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Background: Hope is an important resource that helps patients and families thrive during difficult times. Although several studies have highlighted the importance of hope in different contexts, its specific manifestations in the realm of advanced chronic illness need further exploration. In this study, we sought to elucidate the intricate interplay between the construct of hope and the lived experience of advanced chronic illness within patient-caregiver dyads. Our objectives were (a) to explore the dyadic experience of hope as a changing dynamic over time for patients living with advanced chronic illness and their informal caregivers and (b) to evaluate variations of hope and symptom burden across time., Methods: We conducted a longitudinal mixed-methods study with a convergent design between December 2020 and April 2021. Patients living with advanced chronic illness and informal caregivers participated as a dyad (n = 8). The Herth Hope Index scale was used to measure dyads' level of hope and the Edmonton Symptom Assessment System was used to measure patients' symptom burden. Descriptive statistics were undertaken. A thematic analysis as described by Braun and Clarke was conducted to analyze dyadic interview data. Dyads' experience of hope was described by using the six dimensions of hope in the Model of Hope of Dufault and Martocchio., Results: Dyadic scores of hope and patients' symptom burden were stable over time. The constructs of hope in dyads included "Living one day at the time," "Having inner force/strength," and "Maintaining good health." Changes in patterns of hope were captured for each dyad in their transition over time. Data converged for all dyads except one., Conclusions: The findings of our study show a constant presence of hope even in the face of adversity. Healthcare professionals must find ways to promote hope in dyads of patients living with advanced chronic diseases. Nurses play a pivotal role; dyadic interviews should be promoted to create a safe space for both patients and informal caregivers in order to share experiences. More research is needed to address patients' and informal caregivers' hope in chronic illness because current hope-based interventions primarily target cancer diagnoses., (© 2024. The Author(s).)

Spiritual care is an important dimension of palliative care (PC) and a facet of holistic care that helps ill people find meaning in their suffering and lives. This study aims to: (a) develop and test the psychometric properties of a new instrument, Perceived Barriers to Spiritual Care (PBSC); (b) explore participants' perceptions of how prevalent those (pre-identified) barriers are; and (c) examine the association of their personal and professional characteristics with those perceptions. A descriptive cross-sectional study was carried out using a self-reporting online survey. In total, 251 professionals registered with the Portuguese Association of Palliative Care (APCP) completed the study. The majority of respondents were female (83.3%), nurses (45.4%), had more than 11 years of professional experience (66.1%), did not work in PC (61.8%), and had a religious affiliation (81.7%). The psychometric assessment using PBSC provided sound evidence for its validity and reliability. The three most common perceived barriers were late referral for palliative care (78.1%), work overload (75.3%), and uncontrolled physical symptoms (72.5%). The least commonly perceived barriers were different spiritual beliefs among professionals (10.8%), differences between the beliefs of professionals and patients (14.4%), and the shame of approaching spirituality in a professional context (26.7%). The findings show there is some relationship between sex, age, years of professional experience, working in PC, having a religious affiliation, the importance of spiritual/religious beliefs, and responses to the PBSC tool. The results highlight the importance of advanced training in spirituality and intervention strategies. Further research is needed to properly study the impacts of spiritual care and establish outcome assessments that accurately reflect the effects of the various spiritual care activities.

Inmates are highly exposed to mental and physical disorders. Therefore, periodic screening of their mental health and other health risks is required. This study aims to investigate the perceived fear of COVID-19 and the psychological impact of the pandemic in a sample of young adult male inmates. An institutional-based quantitative cross-sectional study design was performed. Data collection took place from July to September 2022 at a juvenile prison in the central region of Portugal. Data were collected using questionnaires on demographic and health characteristics; fear of COVID-19; depression, anxiety and stress levels; and resilient coping. The sample included 60 male inmates imprisoned for over 2 years. Stress was the most common symptom among inmates (75%), followed by anxiety (38.3%) and depression (36.7%). The mean score on the Fear of COVID-19 Scale was 17.38 ± 4.80, indicating relatively low fear levels. Low resilient scores were found in 38 participants (63.3%). Participants reported moderately high ranges of 3.62 ± 0.87 regarding mental health perception, 3.73 ± 0.95 for physical health perception, and 3.27 ± 0.82 for global health concerning the previous month. The Pearson correlation matrix indicated significant and moderate to strong correlations between fear of COVID-19 and mental health-related variables ( p < 0.001). The predicting factors of fear of COVID-19 were identified by deploying a multiple linear regression model. We found four predictors: age, perception of mental health, and overall levels of anxiety and stress (R 2 = 0.497). Fear of a given scenario or factor may shift with time. Therefore, long-term research is needed to evaluate whether fear of COVID-19 is adaptive or long-reactive in victims. Our study can assist policymakers, mental health and public health experts, and others in recognizing and managing pandemic-related fears and mental health symptoms.

Background: Hope is widely considered a subjective phenomenon able to bring beneficial consequences to human health and existence. Maintaining hope amid a life-threatening disease and during palliative care is critical. The study aims to examine the effectiveness of a psychosocial supportive Hope Promotion Program (HPP) in enhancing hope, comfort, and quality of life in Portuguese adult outpatients with advanced and progressive chronic illness. Method: Using a parallel Randomized Control Trial (RCT) with pre-post design, 56 cancer outpatients from two day hospitals. Participants were randomly assigned to either a control group (n = 28) or an intervention group (n = 28). The primary outcome measure was hope. Secondary measures included comfort and quality of life. Participants were assessed at baseline, day 15, and day 30 of follow-up. Results: Baseline characteristics were similar between the two groups. In the intervention group, there was a significant increase in the total hope scores after the HPP (day 15). Significant differences were still present after one month (p < 0.05). There was also a significant increase in comfort and quality of life scores in the intervention group one month after HPP (p = 0.018). Conclusions: The HPP may be an effective intervention to increase hope and improve comfort and quality of life among palliative patients. Future studies should increase sample size, diversify settings, and include longer and more detailed follow-ups.

