Percorrer por autor "Guerreiro, Mara Pereira"
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- Alcohol-antibacterial drug interactions: comparison of three drug compendiaPublication . Lança, Teresa; Auxtero, Deolinda; Costa, Isabel Margarida; Guerreiro, Mara Pereira
- Barriers and strategies for pain management in non-verbal people with dementia in residential care facilities : protocol for an e-Delphi studyPublication . Félix, Isa Brito; Ramos, Catarina; Guerreiro, Rui; Hughes, Jeffery David; Hoti, Kreshnik; Andrade, Teresa; Guerreiro, Mara PereiraIntroduction: Pain is a prevalent symptom in people living with dementia. Evidence shows that pain frequently remains unrecognised and untreated in this vulnerable population, leading to avoidable suffering. Effective pain management is hindered by multifactorial barriers at the individual, organisational and policy level. This study aims to achieve expert consensus on the key barriers to pain management in non-verbal people living with dementia and strategies to address these barriers within Portuguese residential care facilities. Methods and analysis: An e-Delphi study will be conducted using two rounds of online questionnaires. The Behaviour Change Wheel (BCW) framework guided the development of e-Delphi statements by linking identified determinants (i.e., barriers and facilitators) to intervention functions. Barriers were extracted from the literature reviews and mapped into the capability, opportunity and motivation–behaviour model. Intervention functions were then selected using the BCW linkage matrices and operationalised into practical strategies. A purposive and snowball sampling approach will be used to recruit a heterogeneous panel of experts across national residential care facilities, including nurses, physicians, managers and policymakers with relevant experience in dementia. During the e-Delphi rounds, participants will be invited to rate the relevance of each barrier and associated strategy(ies) on a five-point Likert scale and provide comments or suggestions. Consensus will be defined as ≥75% agreement on each statement. Ethics and dissemination: Ethical approval for this study was obtained from the Egas Moniz Ethics Committee (Ref. 1586), and all procedures will comply with the Declaration of Helsinki. Informed consent will be obtained from all participants. The findings will be disseminated through a peer-reviewed publication, scientific events and stakeholder networks, including residential care facilities, to inform future practice and policy in dementia care.
- Consensual improvement actions for the Tuberculosis Control Programme in Pernambuco state, Brazil: an e-Delphi studyPublication . Bezerra, Simone Santos; Guerreiro, Mara Pereira; Sobrinho, José Lamartine SoaresObjectives: Tuberculosis (TB) remains a major public health problem, particularly in low and middle-income countries. The aim of this study is to consensualise improvement actions for the Tuberculosis Control Programme of the Pernambuco state (SPTC), Brazil. Methods: Firstly, a preliminary workshop was conducted with experts (n = 8), including key stakeholders and health professionals, to select structure and process indicators pertaining to the tuberculosis control programme. Then, an e-Delphi was carried out with a purposive sample of 11 local TB experts. The first-round questionnaire was comprised of 19 open-ended questions on possible improvement actions, based on programme indicators obtained in the previous stage. In the second-round experts rated each action for relevance and feasibility, using a four-point scale. In the last round the participants rated the actions again, in the light of group's answers. We used published criteria to define consensus at the outset of the study. Key findings: Eighty-nine improvement actions achieved a high degree of consensus in both feasibility and relevance in round three. Eighty-six actions were grouped under 19 structure and process indicators, while three were consideredcross-sectional in scope (i.e. related to more than one indicator). Ten out of the 86 actions obtained at least 70% of ratings on the highest score of the scale both for relevance and feasibility. These included: "Request and availability of sputum pots can be made by any health professional in the health unit". Conclusions: The wide array of actions obtained in this Delphi represent a resource from which local SPTC services can select the actions most suitable for each context. The ten most relevant and feasible actions represent a particularly useful starting point to streamline change and potentially improve programme indicators.
