Brazilian Portuguese version and content validity of the Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH)

Abstract Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a personalized, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis (RA). Patients are provided with two guidance documents, the 'Patient Exercise Booklet' and the 'Personal Exercise Guide', to continue the exercises independently at home. Objective This study aimed to translate and culturally adapt the SARAH protocol into Brazilian Portuguese and validate its content. Methods The guidance documents 'Patient Exercise Booklet' and 'Personal Exercise Guide' of the SARAH program were translated and culturally adapted to Brazilian Portuguese. The content validity was obtained by calculating the content validity index (CVI). Results The Brazilian version of the SARAH protocol reached semantic, idiomatic, conceptual, and cultural equivalences. The CVI was greater than 0.8, corresponding to a satisfactory index. The verbal comprehension was 4.9, showing good verbal comprehension ofthe target population. Conclusion The Brazilian Portuguese version of the SARAH protocol is available to Brazilian people with compromised hands due to RA with satisfactory content validity.

Prevalence of Sjögren's syndrome according to 2016 ACR-EULAR classification criteria in patients with systemic lupus erythematosus

Abstract Background Diagnosis of SS is a complex task, as no symptom or test is unique to this syndrome. The American-European Consensus Group (AECG 2002) and the American-European classification criteria of 2016 (ACR/EULAR 2016) emerged through a search for consensus. This study aims to assess the prevalence of Sjögren's Syndrome (SS) in patients with Systemic Lupus Erythematosus (SLE), according to AECG 2002 and ACR-EULAR 2016 classifications, as well as clinical and histopathological features in this overlap. To date, there is no study that has evaluated SS in SLE, using the two current criteria. Methods This cross-sectional study evaluated 237 SLE patients at the outpatient rheumatology clinic between 2016 and 2018. Patients were submitted to a dryness questionnaire, whole unstimulated salivary flow (WUSF), "Ocular Staining Score" (OSS), Schirmer's test I (ST-I), and labial salivary gland biopsy (LSGB). Results After verifying inclusion and exclusion criteria, a total of 117 patients were evaluated, with predominance of females (94%) and mixed ethnicity (49.6%). The prevalence of SS was 23% according to AECG 2002 and 35% to ACR- EULAR 2016. Kappa agreement between AECG 2002 and ACR-EULAR 2016 were 0.7 (p < 0.0001). After logistic regression, predictors for SS were: anti/Ro (OR = 17.86, p < 0.05), focal lymphocytic sialadenitis (OR = 3.69, p < 0.05), OSS ≥ 5 (OR = 7.50, p < 0.05), ST I positive (OR = 2.67, p < 0.05), and WUSF ≤ 0.1 mL/min (OR = 4.13, p < 0.05). Conclusion The prevalence of SS in SLE was 23% (AECG 2002) and 35% (ACR-EULAR 2016). The presence of glandular dysfunction, focal lymphocytic sialadenitis, and anti/Ro were predictors of SS in SLE. The greatest advantage of the new ACR-EULAR 2016 criteria is to enable an early diagnosis and identify the overlapping of these two diseases. ACR- EULAR 2016 criteria is not yet validated for secondary SS and this study is a pioneer in investigating prevalence based on the new criteria.

Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary Sjögren syndrome: results of an epidemiologic systematic review/ meta-analysis and a consensus guideline from the Brazilian society of rheumatology (hepatic, gastrointestinal and pancreatic)

Abstract Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, some systemic manifestations, mainly liver, gastrointestinal, and pancreatic are not routinely evaluated. To address these manifestations, the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology conducted a broad systematic review of the literature on studies investigating prevalence and diagnosis of these symptoms in Sjogren´s patients and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. This is the second part of this guideline, providing 6 recommendations for liver, gastrointestinal, and pancreatic care of SS patients.

