Percorrer por autor "Vieira, Mariana"
A mostrar 1 - 5 de 5
Resultados por página
Opções de ordenação
- Exploring perspectives on the benefits of a tuberculosis short-treatment regimen: a cross-sectional study on treatment experiences and perceptionsPublication . Silva, Fernando Pereira da; Ramos, João Pedro; Barbosa, Pedro; Vieira, Mariana; Duarte, RaquelNo abstract available.
- Mapping risk and protective factors in tuberculosis-related stigma: a scoping reviewPublication . Vieira, Mariana; Barbosa, Pedro; Ramos, João Pedro; Castro, Marta; Torres, Dulce; Duarte, RaquelDespite global efforts to end tuberculosis (TB), slow declines in incidence and mortality rates persist, partly due to entrenched social and structural challenges. TB-related stigma is a critical barrier to effective TB prevention and treatment. However, existing frameworks often overlook broader structural and intersectional influences, underscoring the need for a comprehensive analysis of the social and structural factors influencing TB-related stigma. We aimed to (1) identify risk and protective factors influencing TB-related stigma and (2) examine how cultural, social, and economic determinants shape stigma experiences among people with TB. A systematic search was conducted across PubMed, SCOPUS, Web of Science, APA PsycInfo, and Sociology Source Ultimate. Studies were included if they (a) involved human participants, (b) were published in the last decade, and (c) reported stigma experiences influenced by social, economic, or environmental determinants. A total of 43 studies were included. Key determinants associated with higher TB-related stigma included lower educational attainment, rural residency, low income, gender, and specific mental health conditions. Cultural perceptions of TB, healthcare system interactions, and the dual stigma associated with HIV co-infection significantly exacerbated TB-related stigma experiences. Factors such as social support, patient-provider communication, and prior TB experience emerged as protective against stigma. Findings underscore TB-related stigma's complex intersection with social and structural determinants, highlighting gaps research, especially concerning standardised conceptual definitions and measurements. Addressing stigma is essential for improving TB care-seeking behaviours and health outcomes, particularly in low-resource settings where TB-related social isolation and discrimination are prevalent.
- Patient-reported outcomes in tuberculosis: a qualitative exploration of psychosocial, economic, and treatment-related challengesPublication . Viegas, Pedro; Ferreira, Luís L.; Vieira, Mariana; Barbosa, Pedro; Ramos, João P.; Duarte, RaquelObjective: Personal experiences, perceptions, and views of patients are crucial in understanding the subjective impacts of diseases. The complexity and duration of tuberculosis treatment impose significant physical, emotional, social, and economic burdens, highlighting the need for person-centered, integrated care strategies that address stigma, fatigue, and accessibility to support well-being. Patient-reported outcomes (PROs) are essential for capturing patient perspectives and improving health care strategies. In this study we explored the multifaceted experiences of patients with tuberculosis, seeking to understand their values and priorities during treatment. Methods:Semistructured interviews with adult tuberculosis patients were conducted at a referral center for tuberculosis diagnosis and management in northern Portugal. After verbatim transcription and anonymization, thematic analysis was performed. Results: Seventeen interviews were conducted. Most (58.8%) of the study participants were male, and most had pulmonary tuberculosis. Our thematic analysis identified five PROs: treatment experiences; health-related quality of life; functional status; symptoms and symptom burden; and health behaviors. People with tuberculosis acknowledged the impact of multiple factors on their overall health, particularly the psychological and physical burdens of tuberculosis and its treatment. Several areas for improvement and opportunities for enhanced support were identified, particularly in communication, emotional support, and management of treatment burden. Conclusions: Our findings highlight the need for tailored PRO measures (PROMs) addressing treatment burden, psychosocial distress, and functional limitations in tuberculosis care. Enhancing communication, psychological support, and multidisciplinary approaches in tuberculosis management could improve patient outcomes and overall well-being. Addressing tuberculosis-related stigma and providing targeted interventions may contribute to a more people-centered approach to care.
- Perceptions and experiences of directly observed treatment in tuberculosis: insights from a mixed-methods cross-sectional studyPublication . Amorim, Diana; Ramos, João Pedro; Barbosa, Pedro; Vieira, Mariana; Duarte, RaquelObjective: The demanding nature and psychosocial burdens of directly observed treatment (DOT) have opened a path to alternative strategies such as video-observed therapy (VOT), which offers comparable treatment outcomes and patient satisfaction while potentially saving time and reducing costs. The objective of this study was to evaluate the perceptions and experiences of patients and health care professionals regarding DOT and other treatment strategies implemented in Portugal. Methods: Patients with a confirmed diagnosis of tuberculosis, treated at the Vila Nova de Gaia Outpatient Tuberculosis Centre in the last two years, were asked to complete a brief questionnaire, as were health care professionals working in the northern region of Portugal. Differences were analysed with chi-square tests, complemented by thematic analysis. Results: A total of 62 individuals completed the questionnaire: 29 health care professionals and 33 patients. There were significant differences between the two groups in their views regarding the impact of DOT on treatment outcomes, with health care professionals perceiving a higher degree of negative effects and patients expressing greater satisfaction. Long travel distances, transportation issues and high costs were some of the challenges mentioned by the patients. Significant differences were also found regarding the role DOT plays in ensuring treatment adherence, with patients emphasising personal responsibility and its importance in preventing loss to follow-up and strengthening relationships with health care professionals. Dose dispensing was favoured for its convenience in specific situations, and VOT was generally preferred to reduce constant travelling. Both parties raised some concerns. Conclusions: Existing discrepancies suggest a misalignment between patient experiences and health care provider perceptions, underscoring the need for enhanced communication and a more nuanced understanding of patient perspectives when designing and implementing different tuberculosis treatment adherence strategies.
- Update in tuberculosis treatment: a scoping review of current practicesPublication . Lopes, Sofia R.; Marçal, Mariana; Fernandes, Nicole; Silva, Filipa; Barbosa, Pedro; Vieira, Mariana; Ramos, João Pedro; Duarte, RaquelBackground: Tuberculosis (TB) remains a significant global health challenge despite ongoing control efforts, particularly in the context of drug-resistant TB (DR-TB), where treatment success rates remain low, underscoring the need for new therapeutic options. This review synthesises current evidence, since the publication of the World Health Organization guidelines in 2022, on the safety and efficacy of existing and new regimens for drug-susceptible TB (DS-TB) and DR-TB in adults and children. Methods: A comprehensive search was performed across three databases for studies published between January 2022 and February 2024, focusing on current and new TB treatment regimens. Additional backward and forward citation searches were conducted to identify relevant literature. Results: 35 studies were included, evaluating the efficacy, safety and economic impact of new oral regimens for DS-TB and DR-TB. Regimens based on bedaquiline or delamanid demonstrated high success rates and good tolerability. The BPaLM (bedaquiline, pretomanid, linezolid and moxifloxacin) regimen was more effective and safer than the standard care, while shorter DR-TB regimens reduced costs and increased success rates. However, shorter regimens for DS-TB were associated with increased drug costs. Though limited, paediatric studies suggest that shorter, safer regimens may benefit children. Conclusion: Evidence supports the adoption of shorter treatment regimens for both DR-TB and DS-TB to improve safety, effectiveness and cost-effectiveness, particularly in resource-limited settings.