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Aim: To evaluate the effectiveness of a positive mental health program for adults (PMHP) in the community., Background: Positive mental health (PMH) can be seen as a construct represented by six factors (personal satisfaction, prosocial attitude, self-control, autonomy, problem resolution, and self-actualization, and interpersonal relationship skills) according to the Multifactorial Model for PMH. Although there are several interventions in promoting mental health, research on effective promotion of PMH for adults in the community with structured and validated programs of PMH is scarce., Methods: This study protocol describes a randomized controlled trial (RCT) following a wait-list control design, aimed at evaluating the effectiveness of a PMHP in the community. This study was approved in June 2019 by the Ethics Committee. Participants will be recruited from the school community of teachers. Participants aged ≥ 18 years. The participants will be randomized 1:1 to either (a) an intervention group, which will integrate the PMHP, or (b) the standby control group. Three assessment moments for both groups will take place initial, after the intervention, and a follow-up of 3-6 months. The evaluation instruments will include a sociodemographic questionnaire, a PMH questionnaire, and a psychological vulnerability scale., Conclusion: The current study provides an innovative approach to PMH. Further, the study may demonstrate new interventions in PMH in the community, based on a program with systematized guidelines and sessions structured according to individual needs. It is expected that at the end of the program, the experimental group will increase the level of PMH., Relevance to Clinical Practice: To allow future official implementation of the PMH program and the replication of the study in other professional groups as a promotion tool., No Patient or Public Contribution: There was no funding to remunerate a participant for this study., Trial Registration: ClinicalTrials.gov identifier: NCT04600401. Registered on May 15, 2020., (© 2024 Wiley Periodicals LLC.)

Introduction: Caring for a dependent individual, particularly over an extended period, places significant strain on family caregivers, often leading to adverse physical, mental, emotional, social, and economic outcomes for both caregivers and those they care for. Common challenges include anxiety, depression, loneliness, and diminished overall well-being. E-health applications have emerged as effective tools to support family caregivers by promoting positive mental health through online interventions, enhancing problem-solving skills, autonomy, interpersonal relationships, self-control, and a prosocial attitude. Methods: This study aimed to translate and culturally adapt the Spanish "Program to Promote Positive Mental Health through the Cuidadoras Crónicos Manual" into the Portuguese context, supporting its implementation as a smartphone application. The process involved translation, back-translation by two native experts, and refinement through a focus group with eight participants. The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Results: The translation and back-translation processes identified several adjustments, which informed discussions in the focus group. Three key themes emerged: (i) conceptual and semantic equivalence, (ii) optimisation of content, and (iii) relevance and timeliness of the manual. Conclusions: The Spanish manual for promoting positive mental health among family caregivers was successfully translated and culturally adapted into European Portuguese. Validated through expert input, this marks the first version of the manual tailored to Portuguese caregivers, using Positive Mental Health models to support caregivers of individuals with chronic conditions.

What Is Known on the Subject: Adult psychiatric services typically focus on the mental health needs of the client but they do not support his or her parenting role. Many authors highlight the importance of a non-judgmental approach when providing support and care to clients with mental illness who are parents. Assessments frequently focus on the negative aspects while the strengths of these families were often overlooked. There is a lack of scientific literature exploring nurses' experiences when caring for parents with mental illness and their families., What This Paper Adds to Existing Knowledge: Trust is the basis that helps clients to be open to receiving care and answering parenting-related questions. Therefore, without adequate professional-client trust, some care and interventions addressed to parents with mental illness could be poorly received by the client. Tronto's phases of care facilitated the collection of data and exploration of mental health nurses' experiences of care., What Are the Implications for Practice: Mental health nurses should be aware of the potential needs of these families, as described in the scientific literature, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique. Mental health nurses must take the person's environment into account (family, social and political aspects and different forms of stigma) since all these factors may influence how parents with mental illness receive and provide care., Abstract: Introduction Many authors highlight the importance of a non-judgmental approach when providing care to parents with mental illness. However, assessments frequently focus on the negative aspects while the strengths of such families were often overlooked. Aim To explore the lived experiences of mental health nurses who care for clients who are parents. Method We conducted a qualitative phenomenological study. The main data collection technique was in-depth interviews. Data were analysed according to Colaizzi model, subsequently, the main categories that arised were compared and related to the five phases of Tronto's care. Results The main categories identified from the analysis of the interviews were: (1) individualized care, (2) continuity of care, (3) psychoeducation and counselling, (4) trust and (5) context of the client. Discussion Trust is the basis that helps parents with mental illness to be open to receiving care and answering parenting-related questions. Without trust, some interventions could be poorly received by the client. Implications for Practice Mental health nurses should be aware of the potential needs of these families, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique., (© 2024 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)

