Noninvasive mechanical ventilation assistance in amyotrophic lateral sclerosis: a systematic review

ABSTRACT BACKGROUND: Respiratory failure is the most common cause of death in patients with amyotrophic lateral sclerosis (ALS), and morbidity is related to poor quality of life (QOL). Non-invasive ventilation (NIV) may be associated with prolonged survival and QOL in patients with ALS. OBJECTIVES: To assess whether NIV is effective and safe for patients with ALS in terms of survival and QOL, alerting the health system. DESIGN AND SETTING: Systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting standards using population, intervention, comparison, and outcome strategies. METHODS: The Cochrane Library, CENTRAL, MEDLINE, LILACS, EMBASE, and CRD databases were searched based on the eligibility criteria for all types of studies on NIV use in patients with ALS published up to January 2022. Data were extracted from the included studies, and the findings were presented using a narrative synthesis. RESULTS: Of the 120 papers identified, only 14 were related to systematic reviews. After thorough reading, only one meta-analysis was considered eligible. In the second stage, 248 studies were included; however, only one systematic review was included. The results demonstrated that NIV provided relief from the symptoms of chronic hypoventilation, increased survival, and improved QOL compared to standard care. These results varied according to clinical phenotype. CONCLUSIONS: NIV in patients with ALS improves the outcome and can delay the indication for tracheostomy, reducing expenditure on hospitalization and occupancy of intensive care unit beds. SYSTEMATIC REVIEW REGISTRATION: PROSPERO database: CRD42021279910 — https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=279910.

Quality of life of older adults in Family Health Strategy: a cross-sectional study

ABSTRACT BACKGROUND: With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals. OBJECTIVES: To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program. DESIGN AND SETTING: This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil. METHODS: We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL. RESULTS: The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (β = -4.55; P = 0.014), level of independence for daily living activities (β = 4.92; P < 0.001), self-assessment of regular health (β = 5.35; P < 0.001), and poor health (β = -8.67; P < 0.001). CONCLUSION: The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.

Chronic pain among older adults and its impact on satisfaction with social participation: development and validation of the "Instrument to Assess Older Adults' Social Participation". A descriptive quantitative study

ABSTRACT BACKGROUND: We aimed to develop and validate a practical instrument to assess older adults' satisfaction with their social participation (SP). DESIGN AND SETTING: This methodological validation study was conducted at a public higher education institution. METHODS: A two-phase study was designed, developed, and validated to assess older adults' satisfaction with their SP. In the first phase, we conceptualized SP and developed an "instrument to assess older adults' satisfaction with their SP (IAPSI)," as approved by a committee of specialists, pre-tested, and partially validated. Second, we determined the IAPSI's reproducibility using Cronbach's alpha to measure internal consistency, Pearson's and Spearman's coefficients to measure correlations, the Bland-Altman plot and intraclass correlation coefficient (ICC) to measure reproducibility. We also generated a receiver operating characteristic (ROC) curve. RESULTS: 102 older adults (mean age, 87.29) participated in the first phase. Moderate internal consistency (Cronbach's alpha 0.7) and significant moderate correlations with quality of life by World Health Organization Quality of Life (WHOQOL)-bref and by WHOQOL-old social domains (Pearson's coefficients 0.54 and 0.64, respectively; P < 0.001) were found. The ROC curve indicated an IAPSI score of 17 as the threshold for the impact of pain on satisfaction with SP (83.3% sensitivity and 88.9% specificity, P < 0.001). In the second phase, 56 older adults (between 81 and 90 years old) participated. We found adequate intra- and inter-observer reproducibility for the IAPSI (ICC 0.96 and 0.78, respectively). CONCLUSION: We have developed a practical instrument with appropriate psychometric properties to assess older adults' satisfaction with their SP.

Translation, cross-cultural adaptation, and validation of health and self-management in diabetes questionnaire (HASMID-10) into Brazilian Portuguese

ABSTRACT BACKGROUND: Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages. OBJECTIVE: To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese. DESIGN AND SETTING: A translation, cross-cultural adaptation, and validation study conducted at Ceuma University. METHODS: Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects. RESULTS: Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = −0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed. CONCLUSION: HASMID-10 has adequate measurement properties and may be used for Brazilians.

Quality of life and factors associated among public university employees retired due to disabilities / Qualidade de vida e fatores associados entre servidores aposentados por invalidez de universidades públicas / Calidad de vida y factores asociados de empleados jubilados por invalidez de universidades públicas

Abstract Objective: to analyze quality of life and factors associated among public university employees retired due to disabilities. Method: a cross-sectional study conducted with a sample of public university employees retired due to disabilities. A characterization questionnaire and the World Health Organization Quality of Life - Disabilities instrument were applied via telephone or online contacts from November 2019 to September 2020. The associated factors were verified through multiple linear regression. Results: of the 80 retirees due to disability, 15% were professors and 85% had a technical-administrative career. As for the factors associated with Quality of Life, continuous medication use (βadj: -0.25; p=0.02) and problems in the nervous system (βadj: -0.21; p<0.05) were associated with the Overall domain; continuous medication use (βadj: -0.23; p=0.04), to the Physical domain; smoking (βadj: -0.21; p<0.05) and mental and behavioral disorders (βadj: -0.21; p<0.01), to the Psychological domain; smoking (βadj: -0.46; p<0.01) and respiratory (βadj: -0.21; p=0.03) and circulatory (βadj: -0.21; p=0.03) problems, to the Social domain; smoking (βadj: -0.33; p<0.01) and problems in the nervous system (βadj: -0.22; p=0.04), to the Environmental domain; mental and behavioral disorders, to the Disabilities module (βadj: -0.29; p<0.01) and to the Discrimination domain (βadj: -0.21; p<0.05); and smoking (βadj: -0.32; p<0.01) and problems in the nervous system (βadj: -0.20; p<0.05), to the Inclusion domain. The Autonomy domain did not present any association. Conclusion: the retirees under study presented impaired Quality of Life.

Resumo Objetivo: analisar a qualidade de vida e os fatores associados entre servidores de universidades públicas aposentados por invalidez. Método: estudo transversal, com amostra de servidores aposentados por invalidez de universidades públicas. Um questionário de caracterização e o World Health Organization Quality of Life - Disabilities foram aplicados por contato telefônico ou online no período de novembro de 2019 a setembro de 2020. Verificaram-se os fatores associados por regressão linear múltipla. Resultados: dos 80 aposentados por invalidez, 15% eram docentes e 85% da carreira técnica-administrativa. Quanto aos fatores associados à qualidade de vida, o uso de medicação contínua (βaj: -0,25; p=0,02) e os problemas do sistema nervoso (βaj: -0,21; p<0,05) associaram-se ao domínio Overall; o uso de medicação contínua (βaj: -0,23; p=0,04) ao domínio físico; o tabagismo (βaj: -0,21; p<0,05) e os transtornos mentais e comportamentais (βaj: -0,21; p<0,01) ao domínio psicológico; o tabagismo (βaj: -0,46; p<0,01), os problemas respiratórios (βaj: -0,21; p=0,03) e circulatórios (βaj: -0,21; p=0,03) ao domínio social; o tabagismo (βaj: -0,33; p<0,01) e os problemas do sistema nervoso (βaj: -0,22; p=0,04) ao domínio ambiental; os transtornos mentais e comportamentais ao módulo incapacidades (βaj: -0,29; p<0,01) e ao domínio discriminação (βaj: -0,21; p<0,05); o tabagismo (βaj: -0,32; p<0,01) e os problemas do sistema nervoso (βaj: -0,20; p<0,05) ao domínio inclusão. O domínio autonomia não apresentou associação. Conclusão: os aposentados estudados apresentaram uma qualidade de vida prejudicada.

