icH&Hpsy 2016

Volume XIII, Pages 1- 462 (July 2016)
The European Proceedings of Social & Behavioural Sciences EpSBS
e-ISSN: 2357-1330
©2016 Published by the Future Academy
Edited by: Sandra Cruz
Articles: 1-43
Conference: 2nd icH&Hpsy International Conference on Health and Health Psychology
Dates: 09-06 July 2016
Location: Escola Superior de Enfermagem do Porto (ESEP)  (Nursing School of Porto) & the Faculdade de Medicina da Universidade do Porto (FMUP) (Faculty of Medicine of the University of Porto)
Conference Chair(s): Assoc Prof Dr Sandra Cruz, PhD, Associate Prof Dr at the Escola Superior de Enfermagem do Porto (ESEP) – Portugal, Member of CINTESIS - Center for Health Technology and Services Research
Cover Page here

No: 1
Title: Brief Strategic Therapy and Motivational Interviewing among Cardiac Rehabilitation Patients: pre-post treatment results
Pages 1-11
Author(s): Giada Pietrabissa*, Gian Mauro Manzoni, Alessandro Rossi, Gianluca Castelnuovo
Open Access

Full Text 1
The MOTIV-HEART study is aimed at testing the incremental efficacy of Brief Strategic Therapy (BST) combined with Motivational Interviewing (MI) in improving selected biomedical and psychological outcomes over and beyond the stand-alone BST in Cardiac Rehabilitation (CR). 42 heart patients referring to a single clinical center for CR and weigh loss treatment were randomly allocated into two conditions: i) 3 sessions of BST; ii) 3 sessions of BST plus MI. Data were collected at baseline and discharge (1 month later). Pre-treatment heterogeneity was found between groups, and no significant between-group difference in post-treatment medians was obtained in any variables. Within-group changes were detected for the patients’ extrinsic regulation, which significantly decreased only in the BST group, and for the RAI score and the patients’ willingness to change, significantly increasing only in the control group. No evidence of superiority of the combined treatment (BST+MI) over stand-alone BST within CR was found. Conclusions: since combining BST and MI within CR for the first time, the present investigation sets out to be a pilot study, and its results can therefore guide in the implementation of stronger experimental design that would help clarifying the obtained outcomes. 

No: 2
Title: Nursing Interventions in Patients with Chronic Pain and Depression: A Systematic Review
Original Research Article
Pages 12-26
Author(s): Patricia Gonçalves*, Nicia Pereira, Ana Ribeiro, Celia Santos
Open Access

Full Text 2
Chronic pain affects the whole person, not just physically, but also psychologically, spiritually and emotionally. Several studies have found a relationship between chronic pain and depression. Nurses play a key role in the treatment of these conditions. Which nursing interventions are referenced in the literature for the relief of pain and depression? were some of the research questions. Our purpose was to identify the nursing interventions referenced in the literature for the relief of chronic pain and depression. An electronic research of articles was performed in the following databases: CINHAL Complete, CINHAL Plus and MEDLINE (via EBSCOhost). Selection criteria: experimental or quasi-experimental studies published between 1st January, 2007 and 31st December, 2014; Participants older than 18 years with chronic pain and depression; Nursing interventions; Results in relieving pain and depression. 17 experimental and quasi-experimental studies were included in the final sample, all with a high level of evidence. Cognitive-behavioural therapy and education were the most frequently referenced interventions, with significant results in the relief of chronic pain and depression. Exercise and relaxation also showed an important contribution to the achievement of positive results in these conditions. Conclusions: There is evidence that the combination of intervention such as cognitive behavioural therapy, education and, eventually, exercise and relaxation, may have a positive contribution in reducing chronic pain and depression. The implementation of these interventions should be encompassed within a complex, multimodal treatment plan and it should be individualized, tailored to the specific characteristics of each individual.

No: 3 
Title: Violence, Aggression and Fear in the Workplace
Original Research Article
Pages 27-41
Author(s): Emelda Pacheco, Madalena Cunha*, João Duarte
Open Access

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Fear is the most significant consequence of direct or vicarious experience of violence and aggression in the workplace. Both entities significantly affect workers’ physical and psychological well-being. How does workplace violence/aggression effect workers’ well-being? was one of our research question.  Our purpose was to identify behaviors of psychological aggression perpetrated by the public which occur more often and to analyze the implications of workplace violence/aggression on individual psychological and physical well-being. Cross-sectional and correlational study, developed on a sample of 131 inspectors (68% women) with an average age of 41.89 years. Collection of data: Physical and Vicarious Violence at Work; Fear of Future Violent Events at Work; Workplace Aggression Questionnaire; General Health Questionnaire. The prevalence of aggression in the workplace was significant (40% physical; 90% psychological; 76% vicarious and 50% fear). The results showed that the effects of aggression in the workplace on well-being are indirect effects and mediated by fear. Those who experience both physical and vicarious violence feel more fear and fear affects their physical and psychological well-being. The results convey information which supports conceptualization and assessment models of workplace aggression as a nosology entity originating in negative physical and psychological experiences lived by individuals in their workplace. Knowledge and a better understanding of the types and dimensions of the phenomenon violence and aggression in the workplace is a powerful support instrument for defining more effective prevention strategies.

No: 4
Title: The Fear of Childbirth: A Study in the North of Portugal
Original Research Article
Pages 42-50
Author(s): Ana Paula Prata*, Célia Santos, Margarida Reis Santos
Open Access

Full Text 4
Childbirth is a universal phenomenon and a meaningful experience that has the potential to trigger developmental transitions, stress, anxiety and/or fear, which, at times, can negatively impact future childbirth experiences.
An exploratory and descriptive study was conducted aiming to identify the levels of fear experienced by pregnant women associated with childbirth and their main causes. A convenience sample was selected. Data collection were carried out in an outpatient obstetric hospital in the northern region of Portugal, between July 2010 and July 2012. To evaluate the intensity of fear of childbirth a visual analogic scale of 10 points was applied. Interviews were conducted in order to identify the main causes of fear. Ethical approval and informed consent were obtained.
Regarding the level of fear, the majority (98%) of pregnant women had fear of childbirth, 60.2% reported moderate fear and 28% intense fear. Anxiety, primiparity and lack of knowledge related to birthing were also found to increase the fear of childbirth.
Some of the main causes of fear identified were: complications during childbirth; pain/suffering; not knowing how to cope with pain; not able to give birth; baby with malformation/disease and/or suffering.
Most women feel moderate or intense fear of childbirth and this is associated to well identified causes with high impact on the woman and family. To minimize the effects of fear, an early intervention has to be considered, including childbirth education classes where nurses can address and work women’s fear in order to minimize it and promote a more positive experience.

No: 5
Title: Clinical Skills and Communication in Nursing Students
Original Research Article
Pages 51-60
Author(s): Manuela Ferreira*, Daniel Silva, Ana Pires, Maura Sousa, Mónica Nascimento, Nina Calheiros
Open Access

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Communication is a basic tool in nursing, a crucial element in health care. The quality of the interactions that take place between the nurse and the user/family influences their satisfaction and the security they feel regarding the quality of the care they get from the institution. We tried to identify the communication skills and interpersonal relationships nursing students have with their patients; to identify the socio-demographic and academic variables that may influence nursing students’ communication skills and interpersonal relationships. As a methodology we applied, Quantitative, cross-sectional, descriptive and correlational study. The data collection instrument was a questionnaire which included questions concerning: the students’ socio-demographic and academic characterization, the basic skills which will make interviews and clinical communications easier in health care; the usefulness of those clinical communication skills and possible ranges of communication skills and interpersonal relationships. 374 nursing students from two Portuguese schools formed the sample. The majority of the participants in the survey were female (80.5%) aged 18 to 21. The students seemed to understand and accept the importance of clinical communication skills and interpersonal relationships in nursing practice (82.4%); they agreed with the way the methods of communicational skills were taught (54.3%). In their opinion the training they got in this area was good (71.7%). The participants’ age, the semester during which the study was conducted and the school they were attending influenced students’ communication skills and interpersonal relationships (p <0.5). The results obtained allow us to conclude that the education / training nursing students get in the field of relational contexts and the way they can develop their communication skills is of paramount importance when it comes to empower them with the capacity to become a competent health care professional.

