Uso da adaptação transcultural nos cursos de pós-graduação em Enfermagem / Use of cross-cultural adaptation in Postgraduate Nursing courses / Uso de la adaptación transcultural en las carreras de grado en Enfermería

Objetivo: analisar a produção científica brasileira, na Pós-Graduação em Enfermagem, que utilizou o método de adaptação transcultural. Método: estudo documental, com busca realizada na Biblioteca Digital de Teses e Dissertações, que resultou em 140 dissertações e 72 teses para análise, oriundas de Programas de Pós-Graduação da região Sudeste, seguida das regiões Nordeste, Sul e Centro-Oeste, sem representação da região Norte. Resultados: os instrumentos adaptados foram, em sua maioria, procedentes do idioma inglês. Prevaleceram as pesquisas na área/campo Assistencial, destacando-se a linha de pesquisa Processo de Cuidar em Saúde e Enfermagem. Identificou-se descompasso entre o que é produzido na área e o que é recomendado internacionalmente. Conclusão: verificou-se aumento na utilização da adaptação transcultural como método de pesquisa, com persistência das assimetrias acadêmicas regionais e sem consenso sobre o referencial metodológico.

Objective: to analyze the Brazilian scientific production in Postgraduate Nursing education using the cross-cultural adaptation method. Method: documentary study with searches carried out in the Digital Library of Theses and Dissertations resulting in 140 Master's theses and 72 Doctoral dissertations for analysis originated from Postgraduate Programs carried out in the Southeast region of Brazil, followed by the Northeast, South and Midwest regions ­ there was no representation of the North region. Results: the adapted instruments were, mostly, originally written in English. Research in the Care area/field prevailed, highlighting the line of research called Health and Nursing Care Process. A gap between what is produced in the area and what is recommended internationally was identified. Conclusion: an increase in the use of cross-cultural adaptation as a research method was noticed, with the persistence of regional academic asymmetries and lack of consensus on the methodological framework.

Objetivo: analizar la producción científica brasileña, en el Postgrado en Enfermería, que utilizó el método de adaptación transcultural. Método: estudio documental, la búsqueda se realizó en la Biblioteca Digital de Tesis y Disertaciones, se obtuvieron 140 tesis de maestría y 72 tesis de doctorado para análisis, provenientes de Programas de Posgrado de la región Sudeste, seguida de las regiones Nordeste, Sur y Centro-Oeste, no se encontraron documentos de la región Norte. Resultados: los instrumentos adaptados fueron, en su mayoría, del idioma inglés. Predominaron las investigaciones en el área/campo Asistencial, se destacó la línea de investigación Proceso de Atención en Salud y Enfermería. Se identificó que lo que se produce en el área no coincide con lo que se recomienda a nivel internacional. Conclusión: se comprobó que aumentó el uso de la adaptación transcultural como método de investigación, que persisten las disparidades académicas regionales y que no hay consenso sobre el marco metodológico.

Screening for dysphagia in older people with dementia: Evidence of validity based on internal structure and reliability of the Caregiver Questionnaire - RaDID-QC.

OBJECTIVE: To identify internal structure validity evidence of a dysphagia screening questionnaire for caregivers of older adults with Alzheimer's disease dementia and/or vascular dementia. METHODS: The 24-question Dysphagia Screening in Older Adults with Dementia - Caregiver Questionnaire (RaDID-QC) was administered by interviewing 170 caregivers of older people with dementia, selected by convenience at the Outpatient Reference Center for Older People. Exploratory Factor Analysis (EFA) was used to assess the internal structure validity of the questionnaire, and Cronbach's alpha was used to analyze reliability. Questions with factor loadings lower than 0.45 in magnitude were removed from the final questionnaire. Multivariate multiple linear regression was used to assess the percentage of variance explained by the remaining questions. RESULTS: Kayser-Meyer-Olkin (KMO) and Bartlett's tests suggested that the questionnaire was adequate for EFA. Principal Component Analysis (PCA) suggested that 12 components captured at least 75 % of the total variance. The corresponding 12-factor EFA model showed a statistically significant fit, and 15 out of the 24 questions had factor loadings greater than 0.45. Cronbach's alpha was 0.74 for the 15 questions, which explained 71 % of the total variance in the complete dataset. The questionnaire has adequate internal structure validity and good reliability. Based on EFA, RaDID-QC decreased from 24 to 15 questions. Other internal validity and reliability parameters will be obtained by administering the questionnaire to larger target populations. CONCLUSION: The RaDID-QC applied to caregivers of older adults with dementia due to Alzheimer's disease and/or vascular dementia produced valid and reliable responses to screen dysphagia signs and symptoms.

