Search

Introduction Incarcerated individuals are subject to a heightened risk of both mental and physical ailments. Hence, it is important to conduct regular assessments of their mental well-being and other potential health hazards. Objectives The aim of this study is to examine the subjective experience of fear related to COVID-19 and the psychological consequences of the pandemic among a cohort of young adult male convicts. Methods A research design using an institutional-based quantitative cross-sectional approach was used. The data collecting period was from July to September 2022, during which data was gathered at a juvenile correctional facility located in the center area of Portugal. The researchers used questionnaires to gather data pertaining to demographic and health attributes, fear related to COVID-19, as well as measures of depression, anxiety, stress, and resilient coping. Results The study included a cohort of 60 incarcerated males who had been imprisoned for a duration exceeding 2 years. The prevalence of stress was found to be the highest among offenders, with around 75% reporting this symptom. Anxiety was the second most often reported symptom, with 38.3% of inmates experiencing it, followed closely by depression, which was reported by 36.7% of the inmate population. The average score on the Fear of COVID-19 Scale was 17.38 ± 4.80, suggesting that participants generally reported mild levels of fear. A total of 38 subjects, accounting for 63.3% of the sample, had low scores in resilience. The participants’ responses indicated that their perceptions of mental health were within a fairly high range, with an average score of 3.62 ± 0.87. Similarly, their perceptions of physical health were also moderately high, with an average score of 3.73 ± 0.95. In terms of global health, participants reported a slightly lower average score of 3.27 ± 0.82 for the preceding month. The Pearson correlation matrix revealed statistically significant associations between fear of COVID-19 and characteristics linked to mental health, with the strength of these associations ranging from moderate to high (p < 0.001). The identification of predictive variables for fear of COVID-19 was accomplished by the use of a multiple linear regression model. Four predictors were identified in the study, namely age, perception of mental health, and overall levels of anxiety and stress. These predictors together account for about 49.7% of the variance in the outcome variable. Conclusions The findings of our research indicate a significant prevalence of stress among incarcerated individuals, accompanied by moderate levels of anxiety and depression. Our research has the potential to provide valuable insights for policymakers, mental health professionals, public health specialists, and other relevant stakeholders in the identification and effective management of pandemic-induced anxieties and mental health symptoms. Disclosure of Interest None Declared

Introduction Although increasing resilient coping throughout life is beneficial, it is particularly important in young people. To prevent the development of mental health problems, it is crucial to understand the factors associated with resilience. However, among university students, the characteristics considered conducive to resiliency have not been sufficiently studied, particularly during pandemic times. Objectives The present study examined factors associated with resilient coping in Portuguese higher education students during the COVID-19 pandemic. Methods Data were collected from an opportunity large sample of participants during the academic year 2020/2021. Four self-report measures were utilized within the study: Herth Hope Index, Brief Resilient Coping Scale, Depression Anxiety and Stress Scale – 21 items, and Impact of Event Scale-Revised. Additionally, a demographic questionnaire was used to collect data including age, gender, have children, education level, and study area. Ethics clearance was obtained. In order to test the research question, a multiple regression was conducted (using SPSS 28), with resilient coping as the dependent variable and the other variables entered as potential predictor variables. Results A total of 1522 students (75.1% women and 24.9% men) took part in this study. Most participants were single (91.2%), had no children (93%), and the ages ranged from 18 to 59, with a mean age of 22.88±6.93 years. In terms of study level, the majority of students (73.7%) are at the undergraduate level and are not working (76.6%). Among the participants, 35.7%, 36.2%, and 28.5% had symptoms of stress, anxiety, and depression above the normal range, respectively. High resilience scores were found in 215 participants (14.1%). The mean hope (HHI) was 35.53 (SD = 5.92). Our results also demonstrated that hope is the only predictor of resilient coping (p

Introduction Despite vulnerability being a poorly understood concept is a key concept in health and social care disparities. Typically, vulnerable groups include individuals with physical and/or mental disabilities, children, the elderly, members of the lower social classes, and refugees. In Portugal, the pandemic was responsible for worsening inequalities in access to health and social care for the most vulnerable. To the best of our knowledge, there is a dearth of qualitative research on vulnerability from the viewpoint of those who are vulnerable or work with the most vulnerable. Objectives As expressions of vulnerability are strongly influenced by cultural factors, this study aims to examine issues of vulnerability among people who attend and work in a Portuguese community-based association. Methods Secondary analysis of qualitative data from twelve vulnerable people and fifteen professionals who attended these people. The manifestations of the vulnerability reported by participants included being homeless, being a migrant, having an infectious disease, being drug dependent, living with socioeconomic difficulties (unemployment), and experiencing a process of loss and grief. They also reported having a mental or physical health problem, or both. Depression and anxiety were the most often reported mental health disorders. Regarding the academic background of professionals, most of them (n = 12) are from social sciences (e.g., social workers, social mediators, and psychologists). Results Three main themes emerged from the study: (1) meanings of human vulnerability; (2) barriers to vulnerability mitigation; and (3) approaches to addressing vulnerability. Our findings revealed that vulnerability is a very dynamic process of openness to conditions that impact individual outcomes. However, there is a conceptual gap: being vulnerable is perceived as something negative, but vulnerability also has the potential to change priorities in life for the better. Some participants emphasized the importance of self-care to avoid becoming vulnerable themselves, particularly in terms of mental health. Conclusions Understanding the social determinants of vulnerability is necessary to achieve satisfactory care for human groups. Practitioners need to be aware of these larger societal dynamics, understand them, and make sure their services are responsive to cultural differences. In order to develop interventions that promote social and health outcomes, practitioners should be encouraged to share knowledge on best practices. Disclosure of Interest None Declared

