RESUMO
OBJETIVO: To determine agreement between the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) measurement instruments as a strategy for estimating concurrent validity. METHODS: This was a cross-sectional study conducted with users of the Brazilian National Health System. An agreement approach using a weighted Kappa test for qualitative data was applied in order to test for concurrent validity. RESULTS: 372 individuals participated. It was found that 66% and 62% of them did not have an adequate level of literacy according to SAHLPA-18 and S-TOFHLA, respectively. There was strong correlation between the instruments (p<0.001; r=0.60), although the 65.3% agreement of correct answers found was considered weak (Kappa=0.35; p<0.001). CONCLUSION: The SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. Use of different instruments is indicated in research intended to measure level of literacy, as is the development of instruments specific to health conditions that allow results close to the real context of individuals to be obtained.
Assuntos
Letramento em Saúde , Adulto , Brasil , Estudos Transversais , Confiabilidade dos Dados , Humanos , Reprodutibilidade dos TestesRESUMO
Objetivo: Determinar a concordância entre os instrumentos de mensuração short test of functional health literacy in adults (S-TOFHLA) e short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) como estratégia para estimar a validade concorrente. Métodos: Estudo transversal, com usuários do Sistema Único de Saúde. Para testar a validade concorrente, aplicou-se abordagem de concordância com teste de Kappa ponderado para dados qualitativos. Resultados: Participaram 372 indivíduos, dos quais 66% e 62% não apresentaram nível de letramento adequado, segundo o SAHLPA-18 e o S-TOFHLA, respectivamente. Observou-se correlação forte entre os instrumentos (p<0,001; r=0,60); e a concordância de acertos encontrada, 65,3% (Kappa=0,35; p<0,001), foi considerada fraca. Conclusão: Os instrumentos SAHLPA-18 e S-TOFHLA apresentam constructos diferentes e fraca concordância. É indicado o uso de diferentes instrumentos em pesquisas de mensuração do nível de letramento; e desenvolvimento de instrumentos específicos às condições de saúde que permitam obter resultado próximo ao real contexto dos indivíduos.
Objetivo: Determinar la concordancia entre instrumentos de medición psicométrica short test of functional health literacy in adults (S-TOFHLA) y short assessment of health literacy for portuguese-speaking adults (SAHLPA-18) como estrategia para estimar la validez concurrente. Métodos: estudio transversal realizado con usuarios del Sistema Único de Salud. Para testear la validez concurrente se aplicó un enfoque de concordancia con una prueba ponderada de Kappa para datos cualitativos. Resultados: participaron 372 individuos. Se encontró que 66% y 62% de estos no tenía un nivel adecuado de letramiento según SAHLPA-18 y S-TOFHLA, respectivamente. Hubo una fuerte correlación entre los instrumentos (p<0.001; r=0.60), sin embargo 65.3% de concordancia, se consideró débil (Kappa=0.35; p<0.001). Conclusión: Los instrumentos SAHLPA-18 y S-TOFHLA tienen diferentes construcciones y escasa concordancia. En la investigación se indica el uso de diferentes instrumentos para medir el nivel de letramiento y el desarrollo de instrumentos específicos a las condiciones de salud que permitan obtener resultados cercanos al contexto real de los individuos.
Objetivo: To determine agreement between the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) measurement instruments as a strategy for estimating concurrent validity. Methods: This was a cross-sectional study conducted with users of the Brazilian National Health System. An agreement approach using a weighted Kappa test for qualitative data was applied in order to test for concurrent validity. Results: 372 individuals participated. It was found that 66% and 62% of them did not have an adequate level of literacy according to SAHLPA-18 and S-TOFHLA, respectively. There was strong correlation between the instruments (p<0.001; r=0.60), although the 65.3% agreement of correct answers found was considered weak (Kappa=0.35; p<0.001). Conclusion: The SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. Use of different instruments is indicated in research intended to measure level of literacy, as is the development of instruments specific to health conditions that allow results close to the real context of individuals to be obtained.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Educação em Saúde/tendências , Reprodutibilidade dos Testes , Letramento em Saúde/tendências , Brasil , Estudos Transversais , Confiabilidade dos Dados , Doenças não Transmissíveis/classificaçãoRESUMO
Objective: To determine the agreement between short test of functional health literacy in adults (S-TOFHLA) and short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) measurement instruments as a strategy to estimate concurrent validity. Methods: Cross-sectional study conducted with users of the Unified Health System. To test concurrent validity, an agreement approach with a weighted Kappa test for qualitative data was applied. Results: 372 individuals participated. It was found that 66% and 62% of these did not have an adequate level of literacy through SAHLPA-18 and S-TOFHLA, respectively. There was a strong correlation between the instruments (p<0.001; r=0.60), however 65.3% agreement, considered weak (Kappa=0.35; p<0.001). Conclusion: SAHLPA-18 and S-TOFHLA instruments have different constructs and poor agreement. The use of different instruments is indicated in research to measure the level of literacy and the development of instruments specific to health conditions that allow obtaining results close to the real context of individuals.
