The telephone-based application of the modified fatigue impact scale in individuals with multiple sclerosis: An investigation of measurement properties.

BACKGROUND: Fatigue is one of the most common symptoms reported by individuals with multiple sclerosis and it contributes to the reduction of the functionality. Therefore, it is important to assess the impact of fatigue on daily living of individuals with multiple sclerosis. The Modified Fatigue Impact Scale (MFIS) is an instrument to assess the perception of the impact of fatigue. However, there have been no investigations about the measurement properties of this instrument administered over the telephone for individuals with multiple sclerosis. OBJECTIVES: To verify the concurrent validity, the test-retest reliability, the standard error of measurement (SEM) and the minimal detectable change (MDC) of the MFIS applied over the telephone to assess the perception of the impact of fatigue of individuals with multiple sclerosis. METHODS: The MFIS, composed of 21 items covering three domains: physical, cognitive and psychosocial, was applied at three different moments with an interval of 5-7 days. To establish the concurrent criterion validity, the face-to-face application and the first evaluation by telephone were used. The two telephone assessments were used to assess the test-retest reliability The intraclass correlation coefficient (ICC) with 95 % confidence interval (CI) and the Bland-Altman method were used. The standard error of measurement (SEM) and the MDC was calculated according to reliability results. RESULTS: Thirty individuals (40.83 ± 10.61, 60 % female) were included. The median score on the Expanded Disability Status Scale was 2.00 (±4.00). The majority of participants experienced fatigue (n = 17; 56.67 %). A significant and high magnitude correlation (0.70 ≤ ICC ≤ 0.87, p < 0.001) was found in the investigation of concurrent criterion validity. The Bland-Altman method showed a mean difference between 0.70 to 2.17 points between face-to-face and telephone-based application of the MFIS. For test-retest reliability, a significant and very high magnitude correlation (0.91 ≤ ICC ≤ 0.97, p < 0.001) was found. The Bland-Altman method showed a mean difference between -0.03 and -0.77 points between two telephone-based applications. The SEM and the MDC were 0.71 and 1.97 points. CONCLUSION: The telephone-based application of the MFIS to assess the perceived impact of fatigue in individuals with multiple sclerosis demonstrated adequate measurement properties, and may be a valuable tool to assess patients in clinical practice.

Association between fatigue and MDS-UPDRS in individuals with Parkinson's disease: cross-sectional study.

BACKGROUND: Fatigue is significant in the context of Parkinson's disease (PD), considering that one-third of patients classify it as the most restricting symptom in their daily life activities (DLAs). The objective was to verify the relationship (association) between fatigue and non-motor and motor symptoms of PD. METHODS: A cross-sectional study which included 100 individuals with PD. Initially, demographic and clinical data (modified Hoehn and Yahr scale-HY, anxiety, and depression) were collected. To assess the non-motor and motor symptoms of PD, the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) was applied. Fatigue was evaluated using the Parkinson Fatigue Scale. RESULTS: A higher HY score, greater severity of non-motor aspects of DLAs and motor aspects of DLAs, more motor complications, and higher levels of anxiety as well as depression were observed in the "fatigue" group. Fatigue was associated with a lower daily equivalent levodopa dose (LEDD), a higher body mass index (BMI), anxiety, depression, and the presence of non-motor symptoms. CONCLUSION: Non-motor symptoms are more determining factors for fatigue than the motor condition itself, with an association between fatigue and higher BMI scores, increased anxiety and depression, lower LEDD, and greater severity of non-motor aspects of DLAs. Individuals in the "fatigue" group had higher HY scores, anxiety, and depression, worse non-motor and motor symptoms related to experiences of daily life, as well as motor complications.

Evaluation of functionality-mobility in patients with skeletal dysplasias. Application of the STEMS tool ("everyday symptoms and mobility screening tool for skeletal dysplasias").

