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- Cachim, Afonso, et al.
(author)
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Measuring adherence to inhaled control medication in patients with asthma : Comparison among an asthma app, patient self-report and physician assessment
- 2023
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In: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022. ; 13:2
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Journal article (peer-reviewed)abstract
- BackgroundPrevious studies have demonstrated the feasibility of using an asthma app to support medication management and adherence but failed to compare with other measures currently used in clinical practice. However, in a clinical setting, any additional adherence measurement must be evaluated in the context of both the patient and physician perspectives so that it can also help improve the process of shared decision making. Thus, we aimed to compare different measures of adherence to asthma control inhalers in clinical practice, namely through an app, patient self-report and physician assessment.MethodsThis study is a secondary analysis of three prospective multicentre observational studies with patients (≥13 years old) with persistent asthma recruited from 61 primary and secondary care centres in Portugal. Patients were invited to use the InspirerMundi app and register their inhaled medication. Adherence was measured by the app as the number of doses taken divided by the number of doses scheduled each day and two time points were considered for analysis: 1-week and 1-month. At baseline, patients and physicians independently assessed adherence to asthma control inhalers during the previous week using a Visual Analogue Scale (VAS 0–100).ResultsA total of 193 patients (72% female; median [P25–P75] age 28 [19–41] years old) were included in the analysis. Adherence measured by the app was lower (1 week: 31 [0–71]%; 1 month: 18 [0–48]%) than patient self-report (80 [60–95]) and physician assessment (82 [51–94]) (p < 0.001). A negligible non-significant correlation was found between the app and subjective measurements (ρ 0.118–0.156, p > 0.05). There was a moderate correlation between patient self-report and physician assessment (ρ = 0.596, p < 0.001).ConclusionsAdherence measured by the app was lower than that reported by the patient or the physician. This was expected as objective measurements are commonly lower than subjective evaluations, which tend to overestimate adherence. Nevertheless, the low adherence measured by the app may also be influenced by the use of the app itself and this needs to be considered in future studies.
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| 2. |
- Ferreira, Cláudia, et al.
(author)
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Defensive Responses to Early Memories with Peers : A Possible Pathway to Disordered Eating
- 2017
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In: The Spanish Journal of Psychology. - : Cambridge University Press. - 1138-7416 .- 1988-2904. ; 19
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Journal article (peer-reviewed)abstract
- Childhood and early adolescence experiences, specifically those that provide an adulthood enriched with warm and safe memories, are consistently stated in literature as powerful emotional regulators. In contrast, individuals who scarcely recall positive experiences may begin to believe that others see the self as inferior, inadequate and unattractive. In order to cope with a perceived loss of social desirability and achieve other's acceptance, individuals may become submissive, and women, particularly, may resort to the presentation of a perfect body image. Both mechanisms are defensive responses suggested to be associated with mental health difficulties, particularly disordered eating behaviors. The present study aimed at exploring the association between early memories of warmth and safeness with peers and eating psychopathology. Also, a path analysis was conducted to investigate the mediator role of submissiveness and perfectionistic self-presentation focused on body image on this association, in a sample of 342 female students. Results revealed that the absence of early positive memories with peers holds a significant effect over eating psychopathology's severity, and also that this effect is mediated through submissiveness and body image-related perfectionistic self-presentation. This model accounted for 13%, 19% and 51% of submissiveness, perfectionistic self-presentation of body image and eating psychopathology's variances, respectively, and showed excellent model fit.
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| 3. |
- Ferreira, Cláudia, et al.