Objetivo: Determinar a concordância entre os instrumentos de mensuração short test of functional health literacy in adults (S-TOFHLA) e short assessment of health literacy for Portuguese-speaking adults (SAHLPA-18) como estratégia para estimar a validade concorrente. Métodos: Estudo transversal, com usuários do Sistema Único de Saúde. Para testar a validade concorrente, aplicou-se abordagem de concordância com teste de Kappa ponderado para dados qualitativos. Resultados: Participaram 372 indivíduos, dos quais 66% e 62% não apresentaram nível de letramento adequado, segundo o SAHLPA-18 e o S-TOFHLA respectivamente. Observou-se correlação forte entre os instrumentos (p<0,001; r=0,60); entretanto, a concordância encontrada, 65,3% (Kappa=0,35; p<0,001), foi considerada fraca. Conclusão: Os instrumentos SAHLPA-18 e S-TOFHLA apresentam constructos diferentes e fraca concordância. É indicado o uso de diferentes instrumentos em pesquisas de mensuração do nível de letramento; e o desenvolvimento de instrumentos específicos às condições de saúde presentes, que permitam obter resultados próximos ao real contexto dos indivíduos.
RESUMO
Vitamin D (1,25-dihydroxycolecalciferol) is a prohormone that has attracted the interest of researchers since studies have shown that its effects are not restricted to bone metabolism. Thus, the present review summarizes the most recent findings and discusses the usefulness of prescribing vitamin D and its analogues for treatment and prevention of cardiovascular disorders and endothelial dysfunction. The paper constitutes a narrative review of the literature, selecting articles published from 2012 to 2019. Studies have shown that vitamin D3 and its analogues have beneficial effects on endothelial function, but these results are controversial, since research with larger samples and of longer duration found no reduction in morbidity and mortality or cardiovascular risk factors after use of these substances. Given the current state of the art, there is no clear scientific basis for supplementation with vitamin D or its analogues for treatment of endothelial dysfunction or cardiovascular disease.
RESUMO
Resumo A vitamina D (1,25-dihidroxicolecalciferol) é um pró-hormônio que tem despertado a atenção de pesquisadores após estudos demonstrarem que seus efeitos não estão restritos ao metabolismo ósseo. Assim, a presente revisão sintetiza os achados mais recentes e discute a utilidade da prescrição de vitamina D e seus análogos no tratamento e prevenção de afecções cardiovasculares e disfunção endotelial. Este trabalho consiste em uma revisão narrativa da literatura feita a partir da seleção de artigos publicados no período de 2012 a 2019. Estudos demonstraram efeitos benéficos da vitamina D3 e seus análogos sobre a função endotelial; no entanto, tais resultados mostram-se controversos, visto que pesquisas com maior amostragem e duração não encontraram redução na morbimortalidade ou nos fatores de risco cardiovascular após o uso de tais substâncias. Frente ao estado atual da arte, não existe embasamento científico claro para suplementação de vitamina D ou seus análogos para tratamento de disfunção endotelial ou doenças cardiovasculares.
Abstract Vitamin D (1,25-dihydroxycolecalciferol) is a prohormone that has attracted the interest of researchers since studies have shown that its effects are not restricted to bone metabolism. Thus, the present review summarizes the most recent findings and discusses the usefulness of prescribing vitamin D and its analogues for treatment and prevention of cardiovascular disorders and endothelial dysfunction. The paper constitutes a narrative review of the literature, selecting articles published from 2012 to 2019. Studies have shown that vitamin D3 and its analogues have beneficial effects on endothelial function, but these results are controversial, since research with larger samples and of longer duration found no reduction in morbidity and mortality or cardiovascular risk factors after use of these substances. Given the current state of the art, there is no clear scientific basis for supplementation with vitamin D or its analogues for treatment of endothelial dysfunction or cardiovascular disease.