Introduction The COVID-19 global crisis has resulted in significant disruptions in the lives of students in higher education, leading to negative consequences for their academic achievements and general psychological well-being. Objectives In this study, we sought to examine the psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) among students in Portuguese higher education institutions during the initial phase of the COVID-19 pandemic and its efficacy in capturing mental health symptoms due to a global health crisis. Methods In this cross-sectional study, a convenience sampling method was used to enlist a total of 1522 participants. The sample consisted of 75.1% women and 79.2% undergraduate students. Participants completed an electronic survey that was designed using the Depression Anxiety Stress Scale-21 (DASS-21) — a self-report instrument measuring anxiety, depression, and stress. Results The findings of the study indicated a significant occurrence of depressive symptoms [≥10] (N = 434, 28.5%), anxiety symptoms [≥7] (N = 551, 36.2%), and stress symptoms [≥11] (N = 544, 35.7%). Based on the collected data, a Confirmatory Factor Analysis (CFA) was conducted in order to examine the factor structure of the scale. The analysis revealed a three-factor solution that corresponded to the three subscales of the DASS-21. The Heterotrait-Monotrait (HTMT) correlation ratio was then used to assess the discriminant validity, with good results. Results showed that the DASS21 has satisfactory reliability indexes (Cronbach’s α > 0.90). Conclusions In light of the notable changes in living conditions brought by the COVID-19 pandemic, the present study has shown that the DASS-21 instrument has maintained its reliability and validity. Consequently, this finding supports the appropriateness of using the DASS-21 as a screening tool for assessing mental health among students in Portugal. Moreover, it is recommended that academics and healthcare practitioners use the DASS-21 as a tool for assessing the levels of psychological distress experienced by students. Additional validation studies of this scale are required, using bigger and more representative populations. Disclosure of Interest None Declared

Introduction In ordinary circumstances, the employed individuals demonstrate significant levels of psychological distress and presenteeism, a situation that has been further intensified by the COVID-19 epidemic. Furthermore, a limited number of studies have examined the phenomenon of presenteeism in the context of the COVID-19 pandemic, therefore necessitating the undertaking of the present study. Objectives The goal of this study was to investigate the levels of presenteeism and its related characteristics, as well as job satisfaction and psychological distress, among a sample of employees employed at a Private Social Solidarity Institution (IPSS) in Portugal. Methods A cross-sectional survey was undertaken in 2022 to observe personnel from an IPSS located in the central area of Portugal. The research had a sample size of 71 workers who were provided with a signed authorization. The survey was designed to gather both general and professional information from participants. Additionally, it included the Stanford Presenteeism Scale (SPS-6), the Job Satisfaction Questionnaire (S20/23), and the Kessler Psychological Distress Scale (K10) as measurement tools. Results The occurrence of presenteeism was seen in 32 employees, accounting for 45.1% of the sample, whereas illness absence was reported by 38 workers, representing 54.3% of the sample. The majority of the individual assessments for S20/23 demonstrated a higher degree of satisfaction (mean ≥ 4.5 points.), with the exception of the salary-related issue, which elicited a higher level of discontent (mean = 3.36 ± 1.9 pts.). Approximately 50.7% of the individuals had a high or very high susceptibility to experiencing or developing a mental condition. The correlation matrix revealed a statistically significant moderate positive association between presenteeism and work satisfaction, as well as a statistically significant moderate negative link between presenteeism and psychological distress (p

Introduction Emotional competence is fundamental in the communication that nurses establish with the people they relate to, and therapeutic communication is a crucial tool in nursing care. Objectives This study aimed to understand the influence of nurses’ emotional competence in therapeutic communication with people with manifestations of mental disorder in a portuguese general hospital. Methods A descriptive-correlational and transversal study was performed. The sample consisted of 171 nurses from a general hospital in the Azores. Data were collected between May and July 2021, using an instrument that includes the sociodemographic and professional questionnaire, the Veiga Scale of Emotional Competence–Reduced version [EVCE-Reduced] (Veiga-Branco, 2021) and the questionnaire “Therapeutic communication: use by nurses” (adapted from Coelho, 2015). Results Nurses, mostly female, aged between 31 and 40 years, show moderate levels of emotional competence. Specialized nurses with more time in professional practice demonstrate to be more emotionally literate. The EVCE-Reduced demonstrates good internal reliability. Self-motivation was the most predictive capacity of emotional competence, and self-awareness the capacity with the highest average. Three communication profiles were delineated, with Profile 1 (Nurse centered on the person and on themselves) the most representative. Although there is no correlation between emotional competence and therapeutic communication, it was evident that the more empathetic nurses perceive themselves, the more they use therapeutic communication techniques; and the better they manage emotions, the more they mobilize therapeutic communication techniques and attitudes towards people with manifestations of mental disorder. Conclusions In view of the results, it is important to deepen the way in which therapeutic communication and emotional competence are manifested in professional practice, what facilitates or inhibits its expression, and how its development can be enhanced. In this sense, health institutions must implement actions for the education and training of nurses, through the contribution of specialized practice in Mental Health Nursing, allowing for the improvement of emotional literacy and performance in work contexts. References - Coelho, M. T. (2015). Comunicação terapêutica em enfermagem: utilização pelos enfermeiros. Porto University [doctoral thesis]. Available from: https://repositorio-aberto.up.pt/bitstream/10216/82004/2/33990.pdf (accessed on 15 september 2022); - Veiga-Branco, M. A. (2021). Competência emocional, os Dados Tomam a Palavra. Jornadas da Associação Portuguesa de Inteligência Emocional. Bragança: Instituto Politécnico de Bragança; Disclosure of Interest None Declared

