ABSTRACT
The aim of this study was to evaluate the efficacy of the Portuguese version of the Medication Adherence Training Instrument (MATI) for improving adherence to antiretroviral therapy (ART) in southern Brazil. Two different follow-up modalities were compared in this 225 days randomized controlled study: one based on the MATI protocol and a conventional (non-MATI) clinical follow-up. There were no differences between the groups with the exception of socioeconomic class (P < 0.005). The mean length of continuance in treatment was 111.4 (SD = 13.9) and 137.6 (SD = 17.3) days in the MATI and non-MATI groups, respectively. A Mantel-Cox log-rank test revealed no significant difference between the two interventions (P = 0.34). Despite the sample size limitation, the results from this study indicate that the Portuguese version of the MATI was not more efficacious than the regular follow-up intervention for improving adherence of outpatients to ART.
Subject(s)
Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , Health Promotion/methods , Interviews as Topic/methods , Medication Adherence , Patient Education as Topic/methods , Adult , Brazil , Clinical Protocols , Humans , Kaplan-Meier Estimate , Middle Aged , Prospective Studies , Socioeconomic FactorsABSTRACT
OBJECTIVE: The purpose of this study is to review the main postpartum screening tools currently used in terms of their ability to screen for postnatal depression. Furthermore, the cultural characteristics of depressive postpartum symptomatology are examined. METHOD: A systematic literature search was conducted for the period 1987-2009, using the Medline electronic database for the following keywords: postpartum depression and postnatal depression. These terms were combined with: assessment, screening and psychometric tools. RESULTS: Of the four screening tools reviewed and compared, the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Depression Screening Scale (PDSS) presented substantial sensitivity and specificity as screening tools. However, none of the instruments could be rated flawless when applied to different cultural contexts. CONCLUSIONS: In addition to the EPDS, a new generation of instruments is currently available. Supplementary research is needed to substantiate their use as screening tools in general practice. Additional studies are needed to adapt and test instruments to detect postnatal depression within a wider range of languages and cultures.
Subject(s)
Cross-Cultural Comparison , Depression, Postpartum/diagnosis , Depression, Postpartum/epidemiology , Psychiatric Status Rating Scales/statistics & numerical data , Sensitivity and Specificity , Female , Humans , Prevalence , Validation Studies as TopicABSTRACT
Objective: The purpose of this study is to review the main postpartum screening tools currently used in terms of their ability to screen for postnatal depression. Furthermore; the cultural characteristics of depressive postpartum symptomatology are examined. Method: A systematic literature search was conducted for the period 1987-2009, using the Medline electronic database for the following keywords: postpartum depression and postnatal depression. These terms were combined with: assessment, screening and psychometric tools. Results: Of the four screening tools reviewed and compared, the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Depression Screening Scale (PDSS) presented substantial sensitivity and specificity as screening tools. However, none of the instruments could be rated flawless when applied to different cultural contexts. Conclusions: In addition to the EPDS, a new generation of instruments is currently available. Supplementary research is needed to substantiate their use as screening tools in general practice. Additional studies are needed to adapt and test instruments to detect postnatal depression within a wider range of languages and cultures
