Libras no contexto escolar: instrumento ilustrado de avaliação de narrativas sinalizadas1 / Libras in the school context: illustrated instrument for evaluation of signed narratives

RESUMO O contato inicial com uma língua acessível ocorre, para os estudantes surdos brasileiros, frequentemente no ambiente escolar, ao entrar em contato com outras crianças surdas e com interlocutores adultos fluentes em Língua Brasileira de Sinais (Libras). Esse acesso tardio pode ocasionar um certo atraso na aquisição e no desenvolvimento da linguagem. Assim, a educação bilíngue de surdos coloca os professores frente ao desafio de como avaliar a Libras no contexto escolar. Diante das propostas educacionais, ainda há poucos instrumentos que contribuam para avaliar os conhecimentos em Libras dos estudantes surdos. Portanto, o objetivo deste estudo é, por meio de um instrumento ilustrado de investigação de narrativas sinalizadas, contribuir com a avaliação da Libras e com o trabalho pedagógico de professores que atuam na educação bilíngue de surdos. O instrumento de avaliação de textos narrativos mostra-se bastante sensível para detectar o desenvolvimento linguístico dos discursos narrativos sinalizados, contribuindo intrinsicamente para a observação de funções/necessidades comunicativas.

ABSTRACT The initial contact with an accessible language occurs, for Brazilian deaf students, often in the school environment, when they encounter other deaf children and with adult interlocutors who are fluent in Brazilian Sign Language (LIBRAS). This late access can cause a certain delay in language acquisition and development. Thus, bilingual education for the deaf place's teachers in the face of the challenge of how to evaluate LIBRAS in the school context. In view of the educational proposals, there are still few instruments that contribute to assessing deaf students' knowledge in LIBRAS. Therefore, the objective of this study is, through an illustrated instrument for investigating signaled narratives, to contribute to the evaluation of LIBRAS and to the pedagogical work of teachers who work in bilingual education for the deaf. The instrument for evaluating narrative texts proves to be quite sensitive to detect the linguistic development of signaled narrative discourses, intrinsically contributing to the observation of communicative functions/needs.

Nivel de dificultad y poder de discriminación del examen final de la asignatura Ontogenia Humana y SOMA / Difficulty level and discernment power on Human Ontogeny and SOMA final test subject

RESUMEN Fundamento: La calidad de los instrumentos evaluativos resulta esencial en el proceso de evaluación del aprendizaje. Objetivo: Determinar los índices de dificultad y discriminación del examen final ordinario de la asignatura Ontogenia Humana y Soma. Metodología: Se realizó un estudio retrospectivo transversal en la asignatura Ontogenia y SOMA, del curso 2017-2018 en la Universidad de Ciencias Médicas de Sancti Spíritus, en el que se procesaron 163 exámenes ordinarios finales, el 30 % de los examinados seleccionados mediante un muestreo aleatorio estratificado por grupos, se calcularon el índice de dificultad e índice de discriminación por preguntas, temas y ciencias. Resultados: El número de incisos esperados y reales, de acuerdo con las horas clases para cada ciencia estuvo ajustado, no así en las temáticas Ontogenia de 17 incisos esperados se dedicaron 12 (70.5 %), en SOMA de 34 incisos esperados se dedicaron 29 (85.2 %); el índice de dificultad por temáticas, ciencias y temarios fue medianamente fácil (0.74-0.86) al igual que para el examen en su conjunto. El índice de discriminación del tema Ontogenia fue superior en el temario 1 (T1: 0.37 vs. T2: 0.24) y similar en SOMA (T1: 0.40 vs. T2: 0.39) y a nivel de las ciencias [Embriología (T1: 0.39 vs. T2: 0.31), Anatomía (T1: 0.39 vs. T2: 0.37)]. A nivel de preguntas, el índice de discriminación más bajo lo tuvo la pregunta 1 del primer temario (0.22), el resto tuvo índices de discriminación superiores a 0.30. Conclusiones: Ambos temarios tienen un índice de discriminación similar. El índice de dificultad fue medianamente fácil.