Individuals with differing forms of skeletal dysplasias (SD) frequently report impaired mobility and symptoms. With the objetive to evaluate mobility and associated symptoms in people with SD at an Argentinian pediatric hospital, using an Argentinian version of the Screening Tool for Everyday Mobility and Symptoms (STEMS), a simple questionnaire that allows clinicians to quickly identify the presence of symptoms associated with mobility in people with SD, while considering different environmental settings and the use of assistive devices, an analytical study of a consecutive sample of patients older than 5 years with SD and their affected relatives was carried out.Diagnosis, comorbidities, socioenvironmental, therapeutic, auxological and mobility variables were recorded. The presence and intensity of symptoms was noted through use of both the STEMS and validated scales. Descriptive, association and correlation analyzes were performed. One hundred and nineteen individuals with SD were enrolled in the study and divided into groups: Osteogenesis Imperfecta (OI, n = 55), Achondroplasia (ACH, n = 36) and Other SD resulting in disproportionate short stature (n = 28). Mobility assistive devices were almost exclusively used by individuals with OI. They were more frequently used by individuals with overweight and obesity, more severe form of the disease and in the outdoor settings. Two thirds (66.4%) of the individuals assessed in this study reported pain, 87.4% reported fatigue, and 58.8% reported both pain and fatigue. The intensity of symptoms was similar between groups and correlated with age and auxological variables. The STEMS was clear, easy and quick to use for identifying presence of pain and fatigue in this population group. The STEMS proved to be a simple and useful tool for evaluating functional mobility and associated symptoms in our population of individuals with SD.

Validity study of the Three-Dimensional Work Fatigue Inventory among higher education nursing faculty.

OBJECTIVE: to adapt and validate the Three-Dimensional Work Fatigue Inventory (3D-WFI) for Brazil's cultural reality and assess the psychometric properties. METHODS: a methodological study developed in six stages: initial translation; synthesis of translations; back translation; review by expert committee; pretest; and review of the adaptation process by the researchers. For validity, the instrument was applied to a sample of 318 nursing professors from Brazilian federal and state public universities. Data were analyzed using exploratory and confirmatory factor analysis, composite reliability and instrument reliability (Cronbach's alpha and McDonald's omega). RESULTS: the 3D-WFI instrument showed excellent internal consistency (α=0.95 and ω=0.97), three dimensions and explained variance of 62.77%. CONCLUSIONS: the Brazilian version of the instrument showed excellent psychometric properties for assessing fatigue among Brazilian workers.

A Cross-Sectional Study of the Physical and Mental Well-Being of Long COVID Patients in Aruba.

Objective: To investigate the pattern and prevalence of persistent symptoms of Post-COVID-19 Syndrome (PCS) at 3, 6, 9, and 18 months after discharge. Associated risk factors were further examined to potentially explain the persistence of these symptoms.Design and Setting: A cross-sectional cohort study was conducted at the primary health care facility of Aruba, Dr. Horacio E. Oduber Hospital (HOH).Participants: Inclusion criteria were adults hospitalized at HOH for at least one night between March and July 2021 and laboratory-confirmed COVID-19 diagnosis. Exclusion criteria were deceased before the follow-up, not able to mobilize before or after discharge, living outside of Aruba or in nursing homes, and patients with psychosis, dementia, or hospitalized due to unrelated diseases.Methods: Eligible and willing participants completed a 20-question survey: a self-reported symptoms questionnaire about symptoms during and after COVID-19 infection, level of dyspnea measurement (mMRC-scale), quality of life measurement (EQ-5D-5E with EuroQoL VAS), and mental well-being (WHO-5). Hospitalization related data were gathered via retrospective analysis of patient records. Chi-square test, logistic regression, and ANOVA analyses were conducted; P<0.05 was chosen as level of statistical significance for all analyses.Results: In total, 222 (34.5%) patients were eligible, consenting, and completed the survey. Most participants were interviewed a year or more after their initial COVID-19 infection. Fatigue (37.8%), new-onset dyspnea (38.7%), hair loss (20.3%), and muscle pain (18.0%) were the most frequently reported symptoms at any time post COVID-19 infection. Female participants were found more likely to experience fatigue (P<0.05, OR 2.135, 95% CI 1.154-3.949) and new-onset dyspnea (P<0.05, OR 2.026 95% CI 1.093-3.756) after initial infection. Participants with one or more respiratory comorbidity were more likely to experience new-onset dyspnea (P<0.05, OR 2.681, 95% CI 1.223-5.873). None of the predictor variables was associated with cognitive impairment.Conclusion: This study identified female sex and respiratory comorbidity as crucial risk factors for PCS. Females were also found to have significantly lower health scores. Female participants were more likely to experience fatigue and dyspnea after COVID-19 infection.

