Clinical investigations for SUS, the Brazilian public health system.

CONTEXT AND OBJECTIVE: Scientific and technological development is crucial for advancing the Brazilian health system and for promoting quality of life. The way in which the Brazilian Ministry of Health has supported clinical research to provide autonomy, self-sufficiency, competitiveness and innovation for the healthcare industrial production complex, in accordance with the National Policy on Science, Technology and Innovation in Healthcare, was analyzed. DESIGN AND SETTING: Descriptive investigation, based on secondary data, conducted at the Department of Science and Technology, Ministry of Health. METHODS: The Ministry of Health's research management database, PesquisaSaúde, was analyzed from 2002 to 2009, using the key word "clinical research" in the fields "primary sub-agenda" or "secondary sub-agenda". The 368 projects retrieved were sorted into six categories: basic biomedical research, preclinical studies, expanded clinical research, clinical trials, infrastructure support and health technology assessment. From a structured review on "clinical research funding", results from selected countries are presented and discussed. RESULTS: The amount invested was R$ 140 million. The largest number of projects supported "basic biomedical research", while the highest amounts invested were in "clinical trials" and "infrastructure support". The southeastern region had the greatest proportion of projects and financial resources. In some respects, Brazil is ahead of other BRICS countries (Russia, India, China and South Africa), especially with regard to establishing a National Clinical Research Network. CONCLUSION: The Ministry of Health ensured investments to encourage clinical research in Brazil and contributed towards promoting cohesion between investigators, health policies and the healthcare industrial production complex.

[Translation into Brazilian Portuguese and validation of the Work Limitations Questionnaire]. / Tradução para português brasileiro e validação de um questionário de avaliação de produtividade.

OBJECTIVES: To translate into Brazilian Portuguese, cross-culturally adapt, and evaluate the psychometric properties, reliability, and validity of the Work Limitations Questionnaire (WLQ). METHODS: This cross-sectional observational study was performed in 2005 and 2006 at the Hospital São Paulo/Escola Paulista de Medicina of the Federal University of São Paulo, Brazil. Data from 150 individuals who were employed at the time of the study were obtained using the WLQ, the SF-36 (a generic quality of life questionnaire), and the SRQ-20 (used to screen for mental disorders). The WLQ has 25 items, which are divided into four domains: time management, physical demands, mental-interpersonal demands, and output demands. The questionnaires were administered as interviews to individuals without a university education, and were self-administered to individuals with a university degree. Descriptive statistics were used to characterize the sample. The intraclass correlation coefficient and Cronbach's alpha were used to assess reliability (internal consistency, test-retest, interobserver, and intraobserver agreement). The Pearson's correlation coefficient was used to assess construct validity. RESULTS: The mean age of the subjects was 37.6 years (standard deviation, +/- 9.6 years), and 64.7% of the subjects were female. The mean number of years at the job held at the time of the interview was 8.6 (+/- 8.3 years); 60.7% of the subjects were satisfied with their job, and 94.0% had not missed work in the preceding two weeks. In comparison to completely healthy persons, the mean productivity loss reported by the study subjects was 4.2%. Interobserver agreement was significant and high (0.600 to 0.800) or very high (0.800 to 1.000) in all domains, except physical demands (r = 0.497, moderate agreement). Intraobserver agreement was not significant for the time management and physical demands domains. The correlations associated with intraobserver agreement were moderately significant (0.400 to 0.600). Internal consistency was very high (Cronbach's alpha = 0.800 to 1.000). There was a significant correlation between all the SF-36 questionnaire domains and the WLQ domains of time management, mental-interpersonal demands, and output demands as well as the WLQ index score. A positive correlation was also found between the WLQ domains of time management, mental-interpersonal demands, and output demands and a positive result (score >or= 7) on the SRQ-20. CONCLUSION: The Brazilian Portuguese version of the WLQ is a reliable and valid scale to assess the impact of health problems on the productivity of Brazilian workers.