Resumen Objetivo: analizar la calidad de vida y los factores asociados de empleados de universidades públicas jubilados por invalidez. Método: estudio transversal, con una muestra de trabajadores jubilados por invalidez de universidades públicas. Se aplicó un cuestionario de caracterización y el World Health Organization Quality of Life - Disabilities mediante contacto telefónico u online desde noviembre de 2019 hasta septiembre de 2020. Los factores asociados se verificaron mediante regresión lineal múltiple. Resultados: de los 80 jubilados por invalidez, el 15% era docente y el 85% era técnico-administrativo. En cuanto a los factores asociados a la calidad de vida, el uso continuo de medicamentos (βaj: -0,25; p=0,02) y los problemas del sistema nervioso (βaj: -0,21; p<0,05) se asociaron al dominio overall; el uso continuo de medicamentos (βaj: -0,23; p=0,04) el dominio físico; el tabaquismo (βaj: -0,21; p<0,05) y los trastornos mentales y conductuales (βaj: -0,21; p<0,01) al dominio psicológico; el tabaquismo (βaj: -0,46; p<0,01), los problemas respiratorios (βaj: -0,21; p=0,03) y circulatorios (βaj:-0,21;p=0,03) al dominio social; el tabaquismo (βaj: -0,33; p<0,01) y los problemas del sistema nervioso (βaj: -0,22; p=0,04) al dominio ambiental; los trastornos mentales y conductuales al módulo discapacidad (βaj: -0,29; p<0,01) y al dominio discriminación (βaj: -0,21; p<0,05); el tabaquismo (βaj: -0,32; p<0,01) y los problemas del sistema nervioso (βaj: -0,20; p<0,05) al dominio inclusión. El dominio autonomía no mostró asociación. Conclusión: la calidad de vida de los jubilados por invalidez que participaron del estudio estaba deteriorada.

Quality of life in caregivers of aged stroke survivors in southern Brazil: Arandomized clinical trial / Qualidade de vida de cuidadores de idosos sobreviventes de AVC no sul do Brasil: Ensaio clínico randomizado / Calidad de vida en cuidadores de adultos mayores sobrevivientes de accidentes cerebrovasculares en el sur de Brasil: Ensayo clínico aleatorizado

Abstract Objective: to evaluate the effect of nursing home care interventions on the quality of life in family caregivers of aged stroke survivors. Method: a Randomized Clinical Trial, blinded for outcome evaluation. Forty-eighty family caregivers of aged stroke survivors participated in the study. The Intervention Group received three home visits by nurses one month after hospital discharge to provide stroke-related education (i.e., how to access health services and perform care activities) and emotional support. The Control Group received the usual guidance from the health services. Quality of life was assessed using the World Health Organization Quality of Life Assessment (WHOQOL-BREF) instrument and the Old Module(WHOQOL-OLD) 1 week, 2 months, and 1 year after discharge. Results: the caregivers were mainly women, children, or spouses. The caregivers in the Intervention Group and Control Group did not significantly differ in terms of their Overall Quality of Life at baseline. There was no interaction effect between group allocation and Overall Quality of Life(p=0.625) over time. However, there was an interaction effect for Social Relations(p=0.019) and Autonomy (p=0.004). Conclusion: the intervention exerted a statistically significant effect on the quality of life of family caregivers with respect to social relationships and autonomy. Trial registration: NCT02807012.

Resumo Objetivo: avaliar o efeito de intervenção educativa domiciliar de enfermagem na qualidade de vida de cuidadores familiares de idosos sobreviventes de acidente vascular cerebral (AVC). Método: Ensaio Clínico Randomizado, cego para avaliação de resultados. Quarenta e oito cuidadores familiares de idosos sobreviventes de AVC participaram do estudo. O Grupo de Intervenção recebeu três visitas domiciliares de enfermeiros, um mês após a alta hospitalar, para fornecer educação relacionada ao AVC (como acessar os serviços de saúde e realizar atividades de cuidado) e apoio emocional. O Grupo Controle recebeu as orientações habituais dos serviços de saúde. A qualidade de vida foi avaliada usando o instrumento Avaliação da Qualidade de Vida da Organização Mundial da Saúde (WHOQOL-BREF) e o Módulo Old (WHOQOL-OLD) em 1 semana, 2 meses e 1 ano após a alta. Resultados: os cuidadores eram principalmente mulheres, filhos ou cônjuges. Os cuidadores do Grupo Intervenção e do Grupo Controle não diferiram significativamente em termos de Qualidade de Vida Geral no início do estudo. Não houve efeito de interação entre a alocação do grupo e a Qualidade de Vida Geral (p=0,625) ao longo do tempo. No entanto, houve efeito de interação para Relações Sociais (p=0,019) e Autonomia (p=0,004). Conclusão: a intervenção apresentou efeito estatisticamente significativo na qualidade de vida dos cuidadores familiares no que diz respeito às relações sociais e autonomia. Registro do ensaio clínico: NCT02807012.

Resumen Objetivo: evaluar el efecto de intervenciones de atención domiciliaria de enfermería sobre la calidad de vida en cuidadores familiares de adultos mayores sobrevivientes de accidentes cerebrovasculares. Método: Ensayo Clínico Aleatorizado, cegado para la evaluación de los desenlaces. Los participantes del estudio fueron 48cuidadores familiares de adultos mayores sobrevivientes de accidentes cerebrovasculares (ACV). El Grupo Intervención recibió tres visitas domiciliarias a cargo de enfermeros un mes después del alta hospitalaria, en las que se les ofreció instrucción relacionada con ACV (es decir, cómo acceder a los servicios de salud y realizar las actividades inherentes a los cuidados) y apoyo emocional. Al Grupo Control se le brindó la orientación habitual de los servicios de salud. La calidad de vida se evaluó mediante el instrumento World Health Organization Quality of Life Assessment (WHOQOL-BREF) y el módulo Old(WHOQOL-OLD) 1semana, 2meses y 1año después del alta. Resultados: en su mayoría, los cuidadores fueron mujeres, hijos o cónyuges. Los cuidadores de los grupos Intervención y Control no presentaron diferencias significativas en términos de su Calidad de Vida general de base. La intervención no ejerció ningún efecto entre la asignación a los grupos y la Calidad de Vida general(p=0,625) con el transcurso del tiempo. Sin embargo, la intervención sí tuvo efecto sobre las Relaciones Sociales (p=0,019) y la Autonomía(p=0,004). Conclusión: la intervención ejerció un efecto estadísticamente significativo sobre la calidad de vida de los cuidadores familiares con respecto a las relaciones sociales y a la autonomía. Registro del ensayo: NCT02807012.