Introduction: Literacy of health professionals on patient safety aims to prevent and reduce risks and adverse events in healthcare., Objective: The objective of this study was to translate, adapt, and validate for Portugal of the World Health Organization Questionnaire to Assess the Implementation of the Multiprofessional Guide., Methodology: Following the cultural adaptation process, we carried out a psychometric analysis on a sample of 300 health professionals. The scale was tested for apparent and content validity. Psychometric properties were assessed using Cronbach's alpha coefficient (α) through exploratory and confirmatory factor analysis, convergent validity, and discriminant validity., Results: Exploratory factor analysis led to a tetra factor structure that accounted for 43.0% of the variance and had an overall alpha of 0.759. The hypothesized structure was submitted to confirmatory factor analysis, and the following items were eliminated from factors 1, 2, and 3 and the respective items: 7; 5; and 3, 4, 5, and 6, due to multicollinearity problems. Overall good-of-fit indexes are reliable., Conclusions: The "KIT TOOL-S2 TEXT" scale presents a factor structure with satisfactory validity and reliability results, adequately representing the constructs in question., Competing Interests: The authors 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 Author(s). Published by S. Karger AG, Basel on behalf of NOVA National School of Public Health.)

Background and Purpose: Previous research shows significant benefits resulting from improving culturally competent nursing care. Thus, the purpose of this study was to translate, adapt, and validate the Cultural Competence Assessment (CCA) in a sample of Portuguese nurses. Methods: A psychometric study of the CCA, after translation into European Portuguese, was performed with a snowball sample of 284 nurses. Participants were asked to fill in a sociodemographic questionnaire and the CCA. Results: The four-factor model of the CCA (Portuguese version) exhibited satisfactory indices of fitness without item nine. Cronbach's alpha was 0.85. Correlations between subscales and the total score scale were strong and statistically significant. Conclusions: These data add to the cultural competence knowledge of nurses to promote better practices and culturally competent care., (© 2023 Springer Publishing Company, LLC.)

Positive mental health is defined as the ability to perceive and interpret the context of a situation and to adapt to it whenever necessary. Considering the pandemic situation, identifying the factors that may have the greatest impact on quality of life and consequently, on positive mental health is paramount. The objective of this study was to assess the impact of health literacy on the adoption of behaviours that promote positive mental health during COVID-19. A descriptive, cross-sectional and correlational study was conducted on a sample of 770 patients using a questionnaire for sociodemographic characterization, the Positive Mental Health Questionnaire and the Mental Health Knowledge Questionnaire. Concerning health-promoting behaviours, those who sleep enough hours, exercise regularly, eat healthy and are more aware of mental health promotion activities, or have greater mental health literacy, have higher positive mental health scores. Thus, having more knowledge of mental health and adopting health-promoting behaviours improve positive mental health.

Background: Patients with chronic disease have become one of the major challenges for health and social protection systems in developed countries. Integrated care models (ICM) have demonstrably improved the quality of care of chronic patients. However, new models of integration need further evaluation of its effectiveness and outcomes., Methods: The ICM studied promoted coordination between the health and social sectors during a 6-month period, through an ad hoc developed application (app) that enabled a constant flow of communication between professionals from both sectors. Patients' quality of life, treatment adherence, chronic patient experience and caregiver overload were assessed by questionnaires at baseline, at the end of the intervention and 6 months post-intervention., Results: The implementation of the new health and social ICM permitted new case detection and medical and social services offered to chronic patients. Furthermore, the quality of life and treatment adherence of patients and caregiver overload were significantly improved. These positive effects lasted at least 6 months after the intervention., Conclusions: Integrated care may facilitate access to care services, increase perceived patient quality of life and treatment adherence. Enhanced access to medical and social services from complex chronic patients may have important implications for caregivers and the care systems who are struggling to adapt to an expanding demand., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2023 The Author(s).)

Over the last years, there have been several studies that have shown insufficient levels of adolescents' mental health literacy (MHL). Knowledge about intervention programs that promote positive mental health literacy (PMeHL) among adolescents is still very scarce. In this sense, we defined as objectives to identify and describe the necessary components to design a program proposal that promotes adolescents' PMeHL. We conducted an exploratory, descriptive, qualitative study using two focus groups in July and September 2022 with an intentional non-probability sample of eleven participants (nine professional experts and two adolescents). Data were analyzed using content analysis, using NVivo ® 12 software (version 12, QRS International: Daresbury Cheshire, UK). We obtained a total of four categories and eighteen subcategories: structure (context; format; contents; length and frequency; pedagogical methods; pedagogical techniques; resources; denomination), participants (target group; program facilitators), assessment (timing; evaluation instruments), other components (planning, articulation and adaptation; involvement; training; special situations; partnerships; referral). The perspectives of the professional experts and of the adolescents that we obtained from this study contributed to the design of a proposal for a program to promote adolescents' PMeHL.

