journal article·2025-07-31Open access

Effectiveness of an Intervention Program for Informal Carers of Children Admitted to a Rehabilitation Centre

Sónia Morais, Rui Esteves Pimenta, Carminda Morais, Rui Macedo, Inês Ribeiro, Pedro Lopes Ferreira

Applied Sciences· Volume 15· Issue 15

Abstract

Health literacy improves informal caregivers’ knowledge and ability to provide care. The aim of this study is to analyze the impact of a group-based intervention on the health literacy of informal caregivers of children with special health needs (SHNs). The intervention focuses on movement, hydrotherapy, walking, and relaxation, with three evaluation stages. Participants included 34 informal caregivers of children with SHNs, recruited at a Physical Medicine and Rehabilitation Service. We collected sociodemographic data of the participants and measured their health literacy through the short-form version of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). Around 70% of the participants were female, with a mean age of 41.06 ± 4.98 years, and nearly 85% were married or in a de facto union. About 26% were unemployed, and more than 65% had completed secondary education or higher. The mean scores of the HLS-EU-Q16 were statistically significantly higher throughout the intervention, with differences over the evaluation stages [F(2,56) = 75.55; p < 0.05]. A structured, dynamic, and group-based intervention plan showed improvements in the health literacy of the participants, with an increase in the percentage of participants with sufficient and excellent levels of health literacy at the end of the intervention.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Health Literacy and Information Accessibility · Breastfeeding Practices and Influences · Mobile Health and mHealth Applications

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

North Rehabilitation Center, 4405-565 Valadares, Portugal

Centre for Health Studies and Research, University of Coimbra, 3004-512 Coimbra, Portugal

Centre for Innovative Biomedicine and Biotechnology, 3004-512 Coimbra, Portugal

REQUIMTE/LAQV, Health School, Polytechnic of Porto, 4200-072 Porto, Portugal

Health School, Polytechnic of Viana do Castelo, 4900-314 Viana do Castelo, Portugal

Health Sciences Research Unit: Nursing, UICISA: E, 3046-851 Coimbra, Portugal

Rehabilitation Research Center, Health School, Polytechnic of Porto, 4200-072 Porto, Portugal

References (42)

Show source-provided references
1. UNICEF—United Nations Children’s Fund (2021). Seen, Counted, Included: Using Data to Shed Light on the Well-Being of Children with Disabilities; Report; UNICEF: New York, NY, USA. Available online: https://data.unicef.org/resources/children-with-disabilities-report-2021/.
2. Informal caregivers: Main difficulties and fears in the act of caring
3. (2024, November 21). Law n.° 100/2019. Diário da República n.° 171/2019; Série I 3. Available online: https://files.dre.pt/1s/2019/09/17100/0000300016.pdf.
4. Cuidando de quem cuida: Projeto de intervenção como estratégia de aprendizagem no internato em medicina
5. The burden of informal caregivers of children with autism spectrum disorder
6. Vaz, I. (2020). The Health Literacy of Formal and Informal Caregivers. [Master’s Thesis, School of Health of the Polytechnic Institute of Porto]. Available online: https://recipp.ipp.pt/bitstream/10400.22/17502/1/DM_Iolanda%20Vaz.pdf.
7. Health literacy, from data to action: Translation; validation and application of the European Health Literacy Survey in Portugal
8. Sørensen, K., van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., and Brand, H. (2012). HLS-EU Consortium. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12, Available online: http://www.biomedcentral.com/1471-2458/12/80.10.1186/1471-2458-12-80 ↗
9. Low health literacy and health outcomes: An updated systematic review10.7326/0003-4819-155-2-201107190-00005 ↗
10. General Directorate of Health (2024, December 10). Manual of Good Practices Health Literacy—Training Health Professionals. Available online: https://ciencia.ucp.pt/ws/portalfiles/portal/28776366/literaciaManual.
11. Ferreira, P.L. (2023). Caring for the Informal Caregiver in the Municipality of Cantanhede. Brief Summary of the Main Results, CEISUC.
12. Itineraries and contradictions of a family policy: The Informal Caregiver Statute in Portugal
13. Sousa, L., Gemito, L., Ferreira, R., Pinho, L., Fonseca, C., and Lopes, M. (2022). Programs Addressed to Family Caregivers/Informal Caregivers Needs: Systematic Review Protocol. J. Pers. Med., 12.10.3390/jpm12020145 ↗
14. Sono, exercício e nutrição na saúde mental: Uma revisão integrativa sobre estratégias para a prevenção e tratamento de transtornos psiquiátricos10.34119/bjhrv8n2-192 ↗
15. Role of Physical Activity on Mental Health and Well-Being: A Review
16. Bottcher, L. (2019). Physical activity as an action to promote health: A critical essay. Rev. Eletrônica Gest. Saúde, 98–111.10.26512/gs.v0i0.23324 ↗
17. Atividade física de lazer e saúde: Uma revisão10.15603/2176-1019/mud.v25n1p57-65 ↗
18. The effect of physical exercise on circulating BDNF: A brief literature review
19. Body in Motion Extension Project: Experiences and perceptions10.18310/2446-4813.2019v5n3p129-141 ↗
20. Benefits of the physical properties of water for the human body
21. Anthropometric assessment and motivational factors of water aerobics and walking participants in Guarapuava; Paraná10.30681/252610103333 ↗
22. Pilates in physiotherapy and its benefits for body conditioning
23. Sørensen, K., van den Broucke, S., Pelikan, J.M., Fullam, J., Doyle, G., Slonska, Z., Kondilis, B., Osbornem, R., and Brand, H. (2013). Measuring health literacy in populations: Illuminating the design and development process of the European Health Literacy Survey Questionnaire (HLS-EU-Q). BMC Public Health, 13.10.1186/1471-2458-13-948 ↗
24. Pedro, A., Raposo, B., Luís, L., Amaral, O., Escolval, A., and Dias, S. (2023). Portuguese Version of the HLS-EU-Q6 and HLS-EU-Q16 Questionnaire: Psychometric Properties. Int. J. Environ. Res. Public Health, 20.10.21203/rs.3.rs-1894949/v2 ↗
25. Pelikan, J.M., Röthlin, F., and Ganahl, K. (2014, January 3–4). Measuring comprehensive health literacy in general populations: Validation of instrument, indices and scales of the HLS-EU study. Proceedings of the 6th Annual Health Literacy Research Conference, Bethesda, MA, USA.
26. The COSMIN study reached international consensus on taxonomy; terminology; and definitions of measurement properties for health-related patient-reported outcomes10.1016/j.jclinepi.2010.02.006 ↗
27. Nunnally, J.C., and Bernstein, I.H. (1994). Psychometric Theory, McGraw Hill. [3rd ed.].
28. Brglez, M., and Pietikäinen, S. (2024, December 10). Towards a Common European Action on Care. Procedure File 2021/2253(INI); Legislative Observatory; July 2022. Available online: www.europarl.europa.eu/doceo/document/A-9-2022-0189_PT.html.
29. Monitoring and Evaluation Committee of the Informal Caregiver Statute (2024). Informal Caregiver Status—Monitoring and Evaluation of the Informal Caregiver Status, Instituto da Segurança Social. Report.
30. Impact of long-term outcomes on the caregivers of burn survivors10.1016/j.burns.2022.08.024 ↗
31. National Institute of Statistics (2024, November 21). National Health Survey 2014. Available online: https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_publicacoes&PUBLICACOESpub_boui=263714091&PUBLICACOESmodo=2&xlang=pt.
32. (2024, November 21). Caring for Informal Caregivers Movement. What is Being an Informal Caregiver in Portugal?. Available online: https://movimentocuidadoresinformais.pt/wp-content/uploads/2021/04/cuidadores-informais_infografia_2021_A4.pdf.
33. Zigante, V. (2024, December 10). Directorate-General for Employment; Social Affairs and Inclusion. Informal Care in Europe—Exploring Formalisation; Availability and Quality. European Comission; Publications Office. Available online: https://data.europa.eu/doi/10.2767/78836.
34. Buhr, E., and Tannen, A. (2020). Parental health literacy and health knowledge, behaviours and outcomes in children: A cross-sectional survey. BMC Public Health, 20.10.1186/s12889-020-08881-5 ↗
35. Costa, A., Loura, D.S., Nogueira, P., Melo, G., Gomes, I., Ferraz, I., Viegas, L., and Henriques, M.A. (2022). Informal Caregivers’ Health Literacy in Lisbon; Portugal: A Profile for Health Promotion Prioritization. Geriatrics, 7.10.3390/geriatrics7050092 ↗
36. Associations between health literacy and patient outcomes in adolescents and young adults with cystic fibrosis
37. Walters, R., Leslie, S.J., Polson, R., Cusack, T., and Gorely, T. (2020). Establishing the efficacy of interventions to improve health literacy and health behaviours: A systematic review. BMC Public Health, 20.10.1186/s12889-020-08991-0 ↗
38. (2024, November 21). HLS-EU Consortium. Comparative Report on Health Literacy in Eight EU Member States: The European Health Literacy Project 2009–2012. Available online: http://cpme.dyndns.org:591/adopted/2015/Comparative_report_on_health_literacy_in_eight_EU_member_states.pdf.
39. Mothers of Children With Special Health Care Needs: Exploring Caregiver Burden; Quality of Life; and Resiliency10.1016/j.pedhc.2023.06.003 ↗
40. Health literacy of caregivers for caring in a family context
41. Häikiö, K., Cloutier, D., and Rugkåsa, J. (2020). Is health literacy of family carers associated with carer burden; quality of life; and time spent on informal care for older persons living with dementia?. PLoS ONE, 15.10.1371/journal.pone.0241982 ↗
42. Espanha, R., Ávila, P., and Mendes, R. (2024, December 10). Health Literacy in Portugal: Summary Report. Report; Calouste Gulbenkian Fundation; January 2016. Available online: https://cdn.gulbenkian.pt/wp-content/uploads/2021/05/87Est_Lieracia_Saude.pdf.