BACKGROUND: A patient's knowledge of heart failure (HF) is associated with better outcomes. The more information patients have about their illness, the less likely they are to be readmitted to the hospital. Such knowledge includes the cause, symptoms, probable duration, and expected evolution of the clinical picture. In Portugal, a tool for testing patient knowledge is an unmet need. Therefore, this study aimed to adapt and test the Chronic Heart Failure Knowledge Questionnaire (KQCHF) for the Portuguese context. METHODS: This work includes three cross-sectional studies. In Study 1, subjects were divided between before and after receiving information about HF. In Study 2, participants answered the questionnaire before and after reading the brochure. In Study 3, KQCHF was applied to patients with HF. Studies 1 and 2 were carried out in the general population. Study 3 was carried out with HF outpatients. Convenience sampling was applied to participants in the three studies. RESULTS: In Study 1 (n = 45), those who received information had better scores (9.2 ± 1.9) than those who did not (6.0 ± 2.3). In Study 2 (n = 21), the scores were higher after reading the brochure (10.4 ± 1.7 vs. 6.5 ± 2.9). In Study 3 (n = 169), women had better scores than men (9.1 ± 2.1 vs. 8.3 ± 2.2, overall: 8.5 ± 2.2), and knowledge was correlated with education (r = .340, p < .001) and age (r = -.170, p = .030). CONCLUSION: The Portuguese adaptation of KQCHF captured relevant knowledge about HF and has shown promising results for clinical and research purposes. The questionnaire can be useful in assessing HF patients' knowledge of their disease and as a basis for the implementation of general and personalised educational strategies to improve HF knowledge and, therefore, promote health literacy and self-care.
Health Promotion , Heart Failure , Male , Humans , Female , Portugal , Cross-Sectional Studies , Heart Failure/diagnosis , Heart Failure/therapy , Heart Failure/complications , Surveys and Questionnaires , Self Care , Chronic Disease
BACKGROUND: It has been suggested that children's writing is dependent on transcription and executive functions. However, there is a need for more research examining the relationships among those variables in primary school children, given that most existing studies are cross-sectional and assess transcription and executive functions separately, and there are scarce and mixed longitudinal findings. AIMS: This study used a cross-lagged panel model to explore the relationships among transcription skills, executive functions and text quality from Grade 2 to Grade 3. SAMPLE: The sample included 353 Portuguese children (195 boys, 155 girls) in Grade 2, who were reassessed in Grade 3. METHODS: Children were assessed on transcription, executive functions and writing tasks at two time points. RESULTS: Transcription skills and executive functions in Grade 2 positively predicted the same variables in Grade 3. At Grade 2, transcription skills were associated with executive functions and text quality. At Grade 3, we only found an association between executive functions and text quality. Finally, text quality in Grade 2 predicted transcription skills in Grade 3, but both transcription and executive functions in Grade 2 did not predict text quality in Grade 3. CONCLUSIONS: Transcription skills and executive functions seem to be stable over time, but previous performance on these skills does not seem to predict later text quality. Overall, these findings do put into question the direction of the typically assumed relationships, especially between transcription and text quality. Findings also provide information that can guide the development of instructional programmes in primary school.
Executive Function , Writing , Child , Male , Female , Humans , Cross-Sectional Studies
In the last years, the teaching and learning of literacy has changed due to the development of Information and Communication Technologies (ICT). The use of ICT in the classroom depends largely on teachers, who are the key players in its integration. However, several factors influence teachers' decisions to use ICT in their classroom, both internal (e.g., self-efficacy) and external (e.g., school support). Indeed, despite the potential benefits of using ICT, not all teachers use them in their teaching practice. In the present study, we examined which are the main factors influencing teachers' effective use of ICT in literacy classrooms. A total of 125 teachers lecturing Portuguese Language in grades 5-12 participated in this study (M = 50.00 years, SD = 7.88; 89% women). Teachers filled in an online survey, comprising sociodemographic questions (viz., age, gender, education, years of teaching experience, teaching level, school type, and geographical area) and four questionnaires related to ICT and teaching. Results showed that effective use of ICT was predicted by both internal (ICT' self-efficacy and constructivist conception of teaching) and external (lack of access and support, and gatekeepers) factors. These findings may help in the identification of key targets to facilitate the effective use of ICT in literacy classrooms.