No: 6
Title: Health Surveillance: What Adolescents Expect
Original Research Article
Pages 61-71
Author(s): Isabel Bica*, Patrícia Costa, José Costa, Madalena Cunha, Carlos Albuquerque, Margarida Reis- Santos, Lúcia Oliveira
Open Access

Full Text 6
Involve adolescents and knowing what to expect from a health surveillance query, rather than decide for them without the consult, is of paramount importance. We aimed to know the opinion of adolescents about health surveillance query. As a methodology we applied, Cross-sectional study of qualitative nature and phenomenological approach. There were semi-structured interviews in a non-probabilistic convenience sample of 14 adolescents, aged 15 to 17 years old, attending high school. After the content analysis of the responses, it was found that teens put the emphasis on prevention, there were no differences between the two sample groups. The query should be preventive and about health promotion; the theme that adolescents seem to consider most important is to address sexuality (affections, contraception and STI); professional mentioned was a nurse with specialized training; although they prefer the free time, they like to a fixed schedule to answer questions and education sessions for health; as to the operation site, said the school.

No: 7
Title: Resilience and Depressive Symptomatology in Adolescents: The Moderator Effect of Psychosocial Functioning
Original Research Article
Pages 72-86
Author(s): Luísa Pereira, Ana Paula Matos*, Maria do Rosário Pinheiro, José Joaquim Costa
Open Access

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Depression is a serious health problem, especially in adolescence. Several variables can arise as risk or protective factors in different contexts, promoting a good or bad adjustment. The main goal is to identify if variables like resilience and psychosocial functioning are related to depression in adolescence. Additionally, gender differences in these variables are explored. This study aims to analyze the predictive effect of Resilience and Psychosocial Functioning on Depressive Symptoms, and verify the moderating effects of Psychosocial Functioning, and its areas, on Resilience in the same prediction. The sample consists of 406 adolescents. Two questionnaires were used: the Children's Depression Inventory (CDI, Kovacs, 1985; Portuguese version: Marujo, 1994), and the Resilience Scale-13 (Pinheiro & Matos, 2013), Portuguese version of the RS-14 (Wagnild & Young, 2009). The interview Adolescent Longitudinal Interval Follow-Up Evaluation (A-LIFE, Keller et al., 1993; Portuguese version: Matos & Costa, 2011) was also applied. Results revealed that both Resilience and Psychosocial Functioning were predictors of Depressive Symptomatology.
Thus, adolescents with higher levels of Resilience showed less Depressive Symptomatology, as did adolescents with better Psychosocial Functioning. Global Psychosocial Functioning was a moderator of Resilience only in males, although some of its areas showed moderating effects for the whole sample or just for females. These results emphasized the relevance of Psychosocial Functioning and Resilience in the adolescents’ Depressive Symptomatology and suggested the importance of developing depression prevention programs specifically focused on improving Resilience and Psychosocial Functioning.

No: 8
Title: An Algorithm Proposal To Oral Feeding In Premature Infants
Original Research Article
Pages 87-98
Author(s): Florbela Neto*, Ana Paula França, Sandra Cruz
Open Access

Full Text 8
The transition from tube feeding, to oral feeding is one of the most difficult for preterm infants. It’s a continuous but slow process, which demands physiological development respiratory independence and the ability to coordinate suction, breathing and swallowing. Getting the premature to develop his/her feeding skills is the big challenge to the professionals that work in the NICU. Know the characteristics of preterm infants, essentials for oral feeding; to know the nurses’ opinion on nursing interventions, that promote the transition of gavage feeding for oral feeding in preterm infants; to contribute to the development of a proposal for a guide to oral feeding in preterm infants were our objectives. As a methodology, qualitative, exploratory and descriptive study. Semi-structured interviews were performed to neonatal nurses. Content analysis to treat data was used. Results - Weight, gestational age, physiological stability, sucking coordination, swallowing and breathing, and feeding involvement, are fundamental parameters to begin oral feeding. Positioning the baby, reflexes stimulation, control stress levels, monitoring the temperature and the milk flow, are nursing interventions that promotes the development of feeding skills. The existence of a guide not only gives security but also promotes the respect for the developmental stages of the preterm infant, the standard of care, encourages learning, reduces the subjectivity and fosters the evidence based practice, nevertheless, it ought to have a simple structure, be practical/judicious and small. An algorithm for the preterm infants oral feeding was developed grounded on nurses’ opinion but also in the best available evidence.

No: 9
Title:  Evaluating Use and Attitudes Towards Social Media and ICT for Portuguese youth: the MTUAS-PY scale
Original Research Article
Pages 99-115
Author(s): José J. M. Costa*, Ana Paula Matos, Maria do Rosário Pinheiro, Maria do Céu Salvador, Maria da Luz Vale-Dias & Mário Zenha-Rela
Open Access

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Measures on usage and attitudes towards ICT and social media are very diverse hindering the comparability of data. Due to its heavy use by young Portuguese, it is relevant to have comprehensive and accurate measurement tools.
The main aims were to translate and adapt The Media and Technology Usage and Attitudes Scale (Rosen, Whaling, Carrier and Rokkum, 2013a) for the young Portuguese and to analyze the psychometric characteristics of the resulting scale: The Media and Technology Usage and Attitudes Scale for Portuguese Youth (MTUAS-PY).
This psychometric study included an EFA conducted on a sample of 322 subjects aged between 12 and 18 years old (Mean age=14.78; SD= 2.04), being 59.3% girls. It also included a CFA on a sample of 479 subjects also aged between 12 and 18 years old (Mean age= 14.94; SD= 2.01), being 53% girls. The subjects were invited to participate voluntarily and the confidentiality of the data was assured.
In EFA, for Usage, the PCA with a varimax rotation originated a solution with 10 factors explaining 73% of the total variance and for Attitudes a PCA forced to four factors with oblimin rotation resulted in 61% of total variation explained. The CFA presented acceptable adjustments to fit indices in Usage and Attitudes sub-scales.
The MTUAS-PY scale has adequate psychometric qualities for assessing use and attitudes towards ICT and social media in Portuguese youth. Studies on different profiles throughout the youth and the comparison with behavioral data will further our understanding on a reality in constant technological change.

No: 10
Title: The Factorial Structure of the Quality of Relationships Inventory-Parents Perception (QRI-PP)
Original Research Article
Pages 116-127
Author(s): Ana Paula Matos*, Maria do Rosário Pinheiro, José Joaquim Costa, Andreia Mota
Open Access

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Literature reports that the quality of family relationships, particularly with parents, is associated with psychopathology, namely depression, in adolescents. QRI was developed by Pierce, Sarason and Sarason (1991) and adapted to the Portuguese population by Neves and Pinheiro (2006), and the QRI-PP was created from QRI for adolescents. The present study intends to analyse the factorial structure and reliability of the Quality of Relationships Inventory - Parents Perception (QRI-PP). The sample was composed by 456 parents of adolescents with ages between 12 to 17 years. Similarly to QRI, the QRI-PP assesses the parents’ perceptions of social support, depth and conflict in the relationships with their children. The aims of the study were to conduct an exploratory factor analysis, followed by a confirmatory factor analysis to identify the factorial structure of IQRI-PP. The results obtained showed that the instrument is composed by 16 items, distributed in two factors: support/depth and conflict, with adequate Cronbach's alphas, indicating that QRI-PP is a valid instrument to analyse the parents/children quality of relationships, from the perspective of parents.
A bi-factorial structure was also obtained in previous researches, conducted in Portuguese population, of the father and mother versions of QRI for adolescents (Matos, Pinheiro, Costa, & Mónico, 2015; Matos, Pinheiro, & Marques, 2013; Pinheiro, Matos, & Marques, 2013). Future studies should explore other validity indices of QRI-PP.