- Conversational agents for health and well-being across the life course: protocol for an evidence mapPublication . Guerreiro, Mara Pereira; Angelini, Leonardo; Henriques, Helga Rafael; Kamali, Mira El; Baixinho, Cristina; Balsa, João; Félix, Isa brito; Khaled, Omar Abou; Carmo, Maria Beatriz; Cláudio, Ana Paula; Caon, Maurizio; Daher, Karl; Alexandre, Bruno; Padinha, Mafalda; Mugellini, ElenaBackground: Conversational agents, which we defined as computer programs that are designed to simulate two-way human conversation by using language and are potentially supplemented with nonlanguage modalities, offer promising avenues for health interventions for different populations across the life course. There is a lack of open-access and user-friendly resources for identifying research trends and gaps and pinpointing expertise across international centers. Objective: Our aim is to provide an overview of all relevant evidence on conversational agents for health and well-being across the life course. Specifically, our objectives are to identify, categorize, and synthesize—through visual formats and a searchable database—primary studies and reviews in this research field. Methods: An evidence map was selected as the type of literature review to be conducted, as it optimally corresponded to our aim. We systematically searched 8 databases (MEDLINE; CINAHL; Web of Science; Scopus; the Cochrane, ACM, IEEE, and Joanna Briggs Institute databases; and Google Scholar). We will perform backward citation searching on all included studies. The first stage of a double-stage screening procedure, which was based on abstracts and titles only, was conducted by using predetermined eligibility criteria for primary studies and reviews. An operational screening procedure was developed for streamlined and consistent screening across the team. Double data extraction will be performed with previously piloted data collection forms. We will appraise systematic reviews by using A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2. Primary studies and reviews will be assessed separately in the analysis. Data will be synthesized through descriptive statistics, bivariate statistics, and subgroup analysis (if appropriate) and through high-level maps such as scatter and bubble charts. The development of the searchable database will be informed by the research questions and data extraction forms. Results:As of April 2021, the literature search in the eight databases was concluded, yielding a total of 16,351 records. The first stage of screening, which was based on abstracts and titles only, resulted in the selection of 1282 records of primary studies and 151 records of reviews. These will be subjected to second-stage screening. A glossary with operational definitions for supporting the study selection and data extraction stages was drafted. The anticipated completion date is October 2021. Conclusions: Our wider definition of a conversational agent and the broad scope of our evidence map will explicate trends and gaps in this field of research. Additionally, our evidence map and searchable database of studies will help researchers to avoid fragmented research efforts and wasteful redundancies. Finally, as part of the Harnessing the Power of Conversational e-Coaches for Health and Well-being Through Swiss-Portuguese Collaboration project, our work will also inform the development of an international taxonomy on conversational agents for health and well-being, thereby contributing to terminology standardization and categorization.
- Conversational agents for pharmaceutical use: insights from the eCCo databasePublication . Guerreiro, Mara Pereira; Henriques, Helga Rafael; Mugellini, Elena; Angelini, LeonardoConversational agents are computer programmes designed to replicate bidirectional human conversation through spoken or written language, potentially supplemented with nonverbal features. The eCCo database is a searchable repository of primary studies on conversational agents in health and well-being. It catalogs 657 papers currently, published between 1991 and 2022; 51 address the use of medicines. Most of these papers focus on usability rather than rigorous effectiveness or implementation research, underscoring a need for more robust evaluation. The largest category of conversational agents for pharmaceutical use consists of non-embodied agents (n = 24), followed by virtual embodiment only (n = 19), most using virtual humans (n = 16). This database facilitates the comparison and appraisal of existing research in this field, while contributing to a more nuanced understanding of this technology through multidimensional attributes. We aim to enhance the database accuracy and expand its completeness beyond 2022 with the support of the global research community.
