Intensidade e desconforto do zumbido pós-covid-19: um estudo comparativo / Intensity and discomfort of post-COVID-19 tinnitus: a comparative study

RESUMO Objetivo caracterizar o grau de intensidade e desconforto do zumbido de indivíduos, pós-COVID-19. Métodos pesquisa observacional, exploratória e de corte transversal com 242 participantes, divididos em dois grupos iguais, pareados de acordo com gênero e faixa etária: grupo-controle (GC), composto por indivíduos com zumbido em período pré-pandêmico, e grupo de estudo (GE), composto por participantes que referiram zumbido pós-COVID-19, de diferentes regiões do país. Foram comparados os escores gerais e de domínios específicos do Tinnitus Handicap Inventory (THI) e da Escala Visual Analógica (EVA), por meio de análise estatística descritiva, testes de normalidade, comparação de grupos e de correlação entre as variáveis. Resultados em cada grupo, 93 participantes eram do gênero feminino e 28, do masculino, sendo a média das idades de 35 anos. Os graus desprezível e leve do THI e leve e moderado da EVA foram maiores para o GE, enquanto o domínio catastrófico do THI e a EVA apontaram piores escores para o GC. Houve diferença significativa entre todos os domínios das escalas inter e intragrupos. Conclusão manifestações mais brandas de incômodo, intensidade e desconforto do zumbido pós-COVID-19 foram encontradas, em comparação ao sintoma decorrente de outras causas. Assim, o impacto do zumbido para a população estudada foi menos autorreferido, apontando para melhores possibilidades terapêuticas e prognósticas.

ABSTRACT Purpose to characterize the degree of intensity and discomfort of tinnitus in post-COVID-19 individuals. Methods observational, exploratory and cross-sectional research with 242 participants, divided into two equal groups matched according to sex and age group. The control group, composed of individuals with tinnitus in the pre-pandemic period, and the study group, composed of participants who reported post-COVID-19 tinnitus in different regions of the country. General and domain-specific scores from the Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) were compared through descriptive statistical analysis, normality tests, comparison of groups and correlation between variables. Results in each group, 93 participants were female and 28 male, with a mean age of 35 years. The "negligible" and "mild" degrees of the THI and the "mild" and "moderate" of the VAS were higher for the SG, while the catastrophic domain of the THI and the VAS indicate worse scores for the CG. There was a significant difference between all domains of the inter- and intra-group scales. Conclusion milder manifestations of post-COVID-19 tinnitus disturbance, intensity and discomfort were found, compared to symptoms arising from other causes. Thus, the self-reported impact of the studied population was lower, pointing to better therapeutic and prognostic possibilities.

Atividade física e qualidade de vida em indivíduos renais crônicos / Physical activity and quality of life in chronic kidney individuals

INTRODUÇÃO: As alterações impostas pela doença renal e por seu tratamento interferem negativamente na qualidade de vida dos indivíduos com doença renal crônica. A atividade física é relatada como uma alternativa terapêutica nesta população, porém a maioria dos pacientes submetidos à hemodiálise apresentam baixos níveis de atividade física. OBJETIVO: verificar a correlação entre a atividade física e qualidade de vida em indivíduos com doença renal crônica em hemodiálise. MÉTODOS: Este estudo é observacional, analítico, descritivo e quantitativo, desenvolvido em uma das Unidades de Hemodiálise da região Noroeste do Rio Grande do Sul, Brasil, na atenção clínica terciária, durante o período de novembro de 2018 a fevereiro de 2019. Foram incluídos indivíduos maiores de 18 anos e em tratamento hemodialítico por doença renal crônica há mais de três meses, pertencentes ao serviço de hemodiálise. Os critérios de exclusão foram os indivíduos com diagnóstico de doença renal aguda; aqueles que apresentaram aparentemente dificuldades em compreender, responder ou que não realizaram completamente os instrumentos de avaliação propostos (qualidade de vida e pedômetros), indivíduos que no momento da avaliação não apresentaram condições clínicas estáveis. A coleta de dados foi realizada pela análise dos prontuários clínicos e eletrônicos e entrevista semiestruturada. Utilizou-se avaliação pelos pedômetros e pelo questionário Kidney Disease and Quality of Life Short-Form-KDQOL-SFTM. Análises de modelagem por regressão foram realizadas para testar a associação entre o número de passos/dia e os desfechos avaliados RESULTADOS: Foram incluídos na amostra 40 pacientes, destes, 70% são homens, com média de idade de 59,9 ± 13,0 anos. Na correlação entre atividade física e qualidade de vida, o número de passos/dia teve correlação significativa com as dimensões sintomas e problemas (r=0,523;p=0,003), efeitos da doença (r=0,458; p=0,010), função sexual (r=0,361;p=0,050), sono (r=0,357;p=0,049), função física (r=0,617;p=<0,001), papel físico (r=0,504;p=0,004), dor (r=0,496; p=0,005), bem estar emocional (r=0,407; p=0,023), papel emocional (r=0,435;p=0,014), função social (r=0,522;p=0,003), energia/fadiga (r=0,436;p=0,014) e composição física (r=0,598;p=<0,001). As variáveis idade, índice de massa corporal, tempo de hemodiálise e sexo não apresentaram correlação com o número de passos/dia. CONCLUSÃO: Houve correlação positiva entre atividade física e qualidade de vida, ou seja, quanto maior a média de número de passos/dia melhor a qualidade de vida de indivíduos em hemodiálise.

INTRODUCTION: The changes imposed by kidney disease and its treatment negatively affect the quality of life of individuals with kidney disease. Physical activity is reported as a therapeutic alternative in this population; however, most patients undergoing hemodialysis have low levels of physical activity. OBJECTIVE: To verify the correlation between physical activity and quality of life in individuals with chronic kidney disease undergoing hemodialysis. METHODS: This study is observational, analytical, descriptive, and quantitative developed in one of the Hemodialysis Units in the Northwest region of Rio Grande do Sul, Brazil, in tertiary clinical care, during the period from November 2018 to February 2019. Individuals over 18 years old and undergoing hemodialysis for chronic kidney disease for more than three months; belonging to the hemodialysis service. Data collection was performed by analyzing clinical and electronic medical records and semi-structured interviews. Evaluation using pedometers and the Kidney Disease and Quality of Life Short FormKDQOL-SFTM questionnaire was used. Regression modeling analyzes were performed to test the association between the number of steps/ day and the evaluated outcomes. RESULTS: 40 (Forty) patients were included in the sample, of which 70% are men, with a mean age of 59.9 ± 13.0 years. In the correlation between physical activity and quality of life, the number of steps / day had a significant correlation with the dimensions symptoms and problems (r=0,523;p=0,003), effects of the disease (r=0,458; p=0,010), sexual function (r=0,361;p=0,050), sleep (r=0,357;p=0,049), physical function (r=0,617;p=<0,001), physical role (r=0,504;p=0,004), pain (r=0,496; p=0,005), emotional well-being (r=0,407; p=0,023), emotional role (r=0,435;p=0,014), social function (r=0,522;p=0,003), energy / fatigue (r=0,436;p=0,014) and physical composition (r=0,598;p=<0,001). The sample profile variables did not correlate with the number of steps/day. CONCLUSION: There was a positive correlation between physical activity and quality of life; that is, the higher the average number of steps/day, the better the quality of life of individuals undergoing hemodialysis.

Perfil da qualidade de vida três meses ou mais após o término da radioterapia adjuvante utilizada para o tratamento do câncer de cabeça e pescoço em um Centro de Assistência de Alta Complexidade em Oncologia / Quality of life profile three months or more after the end of adjuvant radiotherapy used for the treatment of head and neck cancer in a High Complexity Oncology Care Center

O tratamento do câncer de cabeça e pescoço (CCP) é multimodal e pode gerar diferentes comprometimentos físicos e psicológicos. O objetivo do estudo foi avaliar o perfil da qualidade de vida dos pacientes com CCP, em busca de possíveis alvos terapêuticos que possam ser reabilitados. Trata-se de um estudo descritivo do tipo observacional transversal, desenvolvido em um Centro de Assistência de Alta Complexidade em Oncologia. Os dados foram coletados através da anamnese e do questionário de qualidade de vida da University of Washington (UW-QOL). A amostra foi composta por 68 pacientes com câncer de cabeça pescoço que realizaram radioterapia adjuvante há no mínimo 90 dias. Houve predomínio do sexo masculino (89%) e acometimento da orofaringe (69%). Além da radioterapia, 53% dos indivíduos também realizaram cirurgia e 65% quimioterapia. As funções estomatognáticas foram as mais afetadas, seguido por implicações negativas relacionadas às atividades de vida diária e de aspectos de ordem psicológica. De acordo com a natureza dos domínios apurados no questionário de vida UW-QOL, a baixa pontuação observada nas questões referentes à atividade de vida diária e nos componentes de avaliação do estado psicológico, é pertinente supor que as complicações tardias impostas tanto pela fisiopatologia do CCP quanto pelo tratamento antineoplásico devam ser abordadas por uma equipe multidisciplinar alinhados no objetivo sinérgico de reabilitar as funções estomatognáticas, a alimentação e a capacidade física. Embora nossos dados não sugiram comprometimentos emocionais, o apoio adicional do psicólogo, poderia ser cogitado com o objetivo de fortalecer e motivar o engajamento na reabilitação do complexo quadro clínico intrínseco ao CCP.

The treatment of head and neck cancer (HNC) is multimodal and can generate different physical and psychological impairments. The aim of this study was to assess the quality of life profile of patients with HNC, in search of possible therapeutic targets that can be improved. This is a descriptive, cross-sectional, observational study, developed at a High Complexity Care Center in Oncology. Data were collected through anamnesis and the University of Washington quality of life questionnaire (UW-QOL). The sample consisted of 68 patients with head and neck cancer who underwent adjuvant radiotherapy for at least 90 days. There was a predominance of males (89%) and an involvement of the oropharynx (69%). In addition to radiation therapy, 53% of individuals also underwent surgery and 65% chemotherapy. Stomatognathic functions were the most affected, followed by negative implications related to activities of daily living and psychological aspects. According to the nature of the domains found in the UW-QOL Questionnaire, the low scores observed in the questions related to the activities of daily living and in the components of the psychological status assessment, it is pertinent to assume that the late complications imposed by both the pathophysiology of the HNC as well as the antineoplastic treatment should be approached by a multidisciplinary team aligned with the synergistic objective of rehabilitating stomatognathic functions, nutrition, and physical capacity. Although our data do not suggest emotional impairments, additional support from a psychologist could be considered in order to strengthen and motivate engagement in the rehabilitation of the complex clinical condition intrinsic to HNC.

Qualidade de vida e experiências religiosas/espirituais de pacientes com câncer em um serviço de emergência / Calidad de vida y experiencias religiosas/espirituales de pacientes con cáncer en um servicio de emergencia / Quality of life and religious/spiritual experiences ofcancer patients in an emergency service

RESUMO Objetivo: avaliar qualidade de vida, experiências espirituais em pacientes com câncer e sua correlação. Método: estudo transversal, realizado na Emergência, de fevereiro a setembro de 2017. Utilizado o Medical Outcome Study 36 - Item Short-Form Health Survey para verificação da qualidade de vida, com oito dimensões, escore de 0 (pior estado) a 100 (melhor estado) e a Escala Diária de Experiência Espiritual, com 16 itens, pontuação entre 16 e 94 (menores pontuações refletem maior frequência de experiências). Utilizou-se o Coeficiente de Spearman para correlacionar qualidade de vida e espiritualidade. Resultados: 83 pacientes, média de idade 58 anos, predomínio masculino. A dimensão da qualidade de vida mais comprometida foi "aspecto físico". A Escala de Experiência Espiritual apresentou média 51, com correlação negativa entre qualidade de vida e espiritualidade. Conclusão: a espiritualidade relaciona-se com qualidade de vida e deve ser considerada no atendimento a pacientes com câncer na emergência.