Brazilian Portuguese Translation and Validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA revised.

INTRODUCTION AND HYPOTHESIS: Condition-specific sexual questionnaires are important patient-reported outcome measures. The aim of this study was to translate and validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into Brazilian Portuguese and to clinically validate it in a Brazilian Portuguese-speaking population. METHODS: Translation and validation of the PISQ-IR was performed according to the International Urogynecological Association-recommended process and guidelines. For external validity, PISQ-IR subscales were compared with the clinical measures, Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale (Pearson correlations). Descriptive statistics, internal consistency (Cronbach's alpha coefficient), and test-retest reliability (interclass correlation coefficient) were calculated for all PISQ-IR subscales. RESULTS: A total of 120 sexually active and 106 not sexually active women were enrolled in the study between March 2015 and July 2019. Internal consistency was acceptable, with Cronbach's alpha values 0.60-0.80, except for the sexual arousal and orgasm, sexual arousal and partner-related issues, sexual arousal and condition-specific issues, global rating of sexual quality and condition impact subscales. PISQ-IR demonstrated good reliability (α > 0.6, CIC = 0.996). The agreement for each individual questionnaire item also individually presented substantial agreement between the assessments (κ 0.61-0.8). There was a correlation between PISQ-IR and POP, mixed, stress and fecal incontinence diagnosis and a positive correlation with pelvic floor muscle function according to the Oxford Scale in sexually active women. For sexually inactive women there was a correlation between PISQ-IR and mixed urinary symptoms. CONCLUSIONS: The Brazilian Portuguese version of PISQ-IR is a reliable and valid tool that can be easily used for the identification and assessment of sexual function in Brazilian Portuguese-speaking women with pelvic floor disorders.

A complete year of urology residency training under COVID-19: impact on education and health.

OBJECTIVES: To evaluate the impact of COVID-19 pandemics on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents after 1 year of socio-economic restrictions. MATERIALS AND METHODS: An electronic survey was e-mailed to all postgraduate (PG) students registered by the Brazilian Society of Urology. The survey inclu-ded an assessment of socio-demographic, clinical practice, educational, health-related and behavior parameters. We also evaluated which subareas of urology were predominantly affected. A similar survey was adapted and sent to the directors of all urology residency programs. RESULTS: COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. Urology residents reported >50% decrease in multiple surgical modalities. We highlight kidney transplantation surgeries (66.2%), minor surgeries (62.3%), endoscopic surgeries (42.6%) and reconstructive surgeries (38.8%). This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. Furthermore, PG students faced stressful situations that caused worsening of mental and physical health, such as getting redirected to assistance of COVID-19 patients (66.9%), and high rate of infection by SARS-CoV-2 (58.2%). CONCLUSIONS: The COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. PG students faced stressful situations that caused worsening of mental and physical health such as redirection to assistance of COVID-19 patients, concern about their own contamination and of family members.

Translation and Validation of the Brazilian Version of the European Obesity Academy Questionnaire on Patients' Motivations for Seeking Metabolic and Bariatric Surgery.

PURPOSE: Understanding patients' motives for undergoing metabolic and bariatric surgery (MBS) is key to managing postoperative expectations. We aimed to translate and validate the 14-item European Obesity Academy Questionnaire on Expectations about Surgical Treatment (EOAQ-EST) to Brazilian Portuguese for research and clinical use. MATERIALS AND METHODS: This study included a total of 198 candidates for MBS at a reference academic hospital in Brazil from January 2021 to February 2022. We followed Beaton and Bombardier's guidelines for translation and cultural adaptation, including translation, back-translation, comparative analysis, expert review, pilot testing, and the creation of the final version of the questionnaire. Reliability was tested with McDonald's omega, and internal validity was assessed using confirmatory factor analysis (CFA). RESULTS: The final version was applied to 161 patients, 85% female, with a mean age of 46.4 ± 10.3 years and a mean BMI of 48.3 ± 8.2 kg/m2. Validity was supported by a bifactorial model (95% CI 0.044-0.104, p = 0.08), excluding one item (improved fertility) due to a floor effect. The reliability analysis showed that the 13 remaining items were internally consistent, with a McDonald's ω of 0.625. CONCLUSIONS: The Brazilian-Portuguese version of EOAQ-EST proved to be user-friendly, consistent, and reliable. This questionnaire may assist multidisciplinary teams in effectively addressing patients' expectations concerning metabolic and bariatric surgery (MBS) outcomes.

Cross-cultural adaptation and validation of Work Productivity and Activity Impairment questionnaires for caregivers of patients with pediatric inflammatory bowel disease in Spain. A multicenter study. / Adaptación transcultural y validación de cuestionarios WPAI (Work Productivity and Activity Impairment) para cuidadores de pacientes con enfermedad inflamatoria intestinal pediátrica en España. Estudio multicéntrico.

Introduction. The WPAI-UC/CD-Caregiver questionnaires assess the impact of ulcerative colitis (UC) or Crohn's disease (CD) on parents'/caregivers' work life and daily activities. Our objective was to adapt and validate these questionnaires in the Spanish population. Methods. A translation and back-translation were done. The document was assessed by an expert committee and a pilot group of families of patients with pediatric inflammatory bowel disease (p-IBD). For validation, the parents/caregivers of patients with p-IBD (10-18 years old) were recruited. The expert committee and the pilot group conducted a subjective assessment of the format and time necessary to complete the questionnaires. Cronbach's alpha coefficient was estimated and a factor analysis with varimax rotation was done. Kaiser- Meyer-Olkin (KMO) coefficients and Bartlett's sphericity test were estimated to test the adequacy of the factor analysis. Results. A total of 370 patients (median age: 14.1 years) and 263 parents/caregivers of patients with UC or unclassified IBD and 261 parents/caregivers of patients with CD were included. The KMO coefficients (0.6947 and 0.7179) and Bartlett's sphericity test (p < 0.001) confirmed the adequacy of the factor analysis. The 6 items targeted the same domain. The factor model accounted for 99.99% and 94.68% of variance, and Cronbach's alpha coefficients (0.6581 and 0.6968) showed an adequate consistency. The format and the median time of 2 minutes to complete the questionnaires were considered optimal. Conclusions. The versions of the WPAI-Caregiver questionnaires validated in the Spanish population may be used in families whose children have IBD.

Introducción. Los cuestionarios WPAI-UC/CD-Caregiver evalúan la repercusión laboral y en actividades cotidianas de los padres/cuidadores de pacientes con colitis ulcerosa (CU) o enfermedad de Crohn (EC). El objetivo fue adaptar y validar estos cuestionarios en la población española. Métodos. Se realizó la traducción y la retrotraducción. El documento fue evaluado por un comité de expertos y por un grupo piloto de familias de pacientes con enfermedad inflamatoria intestinal pediátrica (EII-p). Para la validación, se reclutaron padres/cuidadores de pacientes con EII-p (10-18 años). El comité de expertos y el grupo piloto evaluaron subjetivamente el formato y el tiempo necesario para completar los cuestionarios. Se calculó el coeficiente alfa de Cronbach y se realizó el análisis factorial con rotación Varimax. Se calcularon los coeficientes de Kaiser-Meyer-Olkin (KMO) y la prueba de esfericidad de Bartlett para comprobar la adecuación del análisis factorial. Resultados. Se incluyeron 370 pacientes (mediana 14,1 años), y 263 padres/cuidadores de pacientes con colitis ulcerosa o EII no clasificada y 261 padres/cuidadores de pacientes con enfermedad de Crohn. Los coeficientes KMO (0,6947 y 0,7179) y la prueba de esfericidad de Barttlet (p <0,001) confirmaron la adecuación del análisis factorial. Los 6 ítems se dirigieron a la misma dimensión. El modelo factorial explicó el 99,99 % y el 94,68 % de la varianza, y los alfa de Cronbach (0,6581 y 0,6968) indicaron buena consistencia. El formato y la mediana de 2 minutos para completarlos se consideraron óptimos. Conclusiones. Las versiones validadas en la población española de los cuestionarios WPAI-Caregiver pueden considerarse para su uso en familias con hijos con EII.

Psychometric Properties of the Portuguese Version of the Quality of Life in Autism Questionnaire (QoLA).

