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Fisioter. Pesqui. (Online) ; 27(1): 78-84, jan.-mar. 2020. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1090417


RESUMO O objetivo deste estudo foi traduzir e adaptar a escala de utilidade clínica de Tyson e Connell para o português brasileiro, além de avaliar sua confiabilidade interexaminador e intraexaminador. O processo de tradução e adaptação transcultural foi desenvolvido em cinco estágios: tradução; síntese das traduções; retrotradução; avaliação pelo comitê de especialistas; e teste da versão pré-final. Para avaliação da confiabilidade intra e interexaminador da escala, 20 instrumentos de avaliação foram analisados de forma independente por dois examinadores (confiabilidade interexaminador). Além disso, um dos examinadores fez todas as avaliações, em dois momentos distintos, com um intervalo de 30 dias entre uma e outra (confiabilidade intraexaminador). A tradução e a adaptação transcultural foram realizadas de forma sistemática, seguindo os critérios propostos, de modo que houve apenas pequenas alterações em dois itens para tornar a escala mais útil a todos os instrumentos disponíveis na literatura. Em relação à confiabilidade interexaminador da escala de utilidade clínica de Tyson e Connell-Brasil, o valor encontrado foi CCI=0,85 (IC 95%, 0,79-0,87), enquanto para a confiabilidade intraexaminador o resultado foi CCI=0,89 (IC 95%, 0,85-0,93). Os resultados deste processo indicaram adequado grau de equivalência semântica, conceitual e cultural. Além disso, as medidas de confiabilidade intra e interexaminadores foram consideradas adequadas. Esses achados demonstraram que a escala é adequada para avaliar a utilidade clínica de instrumentos de avaliação comumente utilizados em pacientes. Dessa forma, deve ser incorporada na prática clínica e em pesquisas para a escolha do melhor instrumento.

RESUMEN O objetivo deste estudo foi traduzir e adaptar a escala de utilidade clínica de Tyson e Connell para o português brasileiro, além de avaliar sua confiabilidade interexaminador e intraexaminador. O processo de tradução e adaptação transcultural foi desenvolvido em cinco estágios: tradução; síntese das traduções; retrotradução; avaliação pelo comitê de especialistas; e teste da versão pré-final. Para avaliação da confiabilidade intra e interexaminador da escala, 20 instrumentos de avaliação foram analisados de forma independente por dois examinadores (confiabilidade interexaminador). Além disso, um dos examinadores fez todas as avaliações, em dois momentos distintos, com um intervalo de 30 dias entre uma e outra (confiabilidade intraexaminador). A tradução e a adaptação transcultural foram realizadas de forma sistemática, seguindo os critérios propostos, de modo que houve apenas pequenas alterações em dois itens para tornar a escala mais útil a todos os instrumentos disponíveis na literatura. Em relação à confiabilidade interexaminador da escala de utilidade clínica de Tyson e Connell-Brasil, o valor encontrado foi CCI=0,85 (IC 95%, 0,79-0,87), enquanto para a confiabilidade intraexaminador o resultado foi CCI=0,89 (IC 95%, 0,85-0,93). Os resultados deste processo indicaram adequado grau de equivalência semântica, conceitual e cultural. Além disso, as medidas de confiabilidade intra e interexaminadores foram consideradas adequadas. Esses achados demonstraram que a escala é adequada para avaliar a utilidade clínica de instrumentos de avaliação comumente utilizados em pacientes. Dessa forma, deve ser incorporada na prática clínica e em pesquisas para a escolha do melhor instrumento.

ABSTRACT This study aimed to translate and adapt the Clinical Utility Scale of Tyson and Connell into Brazilian Portuguese, in addition to evaluating intra- and inter-rater reliability. The process of cross-cultural translation and adaptation was developed in five stages: translation, synthesis of translations, retro translation, evaluation by the committee of experts and testing of the pre-final version. To evaluate the intra- and inter-rater reliability of the Clinical Utility Scale of Tyson and Connell, 20 assessment instruments were independently assessed by two examiners (inter-rater reliability). In addition, one of the examiners performed all assessments at two different times with a 30-day interval (intra-rater reliability). The translation and cross-cultural adaptation were performed in a systematic way, following the proposed criteria, and only minor changes in two items were necessary to make the scale more useful to all instruments currently available in the literature. Regarding the inter-rater reliability of the Clinical Utility Scale of Tyson and Connell, the value found was ICC=0.85 (IC 95%, 0,79-0,87), while for intra-rater reliability the result was ICC=0,89 (IC 95%, 0,85-0,93). The results of this process indicated an adequate degree of semantic, conceptual and cultural equivalence. In addition, intra- and inter-rater reliability measures were considered adequate. These findings have shown the scale is adequate to assess the clinical utility of evaluation instruments usually applied to patients. Therefore, it must be incorporated into clinical practice and research when choosing the best evaluation instrument to be used.

Translating , Weights and Measures/instrumentation , Cost-Benefit Analysis/methods , Disability Evaluation , Physical Examination/instrumentation , Reproducibility of Results , Disease Management , Motor Skills Disorders/diagnosis , Mobility Limitation
Article in Korean | WPRIM (Western Pacific) | ID: wprim-811241


OBJECTIVES: To compare the clinical effectiveness of the virtual reality (VR) programs in assessing psychosocial problems, improving symptoms, and reducing suicide risk in depressive patients with those of pharmacotherapy.METHODS: Thirty-six patients were recruited with depression in the treatment group and 22 participants in the healthy control group through internet advertisements between November 2018 and March 2019. Participants in the treatment group were allocated randomly at a 1:1 ratio to either the VR group or pharmacotherapy group. At the baseline, all participants were assessed with a comprehensive battery for their psychological characteristics by structured scales using VR technologies. Assessments of patients in the treatment group were repeated four weeks after therapeutic intervention. The primary outcome measures were the Korean Version of Quick Inventory of Depressive Symptomatology-Self-Report and suicidality scales of the Korean Mini International Neuropsychiatric interview. The borderline personality (Personality Assessment Inventory-Borderline Features Scale) and resilience (Korean Resilience Questionnaire) were also evaluated.RESULTS: Twenty-four depressive patients completed the treatment, and the final assessment was conducted after four weeks of treatment. In the initial assessment, the patient group showed significantly higher depressive symptoms, suicidality, borderline personality trait, and lower resilience than healthy control group. After the four-week therapeutic interventions, the VR group showed significant improvement in depression, suicidality, borderline personality trait, and resilience. In addition, there was no significant difference in the treatment efficacy between the VR group and the pharmacotherapy group.CONCLUSION: In this study, the VR treatment program has clear benefits for emotional distress and reducing suicidality in depressive patients. Evidence-based VR treatments may show new clinical potential for depressive disorder.