ABSTRACT Background: The quality of the assessment instruments is essential in the learning assessment process. Objective: To determine the difficulty and discernment indexes of the Human Ontogeny and SOMA ordinary final test subject. Methodology: A cross-sectional retrospective study was conducted on the Ontogeny and SOMA subject, from 2017 to 2018 academic year at the Sancti Spíritus Faculty of Medical Sciences, 163 final ordinary tests were processed, 30 % of the examinees selected by stratified random cluster sampling, the difficulty and discernment index were calculated by questions, topics and sciences. Results: The number of expected and real items, according to the class hours for each science, was adjusted, but not in the subjects (Ontogeny of 17 expected items were dedicated 12 (70.5 %), in SOMA of 34 expected items 29 were dedicated (85.2 %), the difficulty index by subjects, sciences and syllabus was moderately easy (0.74-0.86) as for the exam as a whole. The discernment index of the topic Ontogeny was higher in the syllabus 1 (T1: 0.37 vs. T2: 0.24) and similar in SOMA (T1: 0.40 vs. T2: 0.39) and [Embryology (T1: 0.39 vs. T2: 0.31), Anatomy (T1: 0.39 vs. T2: 0.37)]. At the science level questions, the lowest discernment index was found in question 1 from the first syllabus (0.22), the rest had discernment indexes higher than 0.30. Conclusions: Both topics have a similar discernment index. The difficulty index was moderately easy.

Development and content validation of an instrument for evaluating competencies in Pediatric Surgery Residency / Desenvolvimento e validação de conteúdo de instrumento para avaliação das competências na residência em cirurgia pediátrica

Abstract: Introduction: a specific instrument is needed to monitor the development of competencies in pediatric surgery during the residency. Objective: to develop an instrument in conformity with the "Milestone Project", using the competencies determined by the Brazilian Association of Pediatric Surgery, for use in the Pediatric Surgery Residency in Brazil. Method: the research was developed in three stages: the development of the initial instrument, qualification with a focal group of experts, and instrument evaluation by Brazilian pediatric surgeons in order to validate and quantify the instrument's acceptance. Result: The initial instrument was created with 4 competencies and 13 sub-competencies, each with 5 levels of assessment. Four experts performed the initial qualification, which resulted in 44 adaptations, and the instrument was finalized with 4 competencies subdivided into 10 sub-competencies, each with 5 levels of assessment. Subsequently, the instrument was evaluated by the Brazilian Pediatric Surgery Group and the Brazilian Pediatric Urology Group. There were 40 expert responses, with a total of 2394 positive responses from the 50 assessment items. The instrument had a general acceptance of 91.2%, being considered applicable (96.7%), reproducible (93.3), relevant to the covered topics (96%), technically (93.6%) and theoretically appropriate (93.3%), reliable (85.5%), and dependable (79.8%). Conclusion: an instrument was developed to assist in the assessment of competencies developed during residency in pediatric surgery in conformity with the Milestone Project. This instrument has been validated by experts and considered applicable, reproducible, relevant, technically and theoretically adequate, reliable and dependable.

Resumo: Introdução: Uma adequada formação na residência em cirurgia pediátrica deve avaliar e acompanhar constantemente o desenvolvimento de competências e, para isso, necessita de um instrumento específico como ferramenta de avaliação. Objetivo: Este estudo tem como objetivo apresentar um instrumento de avaliação nos moldes do "Milestone Project" com base nas competências determinadas pela Associação Brasileira de Cirurgia Pediátrica, para uso nos programas de residência médica em cirurgia pediátrica no Brasil. Método: Adotaram-se as seguintes etapas: desenvolvimento do instrumento, qualificação de um grupo de especialistas e avaliação do instrumento por cirurgiões pediatras brasileiros, a fim de validar e quantificar a aceitação do instrumento quanto à fidedignidade, confiabilidade, aplicabilidade, reprodutibilidade, relevância dos temas abordados e adequação dos pontos de vista técnico e teórico. Resultados: O instrumento inicial possuía quatro competências gerais e 13 subcompetências específicas, com cinco níveis de avaliação. Quatro experts realizaram a qualificação que gerou 44 adaptações, finalizando o instrumento com quatro competências gerais subdividias em dez subcompetências, com cinco níveis avaliativos. Sequentemente, o instrumento foi avaliado pelo Grupo Brasileiro de Cirurgia Pediátrica e pelo Grupo Brasileiro de Urologia Pediátrica. Houve 40 respostas de especialistas, 2.394 respostas positivas dos 50 itens. O instrumento teve aceitação de 91,2% e foi considerado aplicável (96,7%), reprodutível (93,3), relevante (96%), tecnicamente adequado (93,6%), teoricamente adequado (93,3%), confiável (85,5%) e fidedigno (79,8%). Conclusão: Esse instrumento nos moldes do "Milestone Project" foi validado por cirurgiões pediatras e considerado aplicável, reprodutível, relevante, adequado, sob os pontos de vista técnico e teórico, confiável e fidedigno.