- Cross-cultural validation and psychometric evaluation of the Self-Medication Assessment Tool (SMAT) for assessing and optimizing medication therapy management of older peoplePublication . Advinha, Ana Margarida; Barros, Carla Teixeira de; Guerreiro, Mara Pereira; Nunes, Carla; Lopes, Manuel José; Oliveira-Martins, Sofia deBackground, rationale and objectives: The assessment of medication management ability in the elderly can be performed using specific tools, such as the Self-Medication Assessment Tool, which considers real and simulated regimens. The objective of this study was to perform the linguistic and cultural adaptation of the Self-Medication Assessment Tool to European Portuguese and determine its psychometric properties. Methods: The adaptation commenced with the translation/back translation cycle completed by 4 independent bilingual experts. The cultural component was accomplished through an external expert meeting and a longitudinal screening of concepts and construct. The pilot study was carried out in a sample of 150 Portuguese community-dwelling elders. Descriptive data, correlations, internal reliability, response consistency and exploratory factor analysis was conducted using SPSS Statistics (v22). Results: The pilot study was carried out in a sample of 150 community-dwelling elders: 112 (74.7%) participants were women; mean age was 74.73 ± 6.43 years. The Self-Medication Assessment Tool (Portuguese version) standard regimen (simulated medication regimen) mean scores were 20.92 ± 6.83 in functional ability and 38.75 ± 5.92 in cognitive ability; the real regimen (medication taken by the elderly) mean scores were 83.74 ± 15.86 in medication recall, 96.96 ± 11.39 in adherence self-report and 4.82 ± 10.1 in intentional non-adherence. Cronbach's α were 0.87 (functional ability), 0.84 (cognitive ability), 0.57 (medication recall), 0.94 (adherence self-report) and 0.79 (intentional non-adherence). The response consistency between test and re-test was verified. Conclusions: We have developed the European Portuguese version of the Self-Medication Assessment Tool with acceptable psychometric properties which can now be employed in the study of the elderly in clinical and research contexts.
- Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic diseasePublication . Guerreiro, Mara Pereira; Strawbridge, Judith; Cavaco, Afonso Miguel; Félix, Isa Brito; Marques, Marta Moreira; Cadogan, CathalBackground: Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies. Methods: The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases. Results: Twenty-seven competency statements, were presented in Round 1 to the Delphi panel. Consensus was achieved for all statements. Based on comments, two statements were removed, one was added, and 14 were modified. All 15 statements subjected to Round 2 were consensus-approved, yielding a total of 12 foundational competencies for behaviour change in self-management of chronic disease and 14 behaviour change competencies. Four behaviour change competencies related to BCTs. Behavioural psychologists’ feedback led to a core set of 21 BCTs deemed applicable to the five target behaviours across the seven chronic diseases. Conclusions: A behaviour change competency framework comprising 26 statements for European health and other professionals to support self-management of chronic disease was developed, linked with a core set of 21 BCTs from an established taxonomy.
- Editorial : digital approaches in the nutritional prevention and management of chronic diseasesPublication . Guerreiro, Mara Pereira; Félix, Isa Brito; Camolas, José
- ‘Everyone plays defence’: a qualitative exploration of issues that influence the prescribing of antibiotics by Portuguese dentistsPublication . Oliveira, Ana Sofia; Guerreiro, Mara PereiraObjective: The aim of this study was to explore issues influencing antibiotic prescribing by Portuguese dentists. Methods: Semi-structured qualitative interviews were conducted with 14 purposively selected dentists. Interviews were audio-recorded with consent, anonymised during verbatim transcription and analysed using the five-stage ‘Framework Approach’, with the aid of the software WebQDA. Ethical approval was granted. Results: ‘Defensive’ practice emerged as a significant influence on antibiotic prescribing by Portuguese dentists, based on concerns related to avoiding clinical complications and fears of losing patients. Analysis indicated a divide regarding the influence of guidelines on antibiotic prescribing; their influence seemed subtle, even among those who claimed to use them for decision-making. The influence of peers appeared minimal, although less experienced dentists considered it an issue. Dentists recognised the existence of patient pressure; patient demand for antibiotics was mentioned, as well as expectations of not being prescribed such drugs. Pressure from pharmaceutical sales representatives was not unanimously acknowledged; even those mentioning it attempted to demonstrate reluctance in changing prescribing habits. Clinical experience recurred in the dataset as an overarching influence on antibiotic prescribing. Conclusions: The main factors that influence antibiotic prescribing appear to be issues intrinsic to dentists, such as a defensive practice and clinical experience; issues related to the environment seem less prominent. Multimodal interventions targeting both knowledge gaps and these intrinsic issues, such as audit and feedback combined with behaviour change messages, may be useful in optimising antibiotic prescribing in Portuguese dentistry.
- Influences on antibiotic prescribing by dentists: insights from a pilot studyPublication . Oliveira, Ana Sofia; Guerreiro, Mara Pereira
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