Since mid-March 2020, a state of emergency was decreed in Portugal due to the COVID-19 pandemic and, consequently, measures were implemented to protect public health, such as social isolation, which will certainly have a notable impact on the mental health of the population, especially in the most vulnerable groups. Positive Mental Health (PMH) is essential to deal with adversity, in this case with the pandemic, and to live better and with greater satisfaction. We consider it relevant to investigate how PMH was used as a resource to deal with the pandemic, depending on the level of vulnerability and sex. A, cross-sectional study was carried out whose the aim was to evaluate the levels of PMH and psychological vulnerability in people with COVOD-19 infection and analyze the association between PMH and psychological vulnerability among men and women., Methods: The instruments used were a sociodemographic characterization questionnaire, the Positive Mental Health Questionnaire, and the Psychological Vulnerability Scale (PVS), that were sent and filled out online. A quantitative, cross-sectional, descriptive, and correlational study was carried out., Results: After analyzing the results, it was found that approximately 50.4% of the respondents (n = 387) had global PMH values that place them in quartile 50. There was also a statistically significant difference between female and male PMH, with women showing greater psychological vulnerability and lower overall PMH., Conclusions: We conclude that the women present a greater psychological vulnerability and a lower level of PMH when compared to men., Relevance to Clinical Practice: Considering the study's statistically significant results, when we talk about mental health, we should always consider the sex variable as a vulnerability factor, in a pandemic or non-pandemic phase., (© 2022 Sigma Theta Tau International.)

Objective: This study aimed to map the evidence available on patient safety training programs for health professionals., Methods: A scoping review was carried out. Several studies published between January 2010 and March 2020 in the following databases were investigated: CINAHL; MEDLINE; Nursing & Allied Health Collection: Comprehensive; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; Cochrane; MedicLatina , via EBSCOhost; World Health Organization; Google Scholar; BVS- Biblioteca Virtual da Saúde ; PubMed; B-On; and RCAAP- Repositórios Científicos de Acesso Aberto de Portugal ., Results: A total of 2841 articles were found, 7 were included. Most studies report that the development of patient safety programs for health care professionals provides them with tools and techniques to recognize adverse incidents induced by the professional system/practice; recognize human factors related to patient safety, such as nontechnical skills or tiredness; understand high-risk clinical processes; develop strategies that influence and enhance patient safety culture; promote communication, teamwork, and organizational culture concerning patient safety; analyze other characteristic and emerging topics in patient safety; and develop project proposals to improve patient safety, allowing health care professionals to consolidate their knowledge, leading initiatives to improve patient safety., Conclusions: There are still few studies that test patient safety training programs, which is a concern given the importance of implementing safe practices. The existing evidence proves the efficacy of the training programs in improving patient safety, although there are some gaps., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Psychological vulnerability (PV) indicates the individual’s inability to adapt to stressful situations. Adolescents experience negative impacts on their future mental health if they do not acquire the skills and knowledge necessary to have good mental health during their developmental stage. Aim: To compare the PV index among the three stages of adolescence and to explore the factors involved in good mental health, including the relationship between adolescents’ PV indices and sociodemographic variables, and the relationship between adolescents’ PV index and their knowledge of the factors that characterize good mental health. Method: An exploratory, cross-sectional, correlational study was carried out in three public schools in a region of Portugal, using online self-completed questionnaires: the Psychological Vulnerability Scale (PVS) and the Mental Health-Promoting Knowledge (MHPK-10). Results: Our convenience sample consisted of 260 adolescents, with a mean age of 14.07 years who were students between 5th and 12th grades, mostly female. Moderate PV indexes were obtained that were higher in late adolescence, i.e., in older adolescents, who were females in a more advanced school year, with worse self-perceptions of their physical and mental health and body image, and who frequently used a health service due to mental health problems. The association between the PV index and the level of knowledge about the factors involved in good mental health did not reach a statistical significance (p = 0.06). Conclusions: These results suggest a need for a design of personalized interventions that promote adolescents’ mental health literacy, that prevent PV, and that should be initiated in early adolescence.