Recommendations for evaluation and diagnosis of extra-glandular manifestations of primary sjogren syndrome: results of an epidemiologic systematic review/ meta-analysis and a consensus guideline from the Brazilian Society of Rheumatology (articular, pulmonary and renal)

Abstract Sjogren's Syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs, associated with sicca syndrome but also with systemic involvement with varying degrees of severity. Despite their importance, these systemic manifestations are not routinely evaluated and there is no homogenous approach to their diagnosis or evaluation. To close this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of these manifestations and made recommendations based on the findings. Agreement between the experts was achieved using the Delphi method. The first part of this guideline summarizes the most important topics, and 11 recommendations are provided for the articular, pulmonary, and renal care of SS patients.

2021 recommendations of the Brazilian Society of Rheumatology for the gynecological and obstetric care of patients with Sjogren's syndrome

Abstract Sjogren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands and other organs. Women with SS often experience gynecological symptoms due to the disease and need extra care regarding their sexual activity, reproductive health and during pregnancy, conditions that are not properly conducted in the clinical practice. To cover this gap, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of symptoms, diagnosis, monitoring, prognosis, and treatment of these manifestations. A Focus Group meeting was held and included experts in the field and methodologists, based on a previously developed script, with themes related to the objective of the study. The most important topics were summarized and 11 recommendations were provided.

Pain and fatigue are predictors of quality of life in primary Sjögren's syndrome

Abstract Background: Few studies have evaluated the relation of quality of life (QoL) with symptoms and disease activity in primary Sjögren's syndrome (pSS). There is also scant information on the predictors of QoL in this population. The aim of this study was to assess QoL in patients with pSS and to investigate their possible predictors. Methods: In a cross-sectional study, 77 patients with pSS were evaluated using the following questionnaires: Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-Fatigue), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), Short Form-36 Health Survey (SF-36) and World Health Organization Quality of Life Assessment (WHOQOL-BREF). Seventy-seven healthy controls responded to the SF-36 and WHOQOL-BREF. The Mann-Whitney test, t-test, Pearson and Spearman correlation, and multiple regression analysis were used in the statistical analysis. Results: Patients with pSS and healthy controls were matched by gender and age. The mean scores for the ESSDAI, ESSPRI and FACIT-Fatigue were 3.34 ±4.61, 6.58 ± 2.29 and 26.17 ± 11.02, respectively. Patients had a lower employment rate (36.4% versus 62.3%, p < 0.01) and higher work disability (10.4% versus 1.3%, p < 0.01). SF-36 and WHOQOL-BREF values were lower in patients with pSS (p < 0.001), except in the WHOQOL-BREF environment domain. Pain (ESSPRI), fatigue (FACIT-Fatigue), antinuclear antibody (ANA), anti-Ro-SSA and economic class (Brazilian Economic Classification Criteria - CCEB) were independent predictors of QoL. Conclusions: The main predictors of poor QoL in patients with pSS were pain and fatigue, and these symptoms had an impact regardless of disease activity, age, schooling, marital status, work disability and fibromyalgia.

Recommendations from the Brazilian society of rheumatology for the diagnosis of Sjögren's syndrome (Part I): glandular manifestations (systematic review)

Abstract Background: Primary Sjögren's syndrome (pSS) is a systemic immune-mediated disease whose main characteristic is exocrine gland inflammation and, subsequent reduction in tear and saliva production. A delayed diagnosis is common due to the nonspecific clinical manifestations of disease. The aim of the present study was to develop recommendations for the diagnosis of glandular manifestations of pSS based on evidence and expert opinion. Main body of the abstract: We conducted a systematic literature review to retrieve the best evidence available on the accuracy of diagnostic tests for pSS. We also held two in-person meetings with experts (rheumatologists, pathologists, ophthalmologists and dentists) to establish their level of agreement using the Delphi method. Ultimately, we generated 18 recommendations that aim to facilitate the diagnosis of the glandular manifestations of pSS. Conclusion: The diagnosis of glandular manifestations of pSS is complex and multidisciplinary. It requires specific knowledge in the field of ophthalmology, immunology, pathology and imaging, making it compulsory for the rheumatologist to work with professionals from these different areas in order to improve accuracy and early diagnosis. Glandular dysfunction tests, ANA, RF, Anti-Ro, protein electrophoresis, urinalysis, blood count, C-Reactive protein, complement, testing for syphilis and viruses (HCV, HIV) and SGUS should be investigated when dryness or systemic manifestation are present. Minor salivary gland biopsy is recommended for all anti-Ro negative or incomplete criteria cases.