Introduction Nurse presenteeism has long been of global concern, with impacts on nurse staffing levels, patient care, and hospital costs. Objectives This international study aimed to explore the factors associated with presenteeism among frontline nurses and nurse managers in acute, primary, and long-term healthcare settings in Portugal and Switzerland. Methods A qualitative descriptive study involving online Focus Groups (FGs). The FGs included 55 participants and lasted 5 months (from March 2021 to July 2021). A purposive sampling strategy was used to select nurses. The inclusion criteria were as follows: (a) working in a public or private healthcare setting with at least one month of experience in their current workplace (which is officially considered the time required for integration); (b) working at least 20% of a full-time equivalent position; and (c) having a bachelor’s, master’s, or PhD degree. This study followed the COREQ checklist. Results Participants included 55 nurses: 49 females and 6 males. 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 (Laranjeira et al., 2022). Conclusions This study has generated in-depth knowledge about concepts and causes of presenteeism and has instructive for a broad audience of nurse managers and leaders. Our thematic analysis shows that presenteeism can be explained by factors related to the pressure to attend work, by individuals’ constraints and commitment and by the organizational environment. References Laranjeira, C., Pereira, F., Querido, A., Bieri, M., & Verloo, H. (2022). Contributing Factors of Presenteeism among Portuguese and Swiss Nurses: A Qualitative Study Using Focus Groups. International journal of environmental research and public health, 19(14), 8844. Disclosure of Interest None Declared

Introduction With the closure of higher education institutions during the COVID-19 sanitary crisis, students have experienced problems such as interruptions to their education, loss of peer support networks, and mental health issues. Objectives This study aimed to explore adjustment patterns used by students to overcome the impact of the COVID-19 pandemic. Methods A qualitative descriptive study was developed by carrying out Focus Group Discussions (FGDs). Portuguese students enrolled in education levels above high school, including undergraduate and graduate programs, were considered eligible. Participants were recruited using convenience sampling. Each FGD took approximately 60–90 min. Results Twelve students were participated in 2 FGDs, each one with 6 participants. Mostly were undergraduate students (Bachelor’s degree), in the field of health area. The thematic analysis revealed three main themes. The first theme was related to the personal sphere and included most of adjustment strategies used, namely: pandemic as a “window of opportunity” to be involved in new academic and professional projects; work-life balance by organizing and separating work from private life; self-care through the adoption of healthy lifestyles; being compassionate with others and compliance with sanitary measures. In the social sphere, students evoked new ways of communicating via digital networking to compensate for the lack of physical proximity and stay in safe contact with friends and relatives. In the contextual sphere, students talked about the importance of adapting the “teaching/learning” environment. Tailored teaching support was a significant strategy, especially in maintaining their motivation. Conclusions Several strategies were pointed by students to stay mentally healthy and mitigate delayed-onset post-traumatic stress disorder during the COVID-19 pandemic. Besides, positive coping and hope should be integrated into the standard training of students across all study areas. Disclosure of Interest None Declared

Introduction The concept of social vulnerability arises in the individual-collective relationship and points to changing social conditions, built on the basis of power relations. In this context, vulnerability can be directly related to the deterioration of social and civil rights, resulting in the weakening of individuals’ citizenship. On the other hand, vulnerability can also lead to the deterioration of mental health. Stigma and discrimination generate low self-esteem, decreased self-confidence, reduced motivation, and less hope for the future. Objectives This study aimed to explore the perceptions and experiences of vulnerability from the perspective of vulnerable people and identify strategies they used to reduce vulnerability. Methods This study employed a qualitative descriptive design. Using a purposeful sampling method, data were collected in April 2022. The following criteria were applied in the selection process: (1) adults with a personal sense of vulnerability or the experience of being vulnerable; and (2) understanding the Portuguese language and having reflective capacity. Results A total of 12 respondents (6 male; 6 women) participated in study, mostly of middle-age. The manifestations of vulnerability reported by participants included being homeless, being a migrant, having an infectious disease, being drug dependent, experiencing a process of loss and grief and living socioeconomic difficulties. The data was summarized in terms of three major themes: (1) Conceptions about vulnerability, (2) Barriers imposed by vulnerability, and (3) Strategies for dealing with vulnerability. “Three subthemes were identified within the first theme: ontology condition that spreads, being alone “without network” and being exposed to external pressure (others). In the second theme, there were also three subthemes: discrimination/stigma, difficulties in social reintegration, and “my condition is difficult”. Lastly, in the third theme, we found four subthemes: the ability to ask for help/seek support, motivation, and commitment to behavioural change, not exposing others to the same risks, and ignoring the disapproving look of others” (Laranjeira et al., 2022, p.5). Conclusions Our findings demonstrated that vulnerability is a dynamic process of being exposed to circumstances that influence individual outcomes. However, there is a conceptual gap: vulnerability is regarded negatively, but vulnerability also has the capacity to shift life priorities for the better. References Laranjeira C., Piaça I., Vinagre H., Vaz AR., Ferreira S., Cordeiro L., Querido A. (2022). Vulnerability through the Eyes of People Attended by a Portuguese Community-Based Association: A Thematic Analysis. Healthcare. 10(10):1819. https://doi.org/10.3390/healthcare10101819 Disclosure of Interest None Declared