RESUMEN: Objetivo: evaluar la correlación entre la calidad de vida y las experiencias espirituales en pacientes con cáncer. Método: estudio transversal, realizado en el Departamento de Emergencias, de febrero a septiembre de 2017. Par verificar la calidad de vida se utilizó el Medical Outcome Study 36 - Item Short-Form Health Survey, con ocho dimensiones, puntaje de 0 (peor estado) a 100 (mejor estado) y la Escala Diaria de Experiencia Espiritual, con 16 ítems, puntajes entre 16 y 94 (los puntajes más bajos reflejan una mayor frecuencia de experiencias). El coeficiente de Spearman se utilizó para correlacionar la calidad de vida y la espiritualidad. Resultados: el estudio se realizó con 83 pacientes, edad promedio 58 años, predominantemente hombres. La dimensión de calidad de vida más comprometida fue el "aspecto físico". La escala de experiencia espiritual mostró un promedio de 51, con una correlación negativa entre calidad de vida y espiritualidad. Conclusión: la espiritualidad está relacionada con la calidad de vida y debe considerarse en la atención de pacientes con cáncer en la sala de emergencias.

ABSTRACT Objective: Evaluate the quality of life, spiritual experiences in cancer patients and their correlation. Method: Cross-sectional study, carried out in the Emergency, from February to September 2017. Using the Medical Outcome Study 36 - Item Short-Form Health Survey for quality of life verification, with eight dimensions, the scores from 0 (worst condition) to 100 (best condition) and the Daily Scale of Spiritual Experience, with 16 items, scoring between 16 and 94 (lower scores reflect higher frequency of experience). The Spearman coefficient was used to correlate quality of life and spirituality. Results: 83 patients, mean age 58 years, male predominance. The most compromised quality of life's dimension of was "physical aspect". The Spiritual Experience Scale presented a mean of 51, with a negative correlation between the quality of life and spirituality. Conclusion: Spirituality is related to quality of life and should be considered in the care of cancer patients in the emergency.

Impact of primary hyperhidrosis on the life of physical education academics of a university in the Brazilian Northeast

Abstract Aim: To assess the prevalence, quality of life (QoL), and the damages caused by PH, in the professional and personal scope of Physical Education academics with Primary Hyperhidrosis (PH). Methods: A descriptive, exploratory, qualitative and quantitative cross-sectional study was carried out. Twenty-five students from the physical education course at Tiradentes University, Aracaju-SE, were interviewed from August to November 2017. Validated questionnaires were used on PH's influence in academic activities and QoL. absolute and relative frequencies in the case of categorical variables and measures of trend and central variability in the case of numerical variables. Results: The prevalence of PH in students of Physical Education was 11.11%, mainly in combined sites, such as palmoplantar, and with no difference between the sexes. The symptoms started mostly during childhood and adolescence. Most of the interviewees (92%) reported difficulties with activities such as sports, use of personal protective equipment, handling of work equipment and instruments, and exacerbation in stress situations. They reported significant harm to QoL in situations of greeting people with handshakes, writing, wearing socks and dancing socially. Conclusion: Although PH is a disease that negatively impacts the QoL, it is still little known in the academic world with little demand for medical help. Therefore, it is necessary greater dissemination of the disease for its early diagnosis, related to the intensity of the sweating for a better therapeutic approach.

