Influence of chronic medical conditions on older patients' willingness to deprescribe medications: a cross-sectional study.

BACKGROUND: Aging correlates with a heightened prevalence of chronic diseases, resulting in multimorbidity affecting 60% of those aged 65 or older. Multimorbidity often leads to polypharmacy, elevating the risk of potentially inappropriate medication (PIM) use and adverse health outcomes. To address these issues, deprescribing has emerged as a patient-centered approach that considers patients' beliefs and attitudes toward medication and reduces inappropriate polypharmacy in older adults. Our study aims to investigate whether certain chronic medical conditions are associated with older patients' willingness to deprescribe medications. METHODS: A cross-sectional study enrolled 192 community-dwelling individuals aged 65 or older taking at least one regular medication. Data included demographics, clinical characteristics, and responses to the Portuguese revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire. Descriptive statistics characterized participants, while multiple binary logistic regression identified associations between chronic medical conditions and willingness to deprescribe. RESULTS: Among the participants (median age: 72 years, 65.6% female), 91.6% had multimorbidity. The analysis revealed that willingness to deprescribe significantly increased with the presence of gastric disease (adjusted odds ratio [aOR] = 4.123; 95% CI 1.221, 13.915) and age (aOR = 1.121; 95% CI 1.009, 1.246). Conversely, prostatic pathology (aOR = 0.266; 95% CI 0.077, 0.916), higher scores in the rPATD appropriateness factor (aOR = 0.384; 95% CI 0.190, 0.773), and rPATD concerns about stopping factor (aOR = 0.450; 95% CI 0.229, 0.883) diminished patients' willingness to deprescribe. CONCLUSIONS: This study highlights the intricate relationship between older patients' attitudes toward deprescribing and chronic medical conditions. We found that gastric disease was associated with an increased willingness to deprescribe medications, while prostate disease was associated with the opposite effect. Future research should explore how patients with specific diseases or groups of diseases perceive deprescribing of medications general and for specific medications, aiding in the development of targeted interventions.

Health education provided by nurses to children and young people: parents' assessment.

BACKGROUND: Healthy literacy is a determinant key children/teenager's health and health outcomes. The aim of this study to identify the parents' assessment about Health Education practice to children and teenagers. METHODS: We opted for a descriptive, quantitative and cross-sectional research, with a non-probabilistic convenience sample. The inclusion criteria were: being a parent who uses attending children health appointments in primary health care; being a parent who has a child hospitalized and is accompanying him/her in the pediatric hospital inpatient ward. A questionnaire survey was built with three sections: sample characterization, Health Education practices performed by nurses (5 questions) and a scale that measured Health Education Assessment Scale (HEAS), which contained 48 items and was validated. It was applied from September to December 2018. RESULTS: The survey was filled in by 113 parents. The results showed that 100% (n = 113) of the parents feel comfortable to talk with nurses about children/teenagers health; 79.6% (n = 90) consider that nurses have time availability for the doubts clarification; 61.9% (n = 70) point out that nurses identify child/teenager needs; Healthy eating" (60.2%; n = 68), the "National Vaccination Plan" (53.1%; n = 60) and "Harmful behaviors prevention" (46.9%; n = 53) are the most important topics; 56.6% (n = 64) of the parents, when in doubt, turn first to the pediatrician, and 66.4% (n = 75) considered that this practice was equal important, compared with other nursing interventions. DISCUSSION: This study shows that Health Education provided by nurses is based on the need's identification, with a perspective of involvement and participation, promoting health and conscious changes which reinforces the nurses' position as health educators.

FANTASTIC lifestyle questionnaire from 1983 until 2022: A review.

Background: Studying lifestyles has always been important; quantifying them has become more complex. However, a questionnaire produced in 1983 has shown that its simple form of evaluation can be an added value in understanding lifestyles. Our aim is a systematic review of the scientific literature about the use of the FANTASTIC Lifestyle questionnaire (FLQ). Methods: The reflective systematic literature review on PubMed, Medline, Science Direct, and SCIELO databases with the descriptors "FANTASTIC Lifestyle questionnaire" OR "FANTASTICO questionnaire" OR "FANTASTIC questionnaire" OR "FANTASTIC survey" OR "FANTASTIC checklist". PRISMA criteria reporting of systematic reviews and meta-analyses were applied. The inclusion criteria were the use of FLQ instrument to measure lifestyles, presenting quantitative or qualitative results, and psychometric studies. It excluded other lifestyle instruments, incomplete articles, and non-English, Brazilian, Spanish, and Portuguese language articles. Results: Findings reveal 41 scientific articles included in the study. It analyzed the results and most studies use the instrument to assess all dimensions. However, some studies reported assessing specific dimensions such as nutrition, sleep, stress, tobacco, alcohol, and drugs. The questionnaire has been applied to a wide range of ages and literacy levels. Conclusion: This literature review allowed us to conclude that this questionnaire is still in use today and is applied in several contexts and populations. It is also possible to verify the relevance of its use and to design intervention strategies and programs for a healthy society. It is essential to draw attention to this issue and promote health literacy (HL) on this topic.

Predictors of older patients' willingness to have medications deprescribed: A cross-sectional study.

BACKGROUND: Deprescribing is a complex process requiring a patient-centred approach. One frequently expressed deprescribing barrier is patients' attitudes and beliefs towards deprescribing. This study aimed to identify the predictors of patients' willingness to have medications deprescribed. METHODS: A cross-sectional study was conducted with community-dwelling patients aged ≥65 who are taking at least one regular medication. Data collection included patients' demographic and clinical characteristics and the Portuguese revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire. Descriptive statistics were used to present the patients' characteristics. Multiple binary logistic regression analysis was performed to identify the predictors of the patients' willingness to have medications deprescribed. RESULTS: One hundred ninety-two participants (median age 72 years; 65.6% female) were included. Most (83.33%) were willing to have medications deprescribed, and the predictors were age (adjusted odds ratio [aOR] = 1.136; 95% CI 1.026, 1.258), female sex (aOR = 3.036; 95% CI 1.059, 8.708) and the rPATD concerns about stopping factor (aOR = 0.391; 95% CI 0.203, 0.754). CONCLUSIONS: Most patients were willing to have their medications deprescribed if it is recommended by their doctors. Older age and female sex increased the odds of willingness to deprescribe; higher concerns about stopping medications decreased the odds. These findings suggest that addressing patients' concerns about stopping their medicines may contribute to deprescribing success.

Insomnia Severity Index: A reliability generalisation meta-analysis.

The aim of the current study was to conduct a reliability generalisation (RG) meta-analysis of Cronbach's alpha for the Insomnia Severity Index (ISI). A systematic search of three databases (PubMed, Scopus, and Web of Science) from inception to 12 March 2021 was performed. Publications that reported Cronbach's alpha for the total ISI score were included. Only psychometric-focussed studies were considered. Meta-analysis was carried out using a random-effects model to derive a pooled estimate of Cronbach's alphas. The number of participants in the included publications ranged from 25 to 12,056, with 33 studies (42 estimates) comprising internal consistency coefficients, and a combined sample size of N = 29,688. The age range of the included publications was from 13.4 to 74.3 years. Data extraction implied 33 publications out of 706 found through the database search. Cronbach's alphas ranged from 0.65 to 0.92. The majority of the reported coefficients were ≥0.7 and presented a low risk of bias (n = 32). The pooled alpha coefficient was 0.83 (IC [0.81-0.85]; SE = 0.009) with high heterogeneity among the included publications (I2  = 97%). Subgroup analyses including moderators such as continent, setting, risk of bias, and age did not affect significantly the overall result. In general, the cumulative estimate of Cronbach's alpha for the ISI is good. However, this finding should be interpreted with caution since there is a high heterogeneity level and some of the studies might not have checked the assumptions underlying Cronbach's alphas.

Perceived cognitive functioning in breast cancer patients treated with chemotherapy compared to matched healthy women: Evidence from a Portuguese study.

AIM: Cognitive concerns are one of the most frequently reported symptoms by breast cancer survivors. This study aimed to evaluate perceived cognitive functioning in Portuguese women with breast cancer treated with chemotherapy. METHODS: A cross-sectional study enrolling 146 women (73 with breast cancer and 73 healthy) was conducted from August to October 2017, invited to participate through online dissemination. Participants completed self-reported questionnaires to collect sociodemographic and clinical data and assess perceived cognitive functioning and psychological adjustment variables (anxiety and depression). RESULTS: Compared to healthy women, women with breast cancer showed significantly lower scores on the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) subscales and higher levels of depression. Both groups showed significant negative correlations between perceived cognitive functioning and anxiety and depression. Health status and depression seem to better explain perceived cognitive functioning, with health status adding significantly more explained variance beyond sociodemographic and psychological adjustment variables. CONCLUSION: The current findings provide evidence for the existence of more cognitive complaints among Portuguese women with breast cancer, compared to healthy individuals. Anxiety, depression, age and education also explain perceived cognitive functioning. Considering that health status and psychological adjustment seem to significantly explain perceived cognitive functioning, special attention should be given by health-care professionals, including nurses, to designing clinical interventions for breast cancer patients to help manage cognitive impairment.