Evidence of nurse presenteeism has mainly focused on quantifying its prevalence and consequences on productivity, quality of care, and patient safety. Few data exist on nurses' perceptions of their presenteeism and its related causes. We explored concepts of presenteeism and its contributing factors with frontline nurses and nurse managers in different healthcare settings in Portugal and Switzerland. Our qualitative study design involved 8 online focus groups involving 55 participants. The transcribed data was explored using thematic analysis. Three main reasons for presenteeism were identified: unfamiliar terminology; the paradoxical effect of `being present' but absent; and presenteeism as a survival strategy. Six contributing factors were also recognized: (a) institutional disinterest toward employees; (b) paradigm shift: the tension between person-centered and task-centered care; (c) sudden changes in care practices due to the COVID-19 pandemic; (d) a lack of shared work perspectives with hierarchical superiors; (e) the financial burden of being absent from work; and (f) misfit of human responses. This study generates valuable, in-depth knowledge about the concepts and causes of presenteeism, and significant suggestions for the broader audience of nurse managers and leaders seeking to improve the quality of care.

Hope performs an important role in how patients and their families cope with suffering and stressful events. To better inform practice and theory on hope, palliative care research should include both patients and their family carers, given their strong interdependence. The aim of this study was to explore how hope is experienced in dyads formed by end-of-life patients and their family carers. In this qualitative study, data were collected by in-depth interviews with seven Portuguese family dyads. Analysis followed a thematic analysis approach. The analysis of the interviews shed light on the importance of hope for all participants, and the challenges involved. Family dyads noted several barriers and facilitators to perceptions of hope. Barriers to hope included limitations imposed by illness, feelings of anguish and helplessness, and poor communication with clinicians. Hope facilitators included supportive others, positive thinking and sense of humour, connection with nature, faith in religion and science, and a sense of compassion with others and altruism. Given the multidimensional scope of hope, the main challenge for family dyads is to look beyond the disease itself. Thus, palliative care teams should be encouraged to support and foster realistic hope, helping families prepare for death, in the context of advanced cancer.

The COVID-19 pandemic has had significant psychological impact on vulnerable groups, particularly students. The present study aims to investigate the mental and psychological impact of the COVID-19 pandemic and associated factors in a sample of Portuguese higher education students. An online cross-sectional study was conducted among 1522 higher education students selected by convenience sampling. The survey assessed mental health symptoms as well as sociodemographic variables, health-related perceptions, and psychological factors. Results were fitted to binary and multivariable logistic regression models. The overall prevalences of stress, anxiety, and depression were 35.7%, 36.2%, and 28.5%, respectively. Poor mental health outcomes were related with being female, having no children, living with someone with chronic disease, facing hopelessness, and lacking resilient coping. Future studies focusing on better ways to promote mental health and wellbeing among students are warranted. It is necessary to gather more evidence on the post-pandemic mental health using robust study designs and standardized assessment tools.

Background: International research has shown that healthcare professionals (HCPs) and nonhealthcare professionals (NHCPs) are unaware of the goals and purposes of palliative care. This study evaluates the knowledge of palliative care among a sample of Portuguese adults and correlates their level of knowledge with age, gender, profession, and experience of family member's palliative care. Method: A cross-sectional online survey was carried out on a sample of 152 HCPs and 440 NHCPs who completed an anonymous questionnaire of sociodemographic, family, and professional data, and an instrument of 26 dichotomous (true or false) questions focusing on palliative care goals and purposes. Results: The 592 participants had a mean age of 31.3 ± 11.1 years, and most were female. Statistically significant differences between statements considered as correct by HCPs and NHCPs were found in 24 statements; HCPs had the highest percentage of correct answers. The terms most frequently associated with palliative care mentioned by NHCPs were chronic and progressive disease (n = 76), while HCPs mostly mentioned quality-of-life promotion (n = 29). Women, the elderly, and HCPs had a higher level of knowledge regarding palliative care ( p < 0.001). Conclusions : Results clearly show gaps in knowledge of palliative care, especially among NHCPs. An integrated approach is needed to inform and clarify the philosophy and goals of palliative care in different settings in order to improve knowledge.

The main aims of the study are to a) evaluate the effectiveness of a three session program of "art therapy" on changing emotional indicators (depression, anxiety, stress, and psychological well-being) in individuals with mental illness and b) analyze the meanings attributed to creative self-expression. We performed a pre-experimental mixed approach study, with a pretest-posttest design, with twelve Portuguese male subjects, admitted to an acute psychiatry unit. The instruments used were Depression, Anxiety and Stress Scale [DASS-21]; and Ryff Scales of Psychological Well-Being [SPWB - 18] and a semi-structured interview. Comparison of the pre- and posttest indicated improvement in anxiety, stress, self-acceptance, purpose of life, and overall psychological well-being. The categories resulting from the thematic analysis of the interviews revealed the usefulness of the program in the participant recovery process. This type of psychosocial intervention in specialized clinical practice in Mental Health Nursing minimizes the disease's impact in an organizational culture that should increasingly be oriented toward recovery.

The need to promote health emerges incorporated within the practice of public health, which reflects various concerns as to the influence of the physical and social environment on the behaviours that are conducive to health. Its importance has served so as not to allow the idea of equity in health to perish, since efforts to reduce the gap between rhetoric and practice continue far from being reached. The purpose of this article is to stimulate the debate on growth of psychological empowerment grounded on social cohesion in health, variables which compete for the establishment of the structuralist model for promoting health, this because the educational development of people and communities depends on the formulation of appropriate policies, clinical and study.