No: 11
Title: Caregivers’ burden experienced by relatives living with a person suffering from schizophrenia
Original Research Article
Pages 128-138
Author(s): Lidia Cabral*, Maria João Almeida, Manuela Ferreira, Amadeu Gonçalves, João Duarte
Open Access

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Schizophrenia is a complex chronic disease that turns the affected person into a dependent and disorganized patient. This pathology is responsible for a major burden on the family members who are in charge of taking care of that person. Analyze to what extant can socio-demographic, clinical and environmental variables interfere with the burden felt by family members who live with someone suffering from schizophrenia; to analyze the relationship between a depressive mood state and the burden on the family members who live with a person suffering from schizophrenia were our objectives. As a methodology, quantitative and non-experimental, cross-sectional, descriptive and correlational study. The data collection was done through socio-demographic questionnaires; Vaz Serra and Pio Abreu’s Portuguese version of Beck Depression Inventory (1973); Zarit Burden Interview adapted by Sequeira (2007). 95 informal caregivers taking care of schizophrenic patients were assessed. Participants are mainly female (66%), aged 40 or over (79%) and 36 % are the patients’ mothers. Gender, age and existing family ties variables interfered significantly with the impact caused on the caregiver’s burden. There was a statistically significant correlation between the depressive symptomatology and the burden experienced by the family caregivers. Family/ informal caregiver experience several difficulties when they have to go through a daily process of taking care of a family member suffering from schizophrenia. This situation may cause exhaustion, conflicts, emotional suffering and even depressive symptomatology. This burden of care grows stronger as the patients are older, when they are male and when there are no families ties binding patient and caregiver. These variables must be taken into account in these caregivers’ service plans.

No: 12
Title: The help relationship in clinical nursing education
Original Research Article
Pages 139-146
Author(s): Ernestina Silva*, Maria Lucinda Maia, Daniel Silva, Amarilis Rocha, João Duarte
Open Access

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The clinical nursing education involves considerable effort from students. They established interpersonal relationships and they are active participants in this process. What is the perception of nursing students and the parents of the children in the help relationship (HR) developed during the clinical training were some of our research questions. We aimed to identify factors that influence interpersonal relations between nursing students and the mothers of hospitalized children; analyze the relationship between the perspective of students and the parents of the children on the HR developed during the clinical training; identify feelings experienced by students and parents in the relational process of care taking. As methods quantitative, descriptive and correlational study, conducted in a sample of 139 nursing students and 73 mothers of hospitalized children. It was used a questionnaire, which includes socio-demographic, training and clinical characterization and the BarrettLennard Relationship Inventory (BLRI), which evaluates the help relationship in four dimensions have been used. The dimensions of help relationship - Level of Regard, Empathic Understanding and Unconditionally Respect - are scored positively by students and mothers. The Congruence of performance is evaluated negatively by mothers while students are evaluated positively. Prevailing negative feelings referenced by students and the positive feelings by mothers. The perception of help relationship is influenced by some socio-demographic variables of students and mothers. All dimensions establish a dependent relationship with the group of students and mothers. The perception of students on the HR is positive, the perception of mothers regarding student performance is also positive, except in Congruence.

No: 13
Title: Pain assessment in surgical patients with impaired cognition
Original Research Article
Pages 147-157
Author(s): Martins Conceição*, Vera Almeida, Duarte, João, Chaves Cláudia, Campos Sofia, Nelas Paula
Open Access

Full Text 13
Pain is considered the 5th vital sign and its measurement/assessment and records are required and must be systematic. Ineffective pain management involves complications in clinical status of patients, longer hospitalization times and higher costs with health. In the surgical patient with impaired cognition, hetero measurements should be made, based on behavioural and physiological indicators. We used to determine the efficacy and efficiency of the Observer Scale, the Abbey Pain Scale and Pain Assessment in Advanced Dementia (PAINAD). Our study is an applied, non-experimental, quantitative, descriptive and analytical research. The data collection instrument consisted of patients’ sociodemographic and clinical data, the Observer Scale, the Abbey Pain Scale (Rodrigues, 2013) and PAINAD (Batalha et al., 2012). We assessed pain at an early phase and 45 minutes after an intervention for its relief. The sample is non-probabilistic for convenience, consisting of 76 surgical patients with impaired cognition, admitted to the surgery services of a central hospital, aged between 38 and 96 years. There was a positive correlation between the results of the three scales, most evident in the initial evaluation. Pain intensity in the same patient is higher when assessed with PAINAD (OM = 2.16) and lower when assessed with the Observer Scale (OM = 1.78). The most effective and efficient scale is PAINAD. Due to the small sample size, we suggest confirmatory studies so that the results can be generalized.

No: 14
Title: The +Contigo Project in the Voice of Eight-Grade Students
Original Research Article
Pages 158-170
Author(s): Cândida Loureiro*, Maria Helena Quaresma, Jorge Façanha, Maria Erse, Rosa Simões, José Carlos Santos
Open Access

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The +Contigo Project is a longitudinal research project based on a multilevel network intervention aimed at promoting mental health and well-being and preventing suicidal behaviors. Students participate in social skills training sessions on the stigma of mental disorders, adolescence, self-esteem, problem-solving skills, and well-being.
Problem statement: To identify the qualitative impact of the +Contigo Project.
We tried to identify the importance of the project for students, the problem situations which it helped to solve, and its impact on an individual level. Content analysis (Bardin, 2009) with a posteriori categorical identification. Semi-structured interview guide with 5 questions. A convenience sample of 16 students, from three schools of one school cluster in the Center Region of Portugal, was used. The ethical aspects of parental consent, voluntary participation and data confidentiality were addressed. Fourteen categories emerged from the data analysis. The answers to Question 4 ‘How was this project important to you?’ were particularly relevant. Students mentioned that it improved their self-esteem by increasing self-confidence and interpersonal skills, and that it increased their reflection and awareness on problems with which they learned how to cope during the sessions. All interviewees considered that the +Contigo project helped them to solve problems, improve their interpersonal skills and cope with the adolescence period. Students improved their self-esteem and self-knowledge, and were able to apply what they had learned in the sessions in their daily lives. We concluded that the project had a positive impact on the students’ mental health.

No: 15
Title: Representation of death in children
Original Research Article
Pages 171-178
Author(s): Madalena Cunha*, Catarina Costa, Fábio Jerónimo Diogo Silva, Flávia Barbosa, Graça Aparício, Sofia Campos
Open Access

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Child builds her own Depictions on the process of life and death with a background of life experiences. The connotations and feelings built by children about this process are determined by their developing state and naturally influenced by the education given by both parents and the society. What is the predominant Depiction of death in children from 5 to 10 years old?  was our research question while aiming to analyse the Depiction that children have about death. We applied the transversal and descriptive study was made on a sample of 175 children living in Portugal, 50.29% of the children were boys and 49.71% were girls with ages comprehended between 5 and 10 years old (M=7.69years). We found out that the most of the children pledges that after death people go to hell or heaven (49.7%); they distinguish the death of people from the animal one, 51.4% state that nothing happens after death; they think that they won't feel any pain on the moment of death 52.6%, a majority on the age group 7 to 8 years, when it comes to dolls 89.7% of the children say that they don't die; 64.8% never went to a funeral, 36% don't know which is the colour of the casket and 61.7% pledges not to know what it means to grief someone; the irreversibility parameter is a majority on the age group >=9 years. The children take influence from the culture in which they live and from death experiences that they live. The results showed that their perception changes according to their developing stage.