Translation, cross-cultural adaptation and validation of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire to Portuguese: Older adults version.

BACKGROUND: Deprescribing is a patient-centered approach to managing inappropriate polypharmacy that faces several barriers, including patients' attitudes and beliefs about medications that need to be considered. For this purpose, the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire is a helpful instrument, but until now, there is no Portuguese version. OBJECTIVES: To translate and validate the rPATD questionnaire (older adults version) to Portuguese. METHODS: The rPATD questionnaire was translated and cross-culturally adapted using forward-backward translation and pre-testing. A cross-sectional study with 192 older adults aged ≥65 years taking at least 1 regular medication was conducted for validity assessment. Participants were recruited by convenience sampling in 3 Portuguese outpatient rehabilitation medicine clinics. Psychometric properties were evaluated through face and content validity; construct validity, by assessing structural validity through exploratory factor analysis, hypotheses testing, including concurrent validity and cross cultural validity; reliability with internal consistency; and item-total correlation. Floor and ceiling effects were examined. RESULTS: The exploratory factor analysis (EFA) revealed a 4-factor structure that explains 51.08% of the total variance, as in the original rPATD. These 4 factors are related to the level of involvement in medication management, beliefs in the appropriateness of medication, perceived burden of medication, and concerns about stopping medications. Factor loadings ranged from 0.226 to 0.800; 2 items scored <0.3, and no cross-loading was found. The exclusion of the 2 items loading <0.3 in the EFA showed no significant improvement in factor loading or internal consistency, so the item structure was maintained. In hypothesis testing, 78% of the correlations were correctly predicted. The 4 factors internal consistency was generally acceptable, with Cronbach's alpha ranging from 0.638 to 0.830. The item-total correlation ranged between 0.223 and 0.7. CONCLUSION: The Portuguese rPATD questionnaire for older adults presents globally good or acceptable psychometric properties.

Application of the FANTASTIC Lifestyle Questionnaire in the Academic Context.

Studying citizens' lifestyles is extremely important for understanding society and the social conditions of the personal lifestyle. Understanding the lifestyles of university students is especially important because they will be the future citizens and professionals who will shape society's future. The aim of this study was a systematic review of the scientific literature about the use of the FANTASTIC Lifestyle questionnaire in an academic context. The reflective systematic literature review was carried out on PubMed, MEDLINE, Science Direct, and SCIELO databases with the keywords ("FANTASTIC Lifestyle questionnaire" OR "FANTASTICO questionnaire" OR "FANTASTIC questionnaire" OR "FANTASTIC survey" OR "FANTASTIC checklist") AND ("university students"). The PRISMA criteria for reporting systematic reviews and meta-analyses were applied. The inclusion criteria were the use of the "FANTASTIC Lifestyle questionnaire" instrument for measuring lifestyles, the presentation of quantitative or qualitative results, and psychometric studies. The exclusion criteria were no use of FANTASTIC Lifestyle Questionnaire; other population, no quantitative or qualitative analysis, incomplete articles. The 15 scientific articles included in the study were analyzed. This literature review allowed us to conclude the importance and usefulness/actuality of this questionnaire. Furthermore, the importance of diagnosis should be emphasized, as should the development of strategies and intervention programs for the maintenance or creation of healthy societies.

Anxiety and Coping Stress Strategies in Researchers During COVID-19 Pandemic.

The current COVID-19 pandemic has affected the whole world, leading to changes in one's personal and working life. Researchers have undergone extensive changes in their roles, mainly in the area of health care, with research into the virus now the priority. Aim: To assess the anxiety, depression, stress, fears, and coping strategies of Portuguese researchers during the COVID-19 pandemic. Participants and Methods: A total of 243 researchers, with an average age of 37.9 ± 9.6, participated in an online questionnaire. The study was performed between 1 June 2021 and 11 August 2021. The questionnaire included depression, anxiety, and stress (DASS-21), fear of COVID-19 scale (FCV-19S), and coping inventory for stressful situations (CISS). Results: The findings suggest being female and younger seem to be related to more significant fears. Singles and younger researchers showed higher values of stress, depression, and anxiety. Research areas, such as medical and health sciences, presented higher levels in the DASS-21 depression and stress scale (p < 0.05). Also, the results showed a moderate or moderate strong significant positive linear relationship between the scales (p < 0.001): DASS-21 stress, DASS-21 anxiety, and DASS-21 depression (r > 0.70); CISS-21 emotional-oriented with DASS-21 stress (r = 0.683), DASS-21 depression (r = 0.622), and DASS-21 anxiety (r = 0.557); and emotional fear and cognitive fear (r = 0.652). Conclusion: The findings of this study support the growing concern for the psychological well-being of researchers and the need for intervention with more extensive and diverse studies.

