ACeS DL - Agrupamento de Centros de Saúde Dão-Lafões
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O Agrupamento de Centros de Saúde Dão-Lafões (ACeS Dão-Lafões) é uma instituição que tem como missão garantir a prestação de cuidados de saúde primários à população de determinada área geográfica, tendo como área de influência os concelhos de Aguiar da Beira, Carregal do Sal, Castro Daire, Mangualde, Nelas, Oliveira de Frades, Penalva do Castelo, Santa Comba Dão, São Pedro do Sul, Sátão, Tondela, Vila Nova de Paiva, Viseu e Vouzela.
São atribuições do ACeS Dão-Lafões o desenvolvimento de atividades de promoção da saúde e prevenção da doença, prestação de cuidados na doença e ligação a outros serviços para a continuidade dos cuidados, desenvolvimento de atividades de vigilância epidemiológica, investigação em saúde, controlo e avaliação dos resultados e participação na formação de diversos grupos profissionais nas suas diferentes fases, pré-graduada, pós-graduada e contínua.
A constituição do Repositório Científico do ACeS Dão-Lafões tem como objetivo compilar, armazenar e difundir o acervo científico das unidades funcionais que constituem a instituição, visando a promoção da investigação realizada, e a maximização do seu impacto e do prestígio institucional, dando assim a conhecer o comprometimento da instituição com a investigação em saúde.
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Browsing ACeS DL - Agrupamento de Centros de Saúde Dão-Lafões by Subject "Alcohol"
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- Differences between Groups of Family Physicians with Different Attitudes towards At-Risk Drinkers: A Post Hoc Study of the ODHIN Survey in PortugalPublication . Rosário, Frederico; Wojnar, Marcin; Ribeiro, CristinaIntroduction. We have recently shown that family physicians can be classified into two groups based on their attitudes towards at-risk drinkers: one with better and the other with worse attitudes. Objective. To compare the two groups regarding demographics, alcohol-related clinical practice, knowledge of sensible drinking limits, and barriers and facilitators to working with at-risk drinkers. Methods. A random sample of 234 Portuguese family physicians who answered the Optimizing Delivery of Health Care Interventions survey was included. The questionnaire asked questions on demographics, alcohol-related clinical practice, knowledge of sensible drinking limits, and barriers and facilitators to working with at-risk drinkers. Results. Family physicians with better attitudes were younger (p = 0.005) and less experienced (p = 0.04) and with higher male proportion (p = 0.01). This group had more hours of postgraduate training (p < 0.001), felt more prepared to counsel risky drinkers (p < 0.001), and considered themselves to have better counselling efficacy (p < 0.001). More family physicians in the group with worse attitudes considered that doctors cannot identify risky drinkers without symptoms (p = 0.01) and believed counselling is difficult (p = 0.005). Conclusions. Family physicians with better attitudes had more education on alcohol and fewer barriers to work with at-risk drinkers. These differences should be taken into account when designing implementation programs seeking to increase alcohol screening and brief advice.
- Effect of lifestyle on blood pressure in patients under antihypertensive medication: An analysis from the Portuguese Health Examination SurveyPublication . Salvador, Mário Rui; Cunha Gonçalves, Susana; Quinaz Romana, Guilherme; Nunes, Baltazar; Kislaya, Irina; Matias Dias, Carlos; Rodrigues, Ana PaulaIntroduction and Objectives Hypertension is one of the main risk factors for disability and death from cardiovascular disease. Current guidelines include initiatives to control blood pressure in hypertensive patients that focus on lifestyle changes. The main objective of this study was to analyze the association between lifestyle and blood pressure in patients under antihypertensive medication. Methods Data collected in the Portuguese National Health Examination Survey (INSEF) were analyzed. Individuals who met INSEF inclusion criteria and reported being under antihypertensive medication in the two weeks prior to the questionnaire were studied. Lifestyle variables (alcohol consumption, smoking, added salt intake, fruit and vegetable consumption, and physical activity) were assessed by questionnaire, and systolic and diastolic blood pressure were measured by physical examination. Associations between lifestyle factors and blood pressure, stratified by gender and adjusted for sociodemographic variables and obesity, were estimated through a multiple linear regression model. Results Alcohol consumption (beta=6.31, p=0.007) and smoking (beta=4.72, p=0.018) were positively associated with systolic blood pressure in men. Added salt intake, fruit and vegetable consumption, and physical activity were not associated with blood pressure in men. In women, no association was observed for any behavioral variable. Conclusions These conclusions highlight the need in the population under antihypertensive medication, particularly in men, to focus on the fight against high systolic blood pressure in the two modifiable and preventable behaviors of smoking and alcohol consumption.