We explored the views of the professionals (from primary care and social services) and users (caregivers and patients) who participated in the clinical trial of the Salut+Social integrated care model to identify the implementation barriers and facilitators, to assess the impact on health and wellbeing and to obtain an assessment of the program. A qualitative descriptive study with a pragmatic, utilitarian approach was performed. Participants were recruited by purposive and convenience sampling. A focus group (FG) and in-depth interviews were conducted with professionals and users, respectively. Thematic content analysis was employed. A total of 11 professionals and 8 users participated in the FG and interviews, respectively. Seven themes were identified: (1) contextualizing the previous scenario; (2) achievements of the program from the professionals' perspective; (3) facilitators and barriers of the integrated care model; (4) proposals for improving the integrated care model; (5) users' assessment of the care received within the program framework; (6) users' perception of the impact on health and wellbeing; (7) users' demands for better care. Professionals reported improved coordination between services and highlighted the need for a protocol for emergencies and to strengthen community orientation. Users proposed more frequent home visits. This study shows the acceptability of the new model by professionals and the users' satisfaction with the care received.

Purpose: To evaluate the effectiveness of the psychoeducational programme "Living together with dementia" applied to a group of family caregivers of people with dementia., Design and Methods: A quasi-experimental study with pretest and posttest and a 4-month follow-up. Fifteen family caregivers of people with dementia were recruited in a community care unit in northern Portugal., Results: A positive and statistically significant impact on these caregivers' burden was found., Practice Implications: The programme could be an important mechanism to train family caregivers of home-dwelling people with dementia., (© 2022 Wiley Periodicals LLC.)

This study aimed to assess adolescents' Mental Health Literacy (MHL) level, Positive Mental Health (PMH) level, the association between sociodemographic variables and the MHL and PMH levels, and the relationship between adolescent's MHL and PMH levels. A quantitative, cross-sectional, correlational study was conducted with a convenience sample of 260 adolescents studying in the 5th to 12th years of school. The Mental Health Knowledge Questionnaire, the Mental Health-Promoting Knowledge, and the Positive Mental Health Questionnaire were used for data collection. Most of the adolescents were female (55.8%) with a mean age of 14.07 years. The participants showed good levels of MHL (MHKQ). The participants showed good levels of MHL (MHKQ 𝘹¯ = 60.03; MHPK-10 𝘹¯ = 4.49) and high levels of PMH (𝘹¯ = 128.25). The adolescents with higher levels of MHL were the oldest, in a higher year of school, female, those whose mothers are employed, those who have healthy eating habits, and those who have a better body image self-perception. Adolescents in a lower year of school, with adequate sleep habits, who spend fewer hours a day in front of a screen or online, and who have a better self-perception of mental and physical health and body image were the ones with higher PMH levels. These findings suggest the need to implement experimental or quasi-experimental studies to ascertain the effectiveness of interventions that promote adolescents' positive mental health literacy.

After the end of their time as a caregiver, former caregivers have needs and feelings that have been subject to little study to date. The aim of the study is to determine and analyse the feelings, perceptions and practices of former caregivers in the reconstruction of their daily lives. This is a qualitative study based on the Grounded Theory developed by Charmaz. The study involved 14 former caregivers who had cared for their relative for more than 2 years and who had stopped caring for them more than 2 years previously. Fourteen in-depth interviews were conducted and data were collected over 13 months between 2015 and 2017. Data were analysed using the Grounded Theory Method. In addition, this study was approved by the ethics committee of the Institut Universitari d'Investigació en Atenció Primària Jordi Gol. The former caregiver experiences a transition, which begins in the days before the death of their relative and may continue for more than 3 years. Three critical moments in the post-caring transition were found: (1) the post-caring emptiness; (2) the end of the period as a caregiver; and (3) the movement towards a new life. Family and professional support is needed during this transition. Former caregivers experience a transition in the rebuilding of their daily lives; furthermore, former caregivers may be a source of support for other caregivers, which is linked to positive mental health factors. Healthcare organisations need to acknowledge the emotional, psychosocial and psychological health of former caregivers., 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. The handling editor declared a past collaboration with one of the authors CF-G., (Copyright © 2022 Mora-Lopez, Berenguer-Poblet, Berbis-Morelló, Albacar-Rioboo, Montesó-Curto, Aguaron-García and Ferré-Grau.)

