Disentangling the Relationship between Sensory Processing, Alexithymia, and Broad Autism Spectrum: A Study in Parents of Children with Autism Spectrum Disorder and Sensory Processing Disorder
Multidimensional Impact of Cancer Risk Assessment--Brazilian Portuguese Version
P.0348 Sensory processing patterns and autistic and alexithymic traits among parents of children with autism spectrum disorder and sensory processing disorder
Transsexualism refers to the conviction of belonging to one sex in individuals born with normal s... more Transsexualism refers to the conviction of belonging to one sex in individuals born with normal sexual characteristics of the other biological sex. The hormonal-surgical treatment of this population has proliferated throughout the past decades and is recent in Portugal. The irreversibility of the sex-reassignment surgery and the lack of knowledge still surrounding transsexualism raises questions that require research in this area. This paper describes a rare-case occurrence of two transsexual brothers who received hormonal-surgical treatment. The evaluation of the treatment is generally very positive, both from the medical and the subjects' points of view. It is only partially positive in terms of personal and social life in the new sex (e.g., reported sensations, humour, social acceptance and success). The individuals' profiles correspond to potentially positive prognostics, and the results suggest that this treatment may have been adequate for these two cases. Future follow-up studies are nevertheless necessary.
Genetic testing for pheochromocytoma and paraganglioma: <i>SDHx</i> carriers’ experiences
Journal of Genetic Counseling, Feb 18, 2021
Pheochromocytoma and paraganglioma are frequently hereditary tumors commonly associated with succ... more Pheochromocytoma and paraganglioma are frequently hereditary tumors commonly associated with succinate dehydrogenase (SDHx) pathogenic variants (PV). Genetic testing is recommended to relatives of patients carrying SDHx PV. This study aims to explore the experiences associated with genetic testing for this hereditary condition. Semi‐structured interviews with 38 SDHx PV (tumor‐affected and non‐affected) carriers were transcribed and content‐analyzed. Four ways of living with this genetic alteration emerged from the interviews: ‘living as if not knowing’, ‘preventing others from going through this’, ‘feeling privileged’, and ‘still suffering’. Within each, negative, neutral, and positive reactions to the actual test result emerged initially, in addition to blame and guilt. Recognition of the importance of the genetic test and of the follow‐up occurred in all four, but views on fecundity were divided between having and not having children. Consideration for the four different meanings of carrying an SDHx PV can improve participants’ experiences and clinical practice.
Genital reconstruction surgery and hormonal treatment for transsexuals are performed in health ca... more Genital reconstruction surgery and hormonal treatment for transsexuals are performed in health care services following a long and complex evaluation process generally based on the guidelines proposed by the World Professional Association for Transgender Health. Though important to ensure these individuals' health and well-being, such procedures may conflict with their reality, raising obstacles not only for the candidates but also for professionals who deal with them. The reality of this population has been the focus of recent studies, whose results are to be considered in the new version (the seventh) of the procedures, currently under elaboration. In Portugal, the experience transsexuals have of their transition process, and of that process within health care services is still unknown. Yet, integrating that experience with these guidelines may contribute to better adapting procedures to their target population, decreasing obstacles facing the parties involved and improving available services. Seeking to bridge this gap and to contribute to the increased integration of population's needs and professionals' procedures, the current work examines transsexuals' experiences of their transition process, highlighting aspects that constitute difficulties to it or else facilitate it. The study is based on in-depth interviews with biological male transsexuals who request hormonal and surgical interventions to acquire a female physiology. Data were content-analyzed in the software program NUD*IST. The analysis reveals several themes associated with positive experiences in the sample's transition process (e.g., presence and accessibility of services dealing with this issue, presence of guidelines, setting the surgery date), negative experiences (e.g., process duration and uncertainties, professional treatment received), and experiences which cut across both (e.g., quality and variety of available services), as well as some paradoxes. In general, the interviewees defend the existence of non-rigid guidelines used in transgender evaluation, as well as flexibility in the treatment offered by professionals, based on knowledge and respect for each case and on updated information on this domain. Some procedures that may contribute to a more effective handling of the transition process are outlined based on identified themes. The articulation of diverse contexts and services (medical, legal, professional) is necessary for the improved success of the transition.
Avaliação dos efeitos no domínio da formação prática
Teaching doctor-patient communication - a proposal in practice
Acta Médica Portuguesa, May 1, 2010
Traditionally, doctor-patient communication was considered a matter of <<art>> and <<vocation>>, ... more Traditionally, doctor-patient communication was considered a matter of <<art>> and <<vocation>>, and a topic for informal learning. Recently, studies have shown the importance of communication skills in medical practice. Doctor-patient communication skills, such as knowing how to listen, how to observe, and how to inform are today considered important components of Medical Education, although they are often difficult to integrate in Medical Curricula. In the current work, the authors describe the program of Communication in the Doctor-Patient Relationship, initiated in 2001 in the Medical School of the University of Porto, part of its undergraduate program. Future studies will allow us to assess the effectiveness of the learning and application of these skills in clinical practice.
Pheochromocytoma and paraganglioma genetic testing: Psychological impact
Health Psychology, Oct 1, 2020
OBJECTIVE Genetic testing is recommended for all pheochromocytoma/paraganglioma tumor-affected pa... more OBJECTIVE Genetic testing is recommended for all pheochromocytoma/paraganglioma tumor-affected patients and, if positive, for their relatives, who are at risk of developing tumors. This study aims to assess the previously unexamined psychological impact of genetic testing and identify factors associated with this impact. METHOD A nationwide sample of 103 individuals carrying succinate dehydrogenase mutations answered the Multidimensional Impact of Cancer Risk Assessment (MICRA) questionnaire plus two measures of general well-being (the SF-36 Health Survey and the Hospital Anxiety and Depression scale). Sociodemographic, clinical, and personality characteristics (the 5 personality factors and locus of control) were also assessed. Data were analyzed with bivariate and GLM univariate analyses. RESULTS Genetic testing-related mean scores were 6.12 for Distress, 11.58 for Uncertainty, 10.61 for Positive experiences, and almost 30% of the sample displayed high MICRA global suffering. Tumor-affected participants whose neoplasia was identified through presymptomatic screening felt that the genetic test has made it easier to cope with their disease. Significant aspects associated with genetic-testing-related Distress and Uncertainty included higher levels of Neuroticism and Agreeableness. An interaction between having the neoplasia and having children was also associated with higher levels of Distress. Education and Conscientiousness were associated with Positive experiences. Affected mutation carriers presented lower global quality of life and higher anxiety and depression levels than healthy mutation carriers. CONCLUSIONS Genetic testing's impact depends on individual characteristics. The identified characteristics can inform clinical practice regarding who might benefit from special care in genetic counseling. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Preoperative anxiety in ambulatory surgery: The impact of an empathic patient-centered approach on psychological and clinical outcomes
Patient Education and Counseling, May 1, 2016
This study aims to evaluate the influence of an empathic patient-centered approach on preoperativ... more This study aims to evaluate the influence of an empathic patient-centered approach on preoperative anxiety and surgical outcomes in ambulatory surgery patients. A sample of 104 patients undergoing general ambulatory surgery was randomly assigned to the intervention (IG) and the control (CG) groups. Before surgery, the IG received personalized information through an empathic patient-centered interview. The CG received standardized information on surgical procedures. Anxiety was assessed before and after the preoperative interview and after the surgery. Wound healing, post-surgical recovery and satisfaction with the quality of preoperative information were assessed after the surgery. The two groups were identical at baseline regarding anxiety, socio-demographic and clinical characteristics. After the patient-centered intervention, the IG showed lower levels of preoperative anxiety (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and pain (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), better surgery recovery (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) and higher levels of daily activity (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and of satisfaction with the information received (p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01) than the CG. The IG also showed better wound healing (tissue type, p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01; local pain, p&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.01). An empathic patient-centered intervention can reduce preoperative anxiety and increase surgical recovery, wound healing and patient satisfaction. This approach is applicable in pre-surgical interviews and can potentially be used in the routine care of various surgical contexts.
