Claudia S. Lopes

Validade de constructo de escala de apoio social do Medical Outcomes Study adaptada para o português no Estudo Pró-Saúde

This paper evaluates the construct validity of the Medical Outcomes Studys social support scale adapted to Portuguese, when utilized in a cohort study among non-faculty civil servants at a university in Rio de Janeiro, Brazil (Pró-Saúde Study). Baseline data were obtained in 1999, when 4,030 participants (92.0% of those eligible) completed a multidimensional self-administered questionnaire at the workplace. From the original scales five social support dimensions, factor analysis of the data extracted only three dimensions: positive social interaction/affective support; emotional/information support; and material support. We estimated associations between social support dimensions and socio-demographic, health, and well being-related characteristics. We confirmed the hypotheses that less isolated individuals, those with better self-rated health, those who reported more participation in group activities, and those with no evidence of common mental disorders reported better perception of social support. In conclusion, we found good evidence for a high construct validity of this scale, supporting its use in future analyses in the Pró-Saