ABSTRACT
INTRODUCTION: Depression is one of the most common mental disorders and a leading cause of disability worldwide. It constitutes a serious public health problem, particularly among elderly individuals. Most depressed elderly patients are treated by primary care (PC) physicians. The "Patient Health Questionnaire" (PHQ-2) is an instrument used for the detection of depression in PC settings. OBJECTIVE: Evaluate the performance of the PHQ-2 in a low-income and uneducated elderly PC population. METHODS: A non-probabilistic population sample of 142 individuals was selected from the healthcare unit's users ⧠60 years. Criterion validity was assessed by estimating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PHQ-2 in comparison with the structured interview using the DSM-IV. The estimates of sensitivity and specificity were obtained from varying cut-offs of the PHQ-2 score. A Receiver Operator Characteristic (ROC) curve was constructed and the area under the curve (AUC) was calculated. RESULTS: The group was predominantly female (73.9%), with low education level (mean 3 years of schooling). The mean age was 72.5 years old. The prevalence of depression was 26.1%. The best values of sensitivity (0.74), specificity (0.77), PPV (0.50) e NPV (0.90) were obtained with score equal to 1. The AUC was 0.77, indicating a modest performance of the test accuracy. CONCLUSION: The simplicity of the PHQ-2 is an advantage for its use in PC. The high NPV indicated that 90% of those who tested negative would not need additional tests. However, the low PPV indicated that the PHQ-2 is not sufficient to screen for depression. The application of the instrument could be the first step of the screening, that would include a second step to all those with positive tests formerly.
Subject(s)
Depression/diagnosis , Aged , Area Under Curve , Female , Geriatric Assessment , Health Status , Humans , Male , Middle Aged , Poverty , Predictive Value of Tests , Primary Health Care , Psychiatric Status Rating Scales , ROC Curve , Surveys and QuestionnairesABSTRACT
This study presents an instrument, the health-related quality of life (HRQOL) profile for independent elderly, to measure the health-related quality of life of the functionally independent elderly assisted in the outpatient setting, based on the adaptation of four validated scales: Short-Form Health Survey (SF-36), Duke-UNC Health Profile (DUHP), Sickness Impact Profile (SIP), and Nottingham Health Profile (NHP). The study also evaluates the instrument's reliability based on its use by two different observers with a 15-day interval. The instrument includes five dimensions (health perception, symptoms, physical function, psychological function, and social function) and 45 items. Reliability evaluation of the QUASI instrument was based on interviews with 142 elderly outpatients in the city of Rio de Janeiro, Brazil. Prevalence-adjusted kappa statistic was used to assess all 45 items. Correlation was also calculated between overall scores and scores on individual dimensions. In the reliability evaluation, 39 of the 45 items showed prevalence-adjusted kappa greater than 0.60.
Este trabalho apresenta um instrumento, o QUASI - Perfil de Qualidade de Vida Relacionada à Saúde de Idosos Independentes, para a medição da qualidade de vida relacionada à saúde de idosos que freqüentam programas ambulatoriais, a partir da adaptação de quatro instrumentos amplamente validados: Short-Form Health Survey, Duke-UNC Health Profile, Sickness Impact Profile e Nottingham Health Profile. Além disso, avalia a confiabilidade, considerando a sua utilização por dois entrevistadores, em intervalo de 15 dias. O instrumento contempla cinco dimensões: Percepção de Saúde, Sintomas, Função Física, Função Psicológica e Função Social e envolve 45 itens. A avaliação da confiabilidade foi realizada a partir das entrevistas de 142 idosos, inscritos em programas ambulatoriais no Município do Rio de Janeiro, Brasil, com base na apreciação da estatística kappa, ajustada por prevalência, para cada um dos 45 itens incluídos, e na correlação dos escores geral e por dimensão. Na avaliação da confiabilidade, 39 dos 45 itens apresentaram kappa superior a 0,60.
Subject(s)
Humans , Aged , Ambulatory Care , Health of the Elderly , Quality of Life , BrazilABSTRACT
This study presents an instrument, the health-related quality of life (HRQOL) profile for independent elderly, to measure the health-related quality of life of the functionally independent elderly assisted in the outpatient setting, based on the adaptation of four validated scales: Short-Form Health Survey (SF-36), Duke-UNC Health Profile (DUHP), Sickness Impact Profile (SIP), and Nottingham Health Profile (NHP). The study also evaluates the instrument's reliability based on its use by two different observers with a 15-day interval. The instrument includes five dimensions (health perception, symptoms, physical function, psychological function, and social function) and 45 items. Reliability evaluation of the QUASI instrument was based on interviews with 142 elderly outpatients in the city of Rio de Janeiro, Brazil. Prevalence-adjusted kappa statistic was used to assess all 45 items. Correlation was also calculated between overall scores and scores on individual dimensions. In the reliability evaluation, 39 of the 45 items showed prevalence-adjusted kappa greater than 0.60.
Subject(s)
Ambulatory Care , Geriatric Assessment/statistics & numerical data , Health Status , Quality of Life/psychology , Surveys and Questionnaires/standards , Activities of Daily Living , Age Factors , Aged , Brazil , Health Status Indicators , Humans , Middle Aged , Reproducibility of Results , Self Concept , Sickness Impact ProfileABSTRACT
Apresenta um instrumento, o QUASI - Perfil de qualidade de vida relacionada à saúde de idosos independentes, para a medição da qualidade de vida relacionada à saúde em idosos com independência funcional assistidos por programas ambulatoriais, composto a partir da adaptação de quatro instrumentos amplamente validados internacionalmente: Short-form Health Survey (SF-36) Duke-UNC Health Profile (DUHP), Sickness Impact Profile (SIP) e Nottingham Health Profile (NHP). Além disso, avalia a confiabilidade do instrumento considerando a sua utilização por dois entrevistadores, em momentos espaçados em aproximadamente 15 dias. A composição do instrumento deu-se a partir da revisão da literatura acerca de perfis de saúde que utilizam medidas psicométricas e genéricas e da consideração dos objetivos e características da clientela de programas ambulatoriais de assistência a idosos. O instrumento contempla cinco dimensões - percepção de saúde, sintomas, função física, função psicológica e função social, que recebem pesos diferentes na definição de um escore global, estabelecidos com base em notas atribuídas por cinco especialistas atuantes na área de geriatria. No conjunto, as cinco dimensões envolvem 45 ítens. A avaliação da confiabilidade do QUASI foi realizada a partir das entrevistas de 142 idosos, inscritos em três programas ambulatoriais do município do Rio de Janeiro, com base na apreciação da estatísitca Kappa, ajustada por prevalência, para cada um dos 45 ítens incluídos, e na correlação dos escores geral e por dimensão. O processo recursivo de composição e avaliação do QUASI permitiu a exclusão e alteração de itens, levando em conta os objetivos de clareza e parcimônia. Considerando a ampla validação dos instrumentos utilizados como fontes, este trabalho apenas faz algumas apreciações acerca do instrumento resultante. Na avaliação da confiabilidade, observou-se a predominância de concordância boa e muito boa, tendo 39 dos 45 itens apresentado Kappa ajustado por prevalência superior a 0,60.
Subject(s)
Ambulatory Care , Health of the Elderly , Quality of Life , Reproducibility of ResultsABSTRACT
Tem como objetivo expor de uma maneira sucinta, a intervençäo da Psicomotricidade, sua técnica preventiva e reeducativa, e o resultado desta atuaçäo com os grupos da terceira idade.