Relationship between the Perception of Organizational Culture and Ethical Climate and the Perception of Workplace Bullying / Relación entre la percepción de la cultura organizacional y el clima ético y la percepción del acoso laboral

Abstract Workplace bullying takes place in many organizations and it has serious consequences on individuals, organizations and economy. The main aim of this study is to contribute to the field of workplace bullying by empirically testing the theoretically defined relation between socio-organizational variables (organizational culture and ethical climate) and bullying, using two theoretical models well-grounded in organizational studies. The findings, from a sample of 984 Portuguese workers, suggest that there is a strong relation between organizational culture/ethical climate and bullying: the "benevolent" and "principled" climates are negatively related (or even an obstacle) to bullying, as well as the cultural orientation of "support". The opposite is the result of the climate "self-interest" and the cultural orientations of "rules" and "goals". As organizational culture and ethical climate explain 20% of the variance of the negative behaviours perceived by the members of the organization, what shows that managers can achieve changes to a significant organizational, individual and societal problem just by manipulating those two variables.

Resumen El acoso laboral se encuentra en muchas organizaciones y tiene graves consecuencias para las personas, las organizaciones y la economía. El objetivo principal de este estudio es contribuir al campo de estudio del acoso laboral probando empíricamente la relación teórica definida entre variables socio-organizacionales (cultura organizacional y clima ético) y acoso laboral, utilizando dos modelos teóricos fundamentados en estudios organizacionales. Los hallazgos, con 984 trabajadores portugueses, sugieren que existe una fuerte relación entre la cultura organizacional/clima ético y el acoso laboral: los climas "benévolo" y "de principios" están relacionados negativamente (o son incluso un obstáculo) con el acoso laboral, así como la orientación cultural de "soporte". Lo contrario sucede con el clima "interés propio" y las orientaciones culturales de "reglas" y "metas". La cultura organizacional y el clima ético explican el 20% de la varianza del comportamiento negativo, lo que muestra que los gerentes pueden lograr cambios en problemas organizacionales, individuales y sociales significativos manipulando esas dos variables.

Communicational skills in application of interRAI / 中华全科医师杂志

Comprehensive geriatric assessment (CGA) is widely used for creating tailored individual care plans for seniors who usually are suffering from multiple diseases,frailty,disability and cognition decline.Skilled communicators are of importance for high-quality clinical data collection.Communication skills used in CGA are summarized in this article by reviewing related references and combining practical experiences in the process of applying international resident assessment instruments (interRAI).

Reliability and Validity of Chinese Version of Comprehensive Frailty Assessment Instrument / 中国康复理论与实践

Objective To translate the English version of Comprehensive Frailty Assessment Instrument (CFAI) into Chinese and evalu-ate its reliability and validity. Methods CFAI was translated into Chinese with the Brislin's translation mode. From May to July, 2015, 200 community aged people in Shijiazhuang, China were assessed with the Chinese version of CFAI and World Health Organization Quality of Life-BREF (WHOQOL-BREF), and 30 of them were assessed with CFAI again after a week. The content validity was rated by six experts of gereology. The total scores of CFAI and WHOQOL-BREF were analyzed with Pearson's correlation, as well as the scores of CFAI test and retest. The CFAI were analyzed with Factor Analysis. The Cronbach's α was tested. Results There were 23 items in 4 dimensions. The content validity index was 0.782. Six factors were extracted by Factor Analysis and the cumulated variance was 64.05%. The total score of CFAI correlated with the score of WHOQOL-BREF (r=-0.764, P<0.001). The Cronbach's α was 0.704~0.897 in dimensions (P<0.001), and the r= 0.604~0.941 (P<0.001) between test and retest. Conclusion The Chinese version of CFAI is reliable and valid, that can be applied to evaluate frailty in community aged people.

