Adherence to Antihypertensive Therapy and Its Determinants: A Systematic Review.

Hypertension is a globally prevalent condition, and low adherence to antihypertensive therapy is considered one of the main causes of poor blood pressure (BP) control. Non-adherence to antihypertensive treatment is a complex issue that can arise from various factors; however, gaining an understanding of this provides key targets for intervention strategies. This study aimed to provide an overview of the current status and recent developments regarding our understanding of the determinants of patients' adherence to antihypertensives. A systematic review was performed using the electronic databases MEDLINE/PubMed, Web of Science, Scientific Electronic Library Online (SciELO), and "Índex das Revistas Médicas Portuguesas", which included studies published between 2017 and 2021 following the PICOS model: (P) Adult patients with the diagnosis of primary hypertension, using at least one antihypertensive agent; (I) all interventions on both pharmacological and non-pharmacological level; (C) patient's adherence against their non-adherence; (O) changes in adherence to the therapeutic plan; and (S) any study design (except review articles) written in English, French, Spanish or Portuguese. Articles were reviewed by two researchers and their quality was assessed. Subsequently, determinants were classified according to their consistent or inconsistent association with adherence or non-adherence. Only 45 of the 635 reports identified met the inclusion criteria. Adherence was consistently associated with patient satisfaction with communication, patient-provider relationship, their treatment, and use of eHealth and mHealth strategies; a patient's mental and physical health, including depression, cognitive impairment, frailty, and disability, previous hospitalization, occurrence of vital events; drug treatment type and appearance; and unwillingness due to health literacy, self-efficacy, and both implicit and explicit attitudes towards treatment. There were discrepancies regarding the association of other factors to adherence, but these inconsistent factors should also be taken into account. In conclusion, the barriers to adherence are varied and often interconnected between socioeconomic, patient, therapy, condition, and healthcare system levels. Healthcare teams should invest in studying patients' non-adherence motives and tailoring interventions to individual levels, by using a multifaceted approach to assess adherence. Further research is needed to analyze the impact of implicit attitudes, the use of new technological approaches, and the influence of factors that are inconsistently associated with non-adherence, to understand their potential in implementing adherence strategies.

The longitudinal effect of the quality of participation experiences in a voluntary organization on youth psychological empowerment.

Research shows its limitations by not capturing the specificities of individual experiences, which result either from the participation of or interaction among different people in a given context across time. This study explores the effect that the quality of youth participation experiences in a Portuguese voluntary organization can have on the development of their psychological empowerment (PE). This study adopted a longitudinal, quantitative design where the same cohort of 481 participants (62.4% female; Mage = 17.26 years) was followed across three time points. Latent growth curve modeling was performed to examine the effect of the quality of participation experiences (QPE) on the developmental trajectories of PE components. Findings show that the QPE had the most powerful effect on developmental trajectories in PE. The study shows how youth perceptions of opportunities for reflection and action in interaction in a climate of openness to dialogue and the emergence of different ways of thinking and doing affect their PE.

Psicologia Política em Portugal: a importância de cruzar fronteiras / Psicología Política en Portugal: la importancia de cruzar fronteras / Political Psychology in Portugal: the importance of cross border

Neste artigo assumimos uma conceção ampla da psicologia política que reconhece o seu pluralismo disciplinar, teórico e metodológico. Os contributos analisados provêm de diversas áreas das ciências sociais, ora porque assumem a interface entre a psicologia e a política, ora porque reconhecem o papel do poder, da participação e da opressão nos processos de produção de marginalização, empoderamento e transformação social. As investigações são apresentadas em torno de quatro temas principais: (i) ideologia, valores e atitudes; (ii) cultura cívica, capital social e comportamento eleitoral; (iii) o poder como produtor de realidades sociais e espaços de marginalidade, e (iv) participação cívica e política, empoderamento e transformação social. Apesar de a institucionalização e disseminação da Psicologia Política em Portugal ser ainda moderada, são várias as investigações que enfatizam a saliência da relação entre a psicologia e a política, incluindo os fatores que predizem e medeiam o impacto a/da participação cívica e política...

In this paper we assume a broad conception of political psychological that recognizes its disciplinary, theoretical and methodological pluralism. As a result, we review research from diverse disciplines in the social sciences that either focus on the relationship between psychology and politics or emphasize the role of power, participation and oppression in the production of marginalization, empowerment and social change. The studies presented here are organized into four main topics: (i) ideology, values e attitudes; (ii) civic culture, social capital and electoral behavior; (iii) power, social relationships and deviant territories; and (iv) civic and political participation, empowerment and social change. Even if the institutionalization and dissemination of political psychology in Portugal is recent, research appears to recognize the need for a deeper understanding of the relationship between psychology and politics, including the factors that predict and mediate the impact of civic and political participation...

En este artículo asumimos una compreensión amplia de psicología política que reconocce su pluralismo disciplinar, teórico y metodológico. Los contributos analizados provienen de diversas áreas de las ciencias sociales, ora porque asumen la interface entre la psicología y la política, ora porque reconocen el papel del poder, de la participación y de la opresión en los procesos de producción de marginalización, empoderamiento y transformación social. Las investigaciones son presentadas en torno de cuatro temas principales: (i) ideología, valores y atitudes; (ii) cultura cívica, capital social y comportamiento electoral; (iii) el poder como productor de realidades sociales y espacios de marginalidad, y (iv) participación cívica y política, empoderamiento y transformación social. Aunque la institucionalización y diseminación de la Psicología Política en Portugal sea todavía moderada, son varias las investigaciones que enfatizan la saliencia de la relación entre la psicología y la política, incluyendo los factores que predicen y median el impacto a la/de la participación cívica y política...

The developmental quality of participation experiences: beyond the rhetoric that "participation is always good!".

A powerful rhetoric regarding the importance of adolescents' civic engagement and political participation is common in contemporary societies, whilst citizens, both adolescent and adults, seem to express a growing scepticism and alienation regarding politics. Even if this disengagement is debatable, as there are simultaneous signs of an increasing involvement in a variety of emerging and broadly-defined civic and political activities, we argue that the benefits of these experiences should be scrutinized using psychological evidence-based criteria. We rest on classical contributions from developmental psychology, educational theory and political science to define criteria that could inform the quality of participation experiences, and then present two studies that explore its adequacy. Study 1 is a cross-sectional study that observes that higher quality civic and political experiences are connected with more complex modes of thinking about politics. In Study 2, a two-wave longitudinal design, the quality of participation experiences is a significant predictor of change patterns of political attitudes; moreover, results support the argument that participation is not good in itself and that some experiences, with lesser developmental quality, might have a detrimental effect on adolescents' political development.