Qualidade de vida no trabalho na estratégia saúde da família durante a pandemia da Covid-19 / Quality of work life in the family health strategy during the Covid-19 pandemic / Calidad de vida en el trabajo en la estrategia de salud familiar durante la pandemia del Covid-19

Objetivos: analisar a qualidade de vida no trabalho (QVT) na Estratégia Saúde da Família durante o período pandêmico e identificar na visão dos trabalhadores sugestões para promoção da qualidade de vida no ambiente laboral. Métodos: estudo transversal e quantitativo, realizado entre outubro de 2020 a junho de 2021 nas Unidades Básicas de Saúde de Palmas, capital do Tocantins, Brasil. Investigou-se o perfil sociodemográfico, a QVT por meio do Quality of Working Life Questionnaire (QOLWQbref) e sugestões para sua melhoria. Resultados: a QVT foi satisfatória para 91,96% dos 112 participantes, com níveis médios a altos em todos os domínios. Aqueles que não consideravam o trabalho estressante alcançaram melhor QVT. Entre as 113 sugestões para promoção da QVT, destacaram-se aspectos relacionados à Condições de Trabalho (29,19%) e Relacionamento na Equipe (19,46%). Conclusão: apesar da pandemia, a maioria dos participantes avaliaram QVT como satisfatória. As sugestões dos trabalhadores podem colaborar para manutenção e melhoria da QVT, protegendo a saúde do trabalhador.

Objective: to analyze the quality of life at work QoWL in the Family Health Strategy during the pandemic period and to identify suggestions for promoting quality of life in the work environment from the workers' point of view. Methods: quantitative study, carried out between October/2020 and June/2021 in the Primary Care Units of a Palmas, capital in Tocantins, Brazil. The sociodemographic profile, QoWL through the Quality of Working Life Questionnaire (QoWLQ-bref) and suggestions for its improvement were investigated. Results: the QoWL was satisfactory for 91.96% of the 112 participants, with medium to high levels in all domains. Those who did not consider work stressful achieved better QoWL. Of the 113 suggestions for promoting QoWL, aspects related to Working Conditions (29.19%) and Team Relationships (19.46%) stood out. Conclusion: despite the pandemic, most participants rated QoWL as satisfactory. Workers' suggestions can collaborate to maintain and improve QoWL, protecting workers' health.

Objetivo: analizar la calidad de vida en el trabajo (CVT) en la Estrategia de Salud de la Familia durante el período pandémico e identificar sugerencias para la promoción de la calidad de vida en el ambiente laboral desde la perspectiva de los trabajadores. Métodos: estudio cuantitativo, realizado entre octubre/2020 y junio/2021 en las Unidades Básicas de Salud de Palmas, capital del Tocantins, Brasil. Se investigó el perfil sociodemográfico, la CVL a través del Cuestionario de Calidad de Vida Laboral - Quality of Working Life Questionnaire (QoWLQ-bref) y sugerencias para su mejora. Resultados: la CVL fue satisfactoria para el 91,96% de los 112 participantes, cuyos niveles fueron de medios a altos en todos los dominios. Aquellos que no consideraban el trabajo estresante lograron mejor CVT. De las 113 sugerencias para promover la CVT, se destacaron aspectos relacionados con las Condiciones de Trabajo (29,19%) y las Relaciones de Equipo (19,46%). Conclusión: a pesar de la pandemia, la mayoría de los participantes calificaron la CVT como satisfactoria. Las sugerencias de los trabajadores pueden colaborar para mantener y mejorar la CVT, protegiendo la salud de los trabajadores

Auriculoterapia para reducir el dolor crónico de la columna vertebral de los trabajadores de la salud: ensayo clínico / Auriculotherapy for reducing chronic spinal pain in health workers: a clinical trial / Auriculoterapia para redução da dor crônica na coluna vertebral em trabalhadores da saúde: ensaio clínico

Objetivo: evaluar la efectividad de la auriculoterapia para reducir el dolor musculoesquelético crónico de la columna vertebral de los trabajadores de la salud. Método: ensayo clínico aleatorizado, triple ciego, realizado con trabajadores de la salud diagnosticados con dolor crónico en la columna vertebral. Se aplicaron ocho sesiones de auriculoterapia con semillas, dos por semana. Los resultados fueron medidos con la Escala Numérica del Dolor, el Inventario Breve del Dolor, el Cuestionario de Discapacidad de Roland-Morris y los instrumentos SF-36, en la 1.ª, 4.ª, 8.ª sesión y follow-up a los 15 días. Análisis descriptivo e inferencial. Resultados: participaron 34 trabajadores del grupo intervención y 33 del grupo control, ambos mostraron una reducción en la intensidad del dolor (p>0,05). En el follow-up se registró una mayor reducción en el grupo intervención (3,32 ± 0,42) que en el grupo control (5,00 ± 0,43) (p=0,007). En cuanto a la calidad de vida, mejoró la vitalidad (p=0,012) y la limitación por aspectos emocionales (p=0,025). La relación entre auriculoterapia, discapacidad física e interferencia del dolor no difirió entre los grupos (p>0,05). El uso de medicamentos en el follow-up se mantuvo en el grupo control (77,8%) con respecto al grupo intervención (22,2%) (p=0,013). Conclusión: la auriculoterapia tuvo el mismo efecto en ambos grupos sobre la intensidad del dolor y duró más en el follow-up. Hubo una mejora en la calidad de vida y una reducción en el consumo de medicamentos. REBEC: RBR-3jvmdn.

Objective: to evaluate the effectiveness of auriculotherapy in reducing chronic musculoskeletal pain in the spine of health workers. Method: a randomized, triple-blind clinical trial conducted with health workers diagnosed with chronic spinal pain. Eight sessions of auriculotherapy with seeds were applied, two per week. The outcomes were measured with the Numerical Pain Scale, Brief Pain Inventory, Rolland-Morris Disability Questionnaire and SF-36 instruments, in the 1st, 4th and 8th session, and in the 15-day follow-up period. Descriptive and inferential analyses were performed. Results: 34 workers took part in the Intervention Group and 33 in the Control Group, and both presented reduced pain intensity (p>0.05). In the follow-up period, there was a greater reduction in the Intervention Group (3.32 ± 0.42), when compared to the Control Group (5.00 ± 0.43) (p=0.007). In quality of life, there was improved vitality (p=0.012) and limitation due to emotional aspects (p=0.025). The relationship between auriculotherapy, physical disability and pain interference did not differ between the groups (p>0.05). Medication use in the follow-up period remained unchanged in the Control Group (77.8%) when compared to the Intervention Group (22.2%) (p=0.013). Conclusion: auriculotherapy exerted the same effect between the groups on pain intensity, lasting longer in the follow-up period. There was an improvement in quality of life and a reduction in medication use. REBEC: RBR-3jvmdn.

