Intake of oral photoprotectors by postmen in Porto Alegre

Introduction: Postmen are daily exposed to high levels of solar radiation, and lack of protection can result in many health damages. The present study aimed to identify cutaneous phototypes and evaluate the intake of oral photoprotectors by postmen. Methods: Cross-sectional study, carried out from August 2011 to December 2012 in the city of Porto Alegre, state of Rio Grande do Sul, Brazil. Socioeconomic and behavioral data regarding daily solar exposure were collected through a questionnaire. To evaluate the intake of beta-carotene, lycopene and omega-3, two 24-hour dietary recalls were applied. Cutaneous phototypes were assessed by Fitzpatrick's classification. Results: A total of 181 postmen were analyzed, whose mean age was 40.2±11.4 years old, and 140 (77.3%) were male. The cutaneous phototypes II, III and IV were the most prevalent (n=138), totaling 76.3% of the sample. The median for the oral photoprotectors intake was 1.16 mg (0.46-2.29) of beta-carotene, 3.60 mg (1.01-6.31) of lycopene and 0.95 g (0.61-1.45) of n-3 fatty acids, all values significantly lower than the minimal doses to obtain photoprotective effect (p<0.001). The individuals in the group of phototypes V and VI showed lower adherence to the use of sunscreen and lower intake of beta-carotene, comparing to the other groups. Conclusions: The intake of oral photoprotectors is low in this population. Future studies may evaluate the real effect of oral photoprotectors, so that preventive measures using this approach can be included in photoprotection education actions for outdoor workers (AU)

Association between Spirituality and Adherence to Management in Outpatients with Heart Failure / Associação entre Espiritualidade e Adesão ao Tratamento em Pacientes Ambulatoriais com Insuficiência Cardíaca

Abstract Background: Spirituality may influence how patients cope with their illness. Objectives: We assessed whether spirituality may influence adherence to management of outpatients with heart failure. Methods: Cross sectional study enrolling consecutive ambulatory heart failure patients in whom adherence to multidisciplinary treatment was evaluated. Patients were assessed for quality of life, depression, religiosity and spirituality utilizing validated questionnaires. Correlations between adherence and psychosocial variables of interest were obtained. Logistic regression models explored independent predictors of adherence. Results: One hundred and thirty patients (age 60 ± 13 years; 67% male) were interviewed. Adequate adherence score was observed in 38.5% of the patients. Neither depression nor religiosity was correlated to adherence, when assessed separately. Interestingly, spirituality, when assessed by both total score sum (r = 0.26; p = 0.003) and by all specific domains, was positively correlated to adherence. Finally, the combination of spirituality, religiosity and personal beliefs was an independent predictor of adherence when adjusted for demographics, clinical characteristics and psychosocial instruments. Conclusion: Spirituality, religiosity and personal beliefs were the only variables consistently associated with compliance to medication in a cohort of outpatients with heart failure. Our data suggest that adequately addressing these aspects on patient’s care may lead to an improvement in adherence patterns in the complex heart failure management.

Resumo Fundamento: A espiritualidade pode influenciar a maneira com que os pacientes lidam com sua doença. Objetivos: Avaliamos a possibilidade de a espiritualidade influenciar a adesão ao tratamento de pacientes ambulatoriais com insuficiência cardíaca. Métodos: Estudo transversal com pacientes ambulatoriais com insuficiência cardíaca, cuja adesão ao tratamento multidisciplinar foi avaliada. Os pacientes foram avaliados sobre qualidade de vida, depressão, religiosidade e espiritualidade, utilizando questionários validados. Foram obtidas correlações entre adesão e variáveis psicossociais de interesse. Modelos de regressão logística exploraram preditores independentes de adesão. Resultados: Cento e trinta pacientes (idade 60 ± 13 anos; 67% masculinos) foram entrevistados. Observou-se adequado escore de adesão em 38,5% dos pacientes. Nem a depressão ou a religiosidade foram correlacionados à adesão, quando avaliados separadamente. É interessante notar que quando a espiritualidade foi avaliada por ambos, o somatório total de score (r = 0,26; p = 0,003) e os domínios específicos, ela estava positivamente correlacionada à adesão. Por fim, a combinação de espiritualidade, religiosidade e crenças pessoais mostrou-se um preditor independente de adesão quando ajustado às características demográficas, clínicas e a instrumentos psicossociais. Conclusão: Espiritualidade, religiosidade e crenças pessoais foram as únicas variáveis consistentemente associadas à adesão em relação à medicação em uma coorte de pacientes ambulatoriais com insuficiência cardíaca. Nossos dados sugerem que abordar adequadamente esses aspectos no cuidado com o paciente pode auxiliar a melhorar o padrão de adesão no complexo tratamento da insuficiência cardíaca.