Healthcare Services and Formal Caregiver's Psychosocial Risk Factors: An Observational Study.

The prevention and management of chronic disease primarily requires risk reduction measures, through strategic coordination across various government areas. Recognizing that health workers and the public health workforce are integral to building strong and resilient health, the present study analyses the relation between Psychosocial Risk Factors (PRFs, to which formal caregivers are exposed in the healthcare settings), and the work system related elements of the Systems Engineering Initiative for Patient Safety (SEIPS 3.0) framework. An empirical study was carried out, involving 333 formal caregivers of healthcare services. A total of 31 PRFs were assessed (using the COPSOQ III), making it possible to find a relationship between the PRFs analyzed with three elements of the work system, namely Task (5 PRFs), Organizational factors (17 PRFs), and Individual (9 PRFs). The present work contributes not only in terms of outcomes that allow the development of mental illness prevention and mental health promotion actions for healthcare formal caregivers, but also in terms of the relevance that these factors can have on the quality of health services, as well as their users (patients), in line with SEIPS 3.0 model.

Impact of a Virtual Reality-Based Simulation on Empathy and Attitudes Toward Schizophrenia.

Virtual Reality (VR) has been identified as one of the most promising resources for developing empathy towards stigmatized groups as it allows individuals to experience a situation close to reality from another person's perspective. This quasi-experimental study aimed to examine the impact on empathy, knowledge, and attitudes towards people with schizophrenia of a VR simulation that reproduces the experience of psychotic symptoms while performing a cognitive task compared with watching a 2D video and, thus, how these experiences could reduce stigma towards people diagnosed with schizophrenia. The sample comprised of 102 higher education health students, distributed by the experimental and control groups. The impact of the program was measured by completing multiple questionnaires on levels of empathy, attitudes, and mental health knowledge. Both methods (VR and 2D video) were, to a certain extent, effective. However, VR was more effective at eliciting attitudes and knowledge change compared to the control group. These findings suggest that not only VR but also 2D videos could be interesting strategies to enhance empathy and improve attitudes towards people with schizophrenia in higher education health students.

The effects of an educational program based on modeling and social stories on improvements in the social skills of students with autism.

Social communication difficulties are one of the most common issues among individuals with autism spectrum disorder (ASD), as ASD affects their social and academic lives and isolates them from their environment. Several studies that utilized video modeling, video self-modeling, or social stories (or social stories combined with video modeling) have yielded promising outcomes in improving the social skills of individuals with ASD. However, to date, the effects of the combination of all three strategies have not been studied. The current study aimed to examine the effectiveness of an educational program based on multiple strategies, including social stories, animated video modeling, and video self-modeling, to improve the social communication skills of a sample of six high-functioning students with ASD at the Autism Academy of Jordan. A mixed method (quantitative and qualitative) approach was used to examine the impact of the program on the experimental group. The results of the Mann-Whitney test indicated that compared to the monitoring group, all participants in the experimental group achieved significant improvements in the post-test of the Autism Social Skills Profile in both the domains of social reciprocity and social participation skills. Furthermore, the data from teachers' interviews, analyzed using WebQDA software, corroborated the results in terms of significant improvements in students' social skills after the implementation of the educational program. The implications of the study for psychological and educational interventions are addressed, and research suggestions are made to promote the personal and social development of individuals with ASD.

Nurse's Evaluation on Health Education in Portuguese Pediatric Hospitals and Primary Care for Children/Young and Parents.