(author)
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Understanding the Role of Self-Judgment in the Association between Body Dissatisfaction and Quality of Life on Normal-Weight and Overweight Portuguese Women
- 2016
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In: The Spanish Journal of Psychology. - : Cambridge University Press. - 1138-7416 .- 1988-2904. ; 19
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Journal article (peer-reviewed)abstract
- Literature has demonstrated the negative impact of body image dissatisfaction on women's quality of life. Nonetheless, it has been suggested that the relationship between body dissatisfaction and women's well-being is not linear, and that the processes that mediate this association remain unclear. This study aims to clarify the mediator role of self-judgment in the association between negative body image and psychological quality of life, in two groups: normal-weight and overweight women. This cross-sectional study comprised 200 normal-weight and 92 overweight female college students, aged between 18 and 24 years old, that completed self-report instruments of body dissatisfaction, self-judgment, and quality of life. Results showed that women who presented harsher self-judgment about their perceived failures tended to present lower levels in all quality of life domains. Also, results from mediation analyses indicated the relationship between body dissatisfaction and psychological quality of life was significantly mediated by the mechanisms of self-judgment in the two BMI groups (95% CI [-2.41 to -0.04]; 95% CI [-6.35 to -.89]). This mediational model accounted for 28.3% and 40.7% of psychological quality of life in the normal-weight and overweight groups, respectively. These results suggest that a lower ability to deal with one's failures or inadequacies (e.g., negative evaluation of body image) in a kind and accepting manner may significantly increase the negative impact of body dissatisfaction on one's psychological quality of life. In this way, it seems that, the focus of interventions should go beyond body dissatisfaction and also target the development of adaptive attitudes (opposed to self-critical attitudes) to deal with negative body-related experiences.
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| 5. |
- Trindade, Inês A., 1990-, et al.
(author)
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Chronic illness-related cognitive fusion explains the impact of body dissatisfaction and shame on depression symptoms in breast cancer patients
- 2018
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In: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 25:6, s. 886-893
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Journal article (peer-reviewed)abstract
- Breast cancer is linked to psychological distress and mood disorders that are in turn associated with higher psychological dysfunction and decreased breast cancer survival. It is considered that psychological health in breast cancer is considerably affected by body image impairment, which in turn seems to be highly associated with shame. However, the impact of these variables on mental health may not be direct. The current study aimed to explore a comprehensive model regarding the role of chronic illness-related cognitive fusion in the relationship of body image dissatisfaction and chronic illness-related shame with depression symptoms. The sample was composed of 75 women with nonmetastatic breast cancer, recruited in a Radiotherapy Service in central Portugal. The conducted path model presented an excellent fit and accounted for 59% of the variance of depressive symptomatology. Further, it demonstrated that body image dissatisfaction's impact on depressed mood is significantly explained by the mechanisms of chronic illness-related shame and chronic illness-related cognitive fusion. It was also revealed that chronic illness-related cognitive fusion additionally mediated the impact of chronic illness-related shame on depression. These findings are suggestive of the importance of body image and chronic illness shame in the determination of breast cancer patients' depression symptoms and also the central role of chronic illness-related cognitive fusion in these relationships. Therefore, the implementation of acceptance and defusion-based psychotherapeutic interventions to improve mental health in cancer patients seems to be of great importance.
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| 6. |
- Trindade, Inês A., 1990-, et al.
(author)
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Developments on committed action : Validity of the CAQ-8 and analysis of committed action's role in depressive symptomatology in breast cancer patients and healthy individuals
- 2018
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In: Clinical Psychology and Psychotherapy. - : John Wiley & Sons. - 1063-3995 .- 1099-0879. ; 25:1, s. e42-e50
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Journal article (peer-reviewed)abstract
- Committed action, a process of acceptance and commitment therapy's psychological flexibility model, is considered an understudied construct that currently can only be measured by one instrument, the Committed Action Questionnaire (CAQ-8). This study aims at analysing the psychometric properties of the CAQ-8 in healthy individuals and breast cancer patients. This study also aims to explore the specific meditational role of committed action in the well-established relationship between experiential avoidance and depression symptoms. The healthy sample comprised 294 adults from the general population, and the breast cancer samples comprised 82 participants. Both groups completed the validated self-report measures. CAQ-8's robustness was examined through validity analyses, confirmatory factor analyses, and multigroup analysis. The meditational model was conducted using structural equation modelling. The CAQ-8 presented good internal consistency and construct, convergent, concurrent, and divergent validity in both samples. Further, the CAQ-8 showed incremental validity over a measure of engaged living. Findings also demonstrated measurement invariance between healthy individuals and breast cancer patients. Regarding the conducted meditational model that was also invariant between the two analysed groups, it was demonstrated that part of the effect that experiential avoidance holds on depressive symptomatology is explained by committed action. This study suggests that the CAQ-8 is adequate for use in healthy and cancer populations. Moreover, it provides novel, empirical support regarding the links between committed action, experiential avoidance, and depressed mood, being also the first investigation to particularly study committed action in a cancer population. Implications for theory and practice are discussed.
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