Aim: The aim of this study was to analyze the caregiving experience of parents whose adolescent children with a mental illness require admission to a day treatment hospital for mental health services., Method: The study used qualitative interpretative research methods. A total of 18 parents participated in the semi-structured interviews. Data were then transcribed and analyzed in accordance with established methods for the analysis of inductive thematic data., Results: Seven themes were identified: questioning an unseen disease, abnormal behavior, a long road, truancy and loss of parental authority, internalized stigma on admission, regaining the meaning of life and an uncertain future., Discussion: The experience of the parents was analyzed and various emotional, psychological and interpersonal barriers were found that influenced the help-seeking for the adolescent's treatment., Implications for Practice: Nursing interventions should be based on detecting barriers and validating the experience of parents with mentally ill adolescents., (Copyright © 2021 Elsevier Inc. All rights reserved.)

This study aimed to evaluate positive mental health (PMH) and its relation with sociodemographic characteristics, mental health literacy, and the psychological vulnerability scale (PVS) in Portuguese university students aged 17 to 62. A descriptive correlational study was carried out. An online survey was conducted to evaluate demographic variables, and several questionnaires were applied to evaluate positive mental health, psychological vulnerability, and mental health literacy. The data was collected from 1 November 2019 to 1 September 2020. Overall, 3405 students participated in the study. The results show that 67.8% of students revealed a high level of PMH, 31.6% presented a medium level of PMH, and 0.6% had a low level of PMH. Male students reported higher personal satisfaction ( t (3170) = -2.39, p = 0.017) and autonomy ( t (3170) = -3.33, p = 0.001) in PMH compared to female students. Students without a scholarship scored higher ( t (3127) = -2.04, p = 0.42) in PMH than students who held a scholarship. Students who were not displaced from their home reported higher ( t (3170) = -1.99, p = 0.047) self-control in PMH than those displaced from their home. University students with higher PMH results had lower PVS results and higher literacy results. The findings of this study will contribute to identifying students' PMH intervention needs.

Objective: This study sought to explore the perceptions of experts about the performance of nursing homes during the COVID-19 outbreak., Method: A qualitative study was developed in two stages: (1) a focus group, conducted in May 2020, with 5 experts; (2) a modified e-Delphi, implemented in September 2020 with 22 experts, both in the area of assistance in nursing homes from Northern and Center of Portugal., Results: The results allowed identifying three main areas that influenced the performance of nursing homes during the COVID-19 outbreak: organization models and resources; physical and mental health of residents and; family as a support., Conclusions: Older adults residing in nursing homes are particularly vulnerable to severe disease or death from COVID-19. It is emergent that nursing homes prevent physical and mental frailty in older residents and the loneliness aggravated by the pandemic circumstances. Decision-makers need to recognize that older people living in nursing homes have several health needs, which should determine the implementation of new strategies namely the increase in the number of professionals with appropriate skills., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

When a parent has a mental health problem, family members can be affected by it. Nursing professionals can provide care for the whole family, including children. Nurses can support the parental role of parents with mental illness. This integrative review aimed at the following: To identify and to synthesize the views and practices of nurses on parental mental illness (PMI). An integrative review methodology was employed, following PRISMA guidelines. Theoretical and empirical literature was included. Twenty-three articles were obtained to be analysed, using the Whittemore and Knafl approach. A lack of knowledge about nurses' views and practices on PMI was found. Especially, in some demographic areas such as Mediterranean countries and Central and South America. Different issues which influence how nurses perceive PMI were identified: subjective meaning of family concept, personal experience of being parent, and perceptions of mental illness, among others. The main findings on nurses' practices were as follows: guidelines to implement family-focused practices, knowledge, and skills; therapeutic relationship; and teamwork and interagency communication; among others. These issues are intimately related. They could act as enablers or barriers to support parental role of parents with mental illness. Adequate guidelines and policies are necessary to support parents with mental illness and their families. There is a need to include knowledge about PMI and family-focused approach in nursing education curricula. Training could include reflection on nurses' experiences and personal values to become aware of how these can affect their interventions and practices., (© 2021 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

In recent years, there has been an important commitment to the development of programs to promote mental health literacy (MHL) among adolescents, due to the prevalence of mental health problems and the low level of MHL that affects this group. The aim of this study was to map the structure and context of programmes/interventions for promoting MHL among adolescents in school settings. A scoping review was conducted following the guidelines of The Joanna Briggs Institute. We searched for studies on programmes/interventions promoting at least one of the components of MHL of adolescents, written in Portuguese, English or Spanish, published from 2013 to 2020, in MEDLINE, CINAHL Plus with Full Text, SciELO, SCOPUS, OpenGrey, RCAAP and in the article reference lists. This review included 29 articles. The majority of programmes/interventions addressed one or more of the four components of MHL, with the knowledge of mental disorders and stigma reduction components being the most covered; were taught by adolescent's regular teachers; used face to face interventions; had a height variable duration; used non-validated instruments; were implemented in a classroom environment; and showed statistically significant improvements in adolescent's MHL levels. More research is needed to implement/construct programmes/interventions promoting adolescents' MHL concerning knowledge on how to obtain and maintain good mental health.