Recomendações para o tratamento da síndrome de Sjögren / Recommendations for the treatment of Sjögren's syndrome

RESUMOAs recomendações propostas pela Comissão de Síndrome de Sjögren da Sociedade Brasileira de Reumatologia para tratamento da síndrome de Sjögren foram baseadas em uma revisão sistemática da literatura nas bases de dados Medline (PubMed) e Cochrane até outubro de 2014 e opinião de especialistas na ausência de artigos sobre o assunto. Foram incluídos 131 artigos classificados de acordo com Oxford & Grade. Essas recomendações foram elaboradas com o objetivo de orientar o manejo adequado e facilitar o acesso aos tratamentos para aqueles pacientes com adequada indicação de recebê-los, considerando o contexto socioeconômico brasileiro e os medicamentos disponíveis no país.

ABSTRACTThe recommendations proposed by the Sjögren's Syndrome Committee of the Brazilian Society of Rheumatology for the treatment of Sjögren's syndrome were based on a systematic review of literature in Medline (PubMed) and the Cochrane databases until October 2014 and on expert opinion in the absence of studies on the subject. 131 articles classified according to Oxford & Grade were included. These recommendations were developed in order to guide the management and facilitate the access to treatment for those patients with an appropriate indication, considering the Brazilian socioeconomic context and pharmacological agents available in this country.

Validação e propriedades psicométricas do Eular Sjögren's Syndrome Patient Reported Index (ESSPRI) para a língua portuguesa / Validation and psychometric properties of the EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) into Brazilian Portuguese

RESUMOObjetivo:Fazer a adaptação transcultural do Eular Sjögren's Syndrome Patient Reported Index (ESSPRI) para a língua portuguesa e avaliar as suas propriedades psicométricas.Método:Estudo transversal de pacientes com síndrome de Sjögren primária (SS). Foram estudadas as propriedades psicométricas (reprodutibilidade intraobservador e a validade de construto). Na validade de construto, o ESSPRI foi comparado com o Patient's Global Assessment (PaGA), Profile of Fatigue and Discomfort (Profad), Sicca Symptoms Inventory (SSI) e Functional Assessment of Chronic Illness Therapy (Facit-fatigue). Os testes estatísticos usados foram o α-Cronbach, coeficiente de correlação intraclasse (CCI), método de Bland-Altman e coeficiente de Spearman. Foi considerado significativo o p ≤ 0,05.Resultados:Não houve diferença entre as versões nas duas línguas e obteve-se, assim, a versão consensual brasileira. Todos os indivíduos foram mulheres de 49,4 ± 11,6 anos, com início dos sintomas de 7,2 ± 5,4 anos e tempo de diagnóstico de 3 ± 3,3 anos. A média do ESSPRI foi de 6,87 ± 1,97. A reprodutibilidade intraobservador foi alta e significativa (0,911) e, no método de Bland-Altman, não houve viés sistemático na concordância das medidas entre as avaliações. Houve correlação moderada do ESSPRI com todos os instrumentos testados.Conclusão:A versão do ESSPRI em português é válida e reprodutível.