Two Siblings Concordant for Male-to-Female Transsexualism: A Case Report
International Journal of Transgenderism, May 7, 2010
This report presents two male-to-female transsexuals from a family that comprises, in addition, s... more This report presents two male-to-female transsexuals from a family that comprises, in addition, seven nontranssexual and nonhomosexual older siblings. Information was gathered mainly through in-depth interviews and hospital records. Similarities and differences between the two cases are explored within the family context, and some emergent mechanisms for transsexualism are outlined. The reported cases fit the hypothesis that prenatal conditions, such
Transsexualidade: vivência do processo de transição no contexto dos serviços de saúde
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2010
A cirurgia de reconstrucao genital e o tratamento hormonal para transsexuais faz-se nos servicos ... more A cirurgia de reconstrucao genital e o tratamento hormonal para transsexuais faz-se nos servicos de saude mediante um longo e complexo processo de avaliacao geralmente baseado nas linhas orientadoras propostas pela World Professional Association for Transgender Health. Ainda que importantes para assegurar a saude e o bem-estar destes individuos, tais procedimentos podem entrar em conflito com a realidade da populacao a qual se destinam, sendo limitativos para a mesma e para os profissionais que procuram aplicalos. So recentemente comecou a realidade desta populacao a ser foco de estudo sistematico, estando os dados dessa investigacao a ser integrados na nova versao (a setima) dos procedimentos, actualmente em elaboracao. Em Portugal, e ainda pouco conhecida a experiencia que individuos transsexuais tem do seu processo de transicao e desse processo nos servicos de saude. Contudo, a articulacao desta experiencia com as linhas orientadoras a seguir pode contribuir para um maior ajustamento dos procedimentos a populacaoalvo, com consequente diminuicao de obstaculos a ultrapassar pelas partes envolvidas e melhoria dos servicos prestados. Colmatando esta lacuna e procurando contribuir para uma maior conjugacao entre necessidades da populacao-alvo e procedimentos profissionais, o presente trabalho debruca-se sobre a experiencia de transsexuais neste seu processo de transicao, salientando aspectos que se constituem como dificuldades e os que o facilitam. O estudo baseia-se em entrevistas aprofundadas a transsexuais de sexo biologico masculino que requereram intervencao hormono-cirurgica para adquirirem aparencia feminina. Os dados foram examinados com recurso a tecnica da analise de conteudo no programa NUD*IST. A analise revela varios temas associados a experiencias positivas no processo de transicao desta amostra (e.g., existencia e acessibilidade de servicos dirigidos a esta problematica, de linhas orientadoras a seguir, marcacao da cirurgia), negativas (e.g., duracao e incertezas do processo, tratamento profissional recebido) e transversais as duas (e.g., qualidade e variedade de servicos), bem como alguns paradoxos. Em geral, destaca-se a defesa de linhas orientadoras nao rigidas a seguir nos procedimentos de avaliacao de populacao transgenero e flexibilidade tambem por parte dos profissionais nos tratamentos, baseada no conhecimento e respeito por cada caso e em informacao actualizada sobre esta problematica. A partir dos temas identificados, sistematizam-se alguns procedimentos que podem contribuir para uma gestao mais eficaz do processo de transicao, beneficiando profissionais e populacao. Fica tambem reforcada a necessidade de conjugacao de contextos e servicos variados (medicos, legais, laborais) para um maior sucesso da transicao.
The goal of this work was to examine whether elevated iodine intake was associated with adverse e... more The goal of this work was to examine whether elevated iodine intake was associated with adverse effects on IQ among school-age children in Portugal. In a representative sample of children from the north of the country, IQ percentiles by age (assessed with Raven’s Colored Progressive Matrices) were dichotomized to <50 (“below-average” IQs) and ≥50. Morning urine iodine concentrations, corrected for creatinine, were dichotomized to <250 µg/g and ≥250 µg/g, according to the European Commission/Scientific Committee on Food’s tolerable upper level of daily iodine intake for young children. Data were examined with Chi-square tests, logistic regression, and GLM univariate analysis. The sample (N = 1965) was classified as generally iodine-adequate (median urinary iodine concentration = 129 µg/L; median iodine-to-creatinine ratio = 126 µg/g) according to the WHO’s criteria. A greater proportion of children in the ≥250 µg/g group had below-average IQs, compared to children with less tha...
Communication in health has attracted increasing interest in recent decades, revealing the need f... more Communication in health has attracted increasing interest in recent decades, revealing the need for appropriate research tools. The study of the psychometric properties of instruments and the confirmation of their structure is crucial for the reliability and validity of the overall results of scientific work. Repeated analyses of these dimensions over time are important because it allows us to identify changes that result from social and cultural changes. This study aims to assess the reliability, factor structure, and construct validity of the Communication Skills Attitudes Scale.info:eu-repo/semantics/publishedVersio
Uploads
Papers by Irene Carvalho