Introduction Presenteeism is increasingly being seen as a threat to employee efficiency. Nursing professionals are exposed to occupational hazards that may compromise physical and mental health, interfere with the quality of life of the worker and the quality of care provided to the patient and cause illness and generate costs for the institutions. Objectives This study aimed to evaluate which are the personal (age, sex, educational qualifications), professional (organization, seniority in the organization, seniority in function, employment relationship, work regime and professional category) and health variables, that best relate to sickness presenteeism. Methods A quantitative cross-sectional study was conducted. The sample is probabilistic and the universe of this study included all nurses who work in Portuguese health institutions (whether they are of a public, private or public-private nature). Inclusion criteria were nurses with clinical activity and/or management in institutions in the aforementioned modalities, and nurses in teaching activity in higher education institutions were excluded from this study, on an exclusive basis. The final sample was composed of 424 nurses. Results Most of the nurses who answered the e-survey are female (86.8%), aged 40 years or over (59.9%), who live in the northern region of the country (31.4%), who work in public organizations (85.5%), in differentiated health care units (52.6%) and with an employment contract in public functions (63.7%). More than half (53.3%) of participants are specialist nurses and 72.4% of respondents did not have a previous disease condition. The variables that best correlated with presentism were the female gender, the organization where you work (public), and the presence of a previous disease condition. Conclusions The results presented may constitute a challenge for change for policymakers, managers and health professionals, in the sense of addressing presenteeism with the creation of occupational health programs directed to the needs of nurses. Other measures include flexible working hours, work policies that promote staff retention, and a strong commitment to the training and qualification of nurses capable of ensuring better performance and involvement in the organizational culture. Disclosure of Interest None Declared

Introduction Hope should be fostered by providing information to help service users develop an understanding of psychological difficulties and encourage an active role in their self-care. This might include providing an open caring environment, nurse presence, comfort/pain relief, and involving patients in their care. Objectives To analyze the critical importance of hope-inspiring competence as a high-quality mental health nursing care in recovery-oriented practice. Methods This was a reflective and discursive study based on experiential aspects of hope in mental health recovery. Results Hope and hopelessness are important determinants of mental health. Hope has a positive influence on people’s mental health, on increasing comfort and satisfaction with life and on reducing negative emotions and suicide, decreasing the predisposition to addiction, and preventing family exhaustion, with a predictive effect on subjective well-being and protection of mental health. The concept of hope-inspiring competence is introduced to denote a relatively high level of the Advanced Practice Psychiatric Nurses ability to instil and maintain hope for recovery in people with mental health disorders. Conclusions The evidence seems to point to the importance of incorporating hope in collaborative strategies to promote mental health and manage mental health disorders. Despite this recognition of the role of the specialist nurse in psychiatric-mental health in training for hope, the way it develops in the context of specialized practice lacks evidence and visibility. A vision of recovery from mental illness exists, and hope, trust and self-determination should be incorporated into all treatment models. Disclosure No significant relationships.

Introduction The current pandemic crisis disturbed the life of universities and college campuses leading to an overwhelming effect on the educational system, social life, and mental health of students. In this scenario, coping strategies like resilience and hope provide a counterbalance in periods of uncertainty and stress. Objectives This study aims to: a) evaluate the prevalence and severity of depression, anxiety, and stress among higher education students during the COVID-19 pandemic; b) characterize the hope and resilient coping levels of graduate students. Methods Using a convenience sampling method, online self-reported data were collected between April 2020 to January 2021. The information gathered includes a Sociodemographic Form, the Depression, Anxiety, and Stress Scale (DASS-21) the Brief Resilient Coping Scale (BRCS) and the Herth Hope Index (HHI). Results A total of Portuguese 1522 students (75.1% women and 24.9% men) took part in this study. The sample mean age was 22.88±6.93 years [range 18-59 years]. We identified a significant prevalence of symptoms of stress (35.7%), anxiety (36.2%) and depression (28.5%) in our population. The BRSCS score indicated that 60.2% of students exhibited low, 22.7% moderate and 17.1% high levels of resilient coping. The HHI mean was 35.53±5.92 [range 12-48]. Conclusions The study findings indicate a substantial portion of the students is at high risk of psychological consequences during the COVID-19 pandemic. This study recommends that is needed to get a wider picture of today’s “new normal” education and to develop supportive strategies to enhance students’ mental health and well-being in future pandemics. Disclosure No significant relationships.