Post-viral fatigue in COVID-19: A review of symptom assessment methods, mental, cognitive, and physical impairment.

Coronavirus 2 is responsible for Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), and the main sequela is persistent fatigue. Post-viral fatigue is common and affects patients with mild, asymptomatic coronavirus disease-2019 (COVID-19). However, the exact mechanisms involved in developing post-COVID-19 fatigue remain unclear. Furthermore, physical and cognitive impairments in these individuals have been widely described. Therefore, this review aims to summarize and propose tools from a multifaceted perspective to assess COVID-19 infection. Herein, we point out the instruments that can be used to assess fatigue in long-term COVID-19: fatigue in a subjective manner or fatigability in an objective manner. For physical and mental fatigue, structured questionnaires were used to assess perceived symptoms, and physical and cognitive performance assessment tests were used to measure fatigability using reduced performance.

Clinical validation of nursing diagnosis fatigue (00093) in women in the immediate hospital postpartum period.

OBJECTIVE: To perform clinical validation of nursing diagnosis fatigue (00093) in women in the immediate postpartum hospital. METHOD: This is a methodological and clinical validation study of the diagnostic accuracy of nursing diagnosis fatigue (00093) components in women in the immediate postpartum hospital period. Data were collected with women in the immediate postpartum hospital. Sensitivity and specificity accuracy measures, positive and negative predictive values of the aforementioned nursing diagnosis were investigated. RESULTS: The sample consisted of 153 women in the immediate postpartum period hospitalized in the rooming-in ward, with a mean age of 27 years, whose defining characteristic with statistical significance was tiredness. CONCLUSION: The defining characteristics of tiredness and pain and related factor sleep deprivation presented high prevalence and high values of fatigue (00093) accuracy measures, being validated. Thus, it is believed that this study will contribute to clinical practice nurses in the correct identification of postpartum hospital fatigue, a frequent phenomenon in this population that causes much damage throughout the puerperium period. Additionally, it will corroborate the immediate conduct aiming at good outcome.

Brief interprofessional intervention for chronic pain management: a pilot study.

OBJECTIVE: To test the effects of a brief interprofessional intervention for chronic pain management. METHODS: Before and after pilot study. The brief interprofessional intervention had a psychoeducational focus and was based on the Self-Efficacy Theory, using Cognitive-Behavioral Therapy strategies. The intervention aimed to improve the management of chronic pain. It was conducted in group, over six weeks, with a two-hour weekly meeting, including educational strategies on pain management, stretching, and relaxation techniques. Self-efficacy, pain intensity, disability, fatigue, and depressive symptoms were assessed. Data were analyzed using the paired t-test and Pearson's correlation. RESULTS: Adults with moderate to severe pain took part in the study. Post-intervention analysis showed significant improvement in self-efficacy (p = 0.004) and significant reduction in pain intensity (p = 0.024), disability (p = 0.012), fatigue (p = 0.001), and depressive symptoms (p = 0.042). CONCLUSION: The effects of brief interprofessional intervention were positive for chronic pain management. We suggest the conduction of studies with more robust designs and a larger sample to confirm these findings.

TANGO: effect of tango Argentino on cancer-associated fatigue in breast cancer patients-study protocol for a randomized controlled trial.

BACKGROUND: The majority of breast cancer patients suffer from persistent impairments after completion of their primary oncological therapy. Cancer-related fatigue (CRF) in particular is a multidimensional syndrome having a profound negative impact on the quality of life. To counter CRF symptoms, physical activities are suggested as first-line interventions, mind-body therapies have been shown to be effective, and music therapy can also reduce anxiety and stress in breast cancer patients. Tango therapy that combines various elements can have an impact on physical, psychological, and cognitive abilities and could therefore have a beneficial effect on breast cancer patients. The purpose of this study is to investigate whether a 6-week tango module is suited as a therapeutic approach for people after primary breast cancer therapy to favorably influence their quality of life, especially CRF levels. METHODS: Sixty patients with a diagnosis for stage I-III breast cancer 12-48 months before enrollment and with CRF (age > 18) will be recruited and randomized 1:1 to a tango or a waiting-list group. Movement concepts using elements of Argentine tango (self-awareness, musical and spatial perception, self-perception, playfulness, shared experience) will be examined with the participants during six consecutive weekly 1-h tango sessions. The primary outcome will be the improvement of CRF (German version of the Cancer Fatigue Scale), and the secondary outcomes will be the improvement in sleep quality (Pittsburgh Sleep Quality Index) and quality of life (EORTC-QLQ-C30). Patient-reported outcomes will be measured at baseline and 6 weeks later; follow-up will be performed 6, 12, and 24 months after baseline. An evaluation will be performed by means of descriptive data analyses. DISCUSSION: Argentine tango, as a music-based movement therapy, can influence different skills and may improve several outcomes. The therapeutic use of Argentine tango in the care of breast cancer patients has not yet been reported. It is anticipated that participants receiving the tango module will have improved CRF, sleep, and quality of life scores compared to a waitlist control. TRIAL REGISTRATION: German Clinical Trials Registry (DRKS) DRKS00021601 . Retrospectively registered on 21 August 2020.

A Data-Driven Approach to Physical Fatigue Management Using Wearable Sensors to Classify Four Diagnostic Fatigue States.

Physical exercise contributes to the success of rehabilitation programs and rehabilitation processes assisted through social robots. However, the amount and intensity of exercise needed to obtain positive results are unknown. Several considerations must be kept in mind for its implementation in rehabilitation, as monitoring of patients' intensity, which is essential to avoid extreme fatigue conditions, may cause physical and physiological complications. The use of machine learning models has been implemented in fatigue management, but is limited in practice due to the lack of understanding of how an individual's performance deteriorates with fatigue; this can vary based on physical exercise, environment, and the individual's characteristics. As a first step, this paper lays the foundation for a data analytic approach to managing fatigue in walking tasks. The proposed framework establishes the criteria for a feature and machine learning algorithm selection for fatigue management, classifying four fatigue diagnoses states. Based on the proposed framework and the classifier implemented, the random forest model presented the best performance with an average accuracy of ≥98% and F-score of ≥93%. This model was comprised of ≤16 features. In addition, the prediction performance was analyzed by limiting the sensors used from four IMUs to two or even one IMU with an overall performance of ≥88%.