The lack of knowledge and skills for transitioning to motherhood places first-time mothers at greater risk of depression and stress, may lower their perceived self-efficacy and satisfaction with the maternal role, and potentially affects the mother-infant bond. The purpose of this study was to test the efficacy of a multimodal nursing intervention (AMACOMPRI), based on Mercer's Becoming a Mother Theory, in supporting the process of becoming a mother in first-time mothers of term infants. This study was a parallel-group, double-blind, randomized, controlled trial with a 4-month postpartum follow-up. The outcome measures were the process of becoming a mother, functional social support, mother-infant bond, and perceived maternal self-efficacy. Sixty-six first-time mothers completed the study: 33 in the intervention group and 33 in the control group. The intervention was effective in supporting the process of becoming a mother, with a large effect size (Cohen's d = 1.50) and higher scores on the Becoming-a-Mother Scale in the intervention group compared with the control group (intergroup difference 13.04 points; 95% confidence interval: 8.72-17.34). Participants in the intervention group demonstrated higher scores in functional social support, perceived maternal self-efficacy, and mother-infant bond. This study provides evidence for the efficacy of an innovative nursing intervention that supports the process of becoming a mother. Further testing of the intervention is required in different settings and first-time mothers of low and high risk newborns., (© 2021 Wiley Periodicals LLC.)

Objective: To understand the experience of men in relation to the process of living with hemophilia., Method: Qualitative study using the theoretical and methodological referential Symbolic Interactionism and the constructivist strand of Grounded Theory. Participated 12 men with hemophilia followed at a Blood Center in the south of Rio Grande do Sul, Brazil. Intensive interviews, genograms and field notes were used for data collection, with concomitant analysis, following the initial, focused, and theoretical coding stages., Results: The theoretical model was built, which has as central category Adapting to (co)exist with hemophilia and the categories Knowing yourself and the illness: knowing how to deal, Adjusting life: taking care of yourself and Getting used to the illness: being almost normal., Conclusion: It was revealed the experience of men who adapt to (co)exist with hemophilia and their actions and behaviors, aiming to preserve them away from bleeding, pain, and the risk of death.

The aim of this article was to present the preliminary results of a training programme for family caregivers of people with dementia at an early to moderate stage living at home - 'Living Together With Dementia'. In this randomised controlled trial, 27 family caregivers who met the inclusion criteria were recruited from the neurology outpatient consultation clinic of a hospital in the north of Portugal and randomised into two groups (control and experimental) between October 2015 and March 2016. The programme 'Living Together With Dementia' was applied to the participants of the experimental group. The strategies used, overload, difficulties and satisfaction of the caregivers were assessed at three different stages (at the beginning and end of the intervention, as well as at follow-up). For the data analysis, quantitative parametric measures were applied. The Health Ethical Commission of the Hospital Centre approved the study, and its protocol and Helsinki Declaration ethical principles were considered throughout the process. In the final assessment, an improvement in the overload and difficulties was confirmed, as was an increase in the caregivers' satisfaction level and an improvement in coping/problem-solving strategies. In the follow-up stage, the results tended to revert towards those of the initial assessment. The programme 'Living Together With Dementia' appeared to be a major contribution enabling family caregivers of people with dementia, although there is a need to develop an efficacy study using a more substantial sample. The programme contributed to a reduction in the overload and difficulties borne by the family caregivers of people with dementia at an early to moderate stage living at home and to increased caregiver satisfaction., (© 2020 Nordic College of Caring Science.)

Background: Taking care of chronic or long-term patients at home is an arduous task. Non-professional caregivers suffer the consequences of doing so, especially in terms of their mental health. Performing some simple activities through a mobile phone app may improve their mindset and consequently increase their positivity. However, each caregiver may need support in different aspects of positive mental health. In this paper, a method is defined to calculate the utility of a set of activities for a particular caregiver in order to personalize the intervention plan proposed in the app., Methods: Based on the caregivers' answers to a questionnaire, a modular averaging method is used to calculate the personal level of competence in each positive mental health factor. A reward-penalty scoring procedure then assigns an overall impact value to each activity. Finally, the app ranks the activities using this impact value., Results: The results of this new personalization method are provided based on a pilot test conducted on 111 caregivers. The results indicate that a conjunctive average is appropriate at the first stage and that reward should be greater than penalty in the second stage., Conclusions: The method presented is able to personalize the intervention plan by determining the best order of carrying out the activities for each caregiver, with the aim of avoiding a high level of deterioration in any factor.