Introduction Chronic pain has a significant impact on individuals’ daily lives, and its control is essential for improving quality of life. In this sense, the practice of Mindfulness is a useful non-pharmacological technique for self-management of chronic pain. Objectives This study aims to identify the level of knowledge regarding the effectiveness of Mindfulness for self-control of pain by people with chronic pain. Methods A cross-sectional study was conducted on a sample of 23 adults with chronic pain. The online survey assessed sociodemographic characterization, Brief Pain Inventory, and knowledge/opinion about the effectiveness of mindfulness strategies. Results The sample consisted mostly of middle-aged women, with family support, employed and with higher academic qualifications. 47.8% of the sample had experienced pain for over 20 years with the most prevalent diagnosis being fibromyalgia. The average intensity of chronic pain corresponded to moderate pain and the level of acceptance of it was low, interfering in instrumental activities of daily life. Although they had never tried the technique, most of the sample knew what mindfulness consisted of, considering it as a viable option for self-management of chronic pain. Moderate and positive correlations were found between the level of acceptance of pain and greater availability for the practice of mindfulness (rho=.137; p

Introduction Given the negative social representation attributed to mental illness, it is urgent to reconfigure its representation, not as an individual problem, but also as a collective. Several solutions have been indicated to improve the skills and quality of life (QoL) of these individuals. Among these, psychosocial rehabilitation programs stand out to keep individuals inserted in society reaching a level of independent functioning. Objectives This study aims to: - assess the level of QoL, social support, treatment adherence, mental health status and mental health literacy of Portuguese people with HIV integrated into a community intervention program “InPulsar - Giros na Rua” program [which aims to contribute to the improvement of the socio-sanitary conditions of people who use psychoactive substances and to their social and therapeutic referral, as well as promoting risk reduction by intervening in a public space]; - improve mental health literacy levels, adherence to therapeutic regimen and QoL in individuals with HIV, after 12 months of implementation of a psychosocial rehabilitation program [biweekly sessions]. Methods We will perform a single-group pre-experimental study with pre- and post-intervention evaluation, supported by the participatory methodology in health. Results This study has received ethical approval from the local IRB. Data collection will start in November 2021 and will be completed in November 2022. Conclusions Through a multidisciplinary approach, this study will allow the development of health interventions articulated with psychosocial interventions based on various educational and behavioural strategies, promoting literacy and adherence to the therapeutic regimen. Disclosure No significant relationships.

Introduction The COVID-19 pandemic will have a long-lasting impact on healthcare workplaces and professionals alike. For that reason, it is necessary more knowledge and insights about sickness presenteeism behaviour to provide appropriate occupational health services for all healthcare workers affected directly and indirectly by this pandemic. Objectives The aim of this study was to explore and describe presenteeism experiences among frontline nurses due to the COVID-19 pandemic. Methods A qualitative thematic analysis was used to evaluate the perceptions of frontline nurses from different Portuguese hospital institutions joined in two Focus Groups. Using convenience sampling a total of 20 RNs participated in interviews. No restriction was given to their gender, age, career, and wards in charge so as to obtain diverse data on nurses’ experiences of presenteeism. Results The sample mean age was 36 years [range 25 - 42 years]; they had a clinical career of 12 years on average [range 2 - 20 years]. The major theme was the metaphor of “the rotten orange”. This theme implied the presence of a phenomenon that is invisible due to the ignorance of many, but which spreads through the members of a team, leading to an overload of its members for lack of one compassionate leadership. Consequently, leads to loss of the nursing spirit and nursing manpower. Conclusions Our findings point to the development of workplace interventions targets to reduce healthcare worker presenteeism and to help employers foster a ‘healthier’ sickness culture during the pandemic and beyond. Disclosure No significant relationships.

Introduction The ongoing COVID-19 pandemic is inducing fear, and a timely understanding of mental health status is urgently needed for society. Previous research has revealed a profound and wide range of psychosocial impacts on people at the individual, community, and international levels. On an individual level, people are likely to experience fear of falling sick or dying themselves, feelings of helplessness, and stigma. Currently, there is little understanding of mental well-being assessment under scenarios of pandemics that oblige to social isolation and quarantine. Objectives This study aims to: a) establish the prevalence of psychiatric symptoms; b) identify risk and protective factors contributing to psychological stress; and c) identify coping strategies to promote better adjustment during and after the pandemic crisis. Methods We will adopt a mixed-method approach, firstly with a cross-sectional survey design (in both Portugal and Swiss context) to assess the higher education student’s psychosocial response during and after the pandemic, by using an anonymous online questionnaire. In a 2nd phase, and in order to gain more insight into the psychological stress faced by the students as a result of pandemic, a qualitative approach was chosen, focusing on the experiences of the participants. Results This study has received ethical approval from both international and local institutional review boards. Data collection will start in November 2020 and will be completed at February 2021. Conclusions The findings of this study will provide important data to assist government agencies and healthcare professionals in safeguarding the psychosocial wellbeing of the community in the face of COVID-19 outbreak expansion.

Introduction Previous studies about relationship between personality factors and stress related processes mainly focus on relation between these factors and application of coping strategies. Objectives This study expanded previous research by examining the combined contribution of personality traits (NEO-FFI) and coping strategies (Brief COPE) in the prediction of stress, depressive symptoms, anxiety symptoms (DASS-21), and psychological well-being (WHO-5) among undergraduate nursing students. Methods This cross-sectional study was performed in 2017. Participants of this study were 75 nursing students (men=37, women=38) from one Portuguese School of Health Sciences. The students who agreed to participate filled out an informed consent. Then the questionnaires were administered in a random order to avoid order effects in the data. Results Regarding personality, women reported higher conscientiousness and agreeableness than men. There were no gender differences in coping. Among men, openness and agreeableness (inversely) and neuroticism predicted stress. In women, neuroticism and venting predicted stress. Regarding depression, conscientiousness and extraversion (inversely) and neuroticism were predictors for men, whereas neuroticism, self-blame, and denial were predictors for women. Conscientiousness and extraversion (inversely) and venting and denial predicted anxiety in men, as did neuroticism and venting in women. For well-being, conscientiousness and extraversion were predictors among men; neuroticism and seeking instrumental support (inversely) and extraversion were predictors among women. Personality traits dominated the prediction of distress and well-being in men, while both personality and coping were predictors in women. Conclusions These findings indicate that it is not the degree of each personality trait or coping strategy but the pattern of relationship between these phenomena and psychological outcomes that is of relevance. The results could inform gendered preventive and treatment interventions for college students.