ABSTRACTObjective:To carry out the cross-cultural adaptation of EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) for Portuguese language and evaluate its psychometric properties.Method:Cross-secal study of patients with primary Sjögren's syndrome (SS). The psychometric properties (intraobserver reproducibility and construct validity) were studied. In construct validity, ESSPRI was compared with the Patient's Global Assessment (PGA), Profile of Fatigue and Discomfort (Profad), Sicca Symptoms Inventory (SSI) and Functional Assessment of Chronic Illness Therapy (Facit-F). Statistical tests used were: Cronbach's alpha, intraclass correlation coefficient (ICC), Bland-Altman method and Spearman coefficient. A value of p ≤ 0.05 was considered significant.Results:There was no difference between versions in both languages; thus, a Brazilian consensual version was obtained. All subjects were women aged 49.4 ± 11.6 years, with onset of symptoms of 7.2 ± 5.4 years, and time of diagnosis of 3.0 ± 3.3 years. The mean ESSPRI was 6.87 ± 1.97. The intraobserver reproducibility was high and significant (0.911) and, with Bland-Altman method, there was no systematic bias in the agreement of measures among evaluations. A moderate correlation of ESSPRI with all tested instruments was observed.Conclusion:The Brazilian Portuguese version of ESSPRI is a valid and reproducible version.

Avaliação da fadiga e da secura na síndrome de Sjögren primária: versão brasileira do “Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (short form) (Profad-SSI-SF)” / Assessment of fatigue and dryness in primary Sjögren’s syndrome: Brazilian version of “Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (short form) (PROFAD-SSI-SF)”

Objetivo: Fazer a adaptação transcultural e a validação do Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (short form) (Profad-SSI-SF), questionário que avalia os aspectos subjetivos dos sintomas da síndrome de Sjögren primária (SSp), para a língua portuguesa brasileira. Método: Foi avaliada a equivalência conceitual, de item, semântica e operacional. A versão brasileira do Profad-SSI-SF foi aplicada a 62 mulheres com SSp conforme consenso europeu-americano de 2002 para avaliar a equivalência de mensuração. Foi usado o α-Cronbach para consistência interna; coeficiente de correlação intraclasse (ICC) para reprodutibilidade intraobservador; e coeficiente de correlação de Spearman para validade em comparação com o Patient Global Assessment (PaGA), Eular Sjögren’s Syndrome Patient Reported Index (ESS-PRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (Facit-F) e EuroQOL(EQ-5D). Resultados: A consistência interna do Profad, do SSI e da pontuação total foi de 0,80, 0,78 e 0,87, respectivamente. A reprodutibilidade intraobservador do Profad total foi de 0,89; do SSI total de 0,86 e da pontuação total de 0,89. Na validade, o Profad apresentou correlação significativa com o PaGA (r = 0,50), Facit-F (r = 0,59), Esspri (r = 0,58) e todos os domínios do EQ-5D, com exceção da mobilidade. Já o SSI apresentou correlação significativa com o PaGA (r = 0,43), Facit-F (r = 0,57), Esspri (r = 0,55) e a maioria dos domínios do EQ-5D. A pontuação total do Profad-SSI-SF só não obteve correlação estatisticamente significante com o domínio mobilidade e escala 1 a 100 do EQ-D5. .

Objective: To perform a cross-cultural adaptation and validation of the Profile of Fatigue and Discomfort – Sicca Symptoms Inventory (short form) (PROFAD-SSI-SF) questionnaire assessing the subjective aspects of the symptoms of primary Sjögren syndrome (pSS), for the Brazilian Portuguese language. Method: Conceptual, of the item, semantic and operational equivalences were evaluated. The Brazilian version of PROFAD-SSI-SF was administered to 62 women with pSS according to the European-American consensus 2002 to assess measurement equivalence. α-Cronbach was used for internal consistency; intraclass correlation coefficient (ICC) for intraobserver reproducibility; and Spearman correlation coefficient for validity by comparing with Patient Global Assessment (PaGA), EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-F) and EuroQOL(EQ-5D). Results: The internal consistency of PROFAD, SSI and total score was 0.80; 0.78; and 0.87, respectively. The intraobserver reproducibility of total PROFAD was 0.89; of total SSI was 0.86; and total score was 0.89. In terms of validity, PROFAD correlated significantly with PaGA (r = 0.50), FACIT-F (r = 0.59), ESSPRI (r = 0.58) and all domains of EQ-5D, with the exception of Mobility. On the other hand, SSI correlated significantly with PaGA (r = 0.43), FACIT-F (r = 0.57), ESSPRI (r = 0.55) and most domains of EQ-5D. The total score of PROFAD-SSI-SF had a nonstatistically significant correlation only with Mobility domain and with 1–100 range of EQ-5D. .