The therapeutic effect of sports on relieving chronic fatigue / O efeito terapêutico dos esportes no alívio da fadiga crônica / El efecto terapéutico de los deportes para aliviar la fatiga crónica

ABSTRACT Introduction Chronic fatigue syndrome (CFS) is a group of long-term fatigue; the rest is difficult to achieve. At the same time, it is accompanied by corresponding physical dysfunction and psychological and mental symptoms. It is very meaningful to find exercise countermeasures to cope with chronic fatigue syndrome actively. Object This article analyzes the current students' CFS to realize the cognition of the disease. At the same time, it analyzes the effect of sports on the treatment of chronic fatigue to help students formulate related sports programs. Method The article conducts a related questionnaire survey and analysis of students and analyzes CFS and exercise status symptoms. Results Generally, students with CFS did not actively participate in sports and had poor physical fitness, especially muscle endurance and cardiopulmonary function. However, students who actively participate in sports training basically do not have CFS. Conclusion CFS students should strengthen physical exercise and improve the CFS situation through exercise. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução a síndrome da fadiga crônica (SFC) é um grupo de fadiga de longa duração; o descanso é difícil de conseguir. Ao mesmo tempo, é acompanhado por disfunção física correspondente e sintomas psicológicos e mentais. É muito significativo encontrar contramedidas de exercícios para lidar ativamente com a síndrome da fadiga crônica. Objetivo este artigo analisa o CFS de alunos atuais para a compreensão da doença. Ao mesmo tempo, analisa o efeito dos esportes no tratamento da fadiga crônica para ajudar os alunos a formular programas esportivos relacionados. Método o artigo conduz uma pesquisa de questionário relacionada e análise de alunos e analisa CFS e sintomas de status de exercício. Resultados Geralmente, os alunos com SFC não participavam ativamente de esportes e apresentavam má aptidão física, principalmente resistência muscular e função cardiopulmonar. Por outro lado, os alunos que participam ativamente do treinamento esportivo basicamente não possuem CFS. Conclusão os alunos do CFS devem fortalecer o exercício físico e melhorar a situação do CFS por meio do exercício. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El síndrome de fatiga crónica (SFC) es un grupo de fatiga a largo plazo; el descanso es difícil de conseguir. Al mismo tiempo, se acompaña de la correspondiente disfunción física y síntomas psicológicos y mentales. Es muy significativo encontrar contramedidas de ejercicio para hacer frente activamente al síndrome de fatiga crónica. Objeto Este artículo analiza el SFC de los estudiantes actuales para comprender la enfermedad. Al mismo tiempo, analiza el efecto del deporte en el tratamiento de la fatiga crónica para ayudar a los estudiantes a formular programas deportivos relacionados. Método El artículo lleva a cabo un cuestionario relacionado y un análisis de los estudiantes y analiza los síntomas del SFC y el estado del ejercicio. Resultados En general, los estudiantes con SFC no participaron activamente en deportes y tenían una mala condición física, especialmente la resistencia muscular y la función cardiopulmonar. Por otro lado, los estudiantes que participan activamente en el entrenamiento deportivo básicamente no tienen SFC. Conclusión Los estudiantes de CFS deben fortalecer el ejercicio físico y mejorar la situación de CFS a través del ejercicio. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Machine Learning Approach for Fatigue Estimation in Sit-to-Stand Exercise.

Physical exercise (PE) has become an essential tool for different rehabilitation programs. High-intensity exercises (HIEs) have been demonstrated to provide better results in general health conditions, compared with low and moderate-intensity exercises. In this context, monitoring of a patients' condition is essential to avoid extreme fatigue conditions, which may cause physical and physiological complications. Different methods have been proposed for fatigue estimation, such as: monitoring the subject's physiological parameters and subjective scales. However, there is still a need for practical procedures that provide an objective estimation, especially for HIEs. In this work, considering that the sit-to-stand (STS) exercise is one of the most implemented in physical rehabilitation, a computational model for estimating fatigue during this exercise is proposed. A study with 60 healthy volunteers was carried out to obtain a data set to develop and evaluate the proposed model. According to the literature, this model estimates three fatigue conditions (low, moderate, and high) by monitoring 32 STS kinematic features and the heart rate from a set of ambulatory sensors (Kinect and Zephyr sensors). Results show that a random forest model composed of 60 sub-classifiers presented an accuracy of 82.5% in the classification task. Moreover, results suggest that the movement of the upper body part is the most relevant feature for fatigue estimation. Movements of the lower body and the heart rate also contribute to essential information for identifying the fatigue condition. This work presents a promising tool for physical rehabilitation.