Tradução para português brasileiro e validação de um questionário de avaliação de produtividade / Translation into Brazilian Portuguese and validation of the Work Limitations Questionnaire

OBJETIVO: Traduzir para português brasileiro, adaptar culturalmente e avaliar as propriedades psicométricas, a confiabilidade e a validade do questionário sobre limitações no trabalho (Work Limitations Questionnaire, WLQ). MÉTODOS:O presente estudo transversal e observacional foi realizado no Hospital São Paulo/Escola Paulista de Medicina da Universidade Federal de São Paulo, Brasil. Os dados de 150 indivíduos empregados no momento do estudo foram obtidos utilizando o WLQ, o SF-36 (questionário genérico de avaliação de qualidade de vida) e o SRQ-20 (usado para triagem de transtornos mentais). O WLQ apresenta 25 itens agrupados em quatro domínios: gerência de tempo, demanda física, demanda mental-interpessoal e demanda de produção. Os questionários foram administrados por entrevista para indivíduos sem escolaridade superior completa e auto-administrados para indivíduos com escolaridade superior. A estatística descritiva foi utilizada para caracterizar a amostra. Para avaliar a confiabilidade (consistência interna, teste-reteste e consistência inter e intra-observador), foram calculados o coeficiente de correlação intraclasse e o alfa de Cronbach. O coeficiente de correlação de Pearson foi utilizado para aferir a validade da construção. RESULTADOS: A idade média dos entrevistados (64,7 por cento do sexo feminino) foi de 37,6 ± 9,6 anos. O tempo médio na função ocupada no momento da entrevista foi de 8,6 ± 8,3 anos; 60,7 por cento estavam satisfeitos com o emprego e 94,0 por cento não tinham faltado ao trabalho nas 2 semanas anteriores à coleta. A perda média de produtividade registrada foi de 4,2 por cento. A confiabilidade interobservador foi significativa e alta (entre 0,600 e 0,800) ou muito alta (0,800 a 1,000) em todos os domínios, com exceção de demanda física (r = 0,497, confiabilidade moderada). A confiabilidade intra-observador não foi significativa nos domínios gerência de tempo e demanda física. As correlações significativas...

OBJECTIVES: To translate into Brazilian Portuguese, cross-culturally adapt, and evaluate the psychometric properties, reliability, and validity of the Work Limitations Questionnaire (WLQ). METHODS: This cross-sectional observational study was performed in 2005 and 2006 at the Hospital São Paulo/Escola Paulista de Medicina of the Federal University of São Paulo, Brazil. Data from 150 individuals who were employed at the time of the study were obtained using the WLQ, the SF-36 (a generic quality of life questionnaire), and the SRQ-20 (used to screen for mental disorders). The WLQ has 25 items, which are divided into four domains: time management, physical demands, mental-interpersonal demands, and output demands. The questionnaires were administered as interviews to individuals without a university education, and were self-administered to individuals with a university degree. Descriptive statistics were used to characterize the sample. The intraclass correlation coefficient and Cronbachs alpha were used to assess reliability (internal consistency, test-retest, interobserver, and intraobserver agreement). The Pearsons correlation coefficient was used to assess construct validity. RESULTS: The mean age of the subjects was 37.6 years (standard deviation, ± 9.6 years), and 64.7 percent of the subjects were female. The mean number of years at the job held at the time of the interview was 8.6 (± 8.3 years); 60.7 percent of the subjects were satisfied with their job, and 94.0 percent had not missed work in the preceding two weeks. In comparison to completely healthy persons, the mean productivity loss reported by the study subjects was 4.2 percent. Interobserver agreement was significant and high (0.600 to 0.800) or very high (0.800 to 1.000) in all domains, except physical demands (r = 0.497, moderate agreement). Intraobserver agreement was not significant for the time management and physical demands domains. The correlations associated with...