AIM: This study aimed to analyze the nurse's evaluation of the health education practice to children and parents. METHODS: This is a descriptive and transversal research with a quantitative approach. The selection took place by non-probabilistic convenience sampling, and was developed with nurses on health units for pediatric hospitalization and primary health care in northern Portugal (Trás-os-Montes and Alto Douro Hospital Center, EPE, Northern Regional Health Administration, Northern Local Health Unit, EPE.). Data were collected using a questionnaire with a sample of 311 nurses in the second semester of 2018. RESULTS: 77.5% (n = 241) of nurses perform health education daily; 65% (n = 202) prepare according to the identified needs; the "Identification of children/young and parents' health priorities" was considered to be the most facilitating element (n = 279; 89.7%); the most difficult element was the "Fear of confidentiality breach by the children/young and parents" (74.6%; n = 232); and 65.9% (n = 205) of nurses considered this practice to have equal importance compared to other nursing interventions. It was also found that academic/professional qualifications and the place of professional practice influence the importance that nurses attribute to HE practice. CONCLUSIONS: We can state that there is an appreciation of the binomial child and parents for a better identification of needs, and of the importance attributed to the current legal guidelines (letting themes leading to good health practices be addressed by nurses), which translates into a practice capable of influencing the determinants of health, which promotes health-enhancing behaviors and thus both leads to health gains and reinforces the nurse's position as health-promoting agents.

Towards a Better Understanding of the Factors Associated with Distress in Elderly Cancer Patients: A Systematic Review.

This study presents a systematic review of the sociodemographic, clinical, and psychosocial factors associated with distress in elderly cancer patients. Relevant studies were identified using four electronic databases: PubMed, Scopus, Web of Science and ProQuest. Cross-sectional and longitudinal studies exploring factors associated with distress in people over 60 years of age were included and independently assessed using the Joanna Briggs Institute Critical Assessment Checklists. A total of 20 studies met the inclusion criteria. Research showed that being a woman, being single, divorced or widowed, having low income, having an advanced diagnosis, having functional limitations, having comorbidities, and having little social support were factors consistently associated with emotional distress. Data further showed that the impact of age, cancer type, and cancer treatment on symptoms of anxiety and/or depression in elderly patients is not yet well established. The findings of this review suggest that the emotional distress of elderly cancer patients depends on a myriad of factors that are not exclusive, but coexisting determinants of health. Future research is still needed to better understand risk factors for distress in this patient population, providing the resources for healthcare providers to better meet their needs.

The Portuguese Third Version of the Copenhagen Psychosocial Questionnaire: Preliminary Validation Studies of the Middle Version among Municipal and Healthcare Workers.

A third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) was developed internationally aiming to respond to new trends in working conditions, theoretical concepts, and international experience. This article aims to present the preliminary validation studies for the Portuguese middle version of COPSOQ III. This is an exploratory cross-sectional study viewing the cross-cultural adaption of COPSOQ III to Portugal, ensuring the contents and face validity and performing field-testing in order to reduce the number of items and to obtain insight into the data structure, through classic test theory and item response theory approaches. The qualitative study encompassed 29 participants and the quantitative one 659 participants from municipalities and healthcare settings. Content analysis suggested that minor re-wording could improve the face validity of items, while a reduced version, with 85 items, shows psychometric stability, achieving good internal consistency in all subscales. The COPSOQ III Portuguese middle version proved to be a valid preliminary version for future validation studies with various populations, able to be used in correlational studies with other dimensions.

The Soft Skills Inventory: Developmental procedures and psychometric analysis.

When attending and participating in Higher Education, students face a multitude of personal, social, and work-related challenges, which may increase the risk of developing psychopathological symptomatology. To date, there is no instrument that grasps the non-technical skills that may help prepare students to respond to these challenges. This paper presents the development and psychometric properties of the Soft Skills Inventory (SSI). The inventory was developed based on theoretical and empirical findings on the skills associated with academic and professional success, and on students' perception. The SSI was tested with 2030 Portuguese students (of which 77.1% were female) using a two-stage approach: item calibration and model generation (n = 1033), followed by model validation (n = 997). Item calibration analyses led to retaining 49 items that were organized into six-factors: self-determination, resilience, empathy, assertiveness, social support, and teamwork. This measurement model was further validated and proved to be an invariant, and thus credible, tool to compare male and female students on those relevant skills. All measures attained good internal consistency, with alphas ranging from .76 to .88. Female students scored significantly higher than males on self-determination, empathy, social support and teamwork. On the other hand, male students scored significantly higher on resilience. No significant differences were found between men and women for assertiveness. Psychometric analysis showed that the SSI is a reliable and valid instrument to evaluate students intra and interpersonal skills. The SSI may help identify gaps in soft skills and guide targeted interventions to support a more positive student experience in Higher Education.

The role of fear in the relationship between vicarious violence at work and work ability in nurses: A cross-sectional study.