Depression , Depressive Disorder , Drug Therapy , Education , Humans , Internet , Outcome Assessment, Health Care , Psychotherapy , Suicidal Ideation , Suicide , Treatment Outcome , Weights and Measures
Article in English | WPRIM (Western Pacific) | ID: wprim-782075


BACKGROUND AND PURPOSE: This study aimed to determine the clinimetric properties of the Korean version of Parkinson's Disease Sleep Scale-2 (K-PDSS-2) and whether distinct subtypes of sleep disturbance can be empirically identified in patients with Parkinson's disease (PD) using the cross-culturally validated K-PDSS-2.METHODS: The internal consistency, test–retest reliability, scale precision, and convergent validity of K-PDSS-2 were assessed in a nationwide, multicenter study of 122 patients with PD. Latent class analysis (LCA) was used to derive subgroups of patients who experienced similar patterns of sleep-related problems and nocturnal disabilities.RESULTS: The total K-PDSS-2 score was 11.67±9.87 (mean±standard deviation) at baseline and 12.61±11.17 at the retest. Cronbach's α coefficients of the total K-PDSS-2 scores at baseline and follow-up were 0.851 and 0.880, respectively. The intraclass correlation coefficients over the 2-week study period ranged from 0.672 to 0.848. The total K-PDSS-2 score was strongly correlated with health-related quality of life measures and other corresponding nonmotor scales. LCA revealed three distinct subtypes of sleep disturbance in the study patients: “less-troubled sleepers,” “PD-related nocturnal difficulties,” and “disturbed sleepers.”CONCLUSIONS: K-PDSS-2 showed good clinimetric attributes in accordance with previous studies that employed the original version of the PDSS-2, therefore confirming the cross-cultural usefulness of the scale. This study has further documented the first application of an LCA approach for identifying subtypes of sleep disturbance in patients with PD.

Follow-Up Studies , Humans , Parkinson Disease , Quality of Life , Weights and Measures
Chonnam Medical Journal ; : 62-67, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-787272


We evaluated the association between body mass index (BMI) and the prevalence of asthma. Using data from the 2015 Korean Community Health Survey, 214,971 participants aged between 19 and 106 years were included in this study. Asthma was defined based on the self-report of physician diagnosis. BMI was classified as underweight (<18.5 kg/m²), normal weight (18.5 kg/m²≤BMI<23.0 kg/m²), overweight (23.0 kg/m²≤ BMI<27.4 kg/m²), and obese (≥27.5 kg/m²) based on the BMI categories for Asians by the World Health Organization. Multiple logistic regression analysis was performed with sampling weights to evaluate the association between BMI and asthma after adjusting for age, educational level, income, type of residential area, smoking status, alcohol consumption, physical activity, hypertension, and diabetes. In men, BMI had an inverted J-shaped association with the prevalence of asthma, with an odds ratio of 1.88 (95% confidence interval [CI]: 1.89–2.24) for underweight and 1.12 (95% CIs: 0.97–1.29) for obesity. In women, BMI had a J-shaped association with the prevalence of asthma, with an odds ratio of 1.05 (95% CIs: 0.91–1.22) for underweight and 2.29 (95% CIs: 2.06–2.56) for obesity. In conclusion, in a nationally representative sample of Korean adults, the association between BMI and the prevalence of asthma varied between the sexes. This suggests that malnutrition and obesity are involved in the pathophysiology of asthma.

Adult , Alcohol Drinking , Asian Continental Ancestry Group , Asthma , Body Mass Index , Diagnosis , Female , Health Surveys , Humans , Hypertension , Logistic Models , Male , Malnutrition , Motor Activity , Obesity , Odds Ratio , Overweight , Prevalence , Smoke , Smoking , Thinness , Weights and Measures , World Health Organization
Chonnam Medical Journal ; : 68-74, 2020.
Article in English | WPRIM (Western Pacific) | ID: wprim-787271


The aim of this study was to assess the potential of a prone chest CT for the evaluation of esophageal cancer, as compared with a routine supine chest CT. 69 patients (67±18 years old) with pathologically confirmed esophageal cancers underwent MDCT in the supine and prone positions. The supine CT was performed first, followed by the prone position. Localization and staging of individual esophageal lesions on both the prone and supine CTs were assessed by two thoracic radiologists, using a scoring system that consisted of three confidence scales, and the results were correlated with the endoscopic and surgical findings. The mean confidence score for the detection of esophageal cancer was higher in the prone position (2.58±0.74) than that in the supine position (2.42±0.83) with statistical significance (p=0.002). The mean confidence score for predicting local invasion in the selected patients (n=18) who underwent esophagectomy was also higher in the prone position (2.39±0.85) than that in the supine position (2.06±0.73) with statistical significance (p=0.01). In 10 of 11 cases that showed definitive determination for periesophageal infiltration or adjacent organ invasion on the prone CT (score 3), the corresponding findings were also observed in the post-operative evaluations. In conclusion, prone chest CT for evaluating esophageal cancer could have advantages in regards to the localization of esophageal cancer and predicting local invasion compared to that of routine supine CT and can improve the diagnostic accuracy of chest CTs.