Improving cognitive insight can reduce delusions in patients with psychotic disorders. Although institutionalized patients usually have more severe delusions than outpatients, little is known about the differences in cognitive insight between these two groups. In this study, we evaluated the psychometric properties of the Beck Cognitive Insight Scale (BCIS) for a sample of Portuguese patients with psychotic disorders and compared the cognitive insight of institutionalized patients with patients living in the community. Participants in this study were 150 patients diagnosed with psychotic disorder (78 institutionalized patients and 72 outpatients). The tested model of the BCIS was a very good fit. Our study shows that patients living in the community showed higher levels of cognitive insight (total BCIS and self-reflectiveness) than institutionalized patients. Future studies assessing cognitive insight should take into account differences between the cognitive insights of institutionalized psychotic patients and psychotic patients living in the community., (Copyright © 2020. Published by Elsevier B.V.)

Objective: To evaluate the relationship between affectivity and sociodemographic and clinical characteristics, quality of life, functioning, and social support satisfaction in schizophrenia., Method: Cross-sectional study of a sample of 282 schizophrenic patients. An interview was performed using a sociodemographic and clinical questionnaire and scales to evaluate positive and negative affect, quality of life, social support satisfaction, and functioning., Results: Participants' employment status, gender, whether they smoked, hospitalization in the last year, antidepressant medication and benzodiazepines, quality of life, functioning, and satisfaction with social support had relationships with positive or negative affect., Conclusion: This study provides further understanding of the factors related to affectivity in schizophrenia. More studies are needed to prove these relations and their effects on rehabilitation in people with schizophrenia., (© 2020 Wiley Periodicals, Inc.)

Objectives: To determine the face, content, construct validity, and reliability of the functional social support domain of Perinatal Infant Care Social Support (PICSS) translated into Spanish and adapted for first-time mothers of term babies., Methods: Validation study of the functional social support domain of PICSS, which has 22 items with response options from 1 to 4; higher scores indicate greater social support. A translation, back-translation, and cultural adaptation process took place along with an expert review to evaluate face and content validity. In total, 210 mothers participated to establish construct validity and the reliability of the domain. The content validity index and factor analysis were used to identify the structure of the domain. Reliability was estimated using Cronbach's alpha coefficient., Results: Linguistic and cultural adaptations were performed, along with validation and reliability. Face validity for mothers was the following: high comprehension (94%); and for experts: high comprehension (95.83%), high clarity (96.53%), and high precision (92.82%). In relevance and pertinence, the content validity index was high (0.97). Construct validation identified two factors that explained 76% of the variance of the domain evaluated: factor 1 "Supporting presence -emotional and appraisal support" (13 items, 39%) and factor 2 "Practical support -informational and instrumental support-" (9 items, 37%). Cronbach's alpha value was 0.97., Conclusions: Given the robust psychometric properties of the Spanish version of the functional social support domain of PICSS, this may be used to identify the functional social support in the mothers., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright by the Universidad de Antioquia.)

Introduction: Integrated care models aim to provide solutions to fragmentation of care by improving coordination. This study will evaluate the effectiveness of a new integrated care model (Salut + Social), which will promote the coordination and communication between social and healthcare services in southern Catalonia (Spain) to improve quality of life, adherence to treatment and access to medical services for patients with chronic conditions, and also to reduce caregiver burden. Additionally, we will evaluate the experience of caregivers, health professionals and social workers with the new model implemented., Methods and Analysis: A clinical trial using mixed methodology will be carried out. The intervention consists of improving the coordination between the social and healthcare sectors during a 6-month period, by means of information and communication technology (ICT) tools that operate as an interface for the integrated care model. The study subjects are primary care patients with chronic health and social conditions that can benefit from a collaborative and coordinated approach. A sample size of 141 patients was estimated. Questionnaires that assess quality of life, treatment adherence, medical service and caregiver burden will be used at baseline and at 6, 9, and 12 months after the beginning of the study. The principal variable is quality of life. For statistical analysis, comparisons of means and proportions at different time points will be performed. A discussion group and semi-structured interviews will be conducted with the aim of improving the care model taking into account the opinions of professionals and caregivers. A thematic content analysis will be carried out., Ethics and Dissemination: This study protocol has been approved by the Clinical Research Ethics Committee of the Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (code P17/100). Articles will be published in international, peer-reviewed scientific journals., Trial Registration: Clinical-Trials.gov: NCT04164160.