Objetivo: avaliar a eficácia da auriculoterapia na redução da dor musculoesquelética crônica na coluna vertebral de trabalhadores da área da saúde. Método: ensaio clínico randomizado, triplo cego, realizado com trabalhadores da saúde com diagnóstico de dor crônica na coluna vertebral. Aplicaram-se oito sessões de auriculoterapia com sementes, duas por semana. Desfechos mensurados com os instrumentos Escala Numérica da Dor, Inventário Breve de Dor, Questionário de Incapacidade de Rolland-Morris e SF-36, na 1ª, 4ª, 8ª sessão, e follow-up de 15 dias. Análise descritiva e inferencial. Resultados: participaram 34 trabalhadores no grupo intervenção e 33 no controle, ambos apresentaram redução da intensidade da dor (p>0,05). No follow-up, maior redução no grupo intervenção (3,32 ± 0,42), comparado ao controle (5,00 ± 0,43) (p=0,007). Na qualidade de vida, melhorou a vitalidade (p=0,012) e limitação por aspectos emocionais (p=0,025). Relação entre auriculoterapia, incapacidade física e interferência da dor não diferiu entre os grupos (p>0,05). O uso de medicamentos, no follow-up, manteve-se no grupo controle (77,8%) se comparado à intervenção (22,2%) (p=0,013). Conclusão: a auriculoterapia apresentou igual efeito entre os grupos na intensidade da dor, com maior durabilidade deste no follow-up. Houve melhora da qualidade de vida e redução do consumo de medicamentos. REBEC: RBR-3jvmdn.

Síntomas de depresión, ansiedad y estrés en estudiantes del área de la salud e impacto en la calidad de vida / Symptoms of depression, anxiety and stress in health students and impact on quality of life / Sintomas de depressão, ansiedade e estresse em estudantes da saúde e impacto na qualidade de vida

Objetivo: evaluar la asociación entre la calidad de vida y la presencia de síntomas de depresión, ansiedad y estrés en estudiantes universitarios del área de la salud. Método: estudio transversal que incluyó a 321 estudiantes de carreras del área de la salud. La calidad de vida se midió mediante la escala de la Organización Mundial de la Salud, versión abreviada, en los dominios físico, psicológico, relaciones sociales y ambiente, y los síntomas se evaluaron por la escala de depresión, ansiedad y estrés. Se realizó un análisis multivariante por medio de regresión lineal robusta para evaluar la asociación entre la calidad de vida y los síntomas presentados. Resultados: se observó una asociación negativa entre la calidad de vida y los síntomas de depresión en todos los dominios, mientras que los síntomas de ansiedad tuvieron una asociación negativa en el dominio ambiente, y los síntomas de estrés tuvieron una asociación negativa en el dominio psicológico. La gravedad de los síntomas se asoció desfavorablemente con la calidad de vida, es decir, cuanto mayor la gravedad de los síntomas, menores las puntuaciones medias en todos los dominios. Conclusión: los síntomas de depresión, ansiedad y estrés fueron prevalentes e impactaron negativamente en la calidad de vida de los estudiantes, especialmente en presencia de síntomas depresivos. Las puntuaciones disminuidas se asociaron significativamente con la gravedad de los síntomas.

Objective: to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area. Method: cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms. Results: a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains. Conclusion: symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students' quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.

Objetivo: avaliar a associação entre qualidade de vida e presença de sintomas de depressão, ansiedade e estresse em estudantes universitários da área da saúde. Método: estudo transversal que incluiu 321 estudantes de cursos de graduação da área da saúde. A qualidade de vida foi mensurada por meio da escala da Organização Mundial da Saúde, versão abreviada, nos domínios físico, psicológico, relações sociais e meio ambiente, e os sintomas avaliados pela escala de depressão, ansiedade e estresse. Foi realizada análise multivariada utilizando regressão linear robusta para avaliar a associação entre qualidade de vida e sintomas apresentados. Resultados: observou- se associação negativa entre qualidade de vida e sintomas de depressão em todos os domínios, enquanto os sintomas de ansiedade apresentaram associação negativa no domínio meio ambiente, e os sintomas de estresse tiveram associação negativa no domínio psicológico. A gravidade dos sintomas associou-se de forma desfavorável com a qualidade de vida, ou seja, quanto maior a gravidade dos sintomas, menor a média dos escores em todos os domínios. Conclusão: sintomas de depressão, ansiedade e estresse mostraram-se prevalentes e com impacto negativo na qualidade de vida dos estudantes, principalmente na presença de sintomas depressivos. A diminuição dos escores foi significativamente associada à gravidade dos sintomas.

Adaptation and validation of the Spanish version of the thyroid-cancer-specific Thyca-QoL scale: A cross-sectional study / Adaptación y validación de la versión en español de la escala thyroid-cancer-specific Thyca-QoL: Estudio de corte transversal

Introduction. Thyca-QoL is a specific instrument to assess QoL in thyroid cancer patients, but it is not validated in Spanish language. The aim was to assess the psychometric properties of the Thyca-QoL. Methods. This is a prospective cross-sectional study. The Thyca-QoL was translated and adapted to Spanish language. A psychometric validation using an exploratory principal axis factor analysis and confirmatory analysis, concurrent validation compared with EORTC QLQ-C30 and a test-retest reliability assessment was done. Results. A total of 296 patients were included. Exploratory factor analysis showed a seven-factor solution with good diagnostic tests results. Cronbach ́s alpha for the global scale was 0.86. The comparison between the Thyca-QoL and the EORTC QLQ-C30 demonstrated a high correlation (rho= 0.75) and coefficient for test-retest was 0.87. Discussion. The validation process followed all the methodological steps necessary to guarantee the performance of the instrument. The measurements of the internal validity, reliability, and reproducibility reached similar results as the original validation. The factor analysis showed a solution with seven factors that resembles the original results. Reproducibility was high for voice, sympathetic, sex, and chilliness domains and moderate for the others; the instrument had the ability to discriminate between clinical conditions. Conclusion. The spanish version of the thyroid-cancer-specific Thyca-QoL is a reliable and objective instrument to be used in clinical practice and for research objectives in Spanish speaking patients