Objectives: Research into the effectiveness of mindfulness-based programs (MBPs) in school settings has grown substantially. However, studies in the field are still scarce, present methodological limitations, and fail to examine how children's characteristics influence MBPs' effects. The twofold aim of this study was to analyze the effectiveness of an MBP on children's attention and emotional regulation, writing performance, and school grades, and to evaluate the moderating role of baseline scores, age, gender, and socioeconomic status. Methods: Fifty-seven third graders received the MBP (n = 28) or a health-based program (n = 29), which is the active control group, for 8 weeks. In each week, both programs were composed of two 30-min sessions delivered by psychologists and three 5-min sessions delivered by teachers. Before and after the implementation of the programs, we assessed teacher-rated children's attention and emotional regulation, performance-based attention networks (alerting, orienting, and conflict monitoring), writing performance (handwriting fluency, spelling, and text quality), and school grades in Portuguese, Mathematics, and Social Studies. Results: Compared to the control group, after the program, the mindfulness group displayed higher teacher-rated attention and emotional regulation, as well as better Portuguese, Mathematics, and Social Studies grades. Emotional regulation and alerting baseline scores as well as age were found to moderate the MBP's effects. Conclusions: These findings provide preliminary evidence on the effectiveness of a MBP on children's behavior and school grades. This means that students may benefit from the integration of mindfulness practices into the educational setting as a complement to the school curriculum.
The importance of perceptions as determinants of people's behavior has been well-established, but little is known about athletes' perceptions of their sport and the links of these perceptions with other correlates. In this study, we compared karate (n = 51) and football (n = 49) athletes' perceived benefits and aggressiveness risks from their sports and examined whether these perceptions predicted athletes' engagement and quality of life (QoL). Participants completed perception measures of karate and football, and engagement and QoL measures. Results showed that karateka perceived more benefits and fewer risks in karate than football, but footballers generally perceived equal benefits and risks in both sports. Both athlete groups perceived similar physical and psychological benefits in their own sport, but deemed physical benefits as prominent outcomes in the other sport. Notably, karateka's perceived benefits about karate predicted engagement directly and QoL indirectly via vigor. Overall, karate athletes' perceptions seemed to be relevant to experiencing fulfillment in training and general well-being.
Objectives: Despite the increasing interest in mindfulness, there are few multifaceted mindfulness measures for children, mainly in Portuguese. Thus, this study developed the Portuguese version of the Comprehensive Inventory of Mindfulness Experiences (CHIME). Because this scale was initially created for adolescents, we also aimed to adapt it to children. Methods: After translating the original CHIME to Portuguese and adapting the wording for children, the instrument was administered to 223 9-10-year-olds, along with self-report measures of affect and quality of life, teacher-rated measures of inhibition, inattention, and emotional lability, and a performance-based attentional measure. We examined CHIME's factorial validity, inspected facets' reliability, and tested convergent, discriminant, and predictive validity. Results: Confirmatory factor analyses (CFA) supported a 7-factor structure of the scale, after removing the accepting and non-judgmental attitude facet. Factor loadings (> .34) and reliability indices (> .54) were acceptable, though the average variance extracted was less than desirable. Correlations with external correlates provided support to CHIME's convergent and divergent validity (rs range .13-.55, ps < .05). Finally, evidence of predictive validity was found with a regression analysis showing that external awareness (b = - .16) and openness to experience (b = - .17) predicted academic achievement. Conclusions: This study provided preliminary validity and reliability evidence on the Portuguese CHIME. This instrument can provide relevant insights about the mindfulness facets and offer useful indications for the development of evidence-based interventions in childhood.