No: 16
Title: Sociodemographic factors and sleep disorders in the person with palliative situation
Original Research Article
Pages 179-187
Author(s): A. M. Dias*, A. Cunha, C. Albuquerque, R. C. Saraiva, A., C. Andrade, I. Bica
Open Access

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In palliative care, sleep disorders (SD) are common, with studies showing a prevalence of 49%, being the most frequent and relevant the insomnia. Our research questions were, What is the prevalence of sleep disorders of the person with palliative situation? What are the socio-demographic factors that interfere with sleep disorders of the person with palliative situation? We aimed to determine the prevalence of sleep disorders and to relate the influence of several socio-demographic factors in sleep disorders of the person with palliative situation. This study is analytic, correlational and cross-sectional and the non-probabilistic convenience sampling was constituted with 83 palliative patients. Data collection was performed through a self-administered questionnaire (socio-demographic characterization and SD - Oviedo Sleep Questionnaire-OSQ). The OSQ allows to diagnose SD, insomnia and hypersomnia, according to the DSM-IV and ICD-10 criteria. The research protocol was approved by the Ethics Committee. The prevalence of SD was 48,1%. We also found that 47,0% of palliative patients reported subjective satisfaction of sleep; 42,0% insomnia and 47,0% hypersomnia. Among the socio-demographic variables, only gender was related to SD. Men were the most prevalent in SD (61,5%) and they showed 2,6 times more probability to report SD than women (OR=3,69; IC95% [1,061-6,374]). Gender was the only variable found that interfered with the quality of sleep in the person with palliative situation. The results point to the need to investigate more this subject, so that we can draw up strategies that allow ensuring the quality of sleep in people with palliative situation, as a contribution to a better care.

No: 17
Title: Clients’ Physical Restraint Management: Nursing Approach
Original Research Article
Pages 188-196
Author(s): Mariana Guedes*, António Luís Carvalho, Sandra Cruz, Fátima Pinho
Open Access

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Unpredictable, aggressive behaviours from clients occur and it is undeniable that there are difficulties regarding their physical restraint because professionals do not have a common understanding about the theme. The research question of this study is: What are the clients’ physical restraint measures that nurses, in the surgery Department of the Unidade Local de Saúde de Matosinhos (ULSM), E.P.E, usually implement in their clinical practice? The purpose of this exploratory-descriptive quantitative research was to develop a clients’ physical restraint management. We have had a non-probabilistic convenience sample, constituted by 182 clients admitted in the Surgery Department of the ULSM, E.P.E. A questionnaire was applied. The results pointed out that there were numerous physical restraint measures usually implemented by nurses and the most significant were: to equip the bed with side rails that allow protection and client’s safety (98.1%), to switch decubitus in order to prevent pressure ulcers (94.4%) and the client’s status that determined the need for restraint (94.4%).Thus, we recommend a protocol proposal for the client’s physical restraint that enables safety and quality in the nursing practice.

No: 18
Title: Moral Dilemma in Clinical Practice of Nursing Students
Original Research Article
Pages 197-202
Author(s): Petr Snopek*, Mária Popovičová, Barbora Plisková
Open Access

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Moral responsibility is an inseparable part of the professional competence of a nurse. In clinical practice nursing students often find themselves in situations dealing with “moral dilemma”. Are they able and willing to respond appropriately to such situations? Our Research Questions were What are the most frequent professional dilemmas that students encounter during their clinical practice in the hospital? How do they react in such a situation and are they willing to show moral courage? The aim of the survey was to find out the most frequent professional dilemmas encountered by students during their clinical practice in hospitals and whether they are willing and able to respond adequately to such situations. It can be stated that during their clinical practice at the hospital each of the surveyed students witnessed or participated directly in a situation of unprofessional behavior of health care professionals, however, did not want to or could not respond to such unprofessional behavior. These situations had mostly a negative impact on the students. Although nursing students feel moral obligation to act in “critical” situations, they do not have the courage. It is therefore important to identify and work with moral dilemmas in students´ clinical practice, and by doing so reduce stress in students stemming from such situations while raising moral competence of students and other health professionals to take a stand and thus reduce professional blindness.

No: 19
Title: Sociodemographic variables determine the academic performance of Adolescents
Original Research Article
Pages 203-208
Author(s): Leonor Pestana, João Duarte, Emília Coutinho*
Open Access

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It is important to have a holistic approach to student learning, sustained in a multidisciplinary approach, in which socio-demographic factors and lifestyles may relate to academic achievement. Research Question was which socio-demographic variables influence the school performance (study environment, study planning, study method, reading skills, motivation to study, overall school performance) of adolescents? We aimed to identify socio-demographic factors associated with academic performance of adolescents. A quantitative, cross sectional, descriptive, correlational, explanatory, retrospective study applied as research methods. Information collected by questionnaire of direct administration and school performance scale. Non-probabilistic convenience sample of 380 students of 7th, 8th and 9th years of education in the school year 2011/2012, from a 2nd and 3rd cycle Basic School of Viseu Municipality, Portugal. The best school performance in adolescents was associated with female gender (p<0.001); with age ≤ 12 years, (p<0.001); with adolescents whose parents have secondary or higher education (p=0.019). There was no relationship between school performance and socioeconomic status and area of residence. Conclusions: It was concluded that the socio-demographic variables, including gender, younger age and parental education are determinants of adolescent school performance.

No: 20
Title: The importance of school and academic context in educational performance in a sample of Portuguese adolescents
Original Research Article
Pages 209-216
Author(s): Leonor Pestana, João Duarte, Emília Coutinho*
Open Access

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The school/academic context is key in engaging students in the learning process and consequently on school performance. Which academic and school context variables influence school performance (study environment, study planning, study method, reading skills, motivation to study, overall school performance) in adolescent? To assess the association between variables - school success, school environment, academic - and school performance in Portuguese adolescents from a sample of the central region. A quantitative, cross sectional, correlational study. Data collected through questionnaire of direct administration (sociodemographic, academic and school context variables and school performance scale). Non-probabilistic convenience sample of 380 students of 7th, 8th and 9th years of education in the school year 2011/2012, from a 2nd and 3rd cycle Basic School of Viseu Municipality, Portugal. Teens who have never failed (p <0.001), who live closer to school (p = 0.007) and who spend less time traveling to school (p = 0.007) are those who have a better overall school performance. A better school performance is also achieved, in the study planning (p = 0.015) dimension, by the adolescents with fewer years of schooling. Academic and school context variables, like the grade attended by adolescents, the distance they live from the school, and the time taken in traveling to school, are determinants of adolescent school performance.

No: 21
Title: Quality of life and chronic disease in patients receiving primary health care
Original Research Article
Pages 217-226
Author(s): Olinda Preto, Odete Amaral*, João Duarte, Cláudia Chaves, Emília Coutinho, Paula Nelas
Open Access

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Problem Statement: Chronic disease entails physical, psychological and social issues with a decrease in the quality of life. The assessment of QoL has been applied as indicator in patients with chronic diseases.
Research Questions: What is the quality of life in patients with chronic disease? What are the socio-demographic variables that influence the quality of life in patients?
Purpose: To assess the quality of life in patients suffering from chronic disease and identify socio-demographic variables which influence the quality of life of patients suffering from chronic disease.
Research Methods: We conducted a cross-sectional analytical study using a sample composed of 228 users (134 females) from a Family Health Unit in the municipality of Viseu. Data collection was made by means of a questionnaire, consisting of sociodemographic variables, the SF-12 scale and the existence of chronic disease was assessed through the questions – “Do you currently suffer from any chronic disease?”; “If so, which one(s)?”.
Findings: The most common chronic diseases were hypertension (59.9%). Female patients with a chronic disease reported worse physical functioning, role-physical and role-emotional; increased bodily pain and better quality of life regarding general health. Male patients showed worse role-physical, increased bodily pain and vitality. Socio-demographic variables which were associated with quality of life were area of residence, academic qualifications and work situation.
Conclusion: Chronic disease affects quality of life negatively. Quality of life in both patients groups was associated with socio-demographic variables. Health-related quality of life is an essential issue and should be considered as a priority in health policies.