- Factors Influencing the Implementation of Screening and Brief Interventions for Alcohol Use in Primary Care Practices: A Systematic Review ProtocolPublication . Rosário, Frederico; Santos, Maria Inês; Angus, Kathryn; Pas, Leo; Fitzgerald, NiamhIntroduction: Alcohol is a leading risk factor contributing to the global burden of disease. National and international agencies recommend evidence-based screening and brief interventions in primary care settings in order to reduce alcohol consumption. However, the majority of primary care professionals do not routinely deliver such interventions. Objective: To identify factors influencing general practitioners/family physicians' and primary care nurses' routine delivery of alcohol screening and brief intervention in adults. Material and Methods: A systematic literature search will be carried out in the following electronic databases: Medline, CINAHL, CENTRAL, and PsycINFO. Two authors will independently abstract data and assess study quality using the NIH National Heart, Lung, and Blood Institute quality assessment tools for quantitative studies, and the CASP checklist for qualitative studies. A narrative synthesis of the findings will be provided, structured around the barriers and facilitators identified. Identified barriers and facilitators will be further analysed using the Behavioural Change Wheel/Theoretical Domains Framework. Discussion: This review will describe the barriers to, and facilitators for, the implementation of alcohol screening and brief interventions by general practitioners/family physicians and nurses at primary care practices. By mapping the barriers and facilitators to the domains of the Behavioural Change Wheel/Theoretical Domains Framework, this review will also provide implementation researchers with a useful tool for selecting promising practitioner-oriented behavioural interventions for improving alcohol screening and brief intervention delivery in primary care. Conclusion: This review will provide important information for implementing alcohol screening and brief intervention in primary health care. Systematic Review Registration: PROSPERO CRD42016052681
- Family Medicine residents’ attitudes towards patients with Alcohol-Related ProblemsPublication . Santos, Gui; Rosário, FredericoObjectives: to evaluate family medicine residents’ attitudes towards patients with alcohol-related problems. Study design: cross-sectional study. Participants: family medicine residents registered at the Lisbon’s Family Medicine Residency Coordination. Methods: attitudes towards alcohol-related problems were assessed using the Short Alcohol and Alcohol Problems Perception Questionnaire. Associations were tested between questionnaire scores, gender and postgraduate training year. Results: one hundred and ninety five residents meeting inclusion and exclusion criteria answered the questionnaire. The mean residents’ age was 29.2 years, and 74.4% were female. Residents felt role secure in working with drinkers (88.7% scored above Role Security scale midpoint) but reported lower levels of Therapeutic Commitment (57.9% scored above scale’s midpoint). Although residents showed on average positive attitudes, they considered working with drinkers an unpleasant task, since only 22.6% scored above Satisfaction’s subscale midpoint. Male and female residents reported similar attitudes towards drinkers in all questionnaire’s domains (all P>0.05), and their attitudes remain unchanged throughout training (all P>0.05). Conclusions: residents’ attitudes towards patients with excessive alcohol consumption remain unchanged as they go through residency training. Inclusion of alcohol specific training modules into the residency programme that take residents’ attitudes into account may help to improve residents’ willingness to engage with patients with alcohol-related problems.
- Implementing alcohol screening and brief interventions in primary health care: study protocol for a pilot cluster randomized controlled trialPublication . Rosário, Frederico; Vasiljevic, Milica; Pas, Leo; Fitzgerald, Niamh; Ribeiro, CristinaBackground Alcohol is one of the most important risk factors contributing to the global burden of disease. Screening and brief interventions in primary care settings are effective in reducing alcohol consumption. However, implementation of such interventions in routine practice has been proven difficult. Most programmes in practice and research have lacked a theoretical rationale for how they would change practitioner behaviour. Objective To determine whether a theory-based behaviour change intervention delivered to primary care practices significantly increases delivery of alcohol screening. Methods We will conduct a two-arm, cluster-randomized controlled, parallel, open trial. Twelve primary care practices will be randomized to one of two groups: training and support; and waiting-list control. Family physicians, nurses and receptionists will be eligible to participate. The intervention will be a training and support programme. The intervention will be tailored to the barriers and facilitators for implementing alcohol screening and brief interventions following the principles of the Behaviour Change Wheel approach. The primary outcome will be the proportion of patients screened with the Alcohol Use Disorders Identification Test. Conclusion This study will test whether a theory-driven implementation programme increases alcohol screening rates in primary care. Results from this trial will provide a useful addition to existing evidence by informing implementation researchers what areas of behaviour change are critical to increasing alcohol screening rates. Trial registration clinicaltrials.gov NCT02968186