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- Health literacy and its determinants among pregnant women in PortugalPublication . Ferreira, Nuno; Ferreira, Manuela; Santos, Eduardo José Ferreira; Ferreira, Sofia; Arriaga, Miguel Telo; Costa, AndreiaBackground Health literacy is a key determinant of health outcomes and equity, particularly during pregnancy, a period marked by increased information needs and critical health decisions. Despite its importance, data on health literacy among pregnant women in Portugal remain scarce. This study aimed to assess general health literacy levels and their associations with sociodemographic, health-related, and pregnancy-specific factors in a large sample of pregnant women from the district of Viseu, Portugal. Methods A cross-sectional study was conducted with 886 pregnant women aged 18 years or older, using the validated HLS19-Q12 instrument to measure general health literacy. Data collection occurred between October 2023 and May 2024 using a multimodal approach (online, interview, and paper-based). Health literacy was categorized into four levels and also dichotomized as limited versus not limited. Descriptive statistics, bivariate analyses, and binary logistic regression were performed to identify determinants of limited health literacy. Results The mean general health literacy score was 68.3 (SD±10.9). A total of 46.7% of participants were classified as having limited health literacy. Among the pregnant women surveyed, 18.8% were born outside Portugal. Of these, 74.7% were classified as having limited health literacy, compared to 40.2% among Portuguese-born participants. Higher prevalence was observed among women aged 18–29, those born outside Portugal, with lower education, in undifferentiated professions, and facing financial hardship. In the final adjusted logistic regression model, which combined variables selected through forward stepwise inclusion with theoretically important covariates entered in a second block, significant predictors of limited health literacy included being born outside Portugal (adjusted OR 2.43; 95% CI: 1.56–3.80), having lower education (up to high school), holding lower-skilled occupations, financial difficulties, and rating current health as equal or worse. Pre-pregnancy Body Mass Index was also negatively associated with health literacy levels, with higher BMI more prevalent among women with limited health literacy. The model showed good discriminatory ability (area under the ROC curve=0.78). Conclusions A considerable proportion of pregnant women demonstrated limited health literacy, particularly among socioeconomically vulnerable and migrant groups. These findings underscore the urgency of adopting antenatal care approaches that are responsive to health literacy needs. Incorporating brief assessments during early prenatal visits, using plain language and visual communication tools, and offering targeted support to high-risk groups may enhance informed decision-making, promote equity, and improve maternal and neonatal outcomes.
- Influence of the Training Process on the Health Literacy of Angolan Health PromotersPublication . Ferreira, Manuela; Santos, Eduardo José Ferreira; Andrade, Joana; Figueiredo, Inês; Martins, Vitor; Margarida Campos, SofiaBackground: As part of the research project ‘Seigungo–Gungo’s Health, Education, and Maternal and Child Quality of Life: An Action-Research Project’, a study was conducted in the Gungo community in Angola, a region facing significant challenges in terms of access to healthcare and health literacy. The primary aim of the study was to evaluate the effectiveness of an intervention training model designed to improve the health literacy of the participants. Methods: The sample consisted of 30 trainees, 60% of whom were male, with an average age of 45.6 years. Most participants were single (53.3%) and had completed 6 years of formal education (26.7%). Health literacy levels were assessed using the HLS-EU-PT-Q16, a short 16-item questionnaire designed to assess three key domains: healthcare, disease prevention, and health promotion. These domains are related to the focus of the training programme. Data collection took place throughout the year 2024. Results: According to the data obtained, prior to attending the training program, 60% of the participants demonstrated an inadequate level of health literacy. Following the intervention, this percentage dropped significantly to 20%. In contrast, the proportion of participants with sufficient to excellent health literacy rose from 16.7% to approximately 40%. The results indicate that the training program had a positive and statistically significant impact on improving health literacy in the Gungo community. Conclusions: These findings highlight the importance of targeted training and sustained intervention efforts to address the specific health education needs currently affecting this community.