Diagnostic Imaging , Esophageal Neoplasms , Esophagectomy , Humans , Prone Position , Supine Position , Thorax , Tomography, X-Ray Computed , Weights and Measures
Article in English | WPRIM (Western Pacific) | ID: wprim-811205


BACKGROUND: This study evaluated the efficacy of three intraoral topical anesthetics in reducing the injection needle prick pain from local anesthetic among children aged 7–11 years old.METHODS: It is a prospective, Interventional, parallel design, single-blind, randomized clinical trial in which subjects (n=90) aged 7–11 years were included in the study based on an inclusion criteria. Subjects were divided into three groups based on computer-generated randomization with an allocation ratio of 1:1:1. Groups A, B, and C received benzocaine 20% jelly (Mucopain gel, ICPA health products Ltd, Ankleshwar, India), cetacaine anesthetic liquid (Cetylite Industries, Inc, Pennsauken, NJ), and EMLA cream (2% AstraZeneca UK Ltd, Luton, UK), respectively, according to manufacturer's instructions, for 1 minute prior to local anesthetic injection. After application of topical anesthetic agent, for all the groups, baseline pre-operative (prior to topical anesthetic administration) and post-operative scores (after local anesthetic administration) of pulse rate was recorded using Pulse oximeter (Gibson, Fingertip Pulse Oximeter, MD300C29, Beijing Choice Electronic). Peri-operative (i.e., during the administration of local anesthesia) scores were recorded using Face, Legs, Activity, Cry, Consolability (FLACC) Scale, Modified Children hospital of Eastern Ontario Pain Scale (CPS) behavior rating scale, and Faces Pain Scale (FPS-R) – Revised (For self-reported pain). Direct self-reported and physiological measures were ascertained using FPS-R – Revised and Pulse oximeter, respectively, whereas CPS and FLACC scales assessed behavioral measures. To test the mean difference between the three groups, a one way ANOVA with post hoc tests was used. For statistical significance, a two-tailed probability value of P < 0.05 was considered as significant.RESULTS: The Cetacaine group had significantly lower pain scores for self-report (P < 0.001), behavioral, and physiological measures (P < 0.001) than the other two groups. However, there was no significant difference between the Benzocaine group and EMLA group during palatal injection prick.CONCLUSION: Cetacaine can be considered as an effective topical anesthetic agent compared to benzocaine 20% jelly (Mucopain gel) and EMLA cream.

Anesthetics , Behavior Rating Scale , Beijing , Benzocaine , Child , Clinical Study , Heart Rate , Humans , Leg , Needles , Ontario , Palate , Prospective Studies , Random Allocation , Weights and Measures
Article in English | WPRIM (Western Pacific) | ID: wprim-785552


We measured the difference of sitting pressure between the affected and unaffected sides (DSPAU) using sitting pressure measured with a force platform to identify sitting imbalance. The aim of this study is to investigate the relations between sitting balance and functional status or parameters according to characteristics stroke patients. We examine changes in DSPAU and functional assessment before and after a 3 week of rehabilitation in hemiplegic stroke patients (n = 73). These pre- and post-treatment data according to stroke characteristics, and correlations between the DSPAU and functional scales were analyzed. The DSPAU was greater in the non-ambulatory group compared to the ambulatory group, in patients who scored lower in the Medical Research Council (MRC) scores, and in patients whose the MRC scores for the lower limbs were lower than of the upper limbs. We observed that a decrease in the DSPAU was associated with an improvement in functional assessment parameters following rehabilitation. Further, changes in DSPAU were significantly correlated to the Modified Barthel Index. We observed that a decrease in DSPAU was associated with an improvement in functional parameters following rehabilitation. In conclusion, repeated measurements of sitting balance using DSPAU may be helpful to predict motor and functional recovery in stroke patient with hemiplegia.

Hemiplegia , Humans , Lower Extremity , Postural Balance , Recovery of Function , Rehabilitation , Stroke , Upper Extremity , Weights and Measures
Article in English | WPRIM (Western Pacific) | ID: wprim-785550


This study investigated how physical and cognitive function and psychological factors affected the health-related quality of life (HRQoL, hereafter HQ) of stroke patients in South Korea. The study enrolled 32 right-handed subjects with chronic cerebral infarction with disability and preserved cognitive function (Mini-Mental State Examination ≥ 20). Physical disability was assessed using the modified Rankin Scale (mRS) and Korean modified Barthel Index (KMBI). Quality of life was measured using the World Health Organization Quality of Life-Abbreviated form (WHOQOL-BREF, hereafter WB) and the 36-Item Short-form Health Survey (SF-36) in face-to-face interviews. Psychological distress was investigated using the Beck Depression Inventory Scale-II. The associations of each domain of WB and SF-36 were investigated using Pearson correlation analyses. Physical disability was negatively correlated with HQ in the SF-36. The physical function and bodily pain scales of the SF-36 were negatively correlated with physical disability. The general health domain of the SF-36 was negatively correlated with psychological scores. Emotional status was associated with physical health, social relationships, and general health in HQ. In summary, the severity of physical disability was associated with the patient's general and physical health and body pain. These findings suggest the importance of psychological, cognitive, and physiological interventions for improving the quality of life of patients after cerebral infarction.