No: 22
Title: Reproductive concerns and psychosocial adjustment of young breast and gynecologic cancer patients
Original Research Article
Pages 227-236
Author(s): Maria João Cândido, Ana Bártolo, Sara Monteiro*
Open Access

Full Text 22
Confrontation with breast and gynecologic cancer causes difficulties of psychological adaptation. In young women, the reproductive and gynecologic consequences of the disease and treatments emerge as an additional threat. This study aimed to: (i) analyze depressive symptoms, anxiety, quality of life and reproductive concerns in young women with breast or gynecologic cancer, in comparison with healthy women; (ii) explore the mediator effect of depression and anxiety symptoms on the relation reproductive concerns → quality of life in women with cancer.This transversal study was conducted in “Centro Hospitalar Baixo Vouga II”, Aveiro, and through various Facebook pages supporting women with cancer. The sample included 95 women, 52 with breast or gynecologic cancer diagnosis and 43 healthy controls. Participants completed the Reproductive Concerns Scale, the Hospital Anxiety and Depression Scale (HADS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30).Diagnosed women reported more depressive symptoms, anxiety and reproductive concerns than healthy women (p<0.001). An effect mediation of depressive symptoms (p=0.001) was found. Reproductive concerns affected the quality of life in this population, by being associated with more depression and anxiety symptoms.Although there is currently a careful selection of treatments to preserve fertility, our findings show that the diagnosis of breast or gynecologic cancer in phase I to III leads to concerns and beliefs associated with impaired fertility. This fact results in difficulties of psychological adaptation. Thus, we emphasize the importance of directing the psychological interventions towards this aspect.

No: 23
Title: Sleep and academic performance of Portuguese Teenagers
Original Research Article
Pages 237-245
Author(s): Leonor Pestana, João Duarte, Emília Coutinho*, Paula Nelas, Cláudia Chaves, Odete Amaral
Open Access

Full Text 23
Sleep has numerous important functions in the body, such as consolidation of memory, concentration and learning. Changes in sleep cycles in adolescents lead to sleep deprivation with consequences to academic performance. Our research question was What are the sleep habits that influence school performance (study environment, study planning, study method, reading skills, motivation to study, overall school performance) in adolescents? We aimed to identify sleep habits predictors of the quality of school performance in adolescents. Research Methods: Cross-sectional analytical study. Data were collected through a self-administered questionnaire with socio-demographic questions, sleep habits and school performance scale. The sample consisted of 380 students between 7th and 9th grade, with an average age of 13.56 ± 1.23 years in the school year 2011/2012, from a 2nd and 3rd Cycle Basic School of the municipality of Viseu, Portugal. Findings: School performance in adolescents was associated with better subjective quality of sleep (p=0.000), with longer sleep duration (p=0.000), with watching tv/video before sleep (p=0.000), with the habit of studying before bedtime (p=0.012), with no computer use (p=0.013) and with reading habits before bed (p=0.000). School performance was also associated with adolescents who reported not feeling sleepy during class. The teenagers who sleep more and better, and who watch tv/video, study, do not use computers, and who read before going to bed, have a better school performance.

No: 24
Title: Father/baby Bonding: Impact of Vulnerability to Stress
Original Research Article   
Pages 246-253
Author(s): Paula Nelas*, Diana Gândara, Cláudia Chaves, Emília Coutinho, Carla Cruza, Manuela Ferreira
Open Access

Full Text 24
The transition to parenthood is considered normal; however, it includes the need for parental adjustment. Sometimes this transition can be disturbing and induce high levels of stress. Our research question was How is bonding between the father and baby influenced by vulnerability to stress? We aimed To identify the establishment of bonding between father and baby and to analyze how their emotional involvement can be influenced by vulnerability to stress. Research Methods: This is a quantitative, descriptive-correlational and explanatory study, with a non-probabilistic convenience sample (N= 349 fathers), with a mean age of 31.84 years (SD= 6.067). Data is collected by a questionnaire applied up to 48 hours after birth, including socio-demographic, parent involvement and obstetric characterization, the Bonding Scale and the Vulnerability to Stress Scale – 23 QVS. Younger participants, who became fathers for the first time, were involved in the pregnancy and spoke with the baby during the gestational period demonstrated higher levels of positive bonding. It is not clear that those who monitored labor and picked up the child after birth showed high levels of bonding. Functional inhibition and dependency is the only factor which predicts vulnerability to stress. Bonding is a complex process which may be influenced by context and degree of involvement during pregnancy and childbirth. Vulnerability to paternal stress is multi-determined and may be accentuated in this period of transition to parenthood. Encouragement by health professionals in the father’s emotional involvement with the baby and in early detection of vulnerability to stress is pertinent.

No: 25
Title: Burnout and Stigma of Seeking Help in Lithuanian Mental Health Care Professionals
Original Research Article   
Pages 254-265
Author(s): Auksė Endriulaitienė, Kristina Žardeckaitė – Matulaitienė*, Rasa Markšaitytė, Aistė Pranckevičienė, Doug R. Tillman, David D. Hof
Open Access

Full Text 25
Burnout among mental health care professionals is a serious public health concern in different European countries. This calls for the efforts to explore the unique antecedents of burnout like help seeking stigma. The main purpose of this study is to investigate the correlation between help seeking stigma and burnout in four groups of mental health care professionals (psychiatrists, psychologists, social workers, and mental health nurses). 231 mental health care professionals completed self-reported questionnaires that consisted of Maslach Burnout Inventory – General Survey (MBI-GS, Schaufeli et al., 1996) and Self-Stigma of Seeking Help (SSOSH) scale (Vogel, Wade, & Haake, 2006). The results revealed no gender differences in burnout and help seeking stigma. Emotional exhaustion was dominating in all groups of professionals, while lack of professional efficacy was the lowest component of burnout. Mental health nurses had the most negative attitudes towards seeking for psychological help when compared to psychologist, psychiatrists and social workers. Self-stigma of seeking help correlated significantly with higher psychologists’ and nurses’ levels of burnout. In conclusion, mental help seeking stigma is positively related to burnout among mental health care professionals, but gender and occupational group might be important for this relation.

No: 26
Title: Students’ Engagement in Risky Online Behaviour: The Comparison of Youth and Secondary Schools’
Original Research Article   
Pages 266-273
Author(s): Ugnė Paluckaitė, Kristina Žardeckaitė-Matulaitienė*
Open Access

Full Text 26
Nowadaysadolescents use the Internet very often in their daily life activities what, according to the researchers, causes their engagement in risky online behaviour. Youth school’s students may be at greater risks online as they generally come from socially riskier or single-parent families. Thus, the purpose of this study is to find out if there are any differences between youth and secondary schools’ students’ engagement in risky online behaviours. Research method – cross-sectional survey with a questionnaire, created using a variety of risky online behaviour forms (e.g., communicates with unknown people; visit pornographic sites).The tendency to engage in any risky behaviour participants had to rate on the scale from 1 (never engage) to 6 (always engage). The participants also had to answer some demographical questions about their family, age, and gender. 195 students (105 female and 90 male; mean age - 14.8) have participated in the study. Results have shown that youth school’s students are more likely than secondary school’s students to post photos of age forbidden behaviour and to post rude, offensive comments. Students engagement in risky online behaviour is related to their age and time spent online: older and using the Internet more often students are more likely to engage in risky online behaviours.  Thus, older students and students who spend more time on the Internet are more susceptible to online risks despite their social environment. More attention should be paid for youth's risky online behaviour psychological interventions.

No: 27
Title: Lithuanian Historical Heritage: Relation with Authority and Psychological Well-being
Original Research Article   
Pages 274-284
Author(s): Neringa Grigutytė*, Goda Rukšaitė
Open Access

Full Text 27
Relation with authority has been a relevant problem in times of change characteristic of the post-Soviet countries. A number of studies have stressed the importance of relation with authority in interpersonal relationships, psychosocial adjustment and well-being. The purpose of the current study is to explore the links between psychological well-being and relation with authority in three Lithuanian generations: young adults, who were born in independent Lithuania (aged 19-26); the middle generation, who have lived both under the Soviet occupation and in independent Lithuania (aged 27-49), and elderly persons, who have lived longer under the Soviet occupation (aged 50-70), 405 participants in total. The study used the Relation with Authority Scale (Grigutyte & Gudaite, 2015), the Well-Being Index (WHO, 1998) and the subjective ratings of how often the participants a) consumed alcohol, b) used antidepressants, c) had thoughts of suicide, d) turned to family members and friends or e) turned to mental health professionals for help. Results show that different aspects of internal and external relation with authority are important for higher psychological well-being in groups which vary in age and historical heritage. Psychological well-beingis affected by self-esteem and is higher if: a) elderly persons, who have lived longer under the Soviet occupation, have more authorities; b) the middle generation, who have lived under the Soviet occupation and in independent Lithuania, have a less resistant relation with authority; c) young adults, who were born in independent Lithuania, rely more on transpersonal powers and have a less troubled relation with authority.