- Dieta da parturiente de termo sem patologia associada: revisão sistemática da literaturaPublication . Rodrigues, Clara; Ferreira, Manuela; Margarida Campos, Sofia; Pousadas, Daniel; Igual, Ana; Pires, Ana; Firmo, Ana; Cosme, Ana; Santos, Eduardo José Ferreira; Coutinho, EmíliaIntrodução: A ingestão oral em trabalho de parto é praticada de forma inadequada em muitos hospitais e maternidades portugueses, com relatos onde o jejum é uma prática comum e é perpetuado de forma rotineira em todas as parturientes. Objetivo: Identificar a melhor evidência científica sobre qual a dieta mais adequada na parturiente de termo sem patologia associada. Métodos: Foi realizada uma Revisão Sistemática da Literatura (RSL) segundo o método da Joanna Briggs Institute (JBI) e foi redigida de acordo com o Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA 2020). Resultados: A pesquisa foi feita em 5 bases de dados, CINAHL Complete, B-On, PUBMED, MEDLINE Complete e Nursing & Allied Health Colection, no dia 30 de março de 2023. Foram utilizados descritores (MeSH) e termos em linguagem natural, com os operadores boleanos “AND” e “OR”. Os limitadores utilizados foram todos os estudos em língua inglesa, portuguesa e espanhola, com friso temporal de 5 anos. Foram avaliados e analisados para elegibilidade 67 artigos por dois revisores independentes e incluídos 11 artigos na revisão. Conclusão: Os estudos apontam os líquidos claros sem resíduos, ricos em hidratos de carbono e proteínas como a dieta mais adequada e segura em parturientes de termo sem patologia associada, e identificam inúmeros benefícios para a parturiente, para o trabalho de parto e parto, para o feto e recém-nascido.
- The relationship between acute pain and other types of suffering in pre-hospital trauma victims: An observational studyPublication . Mota, Mauro; Melo, Filipe; Henriques, Carla; Matos, Ana; Castelo-Branco, Miguel; Monteiro, Mariana; Reis Santos, Margarida; Madalena Jesus Cunha Nunes, MariaBackground: Acute pain is an important complaint reported by trauma victims, however, the relationship between it and other types of discomfort, such as discomfort caused by cold, discomfort caused by immobilization, and psychological distress such as fear, anxiety, and sadness is limitedly studied and documented. Aim: To assess the relationship between acute trauma pain and other types of suffering in pre-hospital trauma victims. Methods: This is a prospective multicentre cohort study conducted in Immediate Life Support Ambulances in Portugal. All adult trauma victims with a mechanism of blunt and penetrating injuries, falls, road accidents and explosions, were included. Results: 605 trauma victims were included, mainly male, with a mean age of 53.4 years. Before the intervention of the rescue teams, 90.5 % of the victims reported some level of pain, 39.0 % reported discomfort caused by cold, while 15.7 % felt fear, 8.4 % sadness, 49.8 % anxiety and 4.5 % apathy. Victims with high discomfort caused by cold tend to have higher pain levels. Significantly higher pain intensity were observed in victims with fear and anxiety. Univariate and multivariate analysis indicates that immobilization is associated with increased pain levels. Conclusions: There is a statistically significant relationship between acute trauma pain, anxiety, fear, cold and immobilization.
- Exploring Lifestyle Factors and Treatment Adherence among Older Adults with Hypertension Attending a Mobile Health Unit (MHU) in a Rural Area of Central PortugalPublication . Pinto, Cátia; Margarida Correia Balula Chaves, Cláudia; Duarte, João; Raposo, António; Zandonadi, Renata Puppin; Monteiro, Sara; Teixeira-Lemos, EditeThis cross-sectional and analytical study aimed to characterize a sample of hypertensive older adults attending a Mobile Health Unit (MHU) in a rural area of central Portugal according to their lifestyle and to analyze the impact of lifestyles on treatment adherence. The sample comprised 235 Portuguese hypertense patients, mainly females (63.8%) with a mean age of 75 years (±8.14 years) and low level of education. The data collection was carried out through a questionnaire consisting of sociodemographic questions, dietary variables, an Alcohol Dependence Questionnaire, an International Physical Activity Questionnaire (Short Version), a Nutrition Health Determination Questionnaire, a Self-Care with Hypertension Scale, and an Adherence to Treatments Measurement Scale. Only 34.5% of the hypertensive patients have controlled blood pressure values (28.2% men and 38% women). However, more than half (56.2%) of the hypertensive patients are classified as adherent to therapeutic measures. The hypertensive individuals, who present higher levels of adherence to the treatment, do not present alcohol dependence, are frequent consumers of aromatic herbs, sporadically consume salt, present good nutritional health, and practice moderate physical activity. The predictor variables for treatment adherence are the self-care dimensions general dietary (p = 0.001), specific dietary (p = 0.034), physical activity (p = 0.031), and antihypertensive medication intake (p < 0.001). Hypertensive patients with healthier lifestyles present better levels of treatment adherence. Therefore, promoting physical activity and healthy dietary practices is necessary to improve treatment adherence and increase antihypertensive treatment’s effectiveness.