Introducción. Thyca-QoL es un instrumento específico para evaluar la calidad de vida en pacientes con cáncer de tiroides, pero no está validado en idioma español. El objetivo de este estudio fue evaluar las propiedades psicométricas de Thyca-QoL. Métodos. Se hizo un estudio prospectivo transversal. El Thyca-QoL fue traducido y adaptado al idioma español. Se realizó una validación psicométrica mediante un análisis factorial exploratorio del eje principal y un análisis confirmatorio, una validación concurrente en comparación con EORTC QLQ-C30 y una evaluación de la fiabilidad test-retest. Resultados. Se incluyeron 296 pacientes. El análisis factorial exploratorio mostró una solución de siete factores con buenos resultados en las pruebas de diagnóstico. El alfa de Cronbach para la escala global fue de 0,86. La comparación entre Thyca-QoL y EORTC QLQ-C30 demostró una alta correlación (rho = 0,75) y el coeficiente para test-retest fue 0,87. Discusión. El proceso de validación siguió todos los pasos metodológicos necesarios para garantizar el desempeño del instrumento. Las medidas de validez interna, confiabilidad y reproducibilidad alcanzaron resultados similares a los de la validación original. El análisis factorial mostró una solución con siete factores que se asemeja a los resultados originales. La reproducibilidad fue alta para los dominios de voz, simpático, sexo y escalofríos y moderada para los demás; el instrumento tuvo la capacidad de discriminar entre condiciones clínicas.Conclusión. La versión en español de la escala thyroid-cancer-specific Thyca-QoL es un instrumento confiable y objetivo para ser utilizado en la práctica clínica y para objetivos de investigación en pacientes hispanohablantes

Calidad de vida relacionada con la salud en niños y niñas con síndrome de Down / Health-related quality of life in children with Down syndrome

Introducción. Los pacientes con síndrome de Down (SD) presentan características que pueden afectar su calidad de vida. El objetivo de este trabajo fue evaluar la calidad de vida relacionada con la salud (CVRS) en pacientes con síndrome de Down. Población y métodos. Se realizó un estudio de corte transversal para evaluar CVRS con el cuestionario PedsQL 4.0 a pacientes de 2 a 4 años con síndrome de Down y a pacientes sanos en 2020-2021 en un hospital universitario. Resultados. Se incluyeron 51 pacientes en cada grupo. El puntaje de CVRS en infantes con SD fue 82,1 vs. 88 (p = 0,003) comparado con población sin SD. La salud psicosocial fue la más afectada (p = 0,007), especialmente, en el funcionamiento social y el escolar (p = 0,0001). Conclusión. Se observó que los niños y niñas con SD de 2 a 4 años tuvieron menor CVRS. La escala de la salud psicosocial fue más afectada, especialmente, el funcionamiento social y el escolar.

Introduction. The characteristics of patients with Down syndrome (DS) may affect their quality of life. The objective of this study was to assess the health-related quality of life (HRQoL) in patients with DS. Population and methods. This was a cross-sectional study to assess the HRQoL with the PedsQL 4.0 questionnaire administered to patients with DS and healthy patients aged 2 to 4 years in 2020­2021 at a teaching hospital. Results. Each study group included 51 patients. The HRQoL score in children with DS was 82.1 compared to 88 (p = 0.003) in the population without DS. Psychosocial health was impacted the most (p = 0.007), especially in terms of social and school functioning (p = 0.0001). Conclusion. Children with DS aged 2 to 4 years were observed to have a lower HRQoL. The psychosocial health scale was affected the most, especially in terms of social and school functioning.

A comparative study of vision-related quality of life (VRQoL) among glaucoma and nonglaucoma patients at a tertiary care center of North India

Purpose: Glaucoma influences vision?related quality of life (VRQoL) of an individual in various ways. There are very limited studies on the Indian population and the northern part of India. Therefore, we conducted the present study to evaluate VRQoL in glaucoma patients as well as the association between the severity of glaucoma and VRQoL. Methods: An institution?based, cross?sectional, analytical study was conducted from August 2022 to October 2022 involving 190 participants (95 glaucoma patients and 95 controls). The glaucoma quality of life?15 (GQL?15) questionnaire was explained in their vernacular language by the interviewer. The scoring was given according to the validated scoring algorithm for the questionnaire. Results: Mean GQL score in the control group was 19.66 ± 5.5 and in glaucoma cases was 32.8 ± 10.2, whereas the mean score of mild glaucoma cases was 22.3 ± 4.83, moderate glaucoma cases was 36.3 ± 4.09, and severe glaucoma cases was 47.24 ± 3.03. Therefore, as the severity of glaucoma increases, the GQL score also increases, indicating poorer quality of life. Visual field loss was strongly positively correlated (correlation coefficient = 0.759, P < 0.01) with the GQL?15 score, while a weaker positive correlation was found with best corrected visual acuity (BCVA), cup disc ratio, and duration of treatment. Conclusion: Besides controlling or reducing intraocular pressure (IOP) to the target level, the goal of glaucoma treatment should be to provide an individual with good functional vision to maintain an acceptable quality of life. It would also help in providing patients with the best possible treatment, not only in terms of good vision but also in maintaining or improving their overall quality of life.

Adaptación transcultural y validación de la versión en español del cuestionario de carga de tratamiento en personas con diabetes mellitus tipo 2 que concurren a centros de atención primaria del sector público de salud. San Juan / Transcultural adaptation and validation of the spanish version of the treatment burden questionnaire for people with diabetes mellitus type 2 that attend to primary health care centers within the public health care system. San Juan

Introducción: el Treatment Burden Questionnaire (TBQ) evalúa la carga que implica el autocuidado de personas con enfermedades crónicas y el impacto que la asistencia sanitaria genera en su calidad de vida. Objetivos: adaptar y validar psicométricamente la versión en español del cuestionario TBQ-esclerosis múltiple al contexto de la diabetes mellitus (DM) en pacientes atendidos en el sector público de Argentina. Materiales y métodos: estudio analítico de adaptación transcultural y validación psicométrica de un cuestionario. Se realizó un análisis factorial exploratorio (AFE) y un análisis factorial confirmatorio (AFC). La validez de criterio concurrente se evaluó a través de la correlación Pearson con tres escalas (OMS-5, PHQ-9 y test de Morisky-Green). La fiabilidad se analizó a través del coeficiente alfa de Cronbach, de la fiabilidad compuesta y la varianza media extractada. Resultados: participaron 256 personas. La versión adaptada fue adecuadamente comprendida por la población destinataria. El AFE (n=100) permitió hipotetizar cuatro dominios: 1) tratamiento farmacológico; 2) asistencia sanitaria/sistema de salud; 3) mantenimiento de un estilo de vida y su repercusión económica; 4) esfera psicosocial. En el AFC (n=156) las cargas factoriales del 87,5% (14/16) de los ítems fueron mayores a 0,5 con significancia estadística. Se documentó correlación inversa (-0,46; p=0,0002) con el puntaje OMS-5 y directa (0,36; p=0,0046) con PHQ-9. Los pacientes categorizados como "no adherentes" mediante la escala de Morisky-Green-Levine arrojaron un resultado de TBQ-DM de 16,99 (IC 95%: 0,95 a 33,03) puntos más que los pacientes categorizados como "adherentes" (p=0,0383). La consistencia interna del cuestionario fue muy buena (alfa de Cronbach: 0,87), su fiabilidad compuesta fue aceptable y su validez divergente, baja. Conclusiones: el TBQ en español adaptado a DM2 tiene aceptables propiedades psicométricas. Su implementación podría ofrecer cuidados basados en la persona.