No: 28
Title: Parent-Child Interactions in Families with Mothers who had Experienced Early Relational Traumas
Original Research Article  
Pages 285-294
Author(s): Giulia Ballarotto*
Open Access

Full Text 28
Early maternal relational traumas can have an impact on mothers’ psychopathological risk and mother-infant interactions. Research has suggested the importance of fathers’ role as protection or risk factors for child’s development. Few studies had considered fathers in the assessment of the quality of parent-infants interactions during daily routines (e.g. feeding) and there is a lack of research on non-referred samples. This paper aims to assess the quality of parent-infant interactions during feeding in families with mothers who have experienced early relational traumas, such as emotional abuse and neglect or sexual/physical abuse, considering parental psychopathological risks. N= 98 families were recruited and divided into three groups: families with mothers who lived through early sexual/physical abuse (Group A); families with mothers who lived through early emotional abuse or neglect (Group B); healthy controls (Group C). Families were assessed at 6 months of the children with a protocol that included an observation of parent-infant interactions during feeding and a self-report assessing psychopathological risk. Group B showed more maladaptive mother-infants and father-infant interactions with their children. Results show that the interaction of maternal depression and early traumatic experiences of neglect and emotional abuse predicted more maladaptive scores on the affective state of the dyad subscale. Furthermore, paternal anxiety predicted higher scores of child’s food refusal subscales. These results are very important for the planning of prevention and / or treatment , which take into account of the whole family.

No: 29
Title: Psychopathological Risk in Parentally Bereaved Adolescents
Original Research Article  
Pages 295-302
Author(s): Silvia Cimino, Luca Cerniglia, Giulia Ballarotto*, Michela Erriu
Open Access

Full Text 29
For a child, the death of a parent is a traumatic experience and can give rise to several difficulties during the child’s development. International literature in this field has focused on clinical populations; evaluations of the psychological difficulties in adulthood have rarely been aimed at non-referred samples. The present study assessed the psychological functioning of a non-referred sample of adolescents, with consideration given to the impact of the loss of a caregiver during childhood on their psychological profiles. It also evaluated the association between the adolescents’ psychological profiles and possible psychopathological risk in the surviving parents. Three groups of subjects (N=96) were considered: adolescents who had suffered the loss before 3 years of age (Group A); adolescents who had experienced loss between 3 and 10 years of age (Group B); and adolescents who had experienced no loss (Group C). Psychological profiles, eating difficulties, and dissociative symptoms were evaluated during adolescence (14-16 years of age). Also assessed were the psychological profiles of the surviving caregivers. Group A had higher scores than Group B and C, indicating that there had not been an improvement in their psychological well-being. In addition, it was found that the psychological profiles of the surviving caregivers may have had an influence on the adolescents’ psychological difficulties. This result is important for prevention, and it could direct clinical work and early intervention in this specific field by taking into account the influence of the surviving parent.

No: 30
Title: Emotional–Behavioural Profiles and Parental Support in Adolescents with Motor Vehicle Accidents
Original Research Article  
Pages 303-312
Author(s): Michela Erriu*
Open Access

Full Text 30
Adolescents (aged 15–19) are involved in a high number of motor vehicle collisions (MVCs). MVCs are considered complex events that are influenced by personal characteristics and psychological functioning. We propose that adolescents’ psychological functioning preceding road collisions could be associated with the accidents, which in turn could be similar to acting out caused by psychological discomfort. In this study, we want to verify whether the rates of MVCs among adolescents are associated with their emotional–behavioural functioning and low levels of family support. Specifically, the study aims to verify that adolescents involved in motorbike collisions show maladaptive emotional–behavioural functioning and difficulties in identifying and describing their own emotions. The sample was composed of N = 100 adolescents without a psychiatric diagnosis who attended an emergency department following a road accident. They filled out self-report questionnaires to assess their emotional–behavioural functioning (YSR/11–18, Youth Self-report), difficulties in identifying and describing their emotions (TAS-20, Toronto Alexithymia Scale) and perceived levels of family support (PFSE, Adolescents’ Perceived Filial Self-efficacy). We divided the sample into three groups on the basis of the number of MVCs they had experienced. The results show that adolescents involved in more motorbike accidents presented with more maladaptive emotional–behavioural functioning and more difficulties in describing and identifying their emotions. Additionally, lower perceived family support predicted more maladaptive emotional–behavioural functioning (internalizing and externalizing difficulties) and difficulties in describing and identifying their emotions. We concluded that problematic psychological functioning (difficulties in identifying and describing their emotions) was associated with higher MVC rates in adolescents. Thus, MVCs among adolescents can be considered as a form of acting out caused by their own psychological state. Moreover, the level of family support, as perceived by adolescents, can be considered as a protective factor or as a risk factor for the development of adolescent disorders.

No: 31
Title: Mindfulness training and practice: Individual differences in mindfulness facets and its relation to emotional regulation, perceived stress and well-being
Original Research Article  
Pages 313-327
Author(s): Cláudia Ramos, Sónia P. Gonçalves*
Open Access

Full Text 31
Several studies suggested a positive relation between mindfulness and psychological health positive outcomes. But are still lacking studies that can relate facets of mindfulness with specific psychological health dimensions. The main objective of this study is to analyze the relation between the mindfulness facets (non-reactivity to inner experience, noticing sensations, perceptions, thoughts and feelings, acting with awareness, describing with words, non-judging of experience) and some specific psychological health dimensions such as emotion regulation (non-acceptance, goals, impulse, awareness, strategies and clarity), perceived stress and well-being. We will analyze these dimensions according to participant’s mindfulness training and practice. We used validated self-reporting instruments: the Five Facet Mindfulness Questionnaire (FFMQ, Baer et al., 2006), the Difficulties in Emotion Regulation Scale (DERS, Gratz & Roemer, 2004), the Perceived Stress Scale (PSS, Cohen, Kamarck & Mermelstein, 1983) and the IWP Multi-affect Indicator (IWP, Warr, 1990). We evaluated 258 individuals who agreed to participate in this study, of which 72,1% were women, 47,7% had already attended mindfulness training, 52,3% never had and 40,3% practice mindfulness meditation regularly. We performed a Pearson’s r correlation and T-Tests to compare means. Results point to clear correlations between mindfulness facets, emotion regulation, stress and well-being. Perceived stress revealed significantly lower levels in individuals who attended mindfulness training and practice daily meditation. Higher scores in mindfulness facets and related higher levels of awareness, clarity and well-being can also be found. The findings indicate that mindfulness training and regular mindfulness meditation practice have a potential to contribute to improving mental health outcomes.

No: 32
Title: Clinical Communication and Adverse Health Events: Literature Review
Original Research Article  
Pages 328-335
Author(s): Manuela Ferreira, Cláudia Brás*, Maria do Céu Barbieri
Open Access

Full Text 32
Health institutions have an increased risk of occurrence of errors due to their diversity, specificity and volume of services, representing a great concern for health professionals whose main function is to protect the health and lives of their patients. We intend to identify a body of evidence, that shows what the most common adverse events are and what adverse events potentially arise from clinical miscommunication. We made an integrative literature review using the keywords "Adverse Events", "Patient Safety", "Communication". An inquiry ​​on databases of PubMed, Web of Science, Scielo and CINAHL, in articles published between January 2010 and March 2016, was made; all available in Portuguese and English. Of the 216 articles that emerged, we selected eight that answered the research questions: what are the most common adverse events that have their origin in communication errors? Analyzing the selected studies, it appears that the most common adverse events arise in the context of obstetrics and pediatrics, in surgical contexts, in the continuity of careand related medication. Patient safety should be seen as a key component of quality in health care, with good management of the risk of fundamental error for the promotion of this security. The knowledge and understanding that communication failures are one of the main factors contributing to the occurrence of errors in the context of health care, allows the subsequent development of strategies to improve this process and thus ensure safer healthcare.

