Browsing by Author "Santos, Osvaldo"
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- Assessing quality of life in severe obesity: development and psychometric properties of the ORWELL-RPublication . Camolas, José; Ferreira, André; Mannucci, Edoardo; Mascarenhas, Mário; Carvalho, Manuel; Moreira, Pedro; Carmo, Isabel do; Santos, OsvaldoPURPOSE: Several health-related quality-of-life (HRQoL) dimensions are affected by obesity. Our goal was to characterize the psychometric properties of the ORWELL-R, a new obesity-related quality-of-life instrument for assessing the "individual experience of overweightness". METHODS: This psychometric assessment included two different samples: one multicenter clinical sample, used for assessing internal consistency, construct validity and temporal reliability; and a community sample (collected through a cross-sectional mailing survey design), used for additional construct validity assessment and model fit confirmation. RESULTS: Overall, 946 persons participated (188 from the clinical sample; 758 from community sample). An alpha coefficient of 0.925 (clinical sample) and 0.934 (community sample) was found. Three subscales were identified (53.2 % of variance): Body environment experience (alpha = 0.875), Illness perception and distress (alpha = 0.864), Physical symptoms (alpha = 0.674). Adequate test-retest reliability has been confirmed (ICC: 0.78 for the overall score). ORWELL-R scores were worse in the clinical sample. Worst HRQoL, as measured by higher ORWELL-R scores, was associated with BMI increases. ORWELL-R scores were associated with IWQOL-Lite and lower scores in happiness. CONCLUSIONS: ORWELL-R shows good internal consistency and adequate test-retest reliability. Good construct validity was also observed (for convergent and discriminant validity) and confirmed through confirmatory factor analysis (in both clinical and community samples). Presented data sustain ORWELL-R as a reliable and useful instrument to assess obesity-related QoL, in both research and clinical contexts.
- Effectiveness of Social Prescribing Programs in the PrimaryHealth-Care Context:Publication . Costa, Andreia; Sousa, Carla Joana; Seabra, Paulo; Virgolino, Ana; Santos, Osvaldo; Lopes, Joaquim Manuel de Oliveira; Henriques, Maria Adriana; Nogueira, Paulo; Alarcão, VioletaSocial prescribing (SP) is an approach that promotes the use of local non-clinical activities by people. The referral is usually made by primary health-care professionals, in a process wherein local providers play a pivotal role. The main objective of this study was to identify domains of intervention and evidence about the effectiveness of SP programs regarding health-related outcomes. A systematic literature review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was conducted in PubMed, CINHAL, and SCOPUS. Inclusion criteria of the reviewed papers were as follows: (i) effectiveness studies of interventions designated as SP or interventions entailing SP conceptual components; (ii) interventions with adults. Quality assessment was performed with the Cochrane tool for assessing risk of bias in randomized trials; an assessment tool developed by the US National Heart, Lung and Blood Institute was applied to observational studies. Overall, 13 articles were included for analysis, with a total of 4603 patients. Although three studies comprised a control group, only two followed a randomized controlled trials (RCT) design. Nine principal domains of intervention within SP were identified, with three categories of outcome measures: Physical and psychological wellbeing; Health behaviors and self-efficacy; and Health care resources end economic evaluation. SP is an emergent and promising health-care intervention, and it has been used to promote different health behaviors. Evidence of SP effectiveness on patient’s health and wellbeing is not strong. Further research is needed for understanding how SP can be applied efficiently.
- INDIVIDUO: intervenção nutricional direcionada aos estilos de vida em indivíduos com obesidadePublication . Camolas, José; Santos, Osvaldo; Mascarenhas, Mário; Moreira, Pedro; Carmo, Isabel doO paradigma terapêutico em obesidade força os profissionais de saúde a decisões clínicas partilhadas com o doente. A adoção de novos padrões alimentares depende de múltiplas mudanças comportamentais propostas pelos profissionais de saúde, que podem ter impacto negativo na qualidade de vida dos doentes, dificultando a sua manutenção. Este artigo apresenta o modelo de intervenção nutricional INDIVIDUO. Trata-se de uma intervenção estruturada, que integra recomendações nutricionais baseadas na evidência com estratégias relacionais promotoras de mudança comportamental sustentável. Apresenta-se também o protocolo do primeiro ensaio clínico controlado, que visa avaliar a efetividade desta intervenção. Sendo direcionada a candidatos a cirurgia da obesidade, em contexto de consulta multidisciplinar, espera-se que a intervenção seja promotora e/ou catalisadora de mudanças comportamentais sustentáveis, conducentes a melhorias clínicas significativas, a nível do peso corporal, controlo metabólico e qualidade de vida relacionada com a saúde.