Prevalence and Predictors of Fatigue and Neuropsychiatric Symptoms in Patients with Minor Ischemic Stroke.

OBJECTIVES: Patients who are victims of a mild stroke are vulnerable to several invisible and neglected neurological sequelae. In parallel, it is known that fatigue and neuropsychiatric symptoms are common complications after a stroke in general. Our aim was to describe the prevalence and the factors associated with these two outcomes after a minor stroke. MATERIALS AND METHODS: We conducted a prospective observational cohort study that included consecutive patients diagnosed with minor ischemic stroke between 2015 and 2019. Minor stroke was defined as NIHSS < 4 and modified Rankin Scale (mRS) < 2. Patients were followed for 12 months after the index stroke. The primary endpoints included fatigue and neuropsychiatric impairment, which were evaluated with the Fatigue Severity Scale (FSS) and the Hospital Anxiety Depression Scale (HADS), respectively. RESULTS: A total of sixty patients were followed in our cohort. The mean age was 53.0 (SD 15.0) and 51.7% were male. There were 32 (53.3%) and 25 (41.7%) patients who developed PSF and post-stroke neuropsychiatric symptoms, respectively. The use of antidepressants and statins were associated with post-stroke fatigue, while women and younger patients were more likely to develop neuropsychiatric symptoms after the stroke (p < 0.05). Eighteen (30.0%) patients were diagnosed with both post-stroke fatigue and psychiatric disorders. CONCLUSIONS: Post-stroke fatigue and neuropsychiatric symptoms are prevalent in minor stroke and should be independently addressed as a part of the recovery goal.

Symptomatic manifestations of the disease caused by coronavirus (COVID-19) in adults: systematic review.

OBJECTIVE: To identify symptoms of COVID-19 in adults in the scientific literature. METHOD: Systematic review of studies published from December 1, 2019 to April 21, 2020 from the Scopus, Web of Science and PubMed databases, in order to answer the following research question: "What are the symptoms caused by COVID-19 in adults?" using the keywords "Symptoms", "Clinical Manifestations", "Coronavirus", "COVID-19". RESULTS: Of the total 105 references, 13 references that addressed the symptoms of COVID-19 were selected. Fever and normal or dry cough were symptoms present in all studies. CONCLUSION: The symptoms identified in adult patients were fever, normal or dry cough, headache, pharyngalgia, dyspnea, diarrhea, myalgia, vomiting, sputum or expectoration, anxiety or chest pain, fatigue, nausea, anorexia, abdominal pain, rhinorrhea, runny nose or nasal congestion, dizziness, chills, systemic pain, mental confusion, hemoptysis, asthma, taste disorder, smell disorder, belching and tachycardia.

Effect of Mindfulness Training on Fatigue and Recovery in Elite Volleyball Athletes: A Randomized Controlled Follow-Up Study.

Volleyball is a team sport with high physical and perceptual-cognitive demand, hence, increasing the perception of physical and mental fatigue during a competition. To alleviate fatigue (physical and mental), mindfulness and music have been proposed. The aim of this study was to analyze the effect of mindfulness-based mental versus music training on mental fatigue, physical fatigue, and recovery in elite competitive female volleyball athletes using a randomized two-controlled study with follow-up. Participants were 30 elite female Brazilian volleyball athletes. Athletes were randomly assigned to the following groups: 1) mindfulness-based mental training group (MBMT); 2) music-based training group (MBT); or 3) control group (CG). Three variables were evaluated as follows: 1) recovery based on total quality recovery; 2) mental fatigue visual analog scale; and 3) physical fatigue visual analog scale. Regarding recovery, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). A difference in mental fatigue was noted between MBT and CG at follow-up [F(2,26) = 5.71, p = 0.009; large]. Regarding physical fatigue, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). The mindfulness intervention effectively attenuated the mental fatigue caused by competition in volleyball athletes. These results will assist coaches and staff in providing fatigue management and reinforce the applicability of mental training in sports.

Validity and reliability of the Inflammatory Bowel Disease Fatigue Scale in Mexican patients.

INTRODUCTION: Fatigue is an extra-intestinal manifestation of inflammatory bowel disease (IBD). OBJECTIVE: To determine the construct validity, discriminant validity and reliability of an instrument for evaluating the Fatigue Scale for IBD in Mexican patients. METHODS: Two hundred patients with an IBD confirmed diagnosis were included. Current demographic and clinical characteristics of the condition were evaluated. Each patient answered the IBD Fatigue Scale (IBD-F) and the Pittsburgh Sleep Quality Index (PSQI), which was used to determine IBD-F discriminant validity. A factor analysis of each IBD-F section was performed, independent sample Student's t-tests were used to contrast the PSQI, and reliability was evaluated using Cronbach's alpha. RESULTS: The items in both IBD-F sections showed high factor loadings, which explained 68.3 and 38.4% of variance, respectively. Cronbach's alpha was > 0.80 in both, which discriminated patients with greater sleep disturbances. CONCLUSIONS: IBD-F is a valid and reliable scale for Mexican patients with IBD. Fatigue objective evaluation will allow timely interventions in order to reduce its impact on patients with IBD.

INTRODUCCIÓN: La fatiga es una manifestación extraintestinal de la enfermedad inflamatoria intestinal (EII). OBJETIVO: Obtener la validez de constructo, la validez discriminante y la confiabilidad de un instrumento para evaluar una escala de fatiga para EII en pacientes mexicanos. MÉTODOS: Se incluyeron 200 pacientes con diagnóstico confirmado de EII. Se evaluaron las características demográficas y clínicas actuales del padecimiento. Cada paciente contestó la Escala de Fatiga para EII (IBD-F) y el Índice de Calidad de Sueño de Pittsburgh (PSQI), empleado para determinar la validez discriminante de la IBD-F. Se realizó un análisis factorial de cada sección de la IBD-F, se utilizó la t de Student de muestras independientes para el contraste del PSQI y la confiabilidad se evaluó mediante alfa de ZCronbach. RESULTADOS: Los reactivos de ambas secciones de la IBD-F mostraron altas cargas factoriales, que explicaron 68.3 y 38.4 % de la varianza, respectivamente. El alfa de Cronbach fue > 0.80 en ambas, las cuales discriminaron a los pacientes con mayores alteraciones en el sueño. CONCLUSIONES: La IBD-F es una escala válida y confiable para pacientes mexicanos con EII. La evaluación objetiva de la fatiga permitirá realizar intervenciones oportunas para disminuir el impacto de esta manifestación en el paciente con EII.

A fuller picture of COVID-19 prognosis: the added value of vulnerability measures to predict mortality in hospitalised older adults.