Cerebral Infarction , Cognition , Depression , Health Surveys , Humans , Korea , Psychology , Quality of Life , Stroke , Weights and Measures , World Health Organization
Article in English | WPRIM (Western Pacific) | ID: wprim-785548


Robots are being used to assist the recovery of walking ability for patients with neurologic disorders. This study aimed to evaluate the feasibility and functional improvement of training with robot-assisted gait training (RAGT) using the Morning Walk®, an end-effector type robot using footplates and saddle seat support. A total of 189 individuals (65.1% men, 34.9% women; mean age, 53.2 years; age range: 5–87 years) with brain lesions, spinal cord injuries, Parkinson's disease, peripheral neuropathies, and pediatric patients were involved in this retrospectively registered clinical trial. Each participant performed 30 minutes of RAGT, five times a week, for a total of 24 sessions. Failure was defined as an inability to complete all 24 sessions, and the reasons for discontinuation were analyzed. Parameters of Medical Research Council scales and Functional Ambulation Categories were analyzed before and after RAGT training. Among the 189 patients, 22 (11.6%) failed to complete the RAGT. The reasons included decreased cooperation, musculoskeletal pain, saddle seat discomfort, excessive body-weight support, joint spasticity or restricted joint motion, urinary incontinence from an indwelling urinary catheter, and fatigue. Comparison between the pre- and post-training motor and ambulatory functions showed significant improvement. The result of the study indicates that the Morning Walk® is feasible and safe and useful for functional improvement in patients with various neurologic disordersTRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0003627

Brain , Fatigue , Female , Gait , Humans , Information Services , Joints , Male , Muscle Spasticity , Musculoskeletal Pain , Nervous System Diseases , Parkinson Disease , Peripheral Nervous System Diseases , Retrospective Studies , Spinal Cord Injuries , Urinary Catheters , Urinary Incontinence , Walking , Weights and Measures
Med. UIS ; 32(3): 19-25, Sep.-Dec. 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1114973


Resumen La terapia con oxígeno a largo plazo mejoró la supervivencia de los pacientes con enfermedad pulmonar obstructiva crónica. Las medidas propuestas en las guías clínicas para evaluar la indicación y seguimiento de esta terapia son la presión arterial de oxígeno y la saturación arterial de oxígeno. Se ha generalizado el uso de la oximetría de pulso, pero la información para determinar si estas medidas son intercambiables es insuficiente. El objetivo es revisar los fundamentos fisiológicos de las variables relacionadas con la oxigenación y sus formas de medición. En la evaluación del paciente con patología respiratoria, la saturación de pulso es una ayuda clínica valiosa, sin embargo, sus limitaciones no le permiten, en ciertos rangos, reemplazar la valoración directa en sangre arterial (gasometría arterial) de la saturación arterial y la presión arterial de oxígeno, para determinar la indicación de la oxigenoterapia. MÉD.UIS.2019;32(3):19-25

Abstract Long-term oxygen therapy improves the survival of patients with chronic obstructive pulmonary disease. Measures proposed in clinical clinics to evaluate the indication and monitoring of arterial blood pressure therapy and arterial oxygen saturation. The use of pulse oximetry has been widespread, but the information to determine if these measures are interchangeable is insufficient. The objective is to review the physiological foundations of variables related to oxygenation and their forms of measurement. In the assessment of the patient with respiratory pathology, pulse saturation is a valuable clinical aid., however, its limitations do not allow, in certain ranges, to replace direct arterial blood pressure (arterial blood gas) measurement of arterial saturation and arterial oxygen pressure, to determine the indication of oxygen therapy. MÉD.UIS.2019;32(3):19-25

Humans , Oximetry , Pulmonary Disease, Chronic Obstructive , Oxygen , Oxygen Inhalation Therapy , Pathology , Patients , Pressure , Pulse , Survival , Therapeutics , Weights and Measures , Blood , Blood Gas Analysis , Pulmonary Medicine , Oxygenation , Monitoring , Arterial Pressure , Survivorship
Rev. bras. cir. plást ; 34(3): 331-335, jul.-sep. 2019. ilus, tab
Article in English, Portuguese | LILACS (Americas) | ID: biblio-1047148


Introdução: Em 1988, Baroudi et al. publicaram um trabalho descrevendo a utilização de pontos de adesão entre o retalho dermoadiposo e a bainha anterior do músculo reto do abdome, no intuito de diminuir a formação de seroma. O presente estudo propõe-se a demonstrar uma provável correlação entre os pontos de adesão de Baroudi com a força tensional do retalho, através da medida da distância da cicatriz abdominal inferior ao xifoide antes e após os pontos de Baroudi, no transoperatório de dermolipectomia. Métodos: Trata-se de um estudo prospectivo observacional. Foram selecionadas submetidas a lipoabdominoplastia no Serviço de Cirurgia Plástica da Santa Casa de Misericórdia de Porto Alegre, no período de janeiro a abril de 2019. Aferiram-se as medidas transoperatórias da distância do apêndice xifoide esternal à cicatriz umbilical, e da primeira à cicatriz cirúrgica, pré e pós-realização dos pontos de adesão de Baroudi. A análise estatística foi realizada com o software Excel®. Resultados: Verificou-se a diminuição das distâncias apêndice xifoidecicatriz umbilical e apêndice xifoide-cicatriz após a realização da sutura de Baroudi (média de 1,5cm), pressupondo-se diminuição da tensão da cicatriz. Conclusão: As medidas aferidas no presente estudo mostraram uma diminuição da distância xifoide-cicatriz umbilical e xifoide-cicatriz abdominal inferior após a realização dos pontos de Baroudi, evidenciando uma menor tensão na cicatriz. Sugere-se estudos para avaliar como essas medidas se comportam a longo prazo e se realmente se correlacionam a uma cicatriz de melhor qualidade.

Introduction: In 1988, Baroudi et al. published a paper describing the use of adhesion points between the dermoadipose flap and the anterior rectus abdominis sheath to reduce seroma formation. This study aimed to demonstrate a probable correlation between the use of Baroudi adhesion points and reduction in flap tension force by measuring the distance from the lower abdominal scar to the xiphoid before and after using Baroudi points in dermolipectomy transoperatory. Methods: This was a prospective observational study that selected patients who underwent lipoabdominoplasty at the Santa Casa de Misericórdia Plastic Surgery Service of Porto Alegre from January to April 2019. The transoperatory measurements of distance from the sternal xiphoid appendix to the umbilical scar and from the pre-xiphoid to the postxiphoid scar before and after execution of Baroudi's adhesion points were compared. Statistical analysis was performed using Excel® software. Results: A reduction in the distances between the xiphoid-umbilical scar appendix and xiphoidscar appendix was verified after execution of Baroudi suture (mean 1.5 cm), indicating a decrease in scar tension. Conclusion: There was a decrease in the xiphoid-umbilical scar and xiphoid-lower abdominal scar distance after Baroudi stitches, indicating lower scar-tissue tension. Further studies should be conducted to evaluate these measurements in the long term and their correlation with a better-quality scar.

