Health literacy, a more complex concept than knowledge, is a required capacity to obtain, understand, integrate and act on health information [1], in order to enhance individual and community health, which is defined by different levels, according to the autonomy and personal capacitation in decision making [2]. Medium levels of Health literacy in an adolescent population were found in a study conducted in 2013/2014, being higher in sexual and reproductive health and lower in substance use. It was also noticed that the higher levels of health literacy were in the area adolescents refer to have receipt more health information. The health literacy competence with higher scores was communication skills, and the lower scores were in the capacity to analyze factors that influence health. Higher levels were also found in younger teenagers, but in a higher school level, confirming the importance of health education in these age and development stage. Adolescents seek more information in health professionals and parents, being friends more valued as a source information in older adolescents, which enhance the importance of peer education mainly in older adolescents [3]. As a set of competences based on knowledge, health literacy should be developed through education interventions, encompassing the cultural and social context of individuals, since the society, culture and education system where the individual is inserted can define the way the development and enforcement of the health literacy competences [4]. The valued sources of information should be taken into account, as well as needs of information in some topics referred by adolescents in an efficient health education. Schizophrenia is a serious and chronic mental illness which has a profound effect on the health and well-being related with the well-known nature of psychotic symptoms. The exercise has the potential to improve the life of people with schizophrenia improving physical health and alleviating psychiatric symptoms. However, most people with schizophrenia remains sedentary and lack of access to exercise programs are barriers to achieve health benefits. The aim of this study is to evaluate the effect of exercise on I) the type of intervention in mental health, II) in salivary levels of alpha-amylase and cortisol and serum levels of S100B and BDNF, and on III) the quality of life and selfperception of the physical domain of people with schizophrenia. The sample consisted of 31 females in long-term institutions in the Casa de Saúde Rainha Santa Isabel, with age between 25 and 63, and with diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). Physical fitness was assessed by the six-minute walk distance test (6MWD). Biological variables were determined by ELISA (Enzyme-Linked Immunosorbent Assay). Psychological variables were assessed using SF-36, PSPP-SCV, RSES and SWLS tests. Walking exercise has a positive impact on physical fitness (6MWD -p = 0.001) and physical components of the psychological test...
Background: Older adults experience physical and psychological declines affecting independency. Adapted and structured combined interventions composed of cognitive stimulation and physical exercise contribute to comorbidities’ reduction. Methods: Multicenter single-blinded two-arm cluster randomized controlled trial conducted to assess effectiveness of a combined intervention (CI), composed of a cognitive stimulation program (CSP) and a physical exercise program (PEP), on psychological and physical capacities of frail older adults as to on their activities of daily living. Were recruited 50 subjects from two elderly end-user organizations. Of these, 44 (65.9% females, mean age of 80.5 ± 8.47 years) were considered eligible, being randomly allocated in experimental (EG) or control group (CG). Data collected at baseline and post-intervention. EG received CI three times a week during 12 weeks. CG received standard care. Non-parametric measures were considered. Results: At baseline, groups were equivalent for study outcomes. The comparison of pre- and post-intervention data revealed that subjects receiving CI reduced depressive symptomatology and risk of fall based on gait and balance, and improved gait speed. Simultaneously, in the CG a significant decline on activities of daily living was observed. Significant results were found among biomechanical parameters of gait (BPG). EG’ effect size revealed to be small (0.2 ≤ r < 0.5). CG’ effect size was also small; but for activities of daily living there was an evident decrease. Conclusion: The CI is effective on managing older adults’ psychological and physical capacities.
Therapeutic communities emerged to respond to individuals with substance use disorders. The studies carried out emphasize the importance of the Occupational Therapist in the process of constructing occupational meaning. However, there is a paucity of studies addressing the relevance of this profession in this specific context. To understand the intervention of Occupational Therapy in the Therapeutic Community "Clínica do Outeiro -Portugal", describing the perception of individuals with substance use disorders, Occupational Therapists and other team members. Descriptive-exploratory study with a qualitative approach, by means of a case study research. We used interviews with clients and Occupational Therapists and focus group with the multidisciplinary team to collect data. Occupational Therapy is characterized by the greater proximity it establishes with users, as well as by the dynamism, creativity and motivation it infuses, playing a preponderant role in the (re) structuring of routines, performance of ADL and IADL, leisure and social participation of individuals with substance use disorders. The OT emerges as essential in this community, as a professional who is dedicated to the work of adapting and including the individual in the therapeutic community through the acquisition of the necessary occupational performance skills essential for everyday life in society.
