http://hdl.handle.net/20.500.11960/2371 2026-08-27T14:00:30Z http://hdl.handle.net/20.500.11960/5033 Title: Metacognitive training (MCT-Silver) for older adults with depressive symptoms in Portugal: a pilot study Authors: Silva, Celso; Alves, Elisabete; Schneider, Brooke C.; Sampaio, Francisco; Morgado, Bruno; Santos, Bruno M.; Correia, Tânia Sofia Pereira; Coelho, Joana; Tomaz, Mónica Lopo; Ferreira, Rogério; Fonseca, César; Pinho, Lara Abstract: Purpose Depressive symptoms in older adults represent a significant concern with major life impact. This uncontrolled pilot study evaluated the safety, feasibility and acceptance of metacognitive training for depression in later life (MCT-Silver) among Portuguese older adults. MCT-Silver is an 8-week psychological group intervention targeting (meta)cognitive beliefs to reduce depressive symptoms. The study also assessed changes in depressive symptoms, metacognitive beliefs, quality of life, ruminative responses, self-esteem, and dysfunctional attitudes. Methods A pilot, uncontrolled, single-group study with twenty-nine participants aged≥60 years without cognitive impairment and beck depression inventory-II (BDI-II) scores≥14 were included. Blinded assessments occurred at baseline and post-intervention using patient health questionnaire-9 (PHQ-9) (depression), metacognitions questionnaire-30 (MCQ-30) (metacognitive beliefs), world health organization quality of life instruments-Bref, item 1 (WHOQOL-Bref) (quality of life), ruminative responses scale (RRS-10) (ruminative responses), Rosenberg self-esteem scale (RSE) (self-esteem), and dysfunctional attitudes scale-18B (DAS-18B) (dysfunctional attitudes). Acceptance was assessed with a 21-item questionnaire. Results Participants attended an average of 6 sessions (75%) and evaluated the intervention very positively, indicating they found it to be useful in daily life and fun. We did not receive any negative responses. Pre-post comparisons showed statistically significant changes in depressive symptoms, metacognitive beliefs, quality of life, rumination, self-esteem and dysfunctional attitudes; however, given the uncontrolled design, these findings should be interpreted as preliminary and exploratory rather than as evidence of efficacy. Conclusions Results of this uncontrolled single-group pilot study are encouraging, indicating safety, and feasibility of administration as well as high adherence and acceptance among Portuguese older adults. Given the uncontrolled singlegroup design, the observed pre-post improvements in clinical outcomes should not be interpreted as evidence of efficacy. Controlled studies are needed to confirm the efficacy of MCT-Silver in this population. 2026-06-30T00:00:00Z http://hdl.handle.net/20.500.11960/5032 Title: Emotional management, empathy and emotional intelligence in mental health nursing: Educational insights from a scoping review Authors: Moreira, Maria Teresa; Lima, Andreia; Ferreira, Salomé; Fernandes, Carla Abstract: Aim: To map the existing evidence on emotional management strategies used by mental health nurses and explore implications for education, curriculum and clinical practice. Background: Emotional competence is a component of mental health nursing, where nurses are frequently exposed to emotionally complex and demanding interactions. Despite its relevance, evidence remains fragmented regarding how emotional management strategies can inform the education and preparation of mental health nurses. Design: Scoping review. Methods: The review was conducted following the JBI methodology and PRISMA-ScR guidelines. Searches were conducted in MEDLINE, CINAHL and PsycINFO from 2015 to 2024. Studies addressing emotional management strategies among mental health nurses were included. Data were charted and synthesised using thematic analysis. Results: Five studies from Portugal, Canada and the United States met the inclusion criteria. Four key themes were identified: (1) emotional management as a foundational professional competence; (2) education for emotional intelligence through structured training and reflective practice; (3) empathy as central to therapeutic engagement; and (4) self-awareness as a prerequisite for effective emotional regulation. Strategies such as clinical supervision, emotional intelligence training and reflective learning were associated with improved communication, personalised care, increased professional confidence and reduced burnout. Conclusion: Integrating the development of emotional competence into nursing education through structured learning, reflective pedagogies and supervised clinical experiences may enhance resilience, relational competence and preparedness for mental health nursing practice. Implications for Practice: Embedding emotional intelligence, empathy and self-awareness within nursing curricula can strengthen students’ emotional preparedness, promote wellbeing and support sustainable mental health nursing practice across diverse care settings 2026-03-01T00:00:00Z http://hdl.handle.net/20.500.11960/5031 Title: Virtual reality-assisted cognitive behavioural interventions for alcohol use disorder: a scoping review of therapeutic mechanisms with potential implications for anxiety, depression, and precision digital mental health Authors: Moreira, Maria Teresa; Lima, Andreia; Martins, Diana Ribeiro; Guimarães, Maria Inês; Cardoso, Inês Lopes; Fernandes, Carla Sílvia; Costa, Telmo Lima da; Ferreira, Salomé Abstract: Background: Alcohol use disorder (AUD) is a major public health concern frequently associated with anxiety and depressive disorders, highlighting the need for innovative and personalised mental health interventions. Virtual reality (VR) has emerged as a digital tool that may support cognitive behavioural therapy (CBT) by enabling immersive and controlled exposure to relevant stimuli. Methods: This scoping review aimed to map how VR is integrated into CBT-oriented interventions for adults with AUD, with a focus on therapeutic mechanisms and their potential relevance for precision digital mental health. The review followed Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Searches were conducted in PubMed, CINAHL, and Psychology and Behavioural Sciences Collection for studies published in the last ten years in English, Portuguese, or Spanish. Two independent reviewers performed screening and data extraction. Results: Eight studies were included, encompassing approaches such as cue exposure, simulation of high-risk environments, and covert sensitisation. The studies explored mechanisms including craving induction and regulation, identification of individual triggers, emotional processing, and enhancement of self-efficacy. The evidence base was characterised by small sample sizes, heterogeneous designs, and limited longitudinal data. Conclusions: This review provides a structured mapping of current applications of VR within CBT frameworks for AUD and highlights key therapeutic mechanisms that may have transdiagnostic relevance. However, the existing evidence remains preliminary, and findings should be interpreted with caution. The results support the exploration of VR within emerging precision digital mental health approaches, while underscoring the need for further rigorous and standardised research. 2026-06-08T00:00:00Z http://hdl.handle.net/20.500.11960/5030 Title: Design and usability of an immersive virtual reality simulation in orthopaedic nursing education: A pilot study Authors: Fernandes, Carla Sílvia; Galvão, Ana; Volpe, Cris Renata Grou; Ferreira, Marta Campos Abstract: Background: The increasing complexity of musculoskeletal surgical nursing education requires innovative pedagogical strategies that integrate immersive technologies with structured instructional design to enhance clinical reasoning and theory–practice integration. Aim: To design and develop a nursing process–structured immersive virtual reality simulation for orthopaedic nursing education and to pilot test its usability and educational appraisal among undergraduate nursing students. Design: Pilot mixed-methods study. Method: The simulation, NurseTechGames, was designed as a three-dimensional orthopaedic inpatient scenario structured sequentially according to the nursing process and incorporating gamification elements to support clinical reasoning. The intervention was implemented using Meta Quest 3 head-mounted displays. Usability was assessed using the System Usability Scale, and educational appraisal was measured using the Serious Educational Game in Nursing Appraisal Scale. Open-ended responses were analysed through qualitative content analysis. Participants were monitored during and after the sessions for potential cybersickness symptoms. Results: The simulation achieved a mean score of 83.15 on the System Usability Scale, indicating excellent usability. The total mean SEGINAS score was 95.58, reflecting a very high pedagogical evaluation across the dimensions of engagement, impact on learning, and content relevance. The qualitative analysis identified eight categories, with no reports of significant cybersickness symptoms: Perceived Learning Value, Clinical Transfer, Realism and Immersion, Engagement and Motivation, Technical Robustness, Development Potential, Minor Technical Issues, and Time Constraints. Conclusion: The immersive simulation NurseTechGames demonstrated high usability and strong pedagogicalacceptance in musculoskeletal surgical nursing education. Future controlled and longitudinal studies are required to evaluate objective and sustained impact on learning outcomes. 2026-05-01T00:00:00Z