There is evidence for the positive impact of mindfulness in children. However, little is known about the techniques through which mindfulness practice results in differential outcomes. Therefore, this study intended to systematically review the available evidence about the efficacy of meditation techniques used by mindfulness-based programs on cognitive, socio-emotional, and academic skills of children from 6 to 12 years of age. The review was registered on the PROSPERO database, and the literature search was conducted according to PICO criteria and PRISMA guidelines. The EBSCO databases were searched, and 29 studies were eligible: nine randomized controlled trials and 20 quasi-experimental studies. All the included randomized controlled trials were rated as having a high risk of bias. Overall, the evidence for mindfulness techniques improving cognitive and socio-emotional skills was reasonably strong. Specifically, for cognitive skills, results showed that all the interventions used "body-centered meditations" and "mindful observations." Regarding socio-emotional skills, although all the studies applied "body-centered meditations" and "mindful observations," "affect-centered meditations" were also frequent. For academic skills, just one quasi-experimental trial found improvements, thus making it difficult to draw conclusions. Further research is crucial to evaluate the unique effects of different meditation techniques on the cognitive, social-emotional, and academic skills of children. Systematic Review Registration: Identifier: RD42019126767.
Writing is a foundational skill throughout school grades. This study analyzed the development of different levels of written language (word, sentence, and discourse) and explored the relationship between these levels and writing performance. About 95 Portuguese students from two cohorts-Grades 4-7 (n = 47) 6-9 (n = 48)-were asked to produce a descriptive text two times, with a 3-year interval. The produced texts were used to assess spelling, syntactic correctness and complexity, and descriptive discourse as well as text length and quality. The main results showed that there were improvements from Grades 4 to 7 and 6 to 9 in word- and sentence-level skills, along with increases in some dimensions of the descriptive discourse. Moreover, the older cohort performed better than the younger cohort in terms of spelling, syntactic complexity, and text quality, but not in terms of syntactic correctness, one dimension of the descriptive discourse, and text length. Regression analyses showed that writing performance was predicted by word and sentence levels in the younger cohort only, and by discourse-level variables in both cohorts. Overall, despite indicating a generalized growth in writing skills throughout schooling, this study also highlighted the areas that may need additional attention from teachers, mainly in terms of the descriptive features.
Research suggested that developing mindfulness skills in children improves proximal outcomes, such as attention and executive functions, as well as distal outcomes, such as academic achievement. Despite empirical evidence supporting this claim, research on the benefits of mindfulness training in child populations is scarce, with some mixed findings in the field. Here, we aimed to fill in this gap, by examining the effects of a mindfulness training on third graders' proximal and distal outcomes, namely, attention and executive functions (viz., inhibitory control, working memory, and cognitive flexibility) as well as literacy-related achievement (viz., handwriting fluency, text quality, Portuguese grades). These outcomes were measured with behavioral tasks and teacher ratings. Sixty-six Portuguese children were randomly allocated to an experimental group receiving mindfulness training (n = 29) or an active control group receiving relaxation training (n = 37). Both training programs were implemented by psychologists in two 30-min weekly sessions for 8 weeks. All students were assessed before and after the interventions. Three main findings are noteworthy: (a) mindfulness training enhanced teacher-rated cognitive flexibility and a performance-based composite score of executive functions among children with higher pretest scores; (b) relaxation training improved performance-based cognitive flexibility and the composite score of executive functions among children with lower pretest scores; (c) children receiving mindfulness training had higher handwriting fluency and better grades in Portuguese than those receiving relaxation training. These findings provide preliminary evidence on the benefits of mindfulness training in educational settings and highlight the moderating role of baseline performance on those benefits.