Instrumento para la evaluación curricular de la función de administración en la Carrera de Medicina / A tool for curricular evaluation of the management function of Medicine career

Introducción: La formación actual de médicos en Cuba responde a las necesidades de salud de la población de nuestro país y de otros lugares del mundo. El Área de Docencia e Investigación del Ministerio de Salud Pública creó un grupo de investigación, el cual diseñó el proyecto Efectividad del Currículo de Medicina. Uno de los cortes de valoración del currículo evalúa la correspondencia entre el modelo del profesional declarado para las cinco funciones descritas en el currículo y el profesional en formación. Una de las cinco funciones que se describe es la función de administración. Objetivo: Diseñar un instrumento para evaluar la correspondencia entre la función de administración modelada en el currículo de la Carrera de Medicina y los resultados que muestran los profesionales en formación. Material y métodos: Se realizó una investigación de desarrollo tecnológico en tres etapas: primera: diseño del instrumento evaluativo; segunda: aplicación de la encuesta y ejecución del ejercicio teórico-práctico; tercera: valoración del instrumento. Resultados: El instrumento diseñado demostró que con el actual currículo la función de administración se cumple en 77.07 por ciento. La totalidad de los profesores y la mayor parte de los estudiantes se proyectaron correctamente, al focalizar sus opiniones en los aspectos requeridos para la validación. Conclusiones: El instrumento diseñado permitió evaluar la correspondencia entre la función de administración modelada en el currículo de la Carrera de Medicina y los resultados que muestran los profesionales en formación. Las acciones de validación aplicadas apoyan la validez del instrumento en cuanto a su contenido y operatividad en la práctica(AU)

Introduction: Current medical training in Cuba responds to the health needs of the population of our country and others worldwide. The Teaching and Research Department belonging to the Ministry of Public Health created a research group, which designed the project Medicine Curriculum Effectiveness. One of the partial curriculum assessments evaluates the correspondence between the professional model declared for the five functions described in the curriculum and professional training. One of the five functions described in the model is the management function. Objective: To design a tool to assess the correspondence between the management function declared and modeled in the curriculum and the actual results showed by professionalist on training. Material and Methods: An investigation of technological development was performed in three stages: First: design an assessment instrument; Second: implementation of the survey and of theoretical - practical exercise; Third: valuation of the instrument. Results: The designed instrument demonstrated that, with the current educational curriculum, management function is fulfilled in a 77.07 percent. All the teachers and mostly of students disclosed correctly, focusing their opinions on the required aspects for validation. Conclusions: Was designed a tool for assessing the correspondence between the management function declared and modeled in the curriculum and the actual results showed by the training professionalist. The applied validation actions support the instrument's tenability in terms of their operativeness and content(AU)

Clinical Study of Auricular Point Therapy for Chronic Fatigue Syndrome / 上海针灸杂志

Objective To investigate the clinical efficacy of auricular point therapy for chronic fatigue syndrome.Methods Eighty patients with chronic fatigue syndrome were randomly allocated to treatment and control groups, 40 cases each. The treatment group received ear acupuncture plus auricular plaster therapy and the control group, conventional acupuncture. The overall symptom was scored, the Fatigue Assessment Instrument (FAI) score was recorded and immunoglobulins (IgA, IgG and IgM) were measured in the two groups before treatment and after four courses.Results There were statistically significant pre-/post-treatment differences in the overall symptom score, the FAI score and immunoglobulins in the two groups (P<0.05). There were statistically significant post-treatment differences in the FAI score, and IgA and IgG between the treatment and control groups (P<0.05). Conclusion Auricular point therapy is an effective way to treat chronic fatigue syndrome.