The aim of this study was to cross-culturally adapt and validate of the Brazilian Portuguese version of the Quality of Life in Autism Questionnaire (QoLA) among parents of children ASD. The translated version was administered to 91 parents (Male: 4, Female: 85, other: 2) of individuals diagnosed with ASD. Among these, 22 completed the questionnaire twice, providing data for the assessment of test-retest reliability (ICC). The B-QoLA score ranged from 41 to 122, with a mean (SD) of 74.3 ± 18.5 in Part A and ranged from 22 to 94, with a mean (SD) of 61.6 ± 16.4, in Part B. Cronbach's alpha coefficient was 0.94 for Part A, 0.92 for Part B and 0.94 for total B-QoLA, indicating excellent internal consistency. Test-retest reliability was assessed using the intraclass correlation coefficient, which was 0.96 for the total scale, 0.94 for Part A, and 0.95 for Part B. Part A-X2 (df) = 297, (167), X2/2 = 1.7, CFI = 0.85, TLI = 0.84, GFI = 0.78, AGFI = 0.75, and RMSEA (95%CI) = 0.09 (0.07-0.11); Part B-X2 (df) = 297, (167), X2/2 = 1.7, CFI = 0.85, TLI = 0.84, GFI = 0.78, AGFI = 0.75, and RMSEA (95%CI) = 0.09 (0.07-0.11), thus indicating moderate fit of the model. The Brazilian version of the QoLA shows encouraging psychometric properties on each of the two subscales, showing strong internal consistency and good construct validity.

The Effects of the COVID-19 Pandemic on Resident Education and Burnout.

Background: The COVID-19 pandemic has impacted the residency experience for physicians across all specialties. There have been studies examining resident perspectives on changes in curriculum and clinical experiences due to the pandemic; however, little research has been conducted on how residents in different specialties interpreted their educational experience and rates of burnout during the pandemic. Methods: We extended surveys to 281 residents across 15 separate residency programs between November 17, 2020, and December 20, 2020. The questions pertained to burnout and the effects of the pandemic on their careers. Differences between general and specialty medicine resident responses were analyzed using descriptive statistics and the Mann-Whitney U test. Results: The final analysis included 105 responses (40% response rate). We received 62 surveys (59%) from general medicine residents and 43 surveys (41%) from specialty medicine residents, with a higher response rate from junior level trainees in both groups. We found no significant differences between general and specialty residents on the level of burnout, impact on clinical experience, or future career due to COVID-19, though there was a significant difference between resident groups on the perceived impact of COVID-19 on learning. Conclusion: Specialty medicine residents reported a negative perception of the pandemic's impact on their learning during residency suggesting a greater impact on training than was perceived by the general medicine residents. Residents from general and specialty medicine programs reported similar levels of burnout and similar perceptions of the pandemic's impact on their clinical experience and future career prospects. Understanding the impacts of the COVID-19 pandemic on resident education and well-being should serve graduate medical education administrators well and prepare them for future interruptions in the traditional learning process.

Anxiety Inventory for Respiratory Disease: Cross-Cultural Adaptation and Semantic Validity of the Brazilian Version for Individuals with Chronic Obstructive Pulmonary Disease.

Background: Most instruments available to screen for anxiety in people with chronic obstructive pulmonary disease (COPD) are not disease specific. Therefore, the Anxiety Inventory for Respiratory Disease (AIR) was developed to measure anxiety for this patient group; however, it requires cross-cultural adaptation for use in non-English speaking countries. Purpose: To carry out cross-cultural adaptation of the AIR scale for Brazilian patients with COPD and to analyze its semantic validity. Patients and Methods: This methodological study followed six stages: 1) Initial translation by two independent translators fluent in English; 2) Synthesis of translations; 3) Back translation by two English first language translators; 4) Expert committee review (eight healthcare professionals, a methodologist, the translators, and back-translators); 5) Pre-final version evaluation with 30 patients with COPD through a cognitive interview; and 6) Submission of documents. Semantic validity was analyzed by agreement rate and content validity index (CVI) for the committee equivalence assessments. Results: 1) Initial translation: the two translated versions presented eight divergences; 2) Synthesis of translations: the differences were discussed to reach consensus; 3) Back-translation: there were no important inconsistencies; 4) Expert Committee: the experts proposed eight and the instrument developer proposed three changes, which were analyzed and voted on, resulting in the pre-final version; 5) Evaluation of the pre-final version: data collection allowed for other changes and the formulation of instructions by applying the adapted instrument in an interview format. Patients rated the questions as clear or very clear; 6) The expert committee and the developer approved the final documents. The agreement rate and CVI were ≥ 0.80 for all items of the scale final version. Conclusion: The process of cross-cultural adaptation followed all necessary stages and the semantic validity results were adequate, providing the Brazilian version of the AIR to assess anxiety symptoms in patients with COPD.

Medical students experience in working in a public COVID-19 telehealth program: a descriptive study.