Impact of oral health problems on the quality of life of women with breast cancer / Impacto dos problemas bucais na qualidade de vida em mulheres com câncer de mama

ABSTRACT Objective To evaluate the impact of oral health on quality of life and to examine the association with sociodemographic, clinical staging and dental variables in women diagnosed with breast cancer. Methods This is an observational cross-sectional study with sample composed of 89 women treated at a Reference Hospital in Vitória, Espírito Santo, Brazil, between January and December 2012. Two scripts in the form of interviews were used, one to record participants' information; and the Oral Health Impact Profile (OHIP-14), to evaluate the impacts produced by the oral condition on quality of life. Descriptive analysis of data was performed. The comparison of the percentage of the impact dimensions with independent variables was tested by the chi-square test or the Fisher exact test, when appropriate. To assess the strength of association between exposure and event, odds ratio was calculated. Significance level of 5% was adopted. Results The impact was 28.1%, there was a statistically significant association with variables income (p = 0.039) and reason for the visit to the oral health professional (p = 0.012). Conclusion Studies on quality of life of cancer patients are of fundamental importance for understanding the impact of oral health problems on quality of life.

RESUMO Objetivo Avaliar o impacto produzido por problemas bucais na qualidade de vida; e examinar a associação com as variáveis sociodemográficas, odontológicas e de estadiamento clínico em mulheres com diagnóstico de câncer de mama. Métodos Estudo observacional transversal. Amostra composta por 89 mulheres atendidas em um hospital de referência em Vitória, Espírito Santo, Brasil, entre janeiro e dezembro de 2012. Utilizaram-se dois roteiros na forma de entrevista, um para registro das informações das participantes; e o Oral Health Impact Profile (OHIP-14), para avaliar os impactos produzidos pela condição bucal sobre a qualidade de vida. Realizou-se análise descritiva dos dados. A comparação dos percentuais das dimensões do impacto com as variáveis independentes foi verificada pelo teste qui-quadrado ou pelo teste exato de Fisher, quando apropriado. Para avaliar a força da associação entre evento e exposição, calculou-se o odds ratio. Adotou-se o nível de significância de 5%. Resultados O impacto foi de 28,1%, houve associação estatisticamente significante com as variáveis renda (p=0,039) e motivo da visita ao profissional de saúde bucal (p=0,012). Conclusão Estudos sobre qualidade de vida em pacientes oncológicos são de fundamental importância na compreensão do impacto dos problemas bucais em sua vida.

Impact Produced by Oral Conditions on the Quality of Life of Brazilian Workers of a Mixed-Economy Company

Objective: To evaluate the impact on quality of life caused by oral health problems among administrative sector employees of a mixed-economy company, residents in Vitória, Brazil. Material and Methods: This cross-sectional study used a random sample of 167 individuals. Quality of life measured by the subjective indicator OHIP-14, was the outcome considered; independent variables were sociodemographic, oral health dental services use and perceived prosthesis need. OHIP evaluates impairments in the three dimensions of social, psychological and physical functional conditions. To evaluate differences between groups, Chi-Square and Fisher's Exact Tests were used (p<0.05). To assess the strength of association, Odds-Ratio was calculated. Results: The health professional most sought by individuals in the last 12 months was the dentist (88.5%), agreed by the company (62.6%) due to prevention reasons (62.6%). The prevalence of impact caused by oral health problems was 7.8% and most recorded dimensions were physical pain (6%) and psychological discomfort (5.4%). Impact perception was greater among individuals who declared need for partial removable denture at functional limitation and psychological incapacity dimensions. Subjects that used urgency oral health services presented more impact at psychological discomfort dimension. Conclusion: The impact frequency was low. Objective and subjective measures can provide accurate analysis to support health policies directed to the real population needs.

Diseño de una herramienta para la valoración y clasificación de la limitación en fibromyalgia / Design of a tool for the assessment and classification of fibromialgia limitation

Resumen Introducción: El síndrome fibromiálgico se caracteriza por dolor crónico asociado a sintomatología somática no específica y con las limitaciones asociadas a su impacto personal, social, laboral y económico. Su valoración se realiza de forma independiente, analizando sus aspectos clínicos, de severidad, los tratamientos y su efectividad, la repercusión en las actividades de la vida diaria y la repercusión o afectación laboral. La herramienta FM-Check es una escala subjetiva que puede ser de ayuda para valorar de forma conjunta todos estos aspectos y servir de apoyo al profesional en el seguimiento del paciente y facilitar la colaboración conjunta interprofesional. Método: Para elaborar la FM-Check se parte de la historia clínica en la que se definen las variables que se van a utilizar agrupándolas en 4 bloques a los que se asignan porcentajes de limitación para cada variable y cada bloque, para llegar a un porcentaje global de limitación en los roles de las personas. Resultados: La distribución de porcentajes por cada bloque es en máximos: 10% para aspectos personales, 55% para clínico-terapéuticos, 24% para laborales y 10% para repercusión en la vida diaria. En función del porcentaje global obtenido tras la valoración del paciente se asignan grados de limitación: grado 1 hasta un porcentaje global < 20%, grado 2 del 20-40%, grado 3 entre el 41-70% y grado 4 > 70%. Conclusión: FM-Check pretende facilitar la labor médica en la evolución del paciente y la toma de decisiones clínico-terapéuticas tras una valoración global de la limitación del paciente con fibromialgia, siguiendo una metodología unificada que permita comparar resultados evolutivos individuales y la realización de estudios epidemiológicos colectivos.

Abstract Introduction: Fibromialgia syndrome is characterised by chronic pain associated with nonspecific somatic symptoms, and has a personal, social, occupational, and economic impact. The assessment is performed independently, by analysing the clinical aspects, severity, therapies, and their effectiveness, as well as the impact on daily life activities and its effect on employment. The FM-Check tool is a subjective scale that can be helpful in jointly assessing all these aspects, and provide professional support in monitoring the patient, as well as contribute to a multidisciplinary approach. Method: To develop FM-Check is developed by starting with the clinical history in which the variables that are going to be used are defined, and grouped into 4 blocks to which a percentage limitation rate is assigned for each variable and each block. An overall percentage limitation is then calculated for the activities in each person. Results: The distribution of assigned percentages was: a maximum of 10% for personal appearance, 55% for clinical-therapeutic aspects, 24% for work aspects, and 10% for impact on everyday life. The limitation levels were classified according to the overall percentage obtained after assessing the patient; grade 1: an overall percentage < 20%, grade 2: 20-40%, grade 3: 41-70%, and grade 4: > 70%. Conclusion: FM-Check aims to make it easier for the clinician to monitor the patient and making medical-therapeutic decisions after an overall assessment of the limitation of the fibromialgia patient. This achieved by following a unified methodology that can compare individual developmental outcomes, as well as for conducting joint epidemiological studies.

Impact of Oral Problems on the Quality Of Life of Women Subjected To Chemotherapy for Breast Cancer: A Longitudinal Study

Objective: To evaluate the impact of oral problems on the quality of life of women before and during chemotherapy for breast cancer. Material and Methods: A longitudinal study was conducted on women with breast cancer at a Hospital reference, Espírito Santo, Brazil from January 2012 to January 2013. Assessment was performed at three time-points, the first before the onset of therapeutic intervention, the second after the first chemotherapy session, and the third after the second chemotherapy session. The volunteers were assessed using interviews that included the application of the subjective indicator Oral Health Impact Profile (OHIP-14). The data were subjected to descriptive analysis based on tables of absolute and percentage frequencies relative to the OHIP-14 dimensions. McNemar's test assessed the direction of discordance, and the Kappa test measured the levels of concordance among the three assessments. The significance level was established at 5%. Results: The percent frequency of the impact of oral problems on the quality of life increased from the first (27%) to the second (49%) time-point, and functional limitation (p=0.001), physical pain (p=0.039), and physical disability (p=0.039) were statistically significant. Conclusion: Oral problems exerted a substantial impact on the volunteers' quality of life before the onset of chemotherapy, and quality of life became poorer after the onset of treatment. Patients with breast cancer require specific oral care and should be monitored before, during, and after anticancer treatment to minimize the deleterious effects of chemotherapy and improve their quality of life.