Assessment of the Quality of Life in Korean Patients with Vitiligo / 대한피부과학회지

BACKGROUND: Vitiligo is a chronic disfiguring dermatosis and can cause significant psychosocial burden that affects quality of life (QOL). OBJECTIVE: The purpose of this study was to compare the QOL in patients with vitiligo and healthy controls by using general and dermatology-specific (DLQI) questionnaires: World Health Organization QOL Scale (WHOQOL-BREF) and Dermatology QOL Index (DLQI), respectively. METHODS: Vitiligo patients and healthy controls (104 of each) were recruited, all of whom completed the WHOQOL-BREF and DLQI. Total scores and scores of domains of the WHOQOL-BREF and DLQI in the two groups were compared. RESULTS: The scores of total DLQI and categories of symptoms and feelings, daily activities, and leisure of vitiligo patients were significantly higher than those of healthy controls (p<0.05). The QOL score and domains of physical, psychological health, and social relationships of the WHOQOL-BREF in patients with vitiligo were decreased compared with those in healthy controls (p<0.05). Clinical characteristics, including disease duration, treatment duration, vitiligo area, exposed site, self-reported severity, treatment unsatisfaction, Beck Depression Inventory, and Beck Anxiety Inventory showed significant impairment in the QOL of vitiligo patients according to the DLQI and WHOQOL-BREF (p<0.05). High disease activity and Koebner's phenomenon showed a negative correlation with QOL in patients with vitiligo according to the DLQI only (p<0.05). There was no association between the total DLQI and the QOL scores. CONCLUSION: In our study, QOL in patients with vitiligo was poorer than that of healthy controls. The severity of depression and anxiety was the most important predictor of QOL. Therefore, in managing patients with vitiligo, it is important for the dermatologist to consider the psychological aspects of QOL to provide satisfaction of life.

Evidências de validade de instrumentos de reações no ensino superior à distância / Validity evidences of instruments of reaction in distance higher education / Evidencias de validez de instrumentos de reacciones en enseñanza superior a distancia

Com a crescente implantação de cursos superiores oferecidos via internet, os estudos na área de avaliação de ações educacionais a distância assumem grande relevância, ao propor instrumentos de medida para atestar a eficácia e a qualidade de cursos desta natureza. Nesse sentido, objetivou-se verificar as evidências de validade de dois instrumentos de medida: Reação aos Procedimentos Instrucionais e Reação ao Desempenho do Tutor. Alunos de graduação de uma universidade particular no interior paulista, que realizavam cursos a distância ou disciplinas híbridas, responderam a questionários que avaliaram o nível de satisfação com os procedimentos instrucionais adotados e a atuação profissional do tutor. Foram realizadas Análises Fatoriais Exploratórias e de consistência interna. Os escores analisados apontam para as evidências de validade estrutural em ambas escalas, que apresentam estruturas empíricas unifatoriais: 1) "Procedimentos Instrucionais em EAD" (17 itens, α=0,96 e cargas fatoriais entre 0,60 e 0,86); e 2) "Desempenho do Tutor" (27 itens, α=0,98 e cargas fatoriais entre 0,67 e 0,88). As estruturas de fator único já foram encontradas em estudos existentes com as medidas, que devem ser aplicadas em contextos e amostras diferentes, em futuras pesquisas.

Increasing implantation of higher education courses offered by Internet put the assessment studies on distance learning, that propose measuring instruments to attest the effectiveness and quality of these courses, at a relevant level. This study aimed to verify the validity evidences of two instruments: Satisfaction to the Instructional Procedures and Satisfaction to the Tutor's Performance. Undergraduated students from a private university in the State of Sao Paulo, who attended distance learning courses or blended disciplines, answered questionnaires that evaluated their satisfaction with the instructional procedures and tutors' professional performance. Exploratory Factor Analyzes and internal consistency were performed. The analyzed scores indicate for evidences of structural validity of both scales, which present one-factor empirical structures: 1) "Instructional Procedures in Distance Learning" (17 items, α=0.96 and factor loadings between 0.60 and 0.86), and 2) "Tutor's Performance" (27 items, α=0.98 and factor loadings between 0.67 and 0.88). Others studies with the scales found the one-factor structures as well. Future research should use them in different contexts and samples.

Los estudios que proponen instrumentos para verificar la eficacia y la calidad de carreras universitarias ofrecidas a distancia (Internet), son de gran importancia. En este sentido, el objetivo de esta investigación fue verificar la fiabilidad y consistencia interna de dos instrumentos: Reacción a los Procedimientos de Enseñanza y Reacción a la Calidad del Tutor. Los estudiantes de grado de una universidad privada de Sao Paulo, que realizaron cursos de grado o disciplinas online contestaron cuestionarios que evaluaban su satisfacción con los procedimientos adoptados y las actividades profesionales del tutor. Se realizaron Análisis Factoriales Exploratorios y de consistencia interna. Las puntuaciones analizadas indican evidencias de validez estructural de ambas escalas, que tienen estructuras empíricas de un solo factor: 1) "Procedimientos en Enseñanza Virtual" (17 ítems, α = 0,96 y cargas de los factores entre 0,60 y 0,86), y 2) "Desempeño del Tutor" (27 ítems, α = 0,98 y cargas factoriales entre 0,67 y 0,88). Las estructuras de factor único ya fueron encontradas en estudios existentes con las medidas, que deben ser aplicadas en contextos y muestras diferentes, en futuras investigaciones.