Objective: The objective of this study was to determine the validity and the reliability of the Perceived Maternal Parenting Self-Efficacy tool translated into Spanish and adapted to be used among primiparous women of term babies., Methods: Validation study. A total of 210 women participated in the survey to establish construct validity and reliability. The questionnaire has 20 items and four subscales. The higher the score, the higher the self-efficacy. A process of translation/back-translation and cultural adaptation in accordance with international standards and an expert review were conducted to test face and content validity. The Validity Content Index and an exploratory factor analysis were used to identify the structure of the questionnaire. Reliability was estimated using Cronbach's alpha coefficient., Results: Linguistic and cultural adaptation, validation and reliability were performed. Face validity for women was as follows: high comprehension (99%); and for experts: medium comprehension (84.1%), medium clarity (83.9%) and medium precision (80%). Concerning pertinence, the content validity index was 0.93 (i.e., highly pertinent). Concerning relevance, the content validity index was 0.96 (i.e., highly relevant). Factor validation identified four factors that accounted for 91% of the variance. Overall Cronbach's alpha value was 0.98 (IC 95 0.97-0.98)., Conclusions for Practice: Given the robust properties of the Spanish version of the Perceived Maternal Parenting Self-efficacy, it may be used to identify women with low self-efficacy and to assess the effectiveness of health-based interventions.

A systematic review was conducted. So, electronic database including CINAHL, Embase, MEDLINE, Pubmed, Scopus and Cochrane-Central were explored in January 2017 and in October 2017. The aim of this systematic review is to identify, appraise and synthesize the best evidence for the effectiveness of programmes of positive mental health in adults. Mental health is regarded as an ideal functioning state of the human being, which emphasizes the relevance of promoting the person's qualities in the optimization of their potential. Mental health is not inert and definitive but a dynamic and variable state. Studies were reviewed and data extracted by two independent reviewers using Joanna Briggs Institute standardized critical appraisal and data extraction instruments. Six studies met the inclusion criteria for the analysis. However, a meta-analysis could not be performed. The results suggest that positive mental health programmes improve adults' mental condition, although there is neither evidence of content formalization nor of programme sessions criteria. The review findings indicate that interventions promoting positive mental health of young adults can be implemented effectively in community settings with various programmes and results., (© 2019 John Wiley & Sons Ltd.)

Aims and Objectives: To identify which are the needs arised from feelings, perceptions and experiences of the family members during any time within the death process in an emergency service of an acute care hospital, with regard to the assistance received., Background: The publications refer to the needs expressed by bereaved families, who explain the support they received right after the death of a relative in an emergency service, and during the months after the tragedy., Design: Qualitative study drawing on grounded theory based on Charmaz (2006)., Methods: Ten interviews were conducted to a member of each family, who had been in an emergency service with a relative during any of the stages of the dying process. Data were collected from September 2015-June 2016. The analysis was made while data were being collected. Three types of codification were carried out: open, axial and selective. Theoretical saturation was achieved after data collection and analysis., Results: Three thematic categories emerged: the power of information/communication (a), decisions taken by professionals within the dimension of caring (b) and the humanisation of death in emergency services (c)., Conclusions: The quality of the information given to families in the process of death in an emergency service affects to their satisfaction. Family support must be essential in a situation of death. Institutions must guarantee standards of practice, which include orientation on the care of people in bereavement, and the commitment to provide specialised attention those families., Relevance to Clinical Practice: Research findings reveal the need to create changes within clinical practice, regarding how to take care of the family involved in a death process in an emergency service. From the needs detected by the participants, it could be possible to implement an interventional programme, which offers the relatives the emotional support they may need., (© 2018 John Wiley & Sons Ltd.)

Background: To assess the effectiveness of a smartphone app-based intervention compared to a regular intervention of caregivers in primary health care institutions. The intervention is aimed at increasing positive mental health and decreasing caregiver's burden., Methods/design: Randomized and controlled trial with an experimental group and a control group., Subjects: 108 caregivers over 18, with a minimum of 4 months of experience as caregivers. Description of the intervention: an intervention with a smartphone app (n = 54) or a regular intervention for caregivers (n = 54). Each caregiver installs a smartphone app and uses it for 28 days. This app offers them a daily activity (Monday-Friday). These activities are related to the Decalogue of Positive Mental Health, which was designed ad hoc by a group of experts. The outcomes will be the score of caregiver burden, the positive mental health and participant satisfaction. These results will be assessed after the first, third and sixth month., Discussion: The results of this study will offer evidence of the effectiveness of an intervention using a free smartphone app. If its effectiveness is proven and the results are acceptable, this could lead to a rethinking of the intervention offered to caregivers in primary care., Trial Registration: Clinical Register ISRCTN14818443 (date: 24/05/2019).