Browsing by Issue Date, starting with "2025-05-26"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
- Impacto de Políticas de Saúde na Infeção VIH/SIDA em PortugalPublication . Sena, Luís Artur Silva; Maio, António Gonçalves Candeias da GuerraIntrodução: Após 40 anos do início da pandemia do VIH/SIDA em Portugal e com a evolução do perfil da pessoa que vive com VIH, faz-se uma revisão sobre as principais medidas adotadas pelas autoridades portuguesas e o seu impacto na infeção. Objetivos: Listar as políticas de saúde para o VIH/SIDA implementadas em Portugal, averiguar a sua eficácia e propor novas medidas a adotar. Métodos: Para a listagem das medidas implementadas em Portugal, recorreuse aos relatórios de vigilância epidemiológica do Instituto Nacional de Saúde Doutor Ricardo Jorge. Já para a verificação da sua eficácia e proposta de novas medidas a adotar, fez-se uma pesquisa na base de dados PubMed. Desenvolvimento do tema: Várias medidas foram elaboradas e implementadas, focando nas várias componentes associadas com a infeção VIH desde a prevenção, com medidas como a educação para a saúde, transmissão sexual, no âmbito do consumo de drogas injetáveis, na testagem e rastreio, bem como na profilaxia pré e pós-exposição. Analisou-se ainda a evolução da orgânica política para o VIH e também medidas para a proteção das pessoas que vivem com VIH. Todas as medidas mostraram ser suportadas por evidência científica robusta. Outras medidas foram implementadas noutros países com algum sucesso, como o recurso a meios tecnológicos para a modulação de comportamentos de risco ou a aplicação de questionários específicos para avaliação adequada dos fatores de risco na população. Conclusão: A ação política das autoridades de saúde contra o VIH é distinta e comprovada pela evidência. No entanto, mantém-se oportunidade de ação no diagnóstico precoce e potenciação da profilaxia pré-exposição e educação para a saúde nas populações em risco acrescido (pessoas heterossexuais com mais de 50 anos, homens que têm sexo com homens e migrantes). Requerem-se ainda estudos na população portuguesa, com vista a avaliar de forma mais assertiva o impacto das medidas atuais e futuras, ajustadas aos grupos populacionais específicos.
- Chronic Obstructive Pulmonary Disease Patients’ Experiences and Perceptions Towards TelehealthPublication . Nave, Beatriz Anseriz da; Martins, Henrique Manuel Gil; Neves, Diogo Filipe VendeirinhoBackground: In 2021, Chronic Obstructive Pulmonary Disease (COPD) was ranked as the fourth leading cause of death globally. Estimates based on global data point to a prevalence of 10.6 percent in the population aged 25 and over in 2020, which translates into 480 million cases, which are expected to increase further. Caring for COPD patients is challenging due to the disease's unpredictable nature, marked by stable periods, alternating with severe symptom flare-ups. Effective management requires continuous, flexible coordination between patients, providers, and healthcare systems to address its evolving demands. In this complex scenario, telehealth emerged as a promising approach to enhance care delivery and patient self-management. To successfully integrate telehealth into modern healthcare systems, it is essential to understand patients' experiences and perceptions, as they are key to the development of patient-centred solutions that improve the quality of care and to their effective adoption and implementation. However, there are few qualitative systematic reviews on this topic. Objectives: To systematically review and synthesize qualitative studies about how COPD patients experience care received via telehealth, identifying possible barriers and facilitators to its use. Methods: A systematic search was conducted across relevant databases (including PubMed/MEDLINE, Scopus, ISI Web of Science, Cochrane Libraries and IEEE Xplore Digital), to identify the perspectives of COPD patients utilizing electronic and communication technologies to deliver and support healthcare, when distance separates them from healthcare providers. Data was analysed using thematic synthesis methods. Results: Forty-one articles were included, encompassing thirty-eight studies and a total of six hundred and ten patients. Two main themes emerged: i) Acceptability, with sub-themes such as Usability and Utility; and ii) Value for the patient, with the sub-themes Accessibility, Costs, Engagement and Empowerment. The results indicate that COPD patients generally consider telehealth to be a valuable tool, offering convenience and empowerment in the management of their disease. Patients feel safer being monitored by professionals on a more continuous basis and knowing that they have this close contact in case of need, which can also improve the relationship with the carer, who plays a vital role in encouraging patients. Together with the reduction in the number of journeys required to get to healthcare facilities, and the consequent reduction in waiting times for medical attention, telehealth improves access to care, which is greatly favoured by patients. Patients’ empowerment to manage their illness was justified by the easier monitoring of their vital signs, observing patterns between them and the symptoms, and by the educational component of these interventions. On the other hand, some patients consider telehealth to be a challenge, either due to the perception of low self-efficacy in the use of technology, which might be explained by the age and digital literacy of the target population or due to the technical errors of these digital systems. Other patients reveal a sense of uselessness, particularly if their condition is stable or they already consider themselves competent in self-care, perceiving no added value in these interventions compared to the care they received before. Many also feel a lack of more direct and personal contact with professionals, with an emotional impact. The findings of this study along with their discussion lead to a model that demonstrates the connections between the factors that influence the experience of COPD patients with the use of telehealth. This reflection led to consider factors that have a greater impact prior to the introduction of these systems in the patient's life, reflected in their adoption and acceptability, and others that have an impact after the start of their use, satisfying some and leading others to abandon telecare, reflected in these systems’ implementation and use. Conclusions: This systematic review suggests that the majority of COPD patients have a positive attitude towards telehealth interventions. The review adds clarity to the existing contradictory evidence on COPD patients' perceptions towards telehealth, identifying perceived benefits and factors that contribute to poor adherence. Personalised approaches and appropriate training can improve patient engagement. Understanding patients' points of view can guide design and implementation, while fostering a collaborative environment for the future development of these interventions.