Adaptación y validación de un instrumento de valoración de riesgo de caída en pacientes pediátricos hospitalizados / Adaptation and validation of a hospitalized pediatric patients fall risk assessment instrument

Introducción: Un número significativo de pacientes que asisten a instituciones de salud tienen riesgo de caída en cualquier momento de su hospitalización, cuidarlos implica una serie de intervenciones que requieren una previa valoración clínica. Objetivo: Adaptar y validar un instrumento de valoración de caídas en el paciente pediátrico hospitalizado. Métodos: Se adaptó y validó el instrumento J. H. Downton. Se realizó evaluación de la sensibilidad, especificidad, valor predictivo positivo y negativo, así como la consistencia interna del instrumento por medio de la prueba Kuder-Richardson (KR) y resumen de curvas ROC, mediante el programa estadístico SPSS® versión 15 y Epidat 3.1. Resultados: Se obtuvo consistencia interna por KR de 0.92, sensibilidad de 86.92, especificidad de 99.4, valor predictivo positivo (PP) 99.56, y valor predictivo negativo (PN) 81.52, con un índice de confianza del 95%. Conclusiones: Las escalas validadas como la St. Thomas, se encuentra con buena sensibilidad y especificidad 93% y 88%, respectivamente, sin embargo está adaptada para pacientes mayores. La escala validada en el presente estudio tuvo mejores valores de sensibilidad y especificidad que otras 2 escalas específicas de población pediátrica, la escala Humpty Dumpty y la escala CHAMPS, por lo que se concluye que la escala J. H. Downton modificada es altamente sensible y específica para predecir riesgo de caídas en el paciente pediátrico hospitalizado.

Introduction: A significant number of patients who attend health institutions have a risk of fall anytime during their hospitalization. Taking care of these patients requires diverse interventions and clinical assessments. Objective: To adapt and validate a hospitalized pediatric patient fall risk assessment instrument. Methods: The J. H. Downton instrument was adapted and validated. Specificity and sensibility tests, negative and positive predictive value, and Kuder-Richardson (KR) and ROC curve analysis internal consistency were all assessed using the SPSS® v. 15 and Epidat 3.1 statistics programs. Results: KR internal consistency of 0.92, sensibility of 86.92, specificity of 99.4, PP of 99.56, and PN of 81.52 with a confidence interval of 95% were obtained. Conclusions: Validated scales such as the St. Thomas have good sensibility and specificity values (93% and 88%), but this scale is adapted for elder patients. The validated scale of this study had better sensibility and specificity values than two other hospitalized pediatric population scales: the Humpty Dumpty and the CHAMPS, suggesting that the modified H. Downton scale is highly sensible and specific to predict hospitalized pediatric patient fall risks.

Quality of life questionnaire for children with cerebral palsy (CP QOL-Child): translation and cultural adaptation for brazilian portuguese language / Questionário de qualidade de vida de crianças com paralisia cerebral (CP QOL-Child): tradução e adaptação para língua portuguesa

The aim of this study was to verify the reliability of the Brazilian Portuguese version of the instrument Cerebral Palsy: quality of life questionnaire for children: primary caregiver questionnaire (CP QOL-Child: primary caregiver) translated and culturally adapted. Thus, the translation and cultural adaptation of the instrument was made, and then the procedures to verify its reliability were performed. The translated and culturally adapted questionnaire was answered by 30 caregivers of children with cerebral palsy and inter- and intra-observer analysis followed. The data allowed the authors to identify an internal consistency rangering from 0.649 to 0.858, intra-observer reliability from 0.625 to 0.809 and inter-observer reliability from 0.498 to 0.903. The analysis suggests that the instrument has acceptable psychometry...