The Brazilian Portuguese version of the Work Productivity and Activity Impairment: General Health (WPAI-GH) Questionnaire

CONTEXT AND OBJECTIVE: It is still difficult to measure work productivity losses caused by health problems. Despite the importance given to this issue over the last few years, most instruments for performing this task are available only in the English language. This study translated the Work Productivity and Activity Impairment _ General Health (WPAI-GH) Questionnaire into Brazilian Portuguese, adapted it cross-culturally and evaluated its reliability and validity. DESIGN AND SETTING: Cross-sectional survey to test scale reliability and validity, at São Paulo Hospital and the clinic of the Rheumatology division of Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp-EPM). METHODS: Data were obtained from a survey that incorporated the WPAI-GH, short form-36 (SF-36) and some demographic questions. The questionnaires were administered by interview to 100 subjects. RESULTS: Descriptive statistics was used to characterize the subjects. The intraclass correlation coefficient and Cronbach's alpha were used to assess the reliability and internal consistency of the instrument. Intraclass correlation coefficients from 0.79 to 0.90 indicated good reliability. Cronbach's alpha of 0.74 indicated good internal consistency. Pearson's correlation coefficient was used to assess validity. There were significant positive relationships between the WPAI-GH and SF-36. CONCLUSION: The Brazilian Portuguese version of the WPAI-GH is a reliable and valid measurement tool and may be useful for those who seek to measure the impact on productivity of health problems among populations of Brazilian employees.

CONTEXTO E OBJETIVO: Mensurar a perda de produtividade devida a problemas de saúde ainda é uma tarefa difícil. Apesar da importância dada ao tema nos últimos anos, a maioria dos instrumentos disponível para realizar tal tarefa está disponível somente na língua inglesa. Este estudo traduziu para o português do Brasil, fez a adaptação cultural e avaliou a confiabilidade e validade do questionário Work Productivity and Activity Impairment-General Health (WPAI-GH). TIPO DE ESTUDO E LOCAL: Avaliação transversal da validade e confiabilidade dos domínios, realizada no Hospital São Paulo e na clínica da Disciplina de Reumatologia da Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp-EPM). MÉTODOS: Dados foram obtidos através de um levantamento que incluiu o WPAI-GH, SF-36 e algumas questões demográficas. Os questionários foram administrados na forma de entrevista com 100 sujeitos. RESULTADOS: Estatística descritiva foi usada para caracterizar os sujeitos. Para avaliar a confiabilidade e a consistência interna do instrumento, foram usados os coeficientes de correlação intraclasse e o alfa de Cronbach. O coeficiente de correlação intraclasse de 0,79 a 0,90 indicou uma boa confiabilidade. O alfa de Cronbach de 0.74 indicou uma boa consistência interna. O coeficiente de correlação de Pearson foi usado para avaliar a validade. Houve correlação positiva e significativa entre o WPAI-GH e o SF-36. CONCLUSÃO: A versão do WPAI-GH para o português do Brasil é um instrumento que possui validade e reprodutibilidade e pode ser útil para aqueles que procuram medir o impacto dos problemas de saúde na produtividade de uma população de trabalhadores brasileiros.

The Brazilian Portuguese version of the Work Productivity and Activity Impairment: General Health (WPAI-GH) Questionnaire.

CONTEXT AND OBJECTIVE: It is still difficult to measure work productivity losses caused by health problems. Despite the importance given to this issue over the last few years, most instruments for performing this task are available only in the English language. This study translated the Work Productivity and Activity Impairment _ General Health (WPAI-GH) Questionnaire into Brazilian Portuguese, adapted it cross-culturally and evaluated its reliability and validity. DESIGN AND SETTING: Cross-sectional survey to test scale reliability and validity, at São Paulo Hospital and the clinic of the Rheumatology division of Universidade Federal de São Paulo-Escola Paulista de Medicina (Unifesp-EPM). METHODS: Data were obtained from a survey that incorporated the WPAI-GH, short form-36 (SF-36) and some demographic questions. The questionnaires were administered by interview to 100 subjects. RESULTS: Descriptive statistics was used to characterize the subjects. The intraclass correlation coefficient and Cronbach's alpha were used to assess the reliability and internal consistency of the instrument. Intraclass correlation coefficients from 0.79 to 0.90 indicated good reliability. Cronbach's alpha of 0.74 indicated good internal consistency. Pearson's correlation coefficient was used to assess validity. There were significant positive relationships between the WPAI-GH and SF-36. CONCLUSION: The Brazilian Portuguese version of the WPAI-GH is a reliable and valid measurement tool and may be useful for those who seek to measure the impact on productivity of health problems among populations of Brazilian employees.