Adaptação transcultural do "EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI)" para a língua portuguesa / Transcultural adaptation of the "EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI)" into Brazilian Portuguese

INTRODUÇÃO: O EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) é um índice de atividade sistêmica da síndrome de Sjögren primária (SSP). OBJETIVO: Realizar a adaptação transcultural do ESSDAI para a língua portuguesa. MÉTODO: Estudo transversal com 62 pacientes com SSP de acordo com consenso europeu-americano de 2002. Foram realizadas seis etapas: equivalência conceitual, de item, semântica, operacional, funcional e de mensuração (reprodutibilidade interobservador e a validade de constructo). Para a validade, o ESSDAI foi comparado com a avaliação global do médico (PhGA), o Sjögren's Syndrome Disease Activity Index (SSDAI) e o Sjögren's Systemic Clinical Activity Index (SCAI). Os pacientes foram classificados por um médico especialista conforme a atividade da doença em dois grupos, "ativo" e "inativo", e conforme a intenção de tratar nos grupos "aumento de terapia" e "sem aumento de terapia". O ESSDAI foi testado nesses grupos. Utilizou-se os testes estatísticos: coeficiente de correlação intraclasse (CCI) e método de Bland Altman para a reprodutibilidade; e coeficiente de Spearman (r s) e teste de Mann-Whitney para a validade (P < 0,05 e IC 95%). RESULTADOS: A média do ESSDAI foi de 4,95 ± 6,73. A reprodutibilidade obteve um forte CCI de 0,89 e boa concordância. Na comparação com outros índices, apresentou forte coeficiente de Spearman com o PhGA (r s = 0,83; P < 0,000), moderado com o SSDAI (r s = 0,658 ; P < 0,000) e fraco com o SCAI (r s = 0,411; P = 0,001). O grupo "ativo" e o grupo "com aumento de terapia" obtiveram maiores valores de ESSDAI (P = 0,000). CONCLUSÃO: a versão em português do ESSDAI mostrou ser adaptável, reprodutível e válida para a língua portuguesa.

INTRODUCTION: The EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) is an index of primary Sjögren's syndrome (PSS) systemic activity. OBJECTIVE: To perform the ESSDAI transcultural adaptation into Brazilian Portuguese. METHOD: This was a cross-sectional study with 62 patients with PSS according to the criteria of the 2002 American-European Consensus. Six stages were conducted: conceptual, item, semantic, operational, functional, and measurement equivalences (interobserver reproducibility and construct validity). For the validity assessment, the ESSDAI was compared with the Physician's Global Assessment (PhGA), the Sjögren's Syndrome Disease Activity Index (SSDAI), and the Sjögren's Systemic Clinical Activity Index (SCAI). Patients were classified by a specialist physician into two groups according to disease activity (active and inactive), and according to the intention-to-treat (increase in therapy and no increase in therapy). The ESSDAI was tested in these groups. The following statistical tests were used: intraclass correlation coefficient (ICC), Bland-Altman plot for reproducibility, and Spearman's correlation coefficient (r s) and Mann-Whitney's test for validity (P < 0.05 and 95% CI). RESULTS: The mean ESSDAI score was 4.95 ± 6.73. The reproducibility obtained a strong ICC of 0.89 and good agreement. When compared with other indices, it showed a strong r s with PhGA (0.83; P < 0.000), a moderate r s with SSDAI (0.658; P < 0.000) and a weak r s with the SCAI (0.411; P = 0.001). The group "active" and the group " increase in therapy" had higher ESSDAI values (P = 0.000). CONCLUSION: The Brazilian Portuguese version of ESSDAI was shown to be adaptable, reproducible, and valid for this language.