- Tratamento pré-hospitalar da dor traumática aguda: um estudo observacionalPublication . Mota, Mauro; Santos, Margarida Reis; Santos, Eduardo; Henriques, Carla; Matos, Cristina Bico Rodrigues de; Cunha, MadalenaObjective: To describe and analyze the effectiveness of nurses’ interventions in pain reduction among patients with traumatic injury. Methods: Prospective cohort study conducted in the Immediate Life Support Ambulances in Portugal from March 1, 2019 to April 30, 2020. We have collected data on the kind of interventions implemented and the time elapsed during rescue procedures. To investigate the course of acute trauma pain, a 11-point Numeric Rating Scale was used. Changes in the level of pain registered throughout the three assessment moments were studied using linear mixed-effects models with random intercepts to account for the repeated measurements conducted on the same patient. These changes were assessed before and after the administration of the pain relief interventions. Results: 596 patients were included in this study. Most of them were male (65.9%) and had a mean age of 53.05±19.72 years. There was a reduction in the average pain intensity of 2.44 points (p
- Variáveis de contexto pessoal e académico como preditoras do abandono escolarPublication . Ferreira, Manuela; Cardoso, Ana Paula; Campos, Sofia; Duarte, João; Guiné, Raquel; Pereira, AndreiaEnquadramento: A complexidade do fenómeno do abandono escolar, perspetivado como a não con clusão do curso frequentado, pressupõe diferentes preditores deste fenómeno. Objetivos: Identificar variáveis preditoras dos motivos de intenção de abandono escolar nos estudan tes do ensino superior. Metodologia: Estudo quantitativo transversal, descritivo-correlacional e analítico, com uma amostra não probabilística por conveniência de 1175 estudantes portugueses. O instrumento de recolha de dados incluiu um questionário sociodemográfico, uma Escala de Motivos de Intenção de Abandono Escolar do Ensino Superior e outras escalas validadas. Resultados: Os resultados obtidos identificam, como variáveis preditoras das quatro dimensões dos motivos de intenção de abandono escolar, a idade e o sexo, a perceção emocional, a performance de aprendizagem e dimensões das vivências académicas dos estudantes. Conclusão: Constata-se a necessidade de apoiar os estudantes ao nível da gestão de expectativas, dotando-os de uma maior capacidade de lidar com as suas perceções emocionais. Sugere-se a criação de medidas de mitigação do abandono escolar atendendo ao seu perfil sociodemográfico e criação de infraestruturas que garantam a qualidade de vida académica.