Introduction The provision of mental health care should be promoted at the community level, in order to facilitate their recovery process. Thus, the people who care for these individuals go through a situational transition, as they have to play the role of Family Caregivers (FC). Objectives a) to characterize the FC burden of the person with Mental Illness; and b) to correlate FC overload with the variables age, gender, cohabitation, degree of kinship and level of education. Methods A cross-sectional correlational study was conducted. The sample consisted of FC who went to consultations and to the inpatient psychiatric unit of a portuguese hospital. Data were collected through a questionnaire which included sociodemographic data, the Lawton-Brody Index and the Zarit Burden Interview (ZBI). Results Of the 119 FC, 66.4% were female, with an average age of 53.8 years. 73.1% of FC cohabited with the person they care for, in which the majority was cared for by their child or spouse, 45.2% and 36.1%, respectively. It should also be noted that 71.4% felt the need for more support from health professionals. As for autonomy, 52% of the individuals cared for by FC were moderately dependent. It was verified that about 45% of the FC had an intense overload. Female gender has greater overload and that there are no significant differences between the level of education and cohabitation. Conclusions Considering the results, it is understood the importance of valuing FC, as a target and care partners, in order to reduce the burden, they feel when caring for people with MI.

Introduction Web Journal Club as a collaborative learning method, is an effective method to enhance the knowledge base of nursing students, their presentation skills, problem-solving skills and ability to critically appraise literature. Objectives To describe the experience of a online journal club on education of MHN undergraduate students. Methods We implemented a journal club in the online classroom with a total of 24 portuguese undergraduate students enrolled in clinical training of MHN (sixth semester). Over a two-week period, five 2-hour online journal club sessions were conducted in April 2020. During each session, five journal articles were presented synchronously to a live online audience via the Zoom Classroom technology. After all sessions, students were invited by e-mail to complete an anonymous and voluntary online questionnaire via Google Forms. Results All students were all very positive about the journal club sessions and found the opportunity to discuss and reflect on practice issues in depth very helpful. They found the sessions supportive, they helped to bond the group, they learnt a great deal from each others experiences, and they felt that they gained in confidence as a group. Survey results also indicated that few participants experienced technical difficulties during sessions. Conclusions This pedagogical practice enhances gains in the various actors involved: 1) in students, contributing to their learning process and acquisition of competences, articulating research and clinical practice; and 2) lastly, even more indirectly, in people receiving care, since a evidence-based practice ensures safe and quality of nursing care delivery.

Introduction In mental health nursing, the therapeutic relationship is central to the care process, since the restoration of the balance of the person in mental suffering relies on significant interpersonal relationships. Objectives This scoping review aims to map which personal qualities of the nurse favor the therapeutic relationship in mental health nursing. Methods A question was formulated according to the PICo method: What are the nurse’s personal qualities that benefit the therapeutic relationship with the patient in mental health settings? For the selection of studies were used the following databases: Cochrane Database of Systematic Reviews; CINAHL; MEDLINE. A survey was carried out, with the following Boolean conjugation (nurse AND patient) and (personal AND qualities) and (mental AND health) and (therapeutic relation OR relation*). The limit applied to this research was the full text. Results A total of 12 studies were analyzed. These are predominantly qualitative with different methodological approaches. The nurse’s personal attributes or qualities imply not making judgments, be patient, be open and genuine. It was also evidenced the importance of the professional and personal dimensions in the therapeutic relationship. Conclusions In all studies, it was clear that the therapeutic relationship is influenced by attributes of the professional dimension that are linked, mainly, with the theoretical domain, technical knowledge and by attributes of the personal dimension that are related with the professional’s personal qualities or characteristics. The strategies used for the development of the therapeutic relationship imply the involvement of the person nurse, using this to elements of the personal and social sphere. Disclosure No significant relationships.

Background: Stigma education for nursing students has focused solely on stigma reduction, with studies showing temporary improvements in attitudes. However, nursing education research should also emphasize the importance of critical reflection and self-reflection to enhance attitudes, beliefs, topic comprehension, and learning satisfaction. This study aimed to evaluate the effectiveness of the "This is me" intervention regarding knowledge, attitudes, and communication skills of senior undergraduate nursing students in responding to mental illness-related stigma., Methods: This study employed a psychoeducational intervention for reducing mental illness stigma, using a questionnaire survey to assess pre- and post-intervention effects, with 37 eligible nursing students undergoing clinical training in psychiatric services between 16 May and 15 July 2022. Instruments included sociodemographic and health questions, the MICA-4 scale to evaluate students' attitudes toward mental illness, the MAKS to measure mental health knowledge, the Empathy Scale (JSPE-S), the Intergroup Anxiety Scale (SS-12), and the Attribution Questionnaire (AQ-27)., Results: Most students were female (73.0%) and single (70.3%), with a mean age of around 29 years. After implementing the psychoeducational program, there was a statistically significant increase in overall stigma-related knowledge (MAKS: Z = -1.99, p < 0.05), a decrease in intergroup anxiety (IAS: Z = -3.42, p < 0.05), and reductions in the perceptions of patients as dangerous (AQ27-Dangerousness: Z = -2.399, p < 0.05) and fear (AQ27-Fear: Z = -2.415, p < 0.05). Additionally, there was an improvement in empathy, specifically in Perspective Taking (JSPE: Z = -2.555, p < 0.05)., Conclusions: This program may contribute to mental health literacy related to stigma, positively impacting therapeutic relationships and communication with people with mental illness and resulting in more effective care practices.