No: 33
Title: Personality Profiles Of Traffic Offenders: Does It Correlate To Alcohol Consumption?
Original Research Article
Pages 336-350
Author(s): Justina Slavinskienė, Kristina Žardeckaitė – Matulaitienė*, Auksė Endriulaitienė, Rasa Markšaitytė, Laura Šeibokaitė
Open Access

Full Text 33
The aim of this study is to identify personality profiles in the sample of traffic offenders and to find if there are differences in alcohol consumption according to different personality profiles. 683 traffic offenders (611 males, 72 females) participated in the study. The age ranged from 18 to 79 years. A self-administered questionnaire was composed by AUDIT test, Big Five Inventory, Barratt impulsiveness scale (motor-impulsiveness subscale), Aggression scale and Lie subscale. The results show that there are low – risk and high – risk personality profiles of traffic offenders (for both males and females). Those, who have higher expression of impulsiveness, aggression and neuroticism (high risk personality profile), consume alcohol in a hazardous and harmful way. These traffic offenders tend to make more serious road traffic rules violations like driving under the influence of alcohol. Therefore, it could be stated that serious road traffic rules violations might be evaluated as the outcomes of high – risk personality and other problematic behavior such as harmful alcohol consumption.

No: 34
Title: Most Relevant Clinical Supervision Strategies In Nursing Practice
Original Research Article
Pages 351-361
Author(s): Regina Pires*, Margarida Reis Santos, Filipe Pereira, Inês Rocha
Open Access

Full Text 34
Clinical supervision (CS) is a facilitator of professional development and quality of practice, promoting safety and protection of clients, through the adoption of targeted strategies.
Portugal has been developing research aiming to design policies that support the implementation of CS based on partnerships between academic and practice nurses. This strategy empowers professionals with skills essential for professional development.
The study aims to identify the most relevant CS strategies according to nurses’ perspective.
A quantitative and exploratory study was developed. Data were collected from questionnaires between May and October 2012.
The convenience sample included 273 nurses working in hospitals (64.3%) and health care centers (35.7%) in Portugal, 83.2% were females, aged between 24-58 years. Nursing professional experience ranged between 1-36 years.
The majority of the participants (87.5%) considered CS important to professional development. CS strategies relevance: reflective practice (45.8%); feedback (45.8%); observation (45.1%); continuing education (44,3%); support (41.8%); demonstration (40.7%); individual sessions (37.4%); self-supervision (37.0%); cases analysis with supervision (31.9%); analysis of nursing documentation (30.8%); group cases analysis (22.7%); group sessions (21.6%), reflexive report (16.5%); distance supervision: e-mail (7.7%), phone (7.7%) and skype® (4.0%).
The participation of nurses in the design of CS policies is considered meaningful and highly relevant to nursing practice, empowering nurses with qualified skills and contributing to improve the quality of interventions. This research is a valuable input to the development and innovation in nursing, contributing to the design of CS policies based on strategies that nurses consider more appropriate and relevant to practice and professional development.

No: 35
Title: The Relationship Between Occupational Burnout and Perceived Ethical Leadership Style
Original Research Article
Pages 362-369
Author(s): Morkevičiūtė Modesta*, Endriulaitienė Auksė
Open Access

Full Text 35
It is believed that ethical leadership style might be significant for the professional burnout, but mostly in the literature these phenomena are investigated separately. Their correlation is controversial, the previous research results have been limited. The aim of the study was to establish the relationship between employee occupational burnout and perceived ethical leadership style.  Also the importance of employees’ socio-demographic characteristics (such as gender, age, and education) for this relation was tested. 242 employees working in Lithuania (47 men and 195 women) participated in the study. Ethical leadership style was assessed with the  questionnaire of Brown, Trevino & Harrison (2005). Occupational burnout was measure using Copenhagen Burnout Inventory by Kristensen, Borritz, Villadsen &  Christensen (2005). The results revealed that  burnout of employees who consider their leaders as more ethical is lower than that of the employees who consider their leader to be less ethical. The study also showed that employees’ socio-demographic characteristics (gender, education and age) are not significant to the correlation between perceived ethical leadership style and occupational burnout. The conclusion may be drawn that employee attitudes towards their leader is important for the occupational burnout. This means  that in order to reduce burnout leader has to focus on ethical behavior and moral working environment.

No: 36
Title: Adolescent Antisocial Behaviour: A Comparative Analysis of Male and Female Variables Related to Transgression
Original Research Article
Pages 370-386
Author(s): Alice Murteira Morgado*, Maria da Luz Vale-Dias
Open Access

Full Text 36
The adolescent antisocial phenomenon is an important matter for our society due to the increase in frequency and severity of deviant conducts during a developmental stage when individuals face multiple changes. Although most research focuses on male offending, gender differences in antisocial behaviour have been widely recognised. It is important to deepen our knowledge of antisocial behaviour in adolescent males and females, through its related factors and understand gender specificities.
We present a research on antisocial manifestations and their relation with gender, age, socioeconomic status, personality, social skills, self-concept, and family environment in a sample of 489 students between 9 and 17 years old (60.5% females).
Results show common factors that explain why boys and girls have higher antisocial tendencies: psychoticism and social conformity. In girls self-control was also a factor contributing to determine female antisocial tendency. Significant correlations between antisocial behaviour, age, personality, social skills, self-concept and family environment in boys and girls reveal the importance of individual dispositions.
We conclude that there is unexpected equality in contemporary male and female adolescent experiences. Nevertheless, differences in other variables correlated with antisocial behaviour indicate different personal resources and coping mechanisms in boys and that should be addressed in future interventions and longitudinal studies.

No: 37
Title: Effects of an innovative group program of multisensory stimulation of older adults
Original Research Article  
Pages 387-396
Author(s): Ana Torres*, Joana Venâncio
Open Access

Full Text 37
Background: Aging presents a risk for worsening health and quality of life (QoL). Multisensory stimulation programs (MSP) can promote health and QoL of older adults. Art and Mindfulness are innovative strategies. This study has the following purposes: to present an innovative MSP, with art and strategies based in Mindfulness, of 10 sessions to implement in a group of older adults; to present the verified effects of MSP in cognitive functioning, depressive symptomatology and quality of life of Portuguese older adults. Methods: 33 older adults, aged 65 to 94 years old (M=82.18, SD=7.85), participated in 2 groups, group with intervention (GI, n=16) and a waiting group (GC, n=17). A sociodemographic and clinical questionnaire was used, as well as the following evaluation instruments: Mini Mental State Examination; Patient Health Questionnaire-9; WHOQOL-OLD. We also used the MSP developed, with 10 biweekly sessions. Results: We registered a decrease of depressive symptomatology and an increase of the global and some QoL facets (autonomy; activities, social participation and death), as well as, a decrease of the facet of intimacy from pre to post test of the GI; a decrease of the QoL facet sensory functioning from the pre to post test of the GC. Conclusions: The results obtained allow us to conclude that MSP program, with art and strategies based in Mindfulness, is effective on maintain cognitive function, diminish depressive symptomatology and increase QoL of older adults. Taking into account the importance of the results to “give quality to the years” of older adults, future studies with this and similar programs are encouraged.

No: 38
Title: Personality Traits on Persistent Depressive Disorder
Original Research Article  
Pages 397-410
Author(s): Ana Torres*, Andréa Martins, Tiago Santos, Ana Telma Pereira
Open Access

Full Text 38
Evidence emerged for the HEXACO Model, summarized the domains of personality in six dimensions. The difficulties associated with the diagnosis of dysthymia have raised questions in maintaining in mood disorders. Given the literature review and defending a modification in the structural model of personality, this study proves the importance of a preliminary study of the psychometric properties of HEXACO in a Portuguese sample. It is important the exploration of personality traits in a clinical population diagnosed with Persistent Depressive Disorder. The sample, for the first study, consisted of 118 women and 48 men aged 18 to 57 years (M=26.21, SD=10.23). The study 2 includes participants belonging to the clinical group (M=48.33, SD=10.23) and non-clinical group (M=41.23, SD=9.63) all female aged between 23 and 63 years. The instruments used for the study were the HEXACO-60, NEO-FFI-20 and PHQ-9. The results demonstrate that the HEXACO-60 has satisfactory psychometric properties that make it a suitable tool to evaluate the personality, presenting high correlations with NEO-FFI and a higher internal consistency. It is also verified that there are significant correlations between depressive symptoms and personality traits. Although this analysis is preliminary with regard to psychometric study of the assessment tool HEXACO-60 personality, the statistical analysis of the instrument showed that it has adequate psychometric properties proving to be an appropriate tool to evaluate the constructs of personality. We conclude that there is evidence to suggest the need for reformulation of the diagnosis of persistent depressive disorder.