- Development of a Questionnaire to Assess Knowledge and Perceptions about Edible InsectsPublication . Guiné, Raquel; Florença, Sofia De Guiné E; Costa, Cristina Amaro Da; Correia, Paula; Ferreira, Manuela; Duarte, João; Cardoso, Ana Paula; Campos, Sofia; Anjos, OféliaEdible insects (EI) have been consumed as traditional foods in many parts of the globe, but in other regions, they are not readily accepted, particularly in Western countries. However, because EI are suggested to constitute a more sustainable protein food as compared with other sources of animal protein, they can be considered a future food that could help mitigate hunger and malnutrition. Additionally, new gastronomic trends are already targeting this area for exploring new potentialities. The objective of this work was to develop and validate a questionnaire to assess consumers’ perceptions and knowledge about EI in seven different domains: D1. Culture and Tradition, D2. Gastronomic Innovation and Gourmet Kitchen, D3. Environment and Sustainability, D4. Economic and Social Aspects, D5. Commercialization and Marketing, D6. Nutritional Aspects and D7. Health Effects. The 64 items were subjected to item analysis and reliability analysis for validation, and factor analysis was also conducted to identify a grouping structure. The results validated all the items of the seven subscales with high values of Cronbach’s alpha (α = 0.732 for D1, α = 0.795 for D2, α = 0.882 for D3, α = 0.742 for D4, α = 0.675 for D5, α = 0.799 for D6 and α = 0.788 for D7). However, by eliminating 17 items, the final values of the alpha increased in all subscales. Factor analysis with extraction by principal component analysis with varimax rotation extracted 14 factors that explained, in total, 65% of the variance, although the first two factors were the most important (35.7% variance explained). In conclusion, the confirmed usefulness of the questionnaire has been hereby validated for assessing consumer perceptions of and knowledge about EI.
- Effectiveness of prehospital nursing interventions in stabilizing trauma victimsPublication . Mota, Mauro; Cunha, Madalena; Santos, Eduardo José Ferreira dos; Figueiredo, Ândrea; Silva, Márcio; Campos, Rui; Reis Santos, MargaridaBackground: Trauma is a public health issue with a significant social and economic impact. However, national data on its characterization and the role of nursing in its management is still scarce. Objective: To assess the effectiveness of prehospital nursing interventions in stabilizing trauma victims provided by nurses of Immediate Life Support Ambulances in Portugal. Methodology: Observational, prospective, and descriptive-correlational study. Data were collected by nurses of the Immediate Life Support Ambulances in mainland Portugal, from 01/03/2019 to 30/04/2020, and the Azores, from 01/10/2019 to 30/04/2020. Trauma severity indices were assessed before and after the nursing interventions. Results: This study included 606 cases (79.4% blunt trauma; 40.8% road accidents) reported by 171 nurses. Nurses performed mostly interventions for hemodynamic support (88.9%) and non-pharmacological pain control (90.6%) of trauma victims. The nursing interventions improved the Revised Trauma Score and the Shock Index (p<0.001). Conclusion: Prehospital nursing interventions improve trauma victims’ clinical status
- Eating Habits and Food Literacy: Study Involving a Sample of Portuguese AdolescentsPublication . Ferreira, Manuela; Guiné, Raquel; Leitão, A. L.; Duarte, João; Andrade, J.; Amaral, OdeteAdolescents tend to neglect food and their eating pattern is influenced by several factors. Adolescents’ health literacy substantiates their ability to respond to the growing demands of health, being linked to health promotion in several areas, including food. The goal of this work was to analyze the relationship between sociodemographic and contextual variables with secondary school students’ food literacy. A quantitative, cross-sectional, descriptive and analytical study was carried out with a sample of 181 nonprobabilistic secondary school students, aged between 16 and 21 years (mean = 18.09 years ± 1.45), mostly female (58.0%), from 11th grade (35.4%), who are part of a secondary school in central Portugal. As a tool for data collection, the questionnaire of the project “Your PEL – Promote and Empower for Health Literacy in the young population” was used, aggregating three areas: eating behaviors, harmful consumptions and sexuality. The results showed that 58.6% of young people eat 4–5 meals a day, consume fast food weekly (79%) and eat soup (82.3%). Additionally, they eat fruit and vegetables on a daily basis (94.5 and 83.4%, respectively). The results further showed that 10th grade students have higher levels of health and food literacy. It was observed that both girls and boys are interested in receiving information regarding food, transmitted through social networks and by a communication application (84.5 and 73.5%, respectively), with significant differences (χ2 = 4.768; p = 0.028). Adolescents face unique health challenges and a critical level of health literacy compromises their understanding of information about diet and future health. The results indicate that educational plans to empower adolescents in these areas, which integrate gender and age differences and sources of information as important variables to be considered, are pivotal for increasing levels of health and food literacy.