Efeitos do programa de educação em pacientes com artrite reumatoide do Serviço de Reumatologia do Hospital Universitário Cassiano Antônio de Moraes (HUCAM) - projeto piloto / Effects of education program in patients with rheumatoid arthritis RheumatologyService of University Hospital Cassiano Antonio de Moraes (HUCAM) - pilot project

As metas da educação ao paciente com artrite reumatoide (AR) visam estimular o sujeito a alcançar o máximo possível de independência funcional e qualidade de vida. O objetivo do trabalho foi verificar os efeitos do programa de extensão “Educação ao Paciente Reumático”, em um Serviço de Reumatologia, em Vitória/ES. A metodologia utilizada foi um ensaio clínico não controlado do tipo quantitativo. Pacientes foram avaliados ao iniciarem no programa e após quatro semanas, através do Health AssessmentQuestionnaire, do Patient Knowledge Questionnaire e da Escala de autoeficácia para dor crônica. Nos dados foram utilizados o teste t-pareado, para as variáveis paramétricas, e o teste de Wilcoxon, para as não paramétricas, sendo considerado um p<0,05. Os resultados foram os seguintes: cinquenta pacientes com AR participaram do programa, sendo que quinze pacientes compareceram a todos os encontros e dezenove completaram as 1ª e 2ª avaliações; 18,2%completaram o Ensino Médio e 63,6% recebiam até um salário mínimo. Concluiu-se que não houve diferença estatisticamente significativa entre as avaliações iniciais e finais. A amostra utilizada demonstrou que os pacientes não adquiriram mais conhecimentosobre a doença através do programa de educação a curto-prazo, provavelmente devido ao baixo nível de escolaridade, à renda mensal e à falta de adesão dos usuários e familiares...

The goal behind patient’s education about rheumatoid arthritis (RA) is to stimulate the person to achieve maximum functional independence e a healthy life-style. The point of thiswork was to verify the extension program “Education to rheumaticpatient” effects, on a Rheumatologic Service, in Vitória/ES. The applied methodology was a non-controlled clinical trial of the quantitative type. Patients were evaluated in the beginning of the program and after four weeks, through the Health AssessmentQuestionnaire, from Patient Knowledge Questionnaire and from the School of auto effi ciency for chronical pain. It was used the t-paired test on the data, for the parametrical variables, and the Wilcoxon test for the non-parametrical ones, been considered p<0.05. The results were: fi fty patients with RA started the program, being that fi fteenattended to all meetings and nineteen had the 1st and 2nd evaluationscompleted; 18.2% fi nished High School and 63.6% had a minimum wage income. We conclude that there was no signifi cant statistical difference between the initial and final evaluations. The used sample showed that the patients did not acquired more knowledge about the disease through the short-term education program, probably due their low level of education, the low income and lack of family support...

Qualidade de vida em pacientes com osteoporose: correlação entre OPAQ e SF-36 / Quality of life in patients with osteoporosis: correlation between OPAQ and SF-36

