Background: Study older adults’ quality of life is becoming increasingly important in the assessment, quality improvement and allocation of health and social care service. The purpose of this study was to enhance knowledge on the relationship between modifiable (psychological variables) and non-modifiable variables (sociodemographic), and quality of life in elderly, regarding psychological and social variables in Portuguese context. Methods: This is a cross-sectional study, including 604 older adults from general community. 63.6% of the sample was composed by female gender with a mean age of 71.6(SD = 4.81). Participants completed the following instruments: Barthel Index to assess functionality; Satisfaction with Social Support Scale to assess social support; The Spiritual and Religious Attitudes in Dealing with Illness to assess spirituality and Short Form Health Survey 36, to assess mental and physical quality of life. Results: A path analysis model was performed where the presence of a chronic disease, age and functionality has a direct effect on physical quality of life and spirituality had a direct effect on mental quality of life. Social support mediated the relationship between functionality and mental quality of life, and in turn, functionality mediated the relationship between age and physical quality of life. Conclusions: Results reinforce the effect of age and chronic disease as non-modifiable variables as well as functionality, spirituality and satisfaction with social support as modifiable variables, in the quality of life of older people. Social support, health and education programs in the community should be promoted in order to improve quality of life in this population. Strategies to promote functionality and enhance the social support network, especially in the elder with chronic illness, should be a priority.
Cancer is a leading cause of mortality and morbidity all over the world and the second major cause of death in Portugal. Dermatological side effects resulting from cancer treatment have a psychosocial impact on patients’ lives, such as quality of life (QoL), body image, cognitive fusion and social inhibition. This systematic review aimed to explore and synthesize the psychosocial impact of dermatological side effects of cancer treatment, answering the following research objectives: (i) Do the dermatological side effects of the cancer treatment present any psychosocial impact for the patients? (ii) How does the psychosocial impact of the dermatological toxicities of the cancer treatment manifest in patients’ lives? Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and guided a systematic search through the PubMed, Cochrane Library and PyscNet databases. The considered studies correlate dermatological side effects of cancer treatments and their psychological/psychosocial outcomes. The studies found were all published in peer-reviewed journals. The results obtained established that cancer treatment causes the most varied skin changes, consequently reducing self-esteem and QoL; disturbing body image; and contributing to cases of stress, depression and anxiety. There is still limited literature that profoundly investigates the experience of living with these skin toxicities. The development of research lines to improve knowledge in this field will allow for significant improvements in healthcare for patients undergoing cancer treatment who need to focus more on the psychosocial implications of skin toxicities. The novelty of this review lies in adding knowledge summarizing the psychosocial implications of dermatological side effects of cancer treatment to support healthcare providers in the development of integrative therapeutic strategies for these patients in their clinical practice.
6 December 2016 in International Journal of Behavioral Medicine
The influence of the vehicle in topical treatment adherence remains to be elucidated. The aim of this study is to analyze the influence of the pharmaceutical dosage form on adherence to topical treatment in psoriasis patients, taking into consideration the mechanical features. The adherence was evaluated in a sample of 102 psoriasis patients, followed for approximately 45 days. Adherence was calculated with a new combined methodology using a log and medication weights. The effect of the group formulation was evaluated using logistic regression models. A complex effect of the vehicle on adherence was found, mediated by the affected area. The adherence was significantly higher for patients applying gels and creams than for those using ointments, whenever the body area affected was extensive. The opposite was found when the affected area was small. Mechanical properties can partially explain the findings since gels and creams may be easier to apply. Patient beliefs and preferences regarding vehicles and their sensory attributes might also explain the results. It is noteworthy that adherence was strikingly low, with more than 75% non-adherent patients. This real-world evidence provides an insight for pharmaceutical industries and guidance for treatment prescription by physicians aiming to address the public health emergency of treatment non-adherence.
2 December 2018 in Journal of Dermatological Treatment
Background Patient preferences should be considered when prescribing topical treatments to drive up adherence and improve clinical outcomes. Objetive The aim of this work was to identify the most important attributes of topical medicines for psoriasis treatment in the patients’ view, and explore the sociodemographic and clinical determinants of these preferences. Methods A questionnaire for the evaluation of the relevancy given to specific attributes of topical medicines used for psoriasis treatment was developed (PSO-TOPAP) and was applied to a total of seventy-nine patients, members of the Portuguese Association of Psoriasis (PSOPortugal) or outpatients of a dermatology unit of a central hospital. Results Overall, attributes belonging to the formulation and application domains were greatly valued over attributes related with the container. Only a small number of patient preferences was influenced by age, gender, duration of the disease and age at first diagnosis. Limitations Our findings need to be verified in larger and more diverse patient samples, before generalization can be made. Conclusion The insight obtained in this work can provide guidance to pharmaceutical drug product design and has also potential to improve patient care through the acknowledgement of patient preferences in clinical practice.