Yellow fever impact on brown howler monkeys (Alouatta guariba clamitans) in Argentina: a metamodelling approach based on population viability analysis and epidemiological dynamics

In South America, yellow fever (YF) is an established infectious disease that has been identified outside of its traditional endemic areas, affecting human and nonhuman primate (NHP) populations. In the epidemics that occurred in Argentina between 2007-2009, several outbreaks affecting humans and howler monkeys (Alouatta spp) were reported, highlighting the importance of this disease in the context of conservation medicine and public health policies. Considering the lack of information about YF dynamics in New World NHP, our main goal was to apply modelling tools to better understand YF transmission dynamics among endangered brown howler monkey (Alouatta guariba clamitans) populations in northeastern Argentina. Two complementary modelling tools were used to evaluate brown howler population dynamics in the presence of the disease: Vortex, a stochastic demographic simulation model, and Outbreak, a stochastic disease epidemiology simulation. The baseline model of YF disease epidemiology predicted a very high probability of population decline over the next 100 years. We believe the modelling approach discussed here is a reasonable description of the disease and its effects on the howler monkey population and can be useful to support evidence-based decision-making to guide actions at a regional level.

Impacto de la acromegalia y el síndrome de Cushing sobre la salud, una perspectiva vivencial / Impact of acromegaly and the Cushing's syndrome, a prospect experience

Objetivo: describir el impacto de la acromegalia y el síndrome de Cushing sobre la salud, desde la perspectiva de personas con estas enfermedades.Métodos: se utilizó un diseño descriptivo, transversal y metodología cualitativa. Participaron 12 mujeres y 8 varones con cambios corporales resultantes de estas enfermedades, atendidos en el Instituto Nacional de Endocrinología, en La Habana, Cuba. Se realizaron entrevistas en profundidad y técnicas psicológicas proyectivas. El material recogido fue transcrito íntegramente, sometido a codificación, interpretación y triangulación. Los aspectos éticos fueron considerados. Resultados: emergieron 5 categorías interconectadas que fundamentaron el impacto de dichas enfermedades sobre la salud: la construcción de sus manifestaciones en términos de síntoma, las trayectorias para acceder a los servicios de salud, la comunicación del diagnóstico, el origen de la enfermedad y su valoración como experiencia de vida.Conclusiones: desde la perspectiva de los sujetos, la acromegalia y el síndrome de Cushing provocaron un impacto significativo de salud como resultado de: sus manifestaciones psíquicas y corporales, las características del proceso de atención y el diagnóstico. El género, las particularidades de la enfermedad y la escasa difusión de información sobre estas enfermedades influyeron sobre las decisiones de salud. El cuerpo se reconstruyó como desvalorizado, y la enfermedad se estructuró como proceso que provocó modificaciones globales en sus vidas(AU)

Objective: to describe the impact of acromegaly and the Cushing's syndrome on health, from the prospective of the persons presenting these diseases. Methods: a descriptive, cross-sectional design and qualitative methodology were used. Twelve women and 8 men with body changes caused by these diseases, seen in the National Institute of Endocrinology in La Habana, Cuba, participated in this study. Interviews in depth were applied as well as psychological projective techniques. The material collected was entirely transcribed, submitted to codification, interpretation and triangulation. Ethical features were taken into account. Results: appeared five interconnected categories supporting the impact of such diseases on health: reproduction of its manifestations in terms of symptom, the paths to accede to health services, the diagnosis's communication, the disease nature and its assessment as a life experience. Conclusions: from the subject's perspective, acromegaly and Cushing's syndrome had a significant impact on health as result of: its psychic and body manifestations, the characteristics of care process and diagnosis. Genre, disease peculiarities and the lack of diffusion of information on these diseases influenced on the health decisions. The meaning of body was devalued and the disease was structured as a process leading to global manifestations in its lives(AU)