Humans , Female , Adult , Middle Aged , History, 21st Century , Weights and Measures , Statistical Analysis , Prospective Studies , Cicatrix , Anatomic Landmarks , Abdominoplasty , Weights and Measures/standards , Cicatrix/surgery , Cicatrix/complications , Anatomic Landmarks/surgery , Anatomic Landmarks/injuries , Abdominoplasty/adverse effects , Abdominoplasty/methods , /methods
Nursing (Säo Paulo) ; 22(251)abr.2019.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-998874


Objetiva-se analisar as escalas de Acidente Vascular Encefálico (AVE) utilizadas durante o pré e pós-diagnóstico. Revisão bibliográfica simples, descritiva e interdisciplinar nas bases de dados SciELO, Pubmed, LILACS e Biblioteca Virtual em Saúde. Foram utilizados como critério de inclusão artigos em inglês, espanhol e português entre 2011 e 2017, dentre esses foram selecionados assunto ao tema proposto. Segundo as pesquisas, foram selecionados artigos os quais mostram escalas que auxilia na identificação dos sinais e sintomas, auxilia na avaliação do paciente com AVE Hemorrágico, avalia o estado neurológico e classifica o comprometimento funcional do paciente. Com base na confiabilidade e critérios de avaliação das escalas validadas pela American Stroke Asssociation, Cincinnati, LAPSS e NIHSS são as mais aplicadas por serem específicas devidos aos itens que confirmam os sinais clínicos apresentados por pacientes com suspeita de AVE.(AU)

The aim of this study was to analyze the Stroke scales used during pre and post-diagnosis. Simple, descriptive and interdisciplinary bibliographic review in the databases SciELO, Pubmed, LILACS and Virtual Health Library were used as inclusion criteria articles in English, Spanish and Portuguese between 2011 and 2017, among which were selected subject to the proposed theme. According to the researches, articles were selected which show scales that aid in the identification of signs and symptoms, assist in the evaluation of the patient with hemorrhagic stroke, evaluate the neurological status and classify the functional impairment of the patient. Based on the reliability and evaluation criteria of the scales validated by the American Stroke Asssociation, Cincinnati, LAPSS and NIHSS are the most applied because they are specific due to items that confirm the clinical signs presented by patients suspected of having stroke.(AU)

Se pretende analizar las escalas de Accidente Vascular Encefálico (AVE) utilizadas durante el pre y post-diagnóstico. sencillo, descriptivo e interdisciplinar revisión de la literatura en las bases de datos SciELO, PubMed, lilas y Biblioteca Virtual en Salud. Fue utilizado como criterio para artículos de inclusión en Inglés, español y portugués entre 2011 y 2017, entre estos se seleccionaron sujetos a la temática propuesta. Según las encuestas, se seleccionaron artículos que muestran escalas que auxilia en la identificación de los signos y síntomas, auxilia en la evaluación del paciente con AVE Hemorrágico, evalúa el estado neurológico y clasifica el compromiso funcional del paciente. En base a la confiabilidad y criterios de evaluación de las escalas validadas por American Stroke Assocation, Cincinnati, LAPSS y NIHSS, son las más aplicadas por ser específicas debidas a los ítems que confirman los signos clínicos presentados por pacientes con sospechas de AVE.(AU)

Humans , Risk Factors , Stroke , Neurologic Examination , Weights and Measures
Enferm. foco (Brasília) ; 10(1): 87-92, jan. 2019. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1028060


Objetivo: discutir a aplicabilidade do Nursing Activities Score (NAS) à luz da teoria do conforto, relacionando a abrangência das áreas do cuidado descrita neste instrumento aos contextos de conforto propostos na teoria de Kolcaba. Metodologia: estudo teórico, de análise crítica, fundamentado nos princípios da teoria do conforto de Kolcaba. Reflexão: as atividades avaliadas pelo NAS são congruentes com os contextos de conforto propostos na teoria de Kolcaba, podendo contribuir para a promoção do conforto. Nota-se, no entanto, que há menor número de itens para avaliar os contextos socioculturais, psicoespirituais e ambientais. A maioria das atividades valoriza as necessidades orgânicas e biológicas dos pacientes. Conclusão: apesar das atividades do NAS mostrarem-se equivalentes com os contextos de conforto propostos por Kolcaba, não se pode afirmar que os cuidados prestados serão integralmente condizentes aos pressupostos da teoria, necessitando de estudos posteriores para validação clínica.

Objective: To discuss the applicability of the Nursing Activities Score (NAS) in the light of the Comfort Theory, relating the range of care areas described in this instrument to the comfort contexts proposed in Kolcaba’s theory. Methodology: theoretical study, critical analysis, based on the principles of Kolcaba comfort theory. Reflection: the activities evaluated by the NAS are congruent with the contexts of comfort proposed in the Kolcaba theory, and can contribute to the promotion of comfort. It is noted, however, that there are fewer items to evaluate the sociocultural, psycho-spiritual and environmental contexts. Most activities value the organic and biological needs of patients. Considerations: Although the activities of the NAS are consistent with the comfort contexts proposed by Kolcaba, it cannot be said that the care provided will be fully compatible with the theoretical assumptions, requiring further studies for clinical validation.