Introduction: the Treatment Burden Questionnaire (TBQ) assess the load that implies the self-care for people with chronic diseases and the impact that medical assistance produce in their quality of life. Objectives: to adapt and psychometrically validate the spanish version of the TBQ-multiple sclerosis questionnaire to the diabetes mellitus (DM) context in patients treated in the Argentinian public health sector. Materials and methods: analytic study of transcultural adaptation and psychometric validation of a questionnaire. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were performed. Concurrent criterion validity was evaluated through Pearson correlation with three scales (WHO-5, PHQ-9, Morisky-Green Test). Reliability was evaluated through Cronbach's alpha coefficient, composite reliability, and average variance extracted. Results: 256 people participated. The adapted version was adequately understood by the target population. EFA (n=100) allowed for the hypothesis of four domains: 1) pharmacological treatment; 2) healthcare/health system; 3) maintenance of a lifestyle and its economic impact; 4) psychosocial sphere. In the CFA (n=156), the factor loadings of 87.5% (14/16) of the items were greater than 0.5 with statistical significance. An inverse correlation (-0.46; p=0.0002) with the WHO-5 index and a direct correlation (0.36; p=0.0046) with the PHQ-9 scale were documented. Patients categorized as "non-adherent" by the Morisky-Green-Levine scale had a TBQ-DM score of 16.99 (95% CI: 0.95 to 33.03) points higher than patients categorized as "adherent" (p=0.0383). The internal consistency of the questionnaire was very good (Cronbach's alpha: 0.87), its composite reliability was acceptable, and its divergent validity was low. Conclusions: the spanish TBQ adapted to DM2 has acceptable pyshcometric properties. Its implementation can help offer a person-centered care.

A relação entre o comprometimento motor e os sintomas depressivos na doença de Parkinson / The relationship between motor impairment and depressive symptoms in Parkinson's disease

Trata-se de um estudo transversal retrospectivo que incluiu 27 pessoas com doença de Parkinson (DP), diagnosticados por neurologista. O objetivo do estudo foi analisar o tipo de correlação entre o grau de comprometimento motor e grau de depressão em pessoas com DP, tendo como hipótese que quanto maior o grau de comprometimento motor proporcionado pela doença, maior o grau de depressão. Foram utilizados os instrumentos Inventário de Depressão de Beck (BDI II) para a medida de sintomas depressivos e do grau de depressão, e a escala Hoehn & Yahr foi aplicada para identificação do grau de comprometimento motor. Foram excluídos indivíduos que não preencheram um dos instrumentos do estudo, selecionando apenas as pessoas com DP que preencheram ambos os instrumentos. Verificou-se uma correlação positiva e significativa entre os resultados do BDI -II e a escala Hoehn & Yahr modificada (r = 0,41, p = 0,035). O estudo identificou, portanto, uma associação crescente e positiva entre o grau de comprometimento motor das pessoas com DP e a presença de sintomas de depressão. Com isso, foi possível concluir que, uma pessoa com DP e maior grau de comprometimento motor, tende a apresentar maior número de sintomas depressivos e, consequentemente maior grau de depressão e vice-versa. Portanto, deve-se dedicar maior atenção à saúde mental dos casos em que a doença se expressa com maior comprometimento motor.

This is a retrospective cross-sectional study that included 27 people with Parkinson's disease (PD), diagnosed by a neurologist. The objective of the study was to analyze the type of correlation between the degree of physical impairment and degree of depression in people with PD, having as hypothesis that the greater the degree of physical impairment provided by the disease, the greater the degree of depression. The Beck Depression Inventory (BDI II) was used to measure depressive symptoms and the degree of depression, and the modified Hoehn & Yahr scale was applied to identify the degree of physical impairment. Individuals who did not complete one of the study instruments were excluded, selecting only those people with PD who completed both instruments. A positive and significant correlation can be verified between the results of the BDI -II and the Hoehn & Yahr scale (r = 0.41, p = 0.035). The study identified, therefore, an increasing and positive association between the degree of motor impairment of people with PD and the presence of symptoms of depression. With this, it was possible to conclude that, a person with PD and a higher degree of motor impairment, tends to present a higher number of depressive symptoms and, consequently, a higher level of depression and vice versa. Thus, the more physically compromised the person with PD is, the greater the association with a more severe depression. Therefore, greater attention should be paid to mental health in cases in which the disease is expressed with greater physical impairment.

Traducción al español, retraducción y validación de contenido de la escala Quality of Life in Alzheimer's Disease en pacientes con demencia Alzheimer / Spanish translation, retranslation, and content validation of the Quality of Life in Alzheimer's Disease scale in patients with Alzheimer's dementia

Introducción Se estima que para el año 2050 los mayores de 60 años corresponderán al 22% de la población mundial y con ello aumente la incidencia y prevalencia de enfermedad de Alzheimer. Uno de los pilares del tratamiento de esta condición es mejorar la calidad de vida, en este sentido surgen herramientas como la Quality of Life in Alzheimer's Disease Scale que permite medir calidad de vida en pacientes y sus cuidadores. Objetivo Realizar la traducción al español chileno y validación de contenido de la Quality of Life in Alzheimer's Disease Scale en pacientes con demencia por Alzheimer del Hospital Guillermo Grant Benavente de Concepción, Chile. Métodos Se llevó a cabo la traducción, retraducción y validez de contenido por juicio experto, utilizando el análisis Lawshe, pre-test y validación semántica usando la estrategia de respondent debriefing. Resultados Las versiones traducidas y retraducidas fueron comparadas entre ellas y con la versión original. Lawshe indica que una razón de validez de contenido de 0,49 es adecuado para considerar aceptable el ítem cuando en el proceso de validación de contenido han participado 15 expertos como en este estudio. El análisis arrojó una razón de validez de contenido mayor a 0,49 en 11 de los 13 ítems de la escala. De estos, ocho obtuvieron un valor superior a 0,8 y tres entre 0,49 y 0,79. En la validación semántica mediante la estrategia de se aplicó la escala a cinco personas con enfermedad de Alzheimer y a sus respectivos cuidadores. Con los datos obtenidos, se generaron modificaciones en aquellos ítems que obtuvieron una razón de validez de contenido menor a 0,49. Conclusión La versión obtenida en español de la resulta ser válida desde el punto de vista de su contenido y equivalente a su versión original.