OBJETIVO: correlacionar o instrumento de avaliação de qualidade de vida específico para osteoporose, o Osteoporosis Assessment Questionnaire (OPAQ), com o instrumento genérico, o The Medical Outcomes Study 36 - Item Short Form Health Survery (SF-36). PACIENTES E MÉTODOS: estudo observacional de corte transversal que incluiu 40 mulheres acima de 60 anos, diagnosticadas com osteoporose. Houve um momento para avaliação e um único examinador. Para a análise estatística foram utilizados coeficiente correlação de Pearson e análise fatorial do OPAQ. RESUTADOS: houve correlação entre os domínios e componentes finais do SF-36 com os domínios do OPAQ. Evidenciou-se que os coeficientes mais altos foram entre o OPAQ Sintomas e os seguintes domínios do SF-36: dor (r=-0,6), aspectos sociais (r=-0,6 por cento) e saúde mental (r=-0,5). Quase todos os aspectos do SF-36 se correlacionaram com o OPAQ Sintomas. E, ainda, por análise fatorial do OPAQ, observa-se que os seus 18 componentes representaram 63 por cento de carga fatorial, ou seja, eles explicaram o valor total de impacto da osteoporose na qualidade de vida e agruparam-se em cinco fatores: fator 1 (mobilidade, cuidados próprios, independência e trabalho doméstico), fator 2 (flexibilidade, movimentação e sono), fator 3 (dor nas costas, dor relacionada à osteoporose, fadiga e humor), fator 4 (medo de cair, atividades sociais, apoio familiar e tensão) e fator 5 (andar-inclinar, imagem corporal e trabalho). CONCLUSÃO: foi encontrada a correlação esperada entre SF-36 e OPAQ, que é um instrumento de avaliação específico com capacidade para avaliar aspectos específicos e gerais da qualidade de vida nesta população.

OBJECTIVE: to correlate the quality of life assessment instrument, specific to osteoporosis, OPAQ (Osteoporosis Assessment Questionnaire), with the generic instrument SF-36 (Item Short Form Health Survey). PATIENTS AND METHODS: the cross sectional observational study included 40 female patients older than 60 years with osteoporosis. A single assessment was always conducted by the same evaluator. For the statistics analisys the PearsonÆs coefficient and the factor analysis to OPAQ were used. RESULTS: there was a correlation between the domains and final components of SF-36 with the domains of OPAQ. The higher coefficients were between the OPAQ Symptoms and some domains of SF-36: pain (r=-0,6), social aspects (r=-0,6) and mental health (r=-0,5). Almost every aspect of SF-36 was correlated with the OPAQ Symptoms. By factor analysis of OPAQ it was observed that the 18 components of OPAQ represented 63 percent of factor load, and they explained the total account of osteoporosisÆs impact in the quality of life and were grouped in five factors: factor 1 (mobility, self-care, independence and household tasks), factor 2 (flexibility, transfers and sleep), factor 3 (backache, pain related to osteoporosis, fatigue and mood), factor 4 (fear of fall, social activity, family support and tension) and factor 5 (walking and bending, body image and work). CONCLUSION: the expected correlation was achieved between SF-36 and OPAQ, wich is a specific assessment instrument capable of assessing particular and general aspects of the quality of life in patients with osteoporosis.

Fisioterapia preventiva atuando na ergonomia e no stress no trabalho / Preventive physicaltherapy in ergonomic and ocupational stress at work

Qualidade e eficiencia se cria e se constroi, e um processo longo que requer dedicacao e muita saude, tanto fisica quanto mental. Desse modo, toda empresa percebendo que a Qualidade Total passa pela Qualidade de Vida dos seus colaboradores, esta com certeza significativos degraus a frente dos seus concorrentes. Participaram 110 funcionarios do Setor Centro de Operacoes da empresa SERCOMTEL S. A. Este trabalho visou relacionar a prevencao do estresse ocupacional com...

Dengue: conscientizaçäo e prevençäo / Dengue: conscientization and prevention

O tema dengue foi escolhido para este trabalho, entre outros motivos, devido ao alto número de casos notificados no último veräo, na área de abrangência das Unidades Básicas de Saúde do Jardim Sabará e Vila Ricardo. O trabalho consistiu em desencadear um processo educativo da populaçäo para a prevençäo da dengue, com o combate ao mosquito transmissor, Aedes aegypti. Como frutos dessa atividade, pode-se citar o crescimento pessoal de cada integrante do grupo, amadurecimento crítico e integraçäo interdisciplinar e multiprofissional