Objetivo: discutir la aplicabilidad del Nursing Activity Score (NAS) a la luz de la Teoría del Confort, relacionando el alcance de las áreas del cuidado descrito en este instrumento a los contextos de confort propuestos en la teoría de Kolcaba. Metodología: estudio teórico, de análisis crítico, fundamentado en los principios de la teoría del confort de Kolcaba. Reflexión: las actividades evaluadas por el NAS son congruentes con los contextos de confort propuestos en la teoría de Kolcaba, pudiendo contribuir a la promoción del confort. Se observa, sin embargo, que hay menor número de ítems para evaluar los contextos socioculturales, psicoespiritual y ambiental. La mayoría de las actividades valoran las necesidades orgánicas y biológicas de los pacientes. Consideraciones: a pesar de que las actividades del NAS se muestran congruentes con los contextos de confort propuestos por Kolcaba, no se puede afirmar que los cuidados prestados sean íntegramente concordantes a los presupuestos de la teoría, necesitando estudios posteriores para validación clínica.

Male , Female , Humans , Personnel Management , Nursing , Weights and Measures , Nursing Theory
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1015601


Objetivo: Identificar o risco de quedas nos pacientes em observação em um serviço de emergência, por meio da aplicação da Escala de Quedas de Morse. Métodos: Estudo quantitativo, com dados transversais do tipo descritivo, desenvolvido com 30 pacientes internados em um serviço de emergência do Rio Grande do Sul. Os dados foram coletados, entre junho e julho/2018, pela aplicação da Escala de Quedas de Morse. Nas primeiras 12 horas de internação os pacientes foram analisados pela estatística descritiva simples. Resultados: Dos 30 pacientes, 15 eram do sexo feminino e 15 do masculino, com idade entre 30 e 83 anos. Destes, 16 (53,33%) apresentaram alto, 07 (23,33%) médio e 07 (23,33%) baixo risco para quedas. Os fatores de risco mais encontrados foram: terapia endovenosa, diagnóstico secundário e marcha. Conclusão: Os dados representam um alerta aos enfermeiros para o diagnóstico precoce do risco de quedas, prescrição e implementação dos cuidados pela equipe de enfermagem. Assim como a necessidade de implantação de protocolos de prevenção de quedas no serviço de emergência e a realização da avaliação do risco de quedas, diariamente, pelo enfermeiro como uma ferramenta para garantir um cuidado seguro

Objective: To identify the risk of falls in patients under observation in an emergency service, through the application of the Morse Falls Scale. Methods: A quantitative study with descriptive cross-sectional data was developed with 30 patients in emergency service in Rio Grande do Sul. Data were collected from June to July 2018. In the first 12 hours of hospitalization, patients were analyzed by simple descriptive statistics. Results: Of the 30 patients, 15 were female and 15 male, aged between 30 and 83 years. A total of 16 patients (53.33%) presented a high risk of falling, while 07 (23.33%) presented medium risk and 07 presented (23.33%) low risk. The most common risk factors were: intravenous therapy, secondary diagnosis, and gait. Conclusion: The results represent an alert to nurses for the early diagnosis of the risk of falls, prescription, and implementation of care by the nursing team. Furthermore, there is a need to implement protocols for the prevention of falls in the emergency service and to perform fall risk assessments by nurses on a daily basis as a tool to ensure safe care.

Objetivo: Identificar el riesgo de caídas en los pacientes en observación en un servicio de emergencia, por medio de la aplicación de la Escala de Caídas de Morse. Métodos: Estudio cualitativo, descriptivo, desarrollado con 30 pacientes internados en un servicio de emergencia de Rio Grade del Sur. Datos recolectados entre junio y julio de 2018, por medio de la aplicación de la Escala de Caídas de Morse. Las primeras 12 horas de internación de los pacientes fueron analizadas por la estadística descriptiva simple. Resultados: De los 30 pacientes, 15 eran del sexo femenino y 15, masculino, con edad entre 30 y 83 años. De estos, 16 (53,33%) presentaron alto, 07 (23,33%) promedio y 07 (23,33%), bajo riesgo para caídas. Los factores de riesgo más encontrados fueron: terapia endovenosa, diagnóstico secundario y marcha. Conclusión: Los datos representan una alerta a los enfermeros para el diagnóstico precoz del riesgo de caídas, prescripción e implementación de los cuidados por el equipo de enfermería. Así como la necesidad de implantación de protocolos de prevención de caídas en el servicio de emergencia y la realización de la evaluación del riesgo de caídas, a diario, por el enfermero como una herramienta para garantizar un cuidado seguro

Humans , Male , Female , Weights and Measures , Accidental Falls , Nursing , Emergencies
Cogitare enferm ; 24: e54729, 2019. tab
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1019750


RESUMO Objetivo avaliar a atenção psicossocial pela ótica do familiar do paciente esquizofrênico. Metódo estudo correlacional com 40 familiares no Centro de Atenção Psicossocial III de Londrina-PR, entre 2015 e 2016. Foram obtidas variáveis relacionadas à caracterização sociodemográfica e das escalas de avaliação da sobrecarga e de satisfação de familiares. Os dados foram analisados com medidas de tendência central e de correlação. Resultados 24 cuidadores eram mulheres, 23 eram casados e a idade média foi 46 anos. A média de satisfação foi 4,37, a média global para a sobrecarga objetiva foi 2,26 e a sobrecarga subjetiva foi de 2,09. Conclusão Embora muito satisfeitos, diferenças nos escores de sobrecarga revelaram que os familiares recebem bom suporte psicoeducativo, mas a sobrecarga gerada pela preocupação com o ente familiar é o aspecto que mais gera sorimento. Tais resultados podem nortear o enfermeiro no direcionamento das ações de suporte aos familiares, reduzindo a sobrecarga familiar.