Introduction It is estimated that by the year 2050, persons over 60 will account for 22% of the world population. Consequently, the incidence and prevalence of Alzheimer's disease will increase correspondingly. One of the pillars of the treatment of this condition is to improve the quality of life. In this sense, questionnaires such as the Quality of Life in Alzheimer's Disease allow us to measure the quality of life in patients and caregivers. Objective To translate into Chilean Spanish and carry out the content validation of the Quality of Life in Alzheimer's Disease scale in patients with Alzheimer's dementia at the Guillermo Grant Benavente Hospital in Concepción, Chile. Methods Translation, back-translation and content validity were carried out by expert judgment, using Lawshe analysis, pre-test and semantic validation using the respondent debriefing strategy. Results The translated and retranslated versions were compared with each other and with the original version. Lawshe indicates that a Content Validity Ratio equal 0.49 is adequate to consider the item valid when 15 experts participated in the content validation process, as in our study. The analysis yielded a content validity ratio greater than 0.49 in 11 of the 13 items on the scale. Of these, 8 obtained a value greater than 0.8 and 3 between 0.49 and 0.79. In semantic validation using the respondent debriefing strategy, the scale was applied to five people with Alzheimer's and their respective caregivers. With the data obtained, modifications were generated in those items that obtained a content validity ratio of less than 0.49. Conclusions The version obtained in Spanish of the Quality of Life in Alzheimer's Disease scale is valid from the point of view of its content and equivalent to its original version.

Assessment of quality of life in glaucoma patients in a tertiary care center in Eastern India

Purpose: The aim of this study is to assess the quality of life (QOL) in glaucoma patients and find out the sociodemographic factors predicting QOL. Methods: A cross?sectional study was conducted in a tertiary care center from August 2021 to February 2022. Subjects diagnosed with glaucoma for at least 6 months were enrolled. After taking informed consent, demographic details and detailed history were collected for all patients. Comprehensive eye examination (visual acuity, intraocular pressure, gonioscopy, fundoscopy, visual field assessment, ocular coherence tomogram assessment) was done for all and they were asked to fill the WHOQOL?BREF questionnaire. Data were collected and analyzed using SPSS 21. Results: One hundred and ninety?nine patients were recruited. Mean age of participants was 57.99 ± 10.76 years. Based on various domains and subgroups, QOL values were significant with respect to income (P = 0.016). Gender?wise QOL in females was lower than that of males with respect to all the domains (P = 0.001). While marital status affected both environmental and social domain, literacy affected only the social domain. A variation in intraocular pressure affected the QOL in the psychological domain. QOL was not significantly associated with the severity of the disease. Gender was the most predominant predictor out of all sociodemographic factors. Conclusion: Chronic diseases affect the QOL of individuals in many ways. Glaucoma being a chronic disease hampers patients’ vision irreversibly and by extension the various physical, social, and psychological aspects of the patient’s life as well. Hence, knowledge of the change in QOL it brings about can help plan the treatment, counseling, and management of these patients.

Impact of glaucoma on vision-specific quality of life in monocular glaucoma patients using the Indian vision function questionnaire

Purpose: To evaluate the determinants affecting the quality of life in monocular glaucoma patients using the Indian vision function questionnaire. Methods: In this prospective cross?sectional study, total of 196 patients were divided into two groups: cases and controls. Indian Vision Function Questionnaire (IND?VFQ) was administered and analyzed. One hundred twenty?nine (58.6%) patients who had lost their vision in one eye due to glaucoma were included as cases and 67 (30.4%) patients who had lost their vision due to other causes were taken as controls. Results: Median composite score of subscales was 54.62 (29.7–74.7) in group 1 and 45.38 (23.7–76.7) in group 2. The psychosocial impact scale was the most affected scale, the median scores were 33.02 (0 to 60.0) and 19.07 (0 to 53.0) in groups 1 and 2, respectively. Among all dimensions of IND?VFQ, the highest score was for color vision 100.0 (0–100.0) and 100.0 (0–100.0), and the lowest median score was found in mental health and dependency in both the groups. Multiple linear regression analysis demonstrated that visual acuity was associated with a low score (P < 0.001). Female gender was significantly associated with the overall score in the univariate model (P = 0.006). Conclusion: Monocular glaucoma patients have a poor general and vision?related quality of life. Depression associated with monocularity and the perception of dependency and being a burden on their family members greatly impacted the mental health of the participants

Visual acuity, contrast sensitivity, and quality of life after bilateral implantation of multifocal diffractive intraocular lens / Acuidade visual, sensibilidade ao contraste e qualidade de vida após implante bilateral de lente intraocular multifocal difrativa

ABSTRACT Purpose: To evaluate visual outcomes, satisfaction, and quality of life of patients assisted in a Medical School hospital by the Brazilian Public Health System, who underwent bilateral diffractive multifocal intraocular lens implantation. Methods: Case series study with intervention, including 20 patients who underwent bilateral implantation of multifocal IOL EyeDiff® (Eyeol UK, Dunstable, UK). Exclusion criteria were corneal astigmatism >1.5 cylindrical diopters, previous ocular surgery or ocular disease, and intra- or postoperative complications. Patients were evaluated one, three, and six months after surgery. Monocular and binocular visual acuity for distance, intermediate and near, under photopic and mesopic conditions, monocular contrast sensitivity under photopic conditions, defocus curve, and quality of life were assessed. Results: Monocular distance-corrected visual acuity was 0.3 logMAR or better and monocular distance-corrected near visual acuity was J3 or better in all eyes under photopic conditions. Binocular distance-corrected near visual acuity was J1 in all cases. Contrast sensitivity was at the minimum level of normality for low and high spatial frequencies and within normal limits for intermediate spatial frequency. The quality of life questionnaire showed a high level of patient satisfaction. Conclusion: Bilateral implantation of the multifocal intraocular lens EyeDiff® provides patients with good visual acuity and quality of life, besides spectacle independence. The visual acuity and contrast sensitivity progressively improved between one and six postoperative months.

RESUMO Objetivo: Avaliar os resultados visuais, satisfação e qualidade de vida de pacientes atendidos em um hospital escola pelo Sistema Único de Saúde, submetidos a implante bilateral de lente intraocular multifocal difrativa. Métodos: Estudo tipo série de casos com intervenção, incluindo 20 pacientes submetidos a implante bilateral da lente intraocular multifocal difrativa EyeDiff® (Eyeol UK, Dunstable, UK). Os critérios de exclusão foram astigmatismo corneano >1,5 dioptria cilíndrica, cirurgia ou doença ocular prévias e complicações intraoperatórias ou pós-operatórias. Os pacientes foram avaliados após 1, 3 e 6 meses da cirurgia. Foram avaliadas a acuidade visual monocular e binocular para longe, intermediário e perto sob condições fotópica e mesópica, sensibilidade ao contraste monocular sob condições fotópicas, curva de defocus e questionário para avaliação da qualidade de vida. Resultados: A acuidade visual para longe corrigida monocular foi de 0,3 logMAR ou melhor e a acuidade visual para perto com correção para longe foi J3 ou melhor em todos os olhos, sob condições fotópicas. A acuidade visual binocular para perto com a correção para longe foi J1 em todos os casos. A sensibilidade ao contraste estava no nível mínimo de normalidade para frequências espaciais baixas e altas e abaixo dos limites normais para frequência espacial intermediária. O questionário de qualidade de vida mostrou que os pacientes apresentavam altos níveis de satisfação. Conclusão: O implante bilateral da lente intraocular multifocal EyeDiff® proporcionou boa acuidade visual e qualidade de vida, e independência de óculos aos pacientes. A acuidade visual e a sensibilidade ao contraste melhoraram progressivamente entre um e seis meses de pós-operatório.