A família também adoece!: mudanças secundárias à ocorrência de um acidente vascular encefálico na família / La familia también se enferma!: cambios secundarios en la ocurrencia de un accidente vascular encefálico en la familia / The family also becomes sick!: changes secondary to stroke occurring within families

Este estudo buscou compreender o impacto da doença incapacitante na família de pacientes vítimas de acidente vascular encefálico (AVE), investigando as mudanças de ordem estrutural, social e emocional. Foram analisadas nove famílias de pacientes com primeiro episódio de AVE identificados pelo registro geral de doenças do Hospital São Rafael, Salvador, Bahia. A coleta dos dados foi realizada mediante aplicação de questionário, roteiro de entrevista, escala de avaliação funcional e observações registradas em diário de campo. O método empregado para análise dos dados foi o discurso do sujeito coletivo, produzindo representações sociais e transformando em um só discurso a fala dos sujeitos pesquisados. Constatou-se que a ocorrência de um AVE é uma experiência marcada por bruscas transformações no cotidiano familiar e na vida de cada um de seus membros. Os resultados indicam a necessidade de se habilitar a família para o cuidado ao paciente e para o autocuidado.

This study sought to understand the impact of incapacitating illness on the families of stroke victims, investigating the changes of a structural, social and emotional nature. Nine families of patients with a first episode of stroke, identified from the general disease records of Hospital São Rafael, Salvador, Bahia, were analyzed. Data gathering was by means of applying a questionnaire, guided interview and functional evaluation scale and through field diary observations. The data analysis method was collective subject discourse, thus producing social representations and transforming the words of the study subjects into a single line of discourse. It was observed that occurrences of stroke are experiences marked by brusque transformations in the day-to-day life of families and in the lives of each of their members. The results indicate the need to capacitate families to care for the patient and for their own self-care.

Este estudio trata de comprender el impacto de la enfermedad que causa incapacitación en la familia de pacientes víctimas de accidente vascular encefálico (AVE), investigando los cambios de orden estructural, social y emocional. Se analizan nueve familias de pacientes con primer episodio de AVE identificados por el registro general de enfermedades del Hospital São Rafael de la ciudad de Salvador, estado de Bahia, Brasil. La colecta de datos se realizó mediante cuestionario, escala de evaluación y observaciones registradas en diario de campo. El método empleado ha sido el discurso del sujeto colectivo, produciendo representaciones sociales y transformando en un solo discurso la manifestación de los sujetos investigados. Se constata que la ocurrencia de un AVE es experiencia marcada por bruscas transformaciones en el cotidiano familiar y en la vida de cada uno de sus miembros indicando la necesidad de habilitar a la familia para el cuidado del paciente y para el auto-cuidado.

Desarrumou tudo O impacto do acidente vascular encefálico na família / It changed everything The impact of the stroke on the family

O acidente vascular encefálico (AVE) resulta em déficits neurológicos temporários ou permanentes, de variadas intensidades, que podem comprometer a independência do indivíduo acometido na realização de atividades de vida diária. Este estudo de caso investigou famílias de pacientes com diagnóstico de AVE, buscando compreender as dificuldades de ordem estrutural, socioeconômica e emocional pelas quais elas passam; a relação entre o grau de severidade de agravo, tempo de ocorrência da doença e o desenvolvimento de estratégias de proteção e cuidado ao familiar doente. Foram utilizados como instrumentos de coleta de dados: questionário; roteiro de entrevista; observações registradas em diário de pesquisa; aplicação do Índice de Barthel, escala de avaliação funcional internacionalmente validada. A análise dos dados foi realizada pelo Discurso do Sujeito Coletivo, produzindo representações sociais e idéias centrais. Constatou-se que a família passa por um processo de transformação que implica em reorganização e adoção de estratégias de enfrentamento favorecidas pela existência de uma rede de suporte. Esses resultados apontam para a necessidade de se habilitar a família para o cuidado ao paciente com incapacidade decorrente de acidente vascular encefálico e para o autocuidado.