Fear is a powerful emotion that can influence future behavior. This study investigated how fear influences the relationship between vicarious violence at work and employees' work ability. This is a quantitative cross-sectional study. Self-report data were collected from 154 Portuguese nurses who completed an online survey. Statistical significance of the indirect effect was based on bias-corrected bootstrap confidence intervals. The results support the mediation model. Those who observe/hear of others being beaten or threatened experience strong affective reactions, such as fear, which in turn has a negative impact on the assessment of their work ability. We suggest that occupational safety and health programs designed to prevent violence at work take into account those who experience violence at work vicariously and include strategies and interventions focused on affective reactions to minimize the negative effects of vicarious violence at work, with benefits in employees' improved ability to work.

Educators' Attitudes Towards the Inclusion of Students with Autism Spectrum Disorder (ASD) in Jordanian Public Schools / Atitudes dos Educadores em Relação à Inclusão de Estudantes com Transtorno do Espectro Autista (TEA) nas Escolas Públicas Jordanianas

ABSTRACT: The present study aimed to examine the attitudes of teachers and school professionals towards the inclusion of students with Autism Spectrum Disorder (ASD) in Jordanian schools. Specifically, the study investigates whether the variables of knowledge and training in ASD, educational role, experience in ASD, academic qualification, gender, age, and school level are associated with educators' attitudes towards the inclusion of students with ASD. The descriptive survey method was conducted to examine educators' attitudes and their correlations with the study variables. An electronic survey was completed by 430 participants who were educators at public and private schools in Jordan (including general and special education teachers), school principals, and counselors. The results of the study evidence that Jordanian educators hold neutral attitudes towards the inclusion of students with ASD in Jordanian schools. Further, the study shows that these attitudes are correlated with training and knowledge in ASD. In contrast, educational role, experience, academic qualification, age, gender, or school level are not associated with educators' attitudes. The implications and limitations of the study are discussed.

RESUMO: O presente estudo teve como objetivo examinar as atitudes dos professores e dos profssionais das escolas em relação à inclusão de estudantes com Transtorno do Espectro Autista (TEA) nas escolas jordanianas. Especificamente, o estudo investiga se as variáveis de conhecimento e formação em TEA, papel educacional, experiência em TEA, qualificação acadêmica, gênero, idade e nível de escolaridade estão associados às atitudes dos educadores em relação à inclusão de estudantes com TEA. O método de pesquisa descritiva foi conduzido para examinar as atitudes dos educadores e suas correlações com as variáveis do estudo. Um questionário online foi respondido por 430 participantes que eram educadores em escolas públicas e privadas na Jordânia (incluindo professores de educação regular e especial), diretores de escolas e conselheiros escolares. Os resultados do estudo evidenciam que os educadores jordanianos têm atitudes neutras em relação à inclusão de alunos com TEA nas escolas jordanianas. Além disso, o estudo mostra que essas atitudes estão correlacionadas com a formação e o conhecimento em TEA. Em contraste, o papel educacional, a experiência, a qualificação acadêmica, a idade, o gênero ou o nível de escolaridade não estão associados às atitudes dos educadores. As implicações e as limitações do estudo são discutidas.

Effectiveness of Mobile App-Based Psychological Interventions for College Students: A Systematic Review of the Literature.

Serious mental health disorders are increasing among college students and university counseling services are often overburdened. Mobile applications for mental health have been growing exponentially in the last decade and they are emerging in university settings as a promising tool to promote and intervene in college students' mental health. Additionally, considering the recent covid-19 pandemic, mHealth interventions, due to its nature and possibilities, may play an important role in these institutions. Our main objectives are to explore mhealth interventions in universities, regarding its conceptual framework, acceptability and efficacy outcomes and understand its impact and contributions to address treatment delivery and psychological difficulties resulting from covid-19 pandemic. The literature search was conducted in scientific databases, namely, Web of Science, Pubmed, and Scopus. A search in app stores was not conducted, thus regarding commercially available apps, only those found in our database search were included in our review. We selected studies with mobile applications addressing psychological interventions for college students. A total of 2,158 participants were included in the 8 selected studies and most interventions were delivered through mobile apps only and based in cognitive behavioral therapy. Results suggested that college students accept and adhere to these interventions and preliminary evidence of efficacy was demonstrated in different disorders, such as stress, anxiety, depression and risky behaviors such as alcohol and tobacco abuse and sexual knowledge. We conclude that universities, particularly college counseling services, may benefit from mhealth interventions, not only to address college students' mental health but to decrease some of its difficulties related to lack of human resources. Specifically in covid-19 pandemic context, these interventions may contribute significantly by promoting and delivering psychological interventions at a safe distance.