The physical pain of a burn is immeasurable, but the pain of seeing a child suffer is indescribable. Childhood burns not only affect the child directly, but also have a significant impact on the parents and the rest of the family. During the acute phase of the burn, the child's main allies in recovery are their parents, so they face emotional turbulence, having to support their children while witnessing the painful procedures they go through. They often feel helpless and distressed because they are unable to protect their children from suffering and have difficulty managing everything they feel. In addition to the often-present feeling of guilt, they also experience sadness and worry, particularly when returning home. After hospital discharge, fears increase, as do the challenges. There is a need to readapt the entire family dynamic to respond to the needs of the burned child who returns home. This readaptation often generates stress and anxiety, interfering with the entire family structure. It is crucial to try to understand these parents and give them all the support they need. Only capable and well-adjusted parents can ensure resilient family environments with safer and calmer children, thus promoting family well-being. In this perspective paper, the authors underline the role of parents of burnt children during the long trajectory of child rehabilitation and recovery. By acknowledging their needs, feelings and challenges healthcare providers can engage and support suffering parents toward more family-centered approach., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Cioga, Cruz and Laranjeira.)

Background/Objectives: Given the increasing occurrence of long-term illnesses, it is imperative to focus on adequately preparing and assisting those who assume the responsibility of caregiving. Our study aims to explore whether caregivers feel prepared to provide informal palliative home care, their experiences, and the usefulness of telehealth in managing daily activities. Methods: Using a descriptive qualitative research design and a purposeful sampling technique, thirteen primary family caregivers who provide informal palliative home care were recruited. Data collection was conducted through face-to-face individual interviews conducted from May 2023 to July 2023. Data were analyzed using Braun and Clarke's reflexive thematic analysis. Results: Caregivers were mainly female (n = 8) with a mean age of 59.5 years (SD = 9.42). Based on our findings, three overarching themes emerged: (1) becoming a caregiver, (2) support-from-home palliative care team, and (3) telehealth in palliative home care. The reasons that influence the preparedness of family caregivers include their own desires, health conditions, their range of responsibilities, and the consequences that arise from the situation's complexity. Telehealth helps fulfill the patient's wishes to be at home in EoL and provides caregivers with access to professional guidance and support. Conclusions: Specialized home-based palliative care teams must be aware of caregivers' self-assurance, knowledge, skills, and aptitudes in carrying out daily responsibilities and in managing emotions to improve preparedness for caregiving, loss, and its aftermath. The provision of professional PC services in the home along with a robust support system for informal caregivers is invaluable.

Comprehending the significance of legacy in end-of-life (EoL) situations helps palliative care professionals enhance person-centered outcomes for those with a life-threatening illness and their families. Our purpose was to conduct a concept analysis of legacy in EoL care. By employing Walker and Avant's approach, we identified the concept's defining characteristics. Subsequently, we established the antecedents, consequences, and empirical referents. After conducting a thorough review of titles and abstracts, a total of 30 publications were analyzed. These articles were sourced from three databases (CINAHL, Medline via PubMed, and Scopus) from 2002 to 2023. Our analysis identified several core attributes of legacy: (a) leave behind something of value that transcends death; (b) determine how people want to be remembered; (c) build and bestow across generations; (d) integrate advance care planning through EoL conversations and shared decision-making; and (e) develop strategies of dignity-conserving care. The consequences are related to improvements in spiritual and subjective well-being; coping with inevitable EoL existential issues; decreases in EoL suffering; engendering self-awareness, hope, gratitude, and peace; achieving and maintaining dignity; creating good memories; promoting mutually constructive and transformative relationships; and fostering the adjustment of bereaved people. Nevertheless, further effort is required to implement the key attributes of legacy that form the basis for creating legacy-oriented interventions near the EoL.

The COVID-19 pandemic significantly interrupted the grieving experiences of bereaved families and drastically changed their ways of dealing with loss. Our study aims to gain an in-depth understanding of the experience of bereaved relatives of patients who died in palliative care units during the COVID-19 pandemic. The phenomenological research design included sixteen family members of hospitalized palliative patients who died from November 2021 to June 2022. The study involved conducting qualitative in-depth semi-structured interviews with family members 12-24 months after the death of their loved ones. The interviews aimed to gather information about the experiences of the families both before and after the death. The COREQ guidelines were applied in the study. Participants were mainly female (n = 13) with a mean age of 47.25 (SD = 12.58). Data were analysed using the Interpretative Phenomenology Analysis (IPA). The following three categories were identified: (1) navigating loved ones' final weeks and days (troubled deaths); (2) the last farewell was robbed; (3) looking for adjustment after loss. One overall main theme emerged, which was as follows: "Struggling between stolen moments and painful losses to get back into the flow of life". This study provides novel insights into end-of-life care and bereavement from the perspectives of family. Our findings suggest that developing and promoting family-centred culture can lead to compassionate palliative care focused on a myriad ways of affirming that their loved one matters.

