The global increase in elderly population all over the world, especially in Portugal, justifies the importance of mental health study in this age group. The aim of this study was to characterize the elderly patients in Gerontopsychiatry Consultation of Centro Hospitalar São João in Porto, related to socio-demographic aspects, physical and global disabilities, depression, suicidal ideation and quality of life, and to explore the association between suicidal ideation, depression, and quality of life and global and functional disability. In this cross-sectional study, 155 patients were recruited consecutively, with a final sample of 75 subjects (59 women and 16 men) without cognitive deficits and a mean age of 72.8 (SD = 6.04). Concerning the depression level measured with the Geriatric Depression Scale (Barreto et al., 2008) it was found that 66.7% presented severe depression and suicidal ideation (M = 41.96, SD = 36.38), a value considered with a potential risk of suicide using the Suicidal Ideation Questionnaire (Ferreira & Castela, 1999). The elderly also perceived their quality of life as low, revealing global disability assessed with the EasyCare- Elderly Assessment (Sousa & Figueiredo, 2000a). A significant positive correlation was also found between depression and suicidal ideation (rs =.71, p < .001), as well as quality of life (rs = .50, p < .001), and suicidal ideation with quality of life (rs = .40, p < .001). The data obtained in this study corroborate the results found in other studies.

ObjectivesTo quantify the time spent by family physicians (FP) on tasks other than direct patient contact, to evaluate job satisfaction, to analyse the association between time spent on tasks and physician characteristics, the association between the number of tasks performed and physician characteristics and the association between time spent on tasks and job satisfaction.DesignCross-sectional, using time-and-motion techniques. Two workdays were documented by direct observation. A significance level of 0.05 was adopted.SettingMulticentric in 104 Portuguese family practices.ParticipantsA convenience sample of FP, with lists of over 1000 patients, teaching senior medical students and first-year family medicine residents in 2012, was obtained. Of the 217 FP invited to participate, 155 completed the study.Main outcomes measuredTime spent on tasks other than direct patient contact and on the performance of more than one task simultaneously, the number of direct patient contacts in the office, the number of indirect patient contacts, job satisfaction, demographic and professional characteristics associated with time spent on tasks and the number of different tasks performed, and the association between time spent on tasks and job satisfaction.ResultsFP (n=155) spent a mean of 143.6 min/day (95% CI 135.2 to 152.0) performing tasks such as prescription refills, teaching, meetings, management and communication with other professionals (33.4% of their workload). FP with larger patient lists spent less time on these tasks (p=0.002). Older FP (p=0.021) and those with larger lists (p=0.011) performed fewer tasks. The mean job satisfaction score was 3.5 (out of 5). No association was found between job satisfaction and time spent on tasks.ConclusionsFP spent one-third of their workday in coordinating care, teaching and managing. Time devoted to these tasks decreases with increasing list size and physician age.

WHAT KEEPS FAMILY PHYSICIANS SO BUSY? A DESCRIPTION OF MEDICAL WORK BEYOND PATIENT ENCOUNTERSObjectives: Measuring the amount of time family physicians (FP) spend on direct patient encounters and other medical tasks, determining the number of direct patient encounters and indirect contacts, and describing the range of medical tasks performed. Design: Observational study. Setting: Family practices in the Unidade Local de Saúde de Matosinhos (ULSM), Portugal. Population: Family physicians working in ULSM Methods: A convenience sample of 46 family physicians was invited to record their activities during 2 to 5 working days, in June and July, 2010. They measured the time spent in practice, on breaks and on medical tasks aside from direct patient encounters, the numbers of direct and indirect patient contacts, and the types of medical tasks performed. The characteristics of the study participants and the characteristics of their tasks were analyzed using descriptive statistics. Results: Of the 46 family physicians invited, thirteen participated in the study (28% response rate). The activities of 52 working days were recorded, including 986 direct patient encounters, 514 indirect patient contacts and 100 hours of activities. Of the total daily working time, 23% was spent on non-contact medical tasks (on average one hour and 57 minutes per day), with an average of 10 indirect patient contacts per doctor per day. A mean of six hours and 31 minutes were spent on 19 direct patient contacts per doctor per day. The indirect contact tasks most often reported were: telephone calls, e-mails, medical record keeping, evaluation of laboratory and other tests, prescription refills, completing forms, interactions with other members of the team, referrals and staff meetings. Conclusions: This sample of family physicians spends an average of one hour and 57 minutes per day on non-contact patient related tasks, accounting for 23% of their workload. This is similar to the findings from North American studies. There are several likely biases in this study related to sample selection and data collection. This study illustrates the range of tasks that family physicians perform, as well as the amount of time required to perform them. This may contribute to improve the recognition of the workload created by these tasks as well as indicating their importance, with potential effects on professional satisfaction.

A utilização do e-mail para questões de saúde tem sido crescente, sendo objecto de estudo de vários autores, que caracterizaram e avaliaram o conteúdo dos e-mails trocados entre utentes e médicos. 2,3,4,6-15 Dada a utilidade desta ferramenta em cuidados de saúde, várias entidades têm elaborado guidelines para a utilização do correio electrónico com os utentes. 16,17,18 O correio electrónico apresenta vantagens relativamente ao telefone: maior liberdade de acesso, menor custo, a informação não se perde, as mensagens podem ser imprimidas ou guardadas integralmente, as mensagens não têm limite de palavras, permite a discussão do assunto com familiares ou com colegas por parte dos

ObjectiveTo assess Spanish and Portuguese patients’ and physicians’ preferences regarding type 2 diabetes mellitus (T2DM) treatments and the monthly willingness to pay (WTP) to gain benefits or avoid side effects.MethodsAn observational, multicenter, exploratory study focused on routine clinical practice in Spain and Portugal. Physicians were recruited from multiple hospitals and outpatient clinics, while patients were recruited from eleven centers operating in the public health care system in different autonomous communities in Spain and Portugal. Preferences were measured via a discrete choice experiment by rating multiple T2DM medication attributes. Data were analyzed using the conditional logit model.ResultsThree-hundred and thirty (n=330) patients (49.7% female; mean age 62.4 [SD: 10.3] years, mean T2DM duration 13.9 [8.2] years, mean body mass index 32.5 [6.8] kg/m2, 41.8% received oral + injected medication, 40.3% received oral, and 17.6% injected treatments) and 221 physicians from Spain and Portugal (62% female; mean age 41.9 [SD: 10.5] years, 33.5% endocrinologists, 66.5% primary-care doctors) participated. Patients valued avoiding a gain in bodyweight of 3 kg/6 months (WTP: €68.14 [95% confidence interval: 54.55–85.08]) the most, followed by avoiding one hypoglycemic event/month (WTP: €54.80 [23.29–82.26]). Physicians valued avoiding one hypoglycemia/week (WTP: €287.18 [95% confidence interval: 160.31–1,387.21]) the most, followed by avoiding a 3 kg/6 months gain in bodyweight and decreasing cardiovascular risk (WTP: €166.87 [88.63–843.09] and €154.30 [98.13–434.19], respectively). Physicians and patients were willing to pay €125.92 (73.30–622.75) and €24.28 (18.41–30.31), respectively, to avoid a 1% increase in glycated hemoglobin, and €143.30 (73.39–543.62) and €42.74 (23.89–61.77) to avoid nausea.ConclusionBoth patients and physicians in Spain and Portugal are willing to pay for the health benefits associated with improved diabetes treatment, the most important being to avoid hypoglycemia and gaining weight. Decreased cardiovascular risk and weight reduction became the third most valued attributes for physicians and patients, respectively.