There is consensus among researchers that misspellings are something to avoid. However, misspellings also convey relevant information for researchers and educators. The present study is a first effort toward the analysis of misspellings produced by Portuguese children. Specifically, we aimed to examine the association between misspellings in dictation and composing tasks; compare misspellings across grade, type, and task; and test the contribution of different misspellings produced in dictation and in composition to text quality. For that, 933 Portuguese pupils in Grade 2 (n = 297), Grade 4 (n = 302), and Grade 6 (n = 334) performed a spelling-to-dictation task and wrote an opinion essay. Misspellings were categorized into phonetically inaccurate, phonetically accurate, and stress mark errors. Results showed correlations between the same type of misspellings across tasks for phonetically inaccurate errors in Grades 2 and 4, and phonetically accurate errors in Grade 2. Moreover, pupils produced more misspellings in dictation than composing tasks, and there was a progressive decrease in phonetically inaccurate and phonetically accurate misspellings across schooling, though stress mark errors were more frequent in Grade 4 than in other grades. Finally, spelling errors predicted text quality, particularly in younger children. Overall, these findings are aligned with extant results on spelling development and support current voices claiming for fine-grained analyses of misspellings. As they may vary across grade and task, and impact text quality differently, a detailed approach to spelling errors can provide valuable information on the development of this skill.
Research has shown that cognitive flexibility plays a critical role in students' learning and academic achievement. However, the unique contribution of cognitive flexibility to academic achievement across schooling is not fully understood. Thus, this study tested whether cognitive flexibility explained a significant amount of variance in academic achievement (i.e., literacy and mathematics outcomes) across Grades 2, 4, and 6, above and beyond fluid intelligence, inhibitory control, working memory, attention, and planning. The sample included 243 second graders, 284 fourth graders, and 203 sixth graders. For Grades 4 and 6, we found that better performance on the flexibility score was associated with better academic outcomes after controlling for fluid intelligence, attention, inhibitory control, working memory, and planning. This effect was not observed for Grade 2. Our findings showed that cognitive flexibility is a key component for school achievement, particularly for older students.
Academic Success , Executive Function/physiology , Literacy , Mathematics , Memory, Short-Term/physiology , Students/psychology , Adolescent , Child , Child, Preschool , Comprehension , Educational Status , Female , Humans , Intelligence , Male
Little is known about people's perceived benefits and risks of sports, despite their role in shaping people's intentions to engage in them. Here, we developed and tested a scale to measure perceived physical, emotional, cognitive, and social benefits as well as aggression-related risks of karate and football. Additionally, we compared these perceptions within and between these two sports, as well as among undergraduates with current/former participation in different types of physical activity (viz., martial artists, team sports players, participants in other types of physical activity, and non-participants). After a literature review, we created a 5-factor scale with 20 items administered to 184 undergraduates, along with questions about physical activity participation. After removing five items, confirmatory factor analyses supported the factor structure of the scale. Factor loadings and reliability indices were acceptable, though less than desirable results were found concerning the average variance extracted of all benefits dimensions and the reliability of the social benefits dimension. Analyses of variance showed that: (a) physical benefits were seen as the salient outcomes of karate and football, though martial artists perceived karate's physical, emotional, and social benefits to the same extent; (b) in comparison to football, karate was perceived to bring more emotional and cognitive benefits and to entail less aggressiveness risks; (c) karate and football perceptions varied as a function of participant's involvement in physical activity. This study presents a promising instrument to gather information on people's perceptions about karate and football, which can be used to foster people's engagement in them.