RESUMEN Objetivo Evaluar la atención psicosocial acorde la visión del familiar del paciente esquizofrénico. Método Estudio correlacional con 40 familiares en el Centro de Atención Psicosocial III de Londrina-PR, entre 2015 y 2016. Fueron obtenidas variables de caracterización sociodemográfica, de escalas de evaluación de sobrecarga y de satisfacción de familiares. Datos analizados con medidas de tendencia central y de correlación. Resultados Veinticuatro cuidadores eran mujeres; 23 casadas; media etaria de 46 años. El promedio de satisfacción fue 4,37; el promedio global de sobrecarga objetiva fue 2,26; la sobrecarga subjetiva fue 2,09. Conclusión A pesar de la satisfacción, las diferencias en los puntajes de sobrecarga indican que los familiares reciben buen soporte psicoeducativo, pero la sobrecarga determinada por la preocupación por el familiar es el aspecto generador del mayor sufrimiento. Estos resultados pueden orientar al enfermero para que enfoque las acciones de soporte a los familiares, reduciendo la sobrecarga familiar.

ABSTRACT Objective To assess psychosocial care from the perspective of family members of schizophrenic patients. Method A correlational study with 40 family members at a Psychosocial Care Center III of Londrina, Paraná, was conducted in 2015 and 2016. Variables related to the sociodemographic characterization and evaluation scales of the overload and satisfaction of the family members were obtained. Data were analyzed with measures of central tendency and correlation. Results 24 caregivers were women, 23 were married, and the mean age was 46 years. The mean rate of satisfaction was 4.37, the overall mean value for objective overload was 2.26, and the overall mean value for subjective overload was 2.09. Conclusion Although the family members were very satisfied, differences in overload scores revealed that they received good psychoeducational support, but the overload generated by their concern for their family member was the aspect that generated the highest levels of suffering. Such results may guide nurses to give directions to family members, to support then and reduce their overload.

Humans , Schizophrenia , Caregivers , Family Relations , Psychiatric Nursing , Weights and Measures , Health Services Research
Paidéia (Ribeirão Preto, Online) ; 29: e2921, 2019. tab, graf
Article in English | LILACS (Americas), INDEXPSI | ID: biblio-1020093


Abstract Oral conditions impact on the individual's health and quality of life. The use of a valid and reliable instrument provides accuracy in the measurement of this impact. This study aimed to assess the evidences of validity and reliability of the Oral Health Impact Profile instrument (OHIP-14) in adolescents. A total of 763 adolescents participated in the study. The OHIP-14, the 12-Item Short-Form Health Survey (SF-12) and intraoral examinations were used. In the confirmatory factor analysis, the OHIP-14 showed acceptable adjustment indexes: CFI = 0.957; GFI = 0.959 and RMSEA=0.063. Normative oral health conditions show significant association with OHIP-14 scores. Significant correlation was observed between the total OHIP-14 score and the scores of self-perception of oral health (p < 0.001) and the physical and mental dimensions of the SF-12 (p < 0.001). The Cronbach alpha coefficient was adequate (α = 0.87). OHIP-14 was showed satisfactory validity and reliability, subsiding its use in studies that assess the self-perception of oral health for this population.

Resumo As condições bucais impactam na saúde e na qualidade de vida do indivíduo. O uso de instrumento válido e confiável propicia acurácia na medida desse impacto. Este estudo teve como objetivo avaliar as evidências de validade e confiabilidade do instrumento Oral Heath Impact Profile (OHIP-14) em adolescentes. Participaram do estudo 763 adolescentes. Foram utilizados o OHIP-14, o 12-Item Short-Form Health Survey (SF-12) e exames intrabucais. Na análise fatorial confirmatória, o OHIP-14 apresentou índices de ajustes aceitáveis: CFI = 0,957; GFI = 0,959 e RMSEA=0,063. As condições normativas de saúde bucal apresentaram associação significativa com os escores do OHIP-14. Observou-se correlação significativa do escore total do OHIP-14 com os escores da autopercepção da saúde bucal (p < 0.001) e as dimensões física e mental do SF-12 (p < 0.001). O coeficiente de alfa de Cronbach foi adequado (α = 0,87). O OHIP-14 apresentou validade e confiabilidade satisfatórias, evidência que subsidia a sua utilização em estudos que avaliam a autopercepção da saúde bucal para essa população.

Resumen Las condiciones bucales afectan a la salud y la calidad de vida del individuo. La utilización de un instrumento válido y fiable favorece la precisión en la medición de ese impacto. El presente estudio tuvo como objetivo evaluar las evidencias de validez y confiabilidad del instrumento Oral Heath Impact Profile (OHIP-14) en adolescentes. En el estudio participaron 763 adolescentes. Se utilizaron el OHIP-14, el 12-Item Short-Form Health Survey (SF-12) y el chequeo intrabucal. En el análisis factorial confirmatorio, el OHIP-14 presentó índices de regulación aceptables: CFI = 0,957; GFI = 0,959 y RMSEA = 0,063. Las perceptivas de salud bucal presentaron una asociación significativa con los puntajes del OHIP-14. Se observó una correlación significativa del puntaje total del OHIP-14 con los puntajes de la autopercepción de la salud bucal (p < 0.001) y las dimensiones física y mental de SF-12 (p < 0.001). El coeficiente de alfa de Cronbach fue adecuado (α = 0,87). El OHIP-14 tuvo validez y confiabilidad satisfactorias, lo que posibilita su utilización en estudios que evalúan la autopercepción de esa población sobre la salud bucal.

Humans , Male , Female , Adolescent , Weights and Measures , Oral Health , Factor Analysis, Statistical
Yonsei Medical Journal ; : 633-639, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-762097


PURPOSE: Myasthenia gravis (MG) is a lifelong autoimmune disorder that affects neuromuscular transmission. The long-term treatment plan should include immunotherapy. We investigated the long-term safety and efficacy of tacrolimus for the treatment of MG in real-world clinical practice. MATERIALS AND METHODS: We retrospectively reviewed 160 MG patients treated with tacrolimus from 2005 to 2015. Myasthenia Gravis Foundation of America (MGFA) clinical classification, MGFA post-intervention status, myasthenic functional score, and dose of oral prednisolone were investigated. RESULTS: Adverse events occurred in 68 patients (42.5%), most of which were minor and well-managed. Clinical severity scales improved after administration of tacrolimus, compared to the baseline. Compared to 6 months before administration of tacrolimus, prednisolone dose significantly decreased at 12 months after treatment (2.85±0.92 mg/day, p=0.002), 18 months after treatment (3.36±0.99 mg/day, p=0.001), and 24 months after treatment (3.71±0.93 mg/day, p<0.001). CONCLUSION: Tacrolimus may be effective in reducing the severity of MG and may permit a reduction in the steroid dose prescribed to the patients. Adverse events due to tacrolimus treatment were not serious.

Americas , Classification , Humans , Immunotherapy , Myasthenia Gravis , Prednisolone , Retrospective Studies , Tacrolimus , Weights and Measures
Yonsei Medical Journal ; : 1181-1186, 2019.
Article in English | WPRIM (Western Pacific) | ID: wprim-762066


PURPOSE: To examine correlations among rating scales and findings suggestive of tracheal aspiration and pharyngeal residue between fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) in dysphagia patients. MATERIALS AND METHODS: We studied patients referred to our hospital for dysphagia assessment. Three raters judged the residue severity and laryngeal penetration or tracheal aspiration of FEES and VFSS. The raters applied the Penetration-Aspiration Scale (PAS) for tracheal aspiration and pixel-based circumscribed area ratio and Yale Pharyngeal Residue Severity for post-swallow residue in VFSS and FEES, respectively. Anatomy-physiologic findings during FEES associated with tracheal aspiration were also analyzed. RESULTS: A total of 178 participants were enrolled in our study. In correlation analysis, PAS (r=0.74), vallecula retention (r=0.76), and pyriform sinus retention (r=0.78) showed strong positive correlations between FEES and VFSS. Intra-rater agreement between VFSS and FEES was good for PAS (κ=0.65) and vallecula (κ=0.65) and pyriform sinus retention (κ=0.69). Among 72 patients who showed subglottic shelf residue, a suspected finding of aspiration, in FEES, 68 had concomitant tracheal aspiration during VFSS. Both vocal fold hypomobility and glottic gap during phonation were significantly associated with findings suggestive of tracheal aspiration during FEES (p<0.05). CONCLUSION: Quantitative and reliable aspiration and post swallow residue rating scales showed strong positive correlations and good agreement between VFSS and FEES.

Deglutition , Deglutition Disorders , Endoscopes , Fees and Charges , Fluoroscopy , Humans , Phonation , Pyriform Sinus , Vocal Cord Dysfunction , Vocal Cords , Weights and Measures
Article in Korean | WPRIM (Western Pacific) | ID: wprim-760367


PURPOSE: The purpose of this study was to identify the levels of body image, sexual intimacy, and sexual satisfaction, and to explore factors affecting sexual intimacy and satisfaction among women within one year of mastectomy. METHODS: The present study was a cross-sectional survey and involved 101 women who had undergone mastectomy at a University hospital of D city, Korea. Measurement included the scales of body image, sexual intimacy, and sexual satisfaction. RESULTS: Mean age of the subjects was 51 years. Scores of the body image, sexual intimacy, and sexual satisfaction were 59.62, 90.69, and 69.04, respectively. Body image, sexual intimacy, and sexual satisfaction were significantly related to each other. Sexual intimacy was higher when women were of young age (β=−.32), had a shorter period since surgery (β=−.24), and with higher levels of body image (β=.37). Sexual satisfaction was higher when women had higher levels of body image (β=.19) and greater levels of sexual intimacy (β=.74). CONCLUSION: Higher levels of body image and greater levels of sexual intimacy were identified as the significant factors influencing sexual satisfaction among these women. Future research with a mixed-method research is needed to gain a deep understanding of the sexuality between women and their husbands.

Body Image , Breast Neoplasms , Cross-Sectional Studies , Female , Humans , Korea , Mastectomy , Orgasm , Personal Satisfaction , Sexuality , Spouses , Weights and Measures
Article in English | WPRIM (Western Pacific) | ID: wprim-760275


OBJECTIVE: To assess the technical performance of two-dimensional shear wave elastography (2D-SWE) for measuring liver stiffness. MATERIALS AND METHODS: The Ovid-MEDLINE and EMBASE databases were searched for studies reporting the technical performance of 2D-SWE, including concerns with technical failures, unreliable measurements, interobserver reliability, and/or intraobserver reliability, published until June 30, 2018. The pooled proportion of technical failure and unreliable measurements was calculated using meta-analytic pooling via the random-effects model and inverse variance method for calculating weights. Subgroup analyses were performed to explore potential causes of heterogeneity. The pooled intraclass correlation coefficients (ICCs) for interobserver and intraobserver reliability were calculated using the Hedges-Olkin method with Fisher's Z transformation of the correlation coefficient. RESULTS: The search yielded 34 articles. From 20 2D-SWE studies including 6196 patients, the pooled proportion of technical failure was 2.3% (95% confidence interval [CI], 1.3–3.9%). The pooled proportion of unreliable measurements from 20 studies including 6961 patients was 7.5% (95% CI, 4.7–11.7%). In the subgroup analyses, studies conducting more than three measurements showed fewer unreliable measurements than did those with three measurements or less, but no intergroup difference was found in technical failure. The pooled ICCs for interobserver reliability (from 10 studies including 517 patients) and intraobserver reliability (from 7 studies including 679 patients) were 0.87 (95% CI, 0.82–0.90) and 0.93 (95% CI, 0.89–0.95), respectively, suggesting good to excellent reliability. CONCLUSION: 2D-SWE shows good technical performance for assessing liver stiffness, with high technical success and reliability. Future studies should establish the quality criteria and optimal number of measurements.

Elasticity Imaging Techniques , Humans , Liver , Methods , Population Characteristics , Ultrasonography , Weights and Measures