Qualitative research in the area of health: the whys and whereforesResearchers in the area of health, in which the hegemony of clinical trials prevails, still look askance upon the idiosyncrasies of qualitative research. The uncertainty regarding what qualitative research really is, and what its contribution to this area represents, still persists. It is often said "One cannot generalize," "It lacks substance," "Few individuals are studied" and, even disparagingly, "This is very subjective." These criticisms have contributed to the evolution of qualitative research and highlight the rigor behind well-conducted studies. Although statistical generalization has not been established, there has been a marked focus on internal validity that measures the specificities of the group/phenomenon/case studied. The contributions to the construction of knowledge are undeniable, since what is eventually lost in scope is gained in depth and understanding. The detailed description of phenomena and their subsequent deconstruction and reconstruction, enhance the mobilization and critical transferability of knowledge, thereby enabling analytical generalization.The inseparability of the phenomena from their context underpin qualitative research, as it is impossible to discern opinions, perceptions and the significance of individuals by silencing the context. It is the contextualized specification that makes it possible to aspire to higher levels of understanding.After this "eye-opener" on qualitative research, the question arises: Why conduct qualitative research in the area of health? The answer is that qualitative methods have much to offer to those who study the health services. Firstly, the growing credibility of mixed studies today will gradually break down the quantitative-qualitative dichotomy, either by using qualitative investigation as exploratory for the quantitative research or, conversely, by clarifying, based on questionnaires, opinions and behavior in the natural environment in which the phenomenon studied occurred.Secondly, because qualitative studies focus on people, namely on that which makes them have recourse to the care and personal experiences that have an impact on their health status. The essence of qualitative investigation focuses on the search for significance, to the extent that the phenomena, manifestations, occurrences, facts, events, thoughts, feelings and subjects are all formative aspects of human experience. The meanings that are lasting also become culturally shared and are incorporated as a structuring element of the social group that orbits around these representations and symbolisms.Knowing the significance of the health-illness phenomena can contribute greatly to enhance the quality of the relationship between consumers and healthcare providers; foster greater adherence to health measures individually and collectively; and acquire a more profound understanding of the emotions and behavior of patients, families and health professionals. Undoubtedly, health is of the people, for the people and by...
This is an Open Access article distributed under the terms of the Creative Commons Attribution License BY CC Qualitative research and the transformation of public health The increase of qualitative and mixed studies in health has blurred over the quantitative/qualitative dichotomy, enabling the diversification of methods and techniques. As opposed to traditionalist concepts of research, based on the biomedical model and the post-positivist paradigm, qualitative research translates a meaning and interpretation to the findings that ensure enhanced development of citizens, inserted in their social space, and conceptualizes the real world with a greater susceptibility for transformation. A multidimensional assessment contributes to the development of empirical, aesthetic, personal, ethical and biomechanical knowledge, among others. A more constructivist paradigm has progressively increased the perspective of complementarity and even transdisciplinarity in relation to health phenomena. Science and the diversification of knowledge are crucial for the promotion of individual and public health. The relationship of the human being with health and with health professionals is complex, as it involves a multiplicity of factors that are not always easy to identify and control, which is influenced by and influences the multiple relations, and cannot be dissociated from the individual experience. Ribeiro et al. 1 illustrate this complexity aptly by affirming that the inseparability of the phenomena from their context underlies qualitative research, since it is impossible to discern opinions, perceptions and meanings of individuals by taking them out of context. Furthermore, this qualitative transformation of research results in a better understanding of transitions and adaptation processes in terms of health/illness, promoting the quality of care, literacy and co-responsibility in health management. This transformation encourages the creativity of researchers to respond to the challenges of "transferring" knowledge to the end users (professionals) and to the beneficiaries (recipients of care), ensuring that research is grounded on practical needs. Also at this level, qualitative research can be at the forefront in the dissemination of results, making it possible to reduce the conceptual and pragmatic gap between what is produced and what is used to benefit health. This is done by creating networks of communication and collaboration between researchers, professionals and citizens that enables study and reflection on the best way to place the findings of qualitative research at the service of public health, both from the standpoint of the process (transference) and the content (knowledge). This challenge is compounded by the promotion of qualitative clinical decision-making using the results of qualitative research with information on client preferences, experience, clinical context and resources for decision-making. This issue of RC&SC features articles presented at the 6th Ibero-American Congress on Qualitative Research (www.ci...
Qualitative research: where do we stand now?Minayo highlights the complexity of human experience by stating, based on Kant (1724Kant ( -1804, that "all phenomena have proportions of magnitude (quantitative) and profundity (qualitative) and that their understanding occurs when the synthesis of these two dimensions is made" (Minayo, 2016, p.19). The scientific community increasingly recognizes the importance of integrating the qualitative perspective into research processes in order to produce holistic and useful knowledge about the complexity of human experience. In a pragmatic way, one can see this in the evaluations of research projects that provide access to the experience of the social actors that constitute or are associated with any object of study. Access is valued, as well as the validation and return of data interpretation. The existence of journals that publish qualitative papers, of international congresses that prioritize qualitative approaches, as well as the proliferation of online communities where qualitative research is discussed and reflected, reveal the recognition of the qualitative paradigm as a fundamental way to know, perceive and intervene in any phenomenon. Qualitative research has social concerns and highlights the interests of social actors. It gives a voice to people, to society, often to minority groups, explaining how processes are experienced and the meanings attributed to them. This central premise is increasingly understood as an added benefit, thus advancing beyond the hegemony of the quantitative paradigm in research.In their seminal proposal on how to evaluate qualitative research, Guba and Lincoln (1989) point to the involvement, information devolution and empowerment as key premises to be considered, notably with the criteria of ontological, educational, catalytic and tactical authenticity. One of the main added benefits of this paradigm lies precisely in its potential for change -giving power and competencies to act, through its reflective power over action, feelings and representations. As society demands greater power to intervene in the spaces it occupies and builds, and the exercise of citizenship is claimed, qualitative research emerges as the way to acquire in-depth knowledge of the human experience, as well as to intervene, articulate and enhance the exercise of this citizenship.This issue of Revista Ciência & Saúde Coletiva includes six articles presented at the 5th Ibero-American Congress on Qualitative Research (www.ciaiq.org), subject to reformulation and peer evaluation. The selection aimed at methodological diversity and sought to give voice to various groups of professionals and future professionals in the field of public health, with the international discussion of the objects of study, seeking to contribute to the (still fragile) balance between a world that is globalized and the need to prioritize what is singular and unique. We have selected articles that present several phenomenological and methodological approaches and focus on social actors in the field...
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