Neuropsychological and quality of life outcomes in PKU patients: expert recommendations of assessment tools in Brazil / Desfechos neuropsicológicos e de qualidade de vida em pacientes com PKU: recomendações de especialistas sobre ferramentas de avaliação no Brasil

Abstract Background Phenylketonuria (PKU) is an inborn error of metabolism caused by deficient activity of phenylalanine hydroxylase. In Brazil, the National Neonatal Screening Program enables early treatment of patients with PKU, which prevents them from developing severe neurological damage and mental disabilities. However, between 20 and 30% of early-treated patients with PKU present focal cognitive deficits, including deficits in working memory, processing speed, and psychiatric symptoms such as anxiety, depression, and attention deficit hyperactivity disorder (ADHD). Therefore, age-specific neuropsychiatric and cognitive tests are important components of PKU patient care. To date, there are no officially approved guidelines or recommendations of tools in Portuguese validated for use in Brazil that could be applied to assess these parameters in patients with PKU. Objective To recommend tools validated for use in Brazil that can be used in daily clinical practice to assess quality of life and neuropsychological outcomes in patients with PKU. Methods Six Brazilian experts discussed about eligible tools based on their clinical experience, the feasibility of their use in clinical routines, and their availability in public health services. Before the meeting, an independent review of the literature was conducted to identify the currently validated tools in Brazil, using the MEDLINE and SciELO databases. Results The experts recommended nine tools to assess quality of life (Peds-QL, SF-36 or WHOQOL-bref), executive function (BRIEF or Bayley-III), IQ (SONR 2½-7[a] or WASI) and ADHD (MTA-SNAP-IV and ASRS). Conclusions These instruments may be easily incorporated into clinical practice and improve the quality of multidisciplinary care of patients with PKU.

Resumo Antecedentes A fenilcetonúria (PKU) é um erro inato do metabolismo causado pela atividade deficiente da fenilalanina hidroxilase. No Brasil, o Programa Nacional de Triagem Neonatal permite o tratamento precoce de pacientes com PKU, o que os impede de desenvolver danos neurológicos e deficiências intelectuais graves. No entanto, já foi descrito que de 20 a 30% dos pacientes tratados precocemente com PKU apresentam déficits cognitivos focais, incluindo déficits na memória de trabalho, velocidade de processamento e sintomas psiquiátricos como ansiedade, depressão e Transtorno de Déficit de Atenção e Hiperatividade (TDAH). Neste sentido, testes neuropsiquiátricos e cognitivos são componentes importantes no cuidado destes pacientes. Atualmente, não existe um compêndio científico ou recomendações de ferramentas validadas em português para avaliar a saúde mental em pacientes brasileiros com PKU. Objetivo Recomendar ferramentas validadas localmente para avaliar a qualidade de vida e aspectos neuropsicológicos de pacientes com PKU. Métodos Seis especialistas brasileiros discutiram as ferramentas mais apropriadas com base em suas experiências clínicas, a viabilidade de realizar as avaliações na rotina clínica, e o acesso às ferramentas na saúde pública. Antes da reunião, foi realizada uma revisão independente da literatura para identificar as ferramentas validadas no Brasil, utilizando as bases de dados MEDLINE e Scielo. Resultados Os especialistas recomendaram nove ferramentas para avaliar a qualidade de vida (Peds-QL, SF-36 ou WHOQOL-bref), função executiva (BRIEF ou Bayley-III), QI (SONR 2½-7[a] ou WASI) e TDAH (MTA-SNAP-IV e ASRS). Conclusões Estes instrumentos podem ser facilmente incorporados na prática clínica e melhorar a qualidade dos cuidados multidisciplinares dos pacientes com PKU.

Calidad de vida relacionada con edad e ingreso económico en adultos mayores diabéticos. Chillán, Chile, 2019

Fundamento padecer diabetes puede influenciar la percepción del propio individuo y cambiar su rutina diaria, afectando así su calidad de vida; partiendo de ello, la profundización en el tema reviste gran importancia Objetivo determinar la relación entre calidad de vida, edad e ingreso económico en adultos mayores con diabetes mellitus tipo 2. Métodos se realizó un estudio descriptivo, de corte transversal, en 33 adultos mayores con diabetes mellitus tipo 2, seleccionados mediante un muestreo no probabilístico por conveniencia, en la comunidad de las Mariposas (Chillán, Chile), en el año 2019. Para el análisis de la calidad de vida fue aplicado el instrumento Diabetes 39. Se utilizaron las pruebas estadísticas de Kolmogorov-Smirnov y Rho de Spearman. Resultados existió predominio del sexo femenino, así como de personas casadas. La edad tuvo un valor medio de 71,45 años. Con respecto al ingreso económico, un 66,7 % de los participantes refirió imposibilidad para costear los gastos del mes. Entre las dimensiones de la calidad de vida analizadas, las más afectadas fueron: severidad de la diabetes (media de 55,05), energía/movilidad (media de 44,1), y calidad de vida (media de 43,9). La edad y el ingreso económico no mostraron una correlación significativa con ninguna de las dimensiones estudiadas. Conclusiones la calidad de vida de los adultos mayores con diabetes mellitus tipo 2 se ve afectada, sin que exista una relación significativa con la edad e ingresos económicos.

Background suffering from diabetes can influence the perception of the individual himself and change his daily routine, thus affecting his quality of life; Based on this, the deepening of the subject is of great importance Objective to determine the relationship between quality of life, age and income in older adults with type 2 diabetes mellitus. Methods a descriptive, cross-sectional study was carried out in 33 older adults with type 2 diabetes mellitus, selected by non-probabilistic convenience sampling, in the Las Mariposas community (Chillán, Chile), in 2019. The Diabetes 39 instrument was applied for quality of life analysis. The Kolmogorov-Smirnov and Spearman's Rho statistical tests were used. Results the female sex was the predominant, as well as married people. Age had a mean value of 71.45 years. In the economic income, 66.7% of the participants reported the impossibility of paying the expenses of the month. Among the life's quality dimensions analyzed, the most affected were: diabetes severity (mean 55.05), energy/mobility (mean 44.1), and quality of life (mean 43.9). Age and income did not show a significant correlation with any of the dimensions studied. Conclusions the older adults' quality of life with type 2 diabetes mellitus is affected, without a significant relationship with age and economic income.