BACKGROUND: Given the health and social needs generated by the COVID-19 pandemic, the Telehealth Network of Minas Gerais, Brazil, implemented a teleconsultation and telemonitoring program to assist patients with suspected or confirmed COVID-19, the TeleCOVID-MG program. The telemonitoring service was conducted by medical students, under the supervision of a physician. The main goal of this study was to analyze the experience of the students while collaborating on the aforementioned telemonitoring program. METHODS: A questionnaire with 27 questions was developed to address the participation of the students in the telehealth program. The questionnaire included questions about the student's profile, the system usability, and the satisfaction in participating in such a telehealth program. The questionnaire was generated on Google Forms® platform and sent via email to each student who was part of the telemonitoring team. RESULTS: Sixty students were included in the analysis (median age 25 years-old [interquartile range 24-26], 70% women). Of those, 61.6% collaborated on the telehealth program for more than 6 months, 65.1% performed more than 100 telemonitoring calls, 95.2% reported difficulties in contacting the patient through phone calls; 60.3% believe some patients might have felt insecure about being approached by medical students and not by graduate professionals; and 39.6% reported eventual system instabilities. The main strengths reported by the students were related to the system usability and to the self-perception of the quality of healthcare delivered to the patients. Even though 68.3% of the students mentioned technical difficulties, 96.6% reported that they were promptly solved. Finally, 98.3% believed that the program was useful and would recommend it to an acquaintance. CONCLUSION: This study reports a successful experience of undergraduate medical students in a COVID-19 telemonitoring program. Overall, the medical students were satisfied with their participation, especially considering the continuity of clinical practice remotely during a period of classes suspension during the COVID-19 pandemic and their important role in the assistance of patients from low-income regions, which has minimized the health system burden in an emergency context.

Reliability and Validity of the Health-Promoting Lifestyle Profile II Spanish Version in University Students.

AIM: The purpose of this study was to assess the reliability and validity of the Spanish version of the Health Promoting Lifestyle Profile II (HPLP-II) scale in Colombian university students. METHODS: This was a methodological study to verify reliability and construct validity. A total of 763 undergraduate university students in Cali, Colombia, agreed to participate in the study by filling out a form that included information on sociodemographic characteristics and the HPLP-II scale Spanish version. Data were collected between February and June 2021. To determine construct validity, a confirmatory factor analysis was performed, and internal consistency was determined through Cronbach's alpha. RESULTS: The confirmatory factor analysis of the proposed theoretical model showed that the goodness-of-fit indices of the scale demonstrated an acceptable level of validity nearing an excellent level of fit (χ2 = 7168.98; gl = 1268; p < 0.001; root mean square error of approximation = 0.08; normed fit index, adjusted goodness-of-fit index = 0.95). Cronbach's alpha coefficient of the scale was 0.94, and the subscales ranged from 0.68 to 0.89. CONCLUSIONS: The HPLP-II Spanish version is a valid and reliable instrument to assess the health-promoting lifestyle profile of university students.

Development and Validation of the Companion's Satisfaction Questionnaire of Patient's Hospitalized in Intensive Care Units.

Objective: The current study aimed to develop and validate of companions' satisfaction questionnaire of patients hospitalized in ICUs. Methods: This is a methodological study that was performed in three phases: In the first phase, the concept of companion's satisfaction of patients hospitalized in ICUs was defined through qualitative content analysis method. In the second phase, early items of questionnaire were generated based on findings of the first phase. In the third and final phase, validation of the questionnaire was evaluated using face, content and construct validity as well as reliability. Results: In exploratory factor analysis, three subscales including: satisfaction with nursing staff communication (5 items), satisfaction with nursing care (12 items), and satisfaction with decision making (5 items) were extracted by Eigen value above one and factor load above 0.5. Internal consistency and stability of the developed questionnaire confirmed with 0.94 and 0.95 respectively that indicated acceptable reliability. Conclusion: The 22-item developed questionnaire is valid and reliable for measurement of levels of companion's satisfaction of Iranian patients hospitalized in ICUs.

Translation and Cross-Cultural Adaptation of the Questionnaire on Stress in Diabetic Patients (QSD-R) to Brazilian Portuguese.

BACKGROUND: Diabetes mellitus is a chronic disease that can cause psychological stress. This study was conducted to perform the translation and cross-cultural adaptation of the QSD-R for diabetic patients into Portuguese (Brazil). METHODS: This study was a cross-cultural adaptation process carried out in a public university in São Paulo, Brazil, in three stages: translation and backtranslation by two native-speaking independent professionals, analysis by a committee of specialists, and a pre-test phase. RESULTS: The final version was created by seven experts after making semantic, idiomatic, and cultural changes to eighteen items. The results indicated a satisfactory content validation index (CVI ≥ 0.80). This version was applied to 30 patients. No item was excluded from the instrument. CONCLUSION: The translated version of the QSD-R was considered adequate and culturally adapted for use in Brazil to enable the psychometric validation of the instrument.