O objetivo deste estudo foi verificar a confiabilidade da versão em português do Brasil do instrumento Cerebral Palsy: quality of life questionnaire for children: primary caregiver questionnaire (CP QOL-Child: primary caregiver) traduzido e adaptado culturalmente. Para tanto, foi realizada a tradução e a adaptação cultural do instrumento e a seguir foram realizados os procedimentos para verificar a confiabilidade. O questionário traduzido e adaptado culturalmente foi respondido por 30 cuidadores de crianças com paralisia cerebral e realizada a análise inter e intraobservadores. Os dados permitiram identificar que consistência interna variou de 0,649 a 0,858, a confiabilidade intraobservador de 0,625 a 0,809 e a confiabilidade interobservador 0,498 a 0,903. A análise realizada sugere que o instrumento utilizado tem aceitabilidade psicométrica...

Diseño, validación facial y de contenido de un instrumento de valoración de los síntomas en la mujer con enfermedad coronaria, enmarcada en la teoría de los síntomas desagradables / Design, facial and content validation of an instrument for assessing symptoms in women with coronary heart disease, framed in the theory of unpleasant symptoms

OBJETIVO: Diseñar y validar un instrumento para la valoración de los síntomas en la mujer con enfermedad coronaria, enmarcada en la Teoría de los Síntomas Desagradables. METODOLOGIA: Estudio metodológico psicométrico, orientado por: "Los Síntomas" primer Concepto de la Teoría de los Síntomas Desagradables de Lenz y colaboradores. Se realizó Crítica Teórica del constructo elegido demostrando su utilidad en la investigación y práctica disciplinar. Desde lo empírico, se ponderaron 260 evidencias por medio de Crítica Metodológica y Empírica, aplicando el sistema de Revisión Integrativa articulada al Modelo Conceptual Empírico de Fawcett & Garity, obteniéndose tan solo 30 "Piezas Investigativas" utilizadas para la construcción de los ítems; a los síntomas de Lenz, se suman los síntomas psicosociales reportados en mujeres con enfermedad coronaria, generándose un primer diseño compuesto por 87 ítems. RESULTADOS: Al diseño se realiza Validación de Contenido por expertos: Modelo Escobar y Cuervo 2008 (análisis SPSS 20), Coeficiente Correlación de Kendall= 0,682 (p< 0.05), "buena concordancia entre jueces". Modelo de Lawshe Normalizado por Tristán 2008 con Content Validity Ratio= 0.57 e Index Validity Content= 0.797 demostrando que los "Ítems son unidades de análisis esenciales". Finalmente para la Validación Facial, se realizó Prueba Piloto con 21 mujeres que cumplieron los criterios de inclusión, posterior a esto se realizó discriminación semiótica de los ítems obteniéndose un instrumento tipo Autoinforme, heteroaplicado, compuesto por 67 ítems, un remanente investigativo que requiere nuevas validaciones para elevar su capacidad psicométrica. PALABRAS CLAVES: Validez Facial, Validez de Contenido, Instrumento, Valoración, Síntomas en la Mujer, Enfermedad Coronaria, Teoría de los Síntomas Desagradables.

OBJECTIVE: To design and validate an instrument for assessing the symptoms in women with coronary disease framed in the Theory of the Unpleasant Symptoms. METHODOLOGY: Methodological study psychometric oriented by "The Symptoms," first concept of the Theory of Unpleasant Symptoms by Lenz et al. Theoretical Critique of the construct chosen was performed proving usefulness in research and practice discipline. From the empirical 260 evidences were weighted through Methodological and Empirical Critique, applying the Integrative Review System articulated to the empirical Conceptual Model by Fawcett & Garity, obtaining only 30 "Investigative Pieces" used for the construction of the items; to the Lenz symptoms were added the reported psychosocial symptoms in women with coronary disease, generating a first design composed of 87 items. RESULTS: The design was done by Expert Content Validation: Model Escobar and Cuervo 2008 (analysis Statistical Package for the Social Sciences IMB SPSS 20) Kendall Correlation Coefficient, K= 0.682 (p< 0.05): "Good agreement between judges". Model Normalized by Tristan 2008 Lawshe: Content Validity Ratio= 0.57 and Content Validity Index= 0.797, showing: "Items: are units of essential analysis". Finally Validation Facial was the Pilot Test conducted on 21 women who met the inclusion criteria after this, the discrimination semiotics was performed obtaining an instrument type: Self-Report, heteroapplied consisting of 67 items, a remnant of research that requires further validation to increase its psychometric capacity.

Inventário de Fatores de Estresse nos alunos do 12º ano: construção e validação de um instrumento / Inventory of Stress Factors in 12th grade students: construction and validation of an instrument

Os estudantes do 12º ano constituem um grupo em constante exposição a situações de estresse, pois, a par das transformações físicas e psicológicas caraterísticas da adolescência, são confrontados com a eminência da realização de uma série de decisões com impacto significativo no seu percurso atual e futuro. Visando um conhecimento mais aprofundado dos estressores mais frequente e intensamente vivenciados, no contexto português, procedeu-se à construção e validação do Inventário de Fatores de Estresse - 12º ano (IFS). O estudo envolveu um total de 341 alunos do 12º ano de três escolas do Norte de Portugal. Uma análise de componentes principais fez emergir 4 fatores, com alfas de Cronbach oscilando entre 0,72 e 0,93, e explicando 52 por cento da variância. As caraterísticas métricas do IFS sugerem-no como um instrumento válido na identificação da prevalência e intensidade dos fatores de estresse entre alunos do 12º ano.

The 12th grade students are a group in constant exposure to stressful situations. Besides the physical and psychological changes that they experience during adolescence, they usually face the imminent completion of a series of decisions with important impact on their current and future lives. Seeking a better understanding of the most common and intense stress factors experienced by the Portuguese students, the authors built up the questionnaire and also the validation of the Inventory of 12th graders' Stress Factors (ISF - 12th). The study involved a total of 341students, all of them 12th graders from three schools from Northern Portugal. A Principal Component Analyses highlights a four dimension instrument with Cronbach's alphas varying between .72 and .93, and explaining 52 percent of variance. The results suggest the ISF as a valid instrument in the identification of the prevalence and intensity of stress factors among Portuguese 12th graders.

The Reliability and Validity of World Health Organization Quality of Life Assessment Instrument (WHOQOL) in Patients with Breast Cancer: Physical Domain and Depression / 한국유방암학회지

PURPOSE: This study was designed to investigate the reliability and validity of the World Health Organization Quality of Life Assessment Instrument (WHOQOL) in patients with breast cancer according to depressive symptoms. METHODS: One-hundred seventeen patients with breast cancer who had undergone a radical operation were recruited. The 100 item-WHOQOL instrument and Hamilton Rating Scale for Depression were used to measure all the subjects. The five domain scores, except for the WHOQOL spiritual domain, were compared between patients with and without depressive symptoms, and then the reliability and validity of the five domains were calculated. RESULTS: Depressed patients with breast cancer had lower scores in all five domains of the WHOQOL than those who were not depressed in all five domains of WHOQOL [df=(1, 115), F=46.6, p<0.001]. Reliability and validity in the physical domain of depressed patients with breast cancer decreased markedly. CONCLUSION: WHOQOL is a valid and useful instrument for evaluating the quality of life in patients with breast cancer, but is limited in scoring of depressed patients with breast cancer, particularly in the physical domain. Therefore, quality of life must be interpreted with carefully hand in depressed patients with breast cancer.

Effects of Case Management using Resident Assessment Instrument-Home Care (RAI-HC) in Home Health Services for Older People

PURPOSE: To evaluate the effects of case management using Resident Assessment Instrument-Home Care (RAI-HC) in home health service for older people. METHODS: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Cognitive Performance Scale (CPS), Depression Rating Scale (DRS), Pain and the number of Clinical Assessment Protocols (CAP). RESULTS: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression (odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL (OR: 4.423, CI: 1.151-16.999) and the number of CAP (OR: 11.443, CI: 3.805-34.410). CONCLUSION: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

The Functional Assessment Process in Long-Term Care System for Older Persons

This paper was written to provide informations on the functional assessment system in developing public long-term care scheme for frail older persons. Until now in Korea long-term care services tend to be provided to older persons disqualified, because there is no a formal instrument to assess. Fundamentally the scope of function covered by particular measures is composed of four domains:self-care functioning, domestic functioning, cognitive function and challenging behaviour. As a result of review of literatures and each nation's system, assessment indices were suggested 41 items. That is to say, the self-care functioning and domestic functioning are consisted of 22 items, cognitive function and challenging behaviour being 9 items. Besides, it is suggested that 10 items of nursing and rehabilitative needs should be assessed. It is desirable that assessedment should be practised by medical manpowers, for example, medical doctor or nurse and in assessment process firstly visiting examiner make an investigation of physical and cognitive function with a constructed questionnaire and secondly assessment team such as ACAT in Australia decide the level of functional severity.