Writing is a particularly complex and demanding task that needs to be mastered to assure students' success at school. In the last decades, the scientific community has been unanimous about the involvement of cognitive and motivational processes in the learning of writing. However, little is still known about some motivation-related processes, such as the reasons why students write. Therefore, this study analyzed the role of motivation in writing in developing writers, by examining the motives to write of 321 sixth graders. We used the Writing Motivation Questionnaire, which is a new instrument tapping the following motivations for writing: curiosity, involvement, grades, competition, social recognition, emotional regulation, and relief from boredom. Findings confirmed the multidimensional nature of motivations to write and supported the validity and reliability of the instrument. Also, results revealed that the strongest motives to write were grades and curiosity, and that curiosity and social recognition were significant predictors of writing quality, above and beyond attitudes and self-efficacy. Together these findings confirm the key role of motivation in writing and provide validity evidence of the Writing Motivation Questionnaire. This seems a useful tool to better understand the motivational processes involved in learning to write. However, despite the increasing research investment in this area, it is still important to carry out further studies that may contribute to the enrichment of the field of writing motivation.
Mobile health applications are increasingly numerous and varied. However, despite high expectations and large budgets involved in their development they are often rejected by potential users, and little is known on why this happens. This study aimed to fill this gap by investigating the determinants of technology acceptance and its moderators. Aligned with the Unified Theory of Acceptance and Use of Technology, we examined the moderating roles of age, gender, and smartphone experience in the relationship between technology acceptance determinants (performance expectancy, effort expectancy, social influence, and facilitating conditions) and the intention to use mobile health applications (N = 394, 18-65 years). A stepwise multiple linear regression was conducted. Results showed that the intention to use mobile health applications was determined by performance expectancy moderated by age and smartphone experience, and that the role of the other determinants depended on age and gender (e.g., more intention to use in older men if less effort, and in younger men if better facilitating conditions). These findings show that user characteristics are relevant moderators and should be considered when targeting specific populations to use mobile health applications.
Expert writing involves the interaction among three cognitively demanding processes: planning, translating, and revising. To manage the cognitive load brought on by these processes, writers frequently use strategies. Here, we examined the effects of planning strategies on writing dynamics and final texts. Before writing an argumentative text with the triple-task technique, 63 undergraduates were asked either to elaborate an outline with the argumentative structure embedded (structure-based planning condition), to provide a written list of ideas for the text (list-based planning condition), or to do a non-writing-related filler task (no planning condition). Planning showed no effects on the length of the pre-writing pause and cognitive effort, but influenced writing processes occurrences. Compared to participants in the no-planning condition, those in the planning conditions showed a later activation of revising. Moreover, participants in the structure-based condition were mainly focused on translating in the beginning and middle of composition, whereas their peers tended to distribute their attention among all processes. Planning ahead of writing also resulted in texts with longer words, produced at a higher rate. Only the structure-based planning strategy led to an increase in the number of argumentation elements as well as in essays' persuasiveness and overall quality. There was, however, no indication that these improvements in final texts were associated with changes in the dynamics of writing. Overall, the use of structure-based plans seems to be an effective and efficient way of improving undergraduates' argumentative writing.
Students/psychology , Writing , Attention , Female , Humans , Male , Planning Techniques , Young Adult
The importance of quickly assessing personality traits in many studies prompted the development of brief scales such as the Ten-Item Personality Inventory (TIPI), a measure of five personality traits (extraversion, agreeableness, conscientiousness, emotional stability, and openness). In the current study, we present the Portuguese version of TIPI and examine its psychometric properties, based on a sample of 333 Portuguese adults aged 18 to 65 years. The results revealed reliability coefficients similar to the original version (α = 0.39-0.72), very good 4-week test-retest reliability (n = 81, rs > 0.71), expected factorial structure, high convergent validity with the Big-Five Inventory (rs > 0.60), and correlations with self-esteem, affect, and aggressiveness similar to those found with standard measures of personality traits. Overall, our findings suggest that the Portuguese TIPI is a reliable and valid alternative to longer measures: it offers a promising tool for research contexts in which the available time for personality assessment is highly limited.
Writing proficiency is heavily based on acquisition and development of self-regulation and transcription skills. The present study examined the effects of combining transcription training with a self-regulation intervention (self-regulated strategy development [SRSD]) in Grade 2 (ages 7-8). Forty-three students receiving self-regulation plus transcription (SRSD+TR) intervention were compared with 37 students receiving a self-regulation only (SRSD only) intervention and 39 students receiving the standard language arts curriculum. Compared with control instruction, SRSD instruction-with or without transcription training-resulted in more complex plans; longer, better, and more complete stories; and the effects transferred to story written recall. Transcription training produced an incremental effect on students' composing skills. In particular, the SRSD+TR intervention increased handwriting fluency, spelling accuracy for inconsistent words, planning and story completeness, writing fluency, clause length, and burst length. Compared with the SRSD-only intervention, the SRSD+TR intervention was particularly effective in raising the writing quality of poorer writers. This pattern of findings suggests that students benefit from writing instruction coupling self-regulation and transcription training from very early on. This seems to be a promising instructional approach not only to ameliorate all students' writing ability and prevent future writing problems but also to minimize struggling writers' difficulties and support them in mastering writing.
Remedial Teaching/methods , Self-Control , Writing , Child , Female , Handwriting , Humans , Male , Students
BACKGROUND: In the field of intelligence research, it has been shown that some people conceive intelligence as a fixed trait that cannot be changed (entity beliefs), whereas others conceive it as a malleable trait that can be developed (incremental beliefs). What about writing? Do people hold similar implicit theories about the nature of their writing ability? Furthermore, are these beliefs likely to influence students' response to a writing intervention? AIMS: We aimed to develop a scale to measure students' implicit theories of writing (pilot study) and to test whether these beliefs influence strategy-instruction effectiveness (intervention study). SAMPLE: In the pilot and intervention studies participated, respectively, 128 and 192 students (Grades 5-6). METHOD: Based on existing instruments that measure self-theories of intelligence, we developed the Implicit Theories of Writing (ITW) scale that was tested with the pilot sample. In the intervention study, 109 students received planning instruction based on the self-regulated strategy development model, whereas 83 students received standard writing instruction. Students were evaluated before, in the middle, and after instruction. RESULTS: ITW's validity was supported by piloting results and their successful cross-validation in the intervention study. In this, intervention students wrote longer and better texts than control students. Moreover, latent growth curve modelling showed that the more the intervention students conceived writing as a malleable skill, the more the quality of their texts improved. CONCLUSION: This research is of educational relevance because it provides a measure to evaluate students' implicit theories of writing and shows their impact on response to intervention.
Achievement , Aptitude , Culture , Intelligence , Students/psychology , Writing , Child , Curriculum , Female , Humans , Male , Pilot Projects , Teaching
BACKGROUND: It is well established that the activity of producing a text is a complex one involving three main cognitive processes: Planning, translating, and revising. Although these processes are crucial in skilled writing, beginning and developing writers seem to struggle with them, mainly with planning and revising. AIMS: To trace the development of the high-level writing processes of planning and revising, from Grades 4 to 9, and to examine whether these skills predict writing quality in younger and older students (Grades 4-6 vs. 7-9), after controlling for gender, school achievement, age, handwriting fluency, spelling, and text structure. SAMPLE: Participants were 381 students from Grades 4 to 9 (age 9-15). METHOD: Students were asked to plan and write a story and to revise another story by detecting and correcting mechanical and substantive errors. RESULTS: From Grades 4 to 9, we found a growing trend in students' ability to plan and revise despite the observed decreases and stationary periods from Grades 4 to 5 and 6 to 7. Moreover, whereas younger students' planning and revising skills made no contribution to the quality of their writing, in older students, these high-level skills contributed to writing quality above and beyond control predictors. CONCLUSION: The findings of this study seem to indicate that besides the increase in planning and revising, these skills are not fully operational in school-age children. Indeed, given the contribution of these high-level skills to older students' writing, supplementary instruction and practice should be provided from early on.
Creativity , Writing , Adolescent , Age Factors , Analysis of Variance , Aptitude , Child , Female , Humans , Male , Planning Techniques , Portugal , Students/psychology