No: 39
Title: Reliability and Validity of the PHQ-9 in Portuguese Women with Breast Cancer
Original Research Article  
Pages 411-423
Author(s): Ana Torres*, Sara Monteiro, Anabela Pereira, Emília Albuquerque
Open Access

Full Text 39
Depression is often overlooked in oncology practice. Depressive module PHQ-9 was not studied in Portuguese cancer patients, despite its brevity and comparable psychometric proprieties to other depression scales. Which are the psychometric properties of the Portuguese version of the PHQ-9 for use with women with breast cancer? Reliability, sensitivity to change and the construct validity will be studied. The purpose of this study is to assess the psychometric properties of the Portuguese version of the PHQ-9 for use with women with breast cancer. This study intends to evaluate the reliability, the sensitivity to change and the construct validity of the PHQ-9 in a Portuguese Breast Cancer women sample. It was reproduced a principal component analysis and explored the reliability and validity of the questionnaire. The validation used a sample of 63 Portuguese women with breast cancer. A test-retest was conducted in 45 women, after 8 weeks. Construct validity was analyzed. PHQ-9 scores ranged from 0-27, with a mean score of 4,92 (SD= 4,63). The scale presented adequate internal consistency (α = .86) and test retest reliability (ICC= .87). It also presented good construct validity, as overall scores and severity levels were strongly associated with functional and symptoms subscales. The principal component analysis explains 48.42% of the variance. The validation process of the Portuguese PHQ-9 version shows metric properties similar to those in international studies, suggesting that it measures the same constructs, in the same way, as the original version. Data provided evidence for the validity of the PHQ-9 as a brief measure of depression severity in Portuguese women with breast cancer.

No: 40
Title: Professional Factors and Emotional Competence in Healthcare Professionals
Original Research Article   
Pages 424-431
Author(s): A. Andrade*, R. Martins, M. Cunha, C. Albuquerque, & O. Ribeiro
Open Access

Full Text 40
Healthcare professionals may face emotions which are hard to deal with. It's important to improve emotional skills in order to develop an appropriate control when it comes to professional situations. Professional variables interfere with the emotional competence of healthcare professionals; What are the predictor variables of emotional competence in healthcare professionals? was our research focus. We aimed to assess the Emotional Competence in healthcare professionals; To check if the professional variables are related to the Emotional Competence of healthcare professionals with and without experience in Palliative Care; To identify predictor variables of emotional competence in healthcare professionals. Cross-sectional descriptive-correlational quantitative research with a universe of 116 health professionals: 40 with experience in palliative care and 76 without experience. For the measurement of the variables it was used a socio-demographic and professional classification form and the Emotional Competence Questionnaire of Taksic (ECQ) (2000) validated by Lima Santos and Faria (2005) for the Portuguese Population had been applied. Healthcare professionals with high emotional skills are the oldest (≥35 years old), female, with a university degree and with no experience in palliative care ones. Career and the type of relationships at workplace influence the emotional competence of professionals with experience; the type of unit influences healthcare professionals with experience in palliative care. Professional variables (profession, type of relationships at work context and unit type) influence the emotional competence skills of healthcare professionals with and without experience in Palliative Care. Caregiving in the final stages of life brings a diversity of experience to the healthcare professional and it requires training in emotional and intellectual areas to ensure the promotion of stability and emotional comfort.

No: 41
Title: Personality and Suffering in the Hospitalized Chronically Ill
Original Research Article
Pages 432-442
Author(s): Susana Batista, Rosa Martins*
Open Access

Full Text 41
The development of studies correlating personality traits with suffering in illness can be very useful to understand the chronically ill response in a transitional health/ disease process. Do the “subjective experiences of suffering in disease” correlate with personality traits of the hospitalized chronically ill? Do sociodemographic, familiar and clinical variables correlate with personality traits of the hospitalized chronically ill? The purpose of the study is to understand which “personality” traits are present in the hospitalized chronically ill, and the correlation with the “subjective experiences of suffering”, sociodemographic, familiar and clinical variables. This is a non-experimental, cross-sectional descriptive-correlational and quantitative study, used in a non-probabilistic convenience sample of 307 hospitalized chronically ill. Data were collected through a questionnaire between January and June 2013. It was requested the permission of the Hospital de São Teotónio´s ethics committee, as well as the informed consent of each participant. Data processing was performed statistically. The participants in our study had higher values of "neuroticism" than those of the authors of the NEO-FFI-20 inventory. The variable "conscientiousness" explains 12.5% of the variance of "suffering". "Openness to experience", is associated inversely with the experience of "suffering”, which is when it increases hope and “openness to experience”, decreases the "suffering" of the chronically ill. The evidence invites us to reflect on the influence of intrinsic factors in suffering. Patients deal with life/ disease in many diferent ways, wich affects the response to the transitional health/ disease process.

No: 42
Title: Perception of resilience and social support of adolescents and young adults with ulcerous colitis – research performed at 5 gastroenterological outpatient wards in the Czech Republic
Original Research Article
Pages 443-449
Author(s): Pavla Kudlová*, Monika Hynčicová, Ilona Kočvarová
Open Access

Full Text 42
The goal of this study was to determine the perception of resilience in the notion of resilience and social support in a group of persons with ulcerous colitis (UC). To collect data we used a three-part questionnaire: own questions, standardized Resilience Scale and Perceived Social Support Scale. 92 respondents with UC took part in this research: 42 men and 50 women aged 12 to 35 (the average age of 22 years), who were treated in 5 gastroenterological outpatient wards in two regions of the Czech Republic.
Results: In selected groups of respondents (gender, work/study, classification of UC, course of UC, clinical symptoms, way of treatment, BMI, weight loss) medium resilience and a relatively highly perceived social support (= 66.77; SD = 14.51) were established. We can also state that persons, who feel a lot of resilience, also perceive a lot of social support.
Conclusion: Based on our research we can suppose that the group of persons with ulcerous colitis felt their resilience and social support as very good (average to very high). However, the results cannot be generalized. We will continue working on this study.

No: 43
Title: The role of therapeutic change in the treatment of patients with behavioural disorders using CBT approach
Original Research Article
Pages 450-462
Author(s): Ivanna Shubina*
Open Access

Full Text 43
Educational system plays a significant role in drug prevention nowadays. Preventive work requires an interaction of all the links in the anti-drug preventive measures system due to the responsibility and complexity of work with young people. Therefore, the appropriate training of teachers, that will enable them to integrate some components of preventive education programs into the learning process, as well as to use suitable teaching methods is of great importance. The purpose of the paper is to identify key obstacles for teachers in implementation of preventive anti-drug activities among students and to reveal some ways of increasing its effectiveness. According to the results, the key constraints for teachers in delivering drug prevention activities to students are lack of knowledge on the topic; inactive civic standpoint; lack of personal commitment to carry out this type of work; teachers’ belief that drug abuse prevention is a responsibility of specialized trained experts, but not all teaching staff; low level of social recognition of a teacher’s profession in contemporary society.
The article suggests the following possible ways of enhancing the effectiveness of prevention in educational institutions: the development of positive motivation of teachers to implement elements of prevention; qualified pre-service training with the focus on effective prevention techniques; continual education and retraining of both the teachers and the training of staff by means of training courses, workshops; active cooperation of all agencies involved in prevention activities.