- INDIVIDUO: Results from a patient-centered lifestyle intervention for obesity surgery candidatesPublication . Camolas, José; Santos, Osvaldo; Moreira, Pedro; Carmo, Isabel doPreoperative nutritional counseling provides an opportunity to ameliorate patients' clinical condition and build-up adequate habits and perception of competence. Study aimed to evaluate: (a) the effect of INDIVIDUO on weight and metabolic control; (b) the impact of INDIVIDUO on psychosocial variables associated with successful weight-control.
- Insights from the EQUALS4COVID19 study on migrant mental health in Portugal: a cross-sectional mixed-methods approachPublication . Alarcão, Violeta; Candeias, Pedro; Stefanovska-Petkovska, Miodraga; Neves, Júlia; Pintassilgo, Sónia; Machado, Fernando Luis; Santos, Osvaldo; Virgolino, Ana; Santos, Ricardo R.; Heitor, Maria João; Costa, AndreiaBackground: The COVID-19 pandemic and related disruptive consequences in the economic, health, and educational sectors have impacted people's lives, contributing to a context of increased economic and social vulnerability. The pandemic has revealed and accentuated social inequalities and discrimination based on racial or ethnic origin. This study aimed to contribute to the promotion of the mental health and well-being of migrant populations living in Portugal via the definition of an analytical framework and recommendations emerging from the EQUALS4COVID19 project. Methods: To gather information on the impact of the COVID-19 pandemic and resilience determinants among immigrants, a mixed-methods approach was implemented in 2022, combining a cross-sectional survey targeting immigrant adults in Portugal, focus groups with immigrants, focus groups with healthcare professionals, and in-depth individual interviews with stakeholders involved in the implementation of measures related to mental health and well-being during the pandemic. The analysis followed an integrated framework; quantitative data informed the script of qualitative data collection methods, and qualitative analysis informed the reinterpretation of quantitative data. Results: The survey with 604 Brazilian and Cape Verdean immigrants revealed that gender (being a woman) was associated with both psychological distress and depression-related symptomatology and that the perception of discrimination was a major risk factor for psychological suffering, while perceived social support and individuals' resilience characteristics were protective factors. Qualitative data provided deeper insights into these findings, revealing the ways mental health is affected by social structures, such as gender and ethnic hierarchies. Migrants tend to work in precarious jobs requiring physical presence, which, together with dense housing conditions, puts them at higher risk of infection. The deterioration of the economic conditions of the general population has also increased the perception of ethnic-racial discrimination, which was found to be related to the increase in insecurity and anxiety-related symptomatology among the migrant population. Newly arrived migrants, with reduced support networks, experienced a greater sense of insecurity as well as concern and anguish regarding relatives who live far away, in their home country. Migrant women reported greater family-related distress, including work-life balance problems. Conclusions: Proposals to address mental health inequalities should be considered in the context of the necessary global changes both at the societal level and in the delivery of mental health services. Additionally, they should be considered with the active involvement of migrants, families, and communities in the design and delivery of mental health promotion and care processes.
- Promovendo mudanças comportamentais sustentáveis no controlo do peso corporalPublication . Camolas, José; Santos, Osvaldo; Moreira, Pedro; Carmo, Isabel doA obesidade assume atualmente uma importância óbvia, expressa pelos esforços de investigação, de saúde pública e clínicos, a nível mundial. Se a evidência produzida aponta para algumas direções de sucesso terapêutico, a efetividade destas a médio ou longo prazo tende a ser pouco satisfatória. A literatura não é inequívoca em áreas nucleares da intervenção nutricional para tratamento da obesidade, como sejam a magnitude da restrição energética, a proporção dos macronutrientes, o fracionamento alimentar, entre outros. O mesmo acontece na área da recomendação de atividade física. Proliferam assim as formas de intervenção e importa portanto fazer um exercício de integração da evidência científica e clínica. Este artigo consiste numa revisão narrativa de questões centrais para a prática da intervenção em obesidade, nomeadamente no que toca às ações que, no seu conjunto, visam a redução e/ou controlo do peso corporal e seus benefícios. Salienta-se o papel do profissional de saúde como promotor de hábitos que favorecem o controlo do peso corporal, numa perspetiva que integra o saber científico do profissional com a disponibilidade e capacidade para a mudança do doente.