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).)

Breast Cancer Associated Susceptibility Proteins Type 1/2 ( BRCA1/2 ) promote cellular functioning by modulating NRF2-mediated antioxidant signaling. Redox failure in women with BRCA1/2 insufficiency increases the risk for breast/ovarian/uterine cancers. Risk-reducing salpingo-oophorectomy (RRSO) is a prophylactic surgery of the reproductive organs, which is frequently conducted by the age of 40 to lower the occurrence of cancer in women with BRCA1/2 mutations. However, abrupt estrogen decline following RRSO causes ovarian failure, which implicates various cellular physiological processes, resulting in the increased release of free radicals and subsequent severe onset of menopausal symptoms. Comfort measures (e.g., hormonal replacement therapy (HRT) and mindfulness-based stress reduction (MBSR)) may improve chronological menopause-related quality of life, but their specific effects are not clear in women with gene mutations. Aiming to fill the gap, this study used path analysis to examine the effects of HRT and MBSR on menopausal symptoms among RRSO patients (N = 199, mean age = 50.5 ± 6.7 years). HRT directly alleviated the levels of urogenital symptoms (β = -0.195, p = 0.005), which mediated its indirect significant effects on the somatic-vegetative and psychological symptoms of menopause (β = -0.046, -0.067; both p values = 0.004, respectively), especially in BRCA2 carriers and in women who were currently physically active, premenopausal at the time of RRSO, had a high BMI, and had no history of breast cancer. It increased the severity of urogenital symptoms in women with a history of cancer. MBSR, on the other hand, was associated with indirect increases in the intensity of the somatic-vegetative and psychological symptoms of menopause (β = 0.108, 0.029; p = 0.003, 0.033, respectively). It exerted positive direct effects on different menopausal symptoms in multigroup analysis. The results suggest that young women undergoing recent RRSO may benefit from HRT at an individual level, while their need for extensive measures to optimize their psychological wellbeing is ongoing. The adverse effects of MBSR, which are captured in the present study, imply that MBSR may interfere with redox sensitivity associated with estradiol fluctuations in BRCA1/2 carriers. Investigations are needed to test this hypothesis and elaborate on the underlying mechanisms in these women.

Background: Digital inclusion of older people is an important agenda for the future and well-being of the older population, as it represents a form of social inclusion with significant gains for healthy aging. The present study aimed to understand the experiences of Brazilian older adults who use smartphones and the implications in their daily lives., Method: A qualitative study was developed using a constructivist grounded approach. Older people (≥60 years) with prior access to a smartphone were invited to participate in the study. Participation took place through semi-structured, audio-recorded interviews. Data collection and analysis occurred simultaneously using a constant comparative approach. Data management and analysis used the Atlas.ti® software., Results: Overall, 37 older people participated, with an average age of 70.60 ± 6.95 years, predominantly female (n = 33), white (n = 25), married (n = 26) and retired (n = 27). The first sample group included 27 older people with family support and the second group included 10 older people without family support (who lived alone in their homes). A core category emerged from the data analysis-"Expanding the personal and social development of older adults through smartphone communication"-around which three main categories emerged: 1) The smartphone as "a window to the world"; 2) The problem of misinformation and fake news on virtual networks; 3) Technological paradoxes in the use of smartphones., Conclusions: The digital transition associated with smartphone use brings unimaginable benefits to older adults who adopt positive habits to improve their well-being and expand their social connections, following efforts proposed by the Decade of Healthy Aging. However, older adults still face disparities and experience a significant digital divide, which represents a major challenge. Barriers to access are further aggravated in developing countries. We hope this study contributes to public health policies on digital inclusion and healthy aging., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Carlos Laranjeira reports financial support was provided by Foundation for Science and Technology. The corresponding author “Carlos Laranjeira” serves on the editorial board of Helyion as associate editor. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

In our pursuit of a fulfilling and contented life, the study of well-being has emerged as a fundamental field of research. Higher levels of well-being are associated with better mental health outcomes. Individuals with better mental health might possess the personal resources necessary to set and pursue meaningful goals, maintain positive expectations, and overcome adversities. We aim to explore the positive relationship between well-being (hedonic, psychological, and social) and dispositional hope. We suggest that mental health acts as a mediator in this relationship, since improved mental health can create a conducive environment for the development and maintenance of dispositional hope. Data were collected using an e-survey through social media during the last quarter of 2022. The hypothesis of this study was tested using mediation analysis. The sample was composed of 471 participants (85.4% female) with a mean age of 47.72 ± 11.86 years. Participants were mainly workers (88.6%), followed by pensioners (6.8%), university students (2.5%), and unemployed (2.1%). Results revealed that well-being was positively and significantly associated with dispositional hope. Additionally, well-being presented a significant and positive relationship with mental health, which, in turn, also presented a significant and positive relationship with dispositional hope. Finally, using the Hayes process macro for SPSS, we found that mental health mediates the relationship between well-being and dispositional hope. Our findings reinforce the conceptual frameworks that consider well-being and mental health as key contributors to a resilient and optimistic mindset. Interventions that aim to cultivate positive affect, facilitate personal growth, and foster supportive social environments might help improve mental health outcomes.

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18-<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose-response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period.