The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects.

Objective: To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects. Methods: Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages. Results: Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001). Conclusion: Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.

Dysphagia Screening in Brazilian Older Adults with Dementia: Content Development and Validation of a Questionnaire for Caregivers - RaDID-QC.

This study aims to develop and validate the content and response processes of a questionnaire intended for caregivers to screen for dysphagia in Brazilian older adults with dementia due to Alzheimer's disease and/or vascular dementia. The instrument items were developed in Brazilian Portuguese language based on the theoretical framework. A committee of speech-language-hearing therapists analyzed the relevance, objectivity, clarity, and understandability of the items with the Delphi method. The content validity index cutoff agreement score for experts' answers to validate each item in the questionnaire was 0.78; in the intraclass correlation coefficient, it was 0.75 for all items. For response process validity evidence, the questionnaire was applied to 30 caregivers of older adults with dementia, who judged the clarity and understandability of the items. Each item was validated when understood by at least 95% of participants. The first version of the instrument had 29 items. After two expert assessments, the last version had 24 items. The intraclass correlation coefficient was 0.85. Only one item needed semantic adjustments in the pre-test. The dysphagia screening instrument applied to caregivers of older adults with dementia was developed with adequate content and response process validity evidence, enabling adjustments in its construct. Future studies will analyze the remaining evidence of validity and reliability.

Autoestima e qualidade de vida em pacientes submetidos a cirurgia plástica / Self-esteem and quality of life in patients undergoing plastic surgery

Introdução: A autoestima é definida pelo valor que as pessoas dão a si mesmas. É um componente avaliativo do autoconhecimento. A cirurgia plástica tem sido uma alternativa para as pessoas melhorarem a visão de si mesmas, sentindo-se mais confiantes e satisfeitas com seus aspectos corporais. Dessa forma, com a elevação da autoestima nessas pessoas, a cirurgia é capaz de interferir de forma positiva não somente na autoavaliação corporal, mas também na dimensão psicossocial. Método: Foi realizado um estudo observacional descritivo e analítico longitudinal prospectivo no qual foi avaliado o impacto da cirurgia plástica na autoestima e nos relacionamentos pessoais e profissionais. Aplicamos um questionário sociodemográfico, a Escala de Autoestima de Rosenberg, além do Questionário de Qualidade de Vida da OMS abreviado (WHOQOL-bref) em pacientes no pré-operatório e que serão submetidos a cirurgia plástica com, pelo menos, 3 meses de pós-operatório, graduando, desta forma, a melhora ou não da autoestima e qualidade de vida. Resultados: Participaram da pesquisa 52 pacientes, sendo 48 mulheres (92,3%), apresentando idade média de 37±11 anos. Através da aplicação da Escala de Autoestima de Rosenberg, pudemos notar uma evolução da autoestima, em que os pacientes apresentaram uma média de 29,87±2,10 pontos no escore do período pré-operatório, passando para 34,92±1,84 pontos no período pós-operatório. (p<0,001). Já no WHOQOL-bref, foi obtida uma melhora da autoestima através dos escores dos 4 domínios. Conclusão: Através deste estudo, foi evidenciado um aumento da autoestima e qualidade de vida.

Introduction: Self-esteem is defined by the value people place on themselves. It is an evaluative component of self-knowledge. Plastic surgery has been an alternative for people to improve their vision of themselves, feeling more confident and satisfied with their body aspects. Therefore, by increasing self-esteem in these people, surgery is capable of positively interfering not only with body self-assessment but also in the psychosocial dimension. Method: A prospective longitudinal descriptive and analytical observational study was carried out in which the impact of plastic surgery on self-esteem and personal and professional relationships was assessed. We applied a sociodemographic questionnaire, the Rosenberg Self-Esteem Scale, in addition to the abbreviated WHO Quality of Life Questionnaire (WHOQOL-bref) in patients in the preoperative period and who will undergo plastic surgery at least 3 months after surgery. surgery, thus determining whether or not self-esteem and quality of life improve. Results: 52 patients participated in the research, 48 of whom were women (92.3%), with a mean age of 37±11 years. Through the application of the Rosenberg Self-Esteem Scale, we were able to notice an evolution in self-esteem, in which patients presented an average of 29.87±2.10 points in the preoperative period score, rising to 34.92±1.84 points in the postoperative period (p<0.001). In the WHOQOL-bref, an improvement in self-esteem was obtained through the scores of the 4 domains. Conclusion: Through this study, an increase in self-esteem and quality of life was evidenced.

Utilidad y confiabilidad del cuestionario PreViAs para la evaluación de la visión en neonatos y lactantes turcos / The utility and reliability of the PreViAs questionnaire for the assessment of vision in Turkish neonates and infants

Introducción. La evaluación de la visión en los niños durante el periodo preverbal, con un método fácil de usar y basado en la evidencia, permitiría el diagnóstico temprano y la intervención en los trastornos visuales. El objetivo del estudio fue determinar la utilidad y confiabilidad de la versión en idioma turco del cuestionario Preverbal Visual Assessment (PreViAs), desarrollado para evaluar la visión en niños preverbales. Población y métodos. El cuestionario PreViAs se administró a los cuidadores primarios de niños nacidos de término, antes de los 24 meses de edad. Se registraron sus respuestas. Resultados. Se analizaron los datos de 278 participantes para evaluar la consistencia interna del cuestionario PreViAs. Se encontró un alto nivel de consistencia con un alfa de Cronbach de 0,958 para el puntaje total, lo que sugiere una fuerte coherencia interna. Los valores del alfa de Cronbach para cada dominio fueron: 0,890 ­ 0,913 ­ 0,951 y 0,922 para la atención visual, la comunicación visual, el procesamiento visual y la coordinación visomotora respectivamente; esto indica una buena consistencia interna para cada subdominio. Conclusión. La versión en idioma turco del cuestionario PreViAs es útil y confiable para evaluar la visión durante el periodo preverbal.

Introduction: Evaluating the visual functions of children with an easy-to-use and evidence-based method during the preverbal period will enable early diagnosis and intervention of visual impairments. The aim of this study is to determine the utility and reliability of the Turkish version of the Preverbal Visual Assessment (PreViAs) questionnaire, which was developed to evaluate the visual functioning of preverbal infants. Population and Methods: The PreViAs questionnaire was administered to primary caregivers of term infants under 24 months of age, and their responses were recorded. Results: Data from the 278 participating infants were analyzed to assess the internal consistency of the PreViAs questionnaire. Results showed a high level of consistency with Cronbach's alpha value of 0.958 for the total score, suggesting strong internal coherence. In addition, the Cronbach's alpha values for each domain were 0.890, 0.913, 0.951, and 0.922 for visual attention, visual communication, visual processing, and visual-motor coordination, respectively, indicating good internal consistency for each subdomain. Conclusion: The Turkish version of the PreViAs questionnaire is useful and reliable for assessing functional vision during the preverbal period.

Encuesta nacional para pediatras de Argentina: vacunación en la práctica diaria, percepción de conocimientos y barreras / National survey for pediatricians in Argentina: Vaccination in daily practice, perception of knowledge and barriers

Introducción. El descenso de las coberturas de vacunación fue muy significativo en la última década. Los pediatras son una pieza fundamental para recuperar coberturas y aumentar la confianza en la vacunación. Objetivos. Describir la percepción de los pediatras acerca del conocimiento y prácticas sobre vacunas, e identificar barreras en el acceso. Métodos. Estudio analítico observacional, mediante encuesta en línea. Se incluyeron variables del perfil del profesional, capacitación y barreras en inmunizaciones. Resultados. Participaron 1696 pediatras (tasa de respuesta: 10,7 %), media de 50,4 años. El 78,7 % fueron mujeres. El 78,2 % contaba con ≥10 años de ejercicio profesional. El 78,4 % realizaba atención ambulatoria y el 56,0 % en el subsector privado. El 72,5 % realizó una capacitación en los últimos 2 años. Se manifestaron "capacitados" para transmitir a sus pacientes los beneficios de las vacunas: 97,2 %; objetivos de campañas: 87,7 %; contraindicaciones: 82,4 %; efectos adversos: 78,9 %; recupero de esquemas: 71,2 %; notificación de ESAVI: 59,5 %. La proporción fue estadísticamente superior, en todos los aspectos, en pediatras con ≥10 años de ejercicio y en aquellos con capacitación reciente (p ≤ 0,01). Barreras identificadas en el acceso a la vacunación: falsas contraindicaciones (62,3 %); falta temporaria de vacunas (46,4 %); motivos culturales (41,4 %); horario restringido del vacunatorio (40,6 %). Conclusiones. La percepción del grado de capacitación fue variable según el aspecto de la vacunación. Aquellos con mayor tiempo de ejercicio profesional y con actualización reciente se manifestaron con mayor grado de capacidad. Se identificaron múltiples barreras frecuentes asociadas al acceso en la vacunación.

Introduction. The decline in vaccination coverage has been very significant in the past decade. Pediatriciansplay a key role in catching-up coverage and increasing confidence in vaccination. Objectives. To describe pediatricians' perceptions of vaccine knowledge and practices and to identify barriers to access. Methods. Observational, analytical study using an online survey. Variables related to professional profile, training and barriers to vaccination were included. Results. A total of 1696 pediatricians participated (response rate: 10.7%). Their mean age was 50.4 years; 78.7% were women; 78.2% had ≥ 10 years of experience; 78.4% provided outpatient care and 56.0%, in the private subsector; and 72.5% received training in the past 2 years. Respondents described themselves as "trained" in convey the following aspects to their patients: benefits of vaccines: 97.2%; campaign objectives: 87.7%; contraindications: 82.4%; adverse effects: 78.9%; catchup vaccination: 71.2%; reporting of events supposedly attributable to vaccination or immunization: 59.5%. The proportion was statistically higher in all aspects, among pediatricians with ≥ 10 years of experience and those who received training recently (p ≤ 0.01). The barriers identified in access to vaccination were false contraindications (62.3%), temporary vaccine shortage (46.4%), cultural reasons (41.4%), and restricted vaccination center hours (40.6%). Conclusions. The perception of the level of training varied depending on the vaccination-related aspect. Pediatricians with more years of professional experience and those who received recent updates perceivedthemselves as more trained. Multiple barriers associated with access to vaccination were identified.

Brazilian undergraduates' and dentists' knowledge on preventing, diagnosing and managing dentin hypersensitivity: A cross-sectional questionnaire study.

OBJECTIVES: To analyse the knowledge of dental undergraduates and dentists on the prevention, diagnosis and management of dentin hypersensitivity (DH); to compare their knowledge scores; and to understand the related variables using a regression model. METHODS: An original online questionnaire investigated the attitudes, self-reported knowledge ('how much they thought they knew') and real knowledge ('how much they really knew') of 132 students and 338 dentists. Data were analysed descriptively, both knowledge scores were compared using Mann-Whitney and Wilcoxon signed-rank tests and data were subjected to two multiple linear regression analyses considering real knowledge scores as the dependent variable (α < 0.05). RESULTS: The self-reported knowledge on DH was higher than the real knowledge for both students and dentists, but dentists presented the highest scores. Gingival recession and acidic diet were reported as the main predisposing factors for DH by undergraduates and dentists. Students normally managed DH with dietary and hygiene instructions followed by a desensitizing agent application, while dentists managed with occlusal adjustments. The mechanism of glutaraldehyde/HEMA and bioactive fillers on DH is widely unknown by students and dentists. The majority of the questioned individuals cannot differentiate DH from sensitivity of caries or molar-incisor hypomineralization. CONCLUSION: Both students and dentists overestimate their knowledge of DH, revealing deficiencies in prevention, diagnosis and management. Students' knowledge improves towards the end of the Dentistry course, while younger dentists and PhD holders are more knowledgeable. Institutions should implement ongoing DH education for undergraduates and conduct interventions for experienced professionals, especially older ones.

Exploring the Ideal of Breast Beauty: A Morphometric Analysis Based on the Opinions of the Brazilian Population.

Background The quest to identify parameters deemed optimal for breast aesthetics holds paramount significance in both aesthetic and reconstructive surgery. The definition of ideal breast beauty, however, is subject to cultural variations and diverse standards, necessitating a detailed understanding. Objective This study delves into the perspectives of the Brazilian population regarding the aesthetics of the female breast. Methods A selection of images portraying variations in the distribution of upper and lower pole ratios across four distinct proportion models (35:65, 45:55, 50:50, and 55:45) was presented to participants. Through a meticulously crafted questionnaire administered via Google Forms, respondents were tasked with identifying the images they deemed most beautiful and attractive. Comprehensive demographic data of the study participants were gathered and subsequently correlated with their group-specific opinions. Results A total of 3744 questionnaire responses were collected 228 of which were from plastic surgeons/residents. The average age was 35 years, with 55.3% being women. Notably, breasts featuring a ratio of 45:55 emerged as the consensus choice for the epitome of beauty, garnering preference from 73% of the general population, 68% of women, 78% of men, and an equal 78% of plastic surgeons. This preference was consistent across all regions of the country. Conclusion Breasts with a ratio of 45:55 were universally deemed the most aesthetically pleasing. Similarly, breasts with a 50:50 ratio of breast tissue emerged as the next preferred choice. These insights contribute valuable perspectives on aesthetic considerations in breast surgery within the unique cultural context of Brazil.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .