropriate) was used to examine the association of the needs (unmet and met) with the levels of dementia and frailty. Participants were diagnosed previously with moderate or severe dementia and benefited from a structured home-care program. There was a high number rated as "severe dementia," "fully dependent," "severely or fully dependent in the activities of daily living (ADL)," and "severe frailty." There were statistically significant differences among needs identified in people with moderate or severe dementia and moderate or severe frailty. The most prevalent healthcare needs in the sample were food preparation, medication/taking pills, looking after their home, toilet use, sensory problems, communication/interaction, bladder, bowels, eating and drinking, memory, sleeping, and falls prevention. In particular, the study identifies a set of needs that are present simultaneously in both frailty and dementia stages. This study underlines that despite well-structured home-care programs for people with dementia, unmet health needs remain. Timely healthcare needs assessment may help professionals to avoid fragmented care and to tailor quality-integrated interventions, including the emotional and psychological balance of the caregiver.
- O trabalho do tutor na aprendizagem clínica dos estudantes: recurso ao processo supervisivoPublication . Soares, Sérgio; Abreu, Wilson; Costa, NilzaA investigação sobre supervisão e ensinos clínicos dos estudantes do curso de licenciatura em Enfermagem tem vindo a realçar a centralidade do tutor. Häggman-Laitila et al. (2007) sugerem a sistematização do seu trabalho. A pesquisa é parte de outra mais abrangente que circunda a complexidade da formação dos estudantes de enfermagem em contexto clínico, sendo o focus de atenção a intervenção supervisiva do tutor. Os objetivos foram: analisar atividades de orientação dos estudantes; caraterizar expectativas em relação ao tutor; avaliar como as parcerias interferem no trabalho do tutor e identificar fatores contextuais que se interpõem com as funções do tutor. Recorremos à observação etnográfica em três contextos distintos durante seis meses: USF, UCP e unidade de cirurgia. Socorremo-nos de um grupo de peritos e à análise documental. As representações em relação às problemáticas apresentadas foram assentes através da análise de conteúdo temática. Os principais resultados situam-se nas seguintes dimensões: atividades cuidativas e formativas do tutor, expetativas dos atores sobre o trabalho do tutor, recurso a estratégias supervisivas (reflexão, observação, questionamento, comunicação e avaliação) e a avaliação do desempenho do tutor. As dificuldades manifestas no decurso da tutoria situam-se fundamentalmente em áreas com sentido para a Enfermagem (promoção do autocuidado, gestão do regime terapêutico, gestão de sinais e sintomas). Concluímos que o tutor evidencia uma preocupação com a relação entre pares e com a gestão de emoções. O acompanhamento do estudante é pouco sistematizado e colocase também em evidência a necessidade de uma avaliação consistente do tutor.
- Understanding family caregivers’ needs to support relatives with advanced progressive disease at home: an ethnographic study in rural PortugalPublication . Teixeira, Maria João Cardoso; Abreu, Wilson; Costa, Nilza; Maddocks, MatthewFamily caregivers play an important role supporting their relatives with advanced progressive disease to live at home. There is limited research to understand family caregiver needs over time, particularly outside of high-income settings. The aim of this study was to explore family caregivers' experiences of caring for a relative living with advanced progressive disease at home, and their perceptions of met and unmet care needs over time.