BACKGROUND: Although coronavirus disease 2019 (COVID-19) disproportionally affects older adults, the use of conventional triage tools in acute care settings ignores the key aspects of vulnerability. OBJECTIVE: This study aimed to determine the usefulness of adding a rapid vulnerability screening to an illness acuity tool to predict mortality in hospitalised COVID-19 patients. DESIGN: Cohort study. SETTING: Large university hospital dedicated to providing COVID-19 care. PARTICIPANTS: Participants included are 1,428 consecutive inpatients aged ≥50 years. METHODS: Vulnerability was assessed using the modified version of PRO-AGE score (0-7; higher = worse), a validated and easy-to-administer tool that rates physical impairment, recent hospitalisation, acute mental change, weight loss and fatigue. The baseline covariates included age, sex, Charlson comorbidity score and the National Early Warning Score (NEWS), a well-known illness acuity tool. Our outcome was time-to-death within 60 days of admission. RESULTS: The patients had a median age of 66 years, and 58% were male. The incidence of 60-day mortality ranged from 22% to 69% across the quartiles of modified PRO-AGE. In adjusted analysis, compared with modified PRO-AGE scores 0-1 ('lowest quartile'), the hazard ratios (95% confidence interval) for 60-day mortality for modified PRO-AGE scores 2-3, 4 and 5-7 were 1.4 (1.1-1.9), 2.0 (1.5-2.7) and 2.8 (2.1-3.8), respectively. The modified PRO-AGE predicted different mortality risk levels within each stratum of NEWS and improved the discrimination of mortality prediction models. CONCLUSIONS: Adding vulnerability to illness acuity improved accuracy of predicting mortality in hospitalised COVID-19 patients. Combining tools such as PRO-AGE and NEWS may help stratify the risk of mortality from COVID-19.

Validation of chronic obstructive pulmonary disease severity score (COPDSS) for primary care in a Colombian population / [Validación del puntaje de valoración de la gravedad de la enfermedad pulmonar obstructiva crónica en población colombiana en un servicio de atención primaria].

Introduction: Chronic obstructive pulmonary disease (COPD) is a major global health problem causing high morbidity and mortality. Easy to apply, cost-effective, and available COPD severity measures are required in rural areas. Objective: To assess the validity and reliability of the COPD Severity Score (COPDSS) in Colombian patients attended in primary care. Materials and methods: A cross-sectional study was conducted in a sample of 100 patients diagnosed with COPD according to GOLD guidelines. Convergent validity was assessed by correlating the COPDSS results with other important variables such as those assessed through the Chronic Respiratory Disease Questionnaire (CRQ) and the forced expiratory volume in one second (FEV1). Results: The COPDSS showed a significant correlation with the FEV1 (r=-0.33), with the CRQ (r=-0.57) and its dimensions: Dyspnea (r=0.51), fatigue (r=0.53), emotional function (r=0.43), and disease control (r=0.50). The factor analysis identified a single factor with a cumulative variance of 59.1%. The internal consistency analysis showed an adequate Cronbach's alpha of 0.76. Conclusions: The use of the COPDSS as an assessment test for COPD patients in Colombia showed adequate validity, reliability, and easy application in primary care.

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) es un importante problema de salud mundial con una alta morbimortalidad. Se requiere la medición de la gravedad de la enfermedad mediante una herramienta de fácil aplicación, bajo costo y fácil disponibilidad en áreas rurales. Objetivo. Evaluar la validez y confiabilidad del puntaje de valoración de la gravedad de la EPOC (Chronic Obstructive Pulmonary Disease Severity Score, COPDSS) en una población de atención primaria en Colombia. Materiales y métodos. Se hizo un estudio de corte transversal en una muestra de 100 pacientes con diagnóstico de EPOC según las guías GOLD. La validez concurrente se evaluó correlacionando los resultados del COPDSS con otras variables de importancia como las del cuestionario sobre la enfermedad respiratoria crónica (Chronic Respiratory Disease Questionnaire, CRQ) y el volumen espiratorio forzado en el primer segundo (Forced Expiratory Volume in one second, FEV1). Resultados. El COPDSS presentó una correlación significativa con el FEV1 (r=-0,33), con el CRQ (r=-0,57) y sus dimensiones: disnea (r=0,51), fatiga (r=0,53), función emocional (r=0,43) y control de la enfermedad (r=0,50). En el análisis factorial se determinó un solo factor con una varianza acumulada de 59,1 %. El análisis de coherencia interna mostró un alfa de Cronbach de 0,76, valor este considerado adecuado. Conclusiones. Se observó que el uso del COPDSS como cuestionario de valoración de la gravedad de pacientes con EPOC en Colombia tenía validez y confiabilidad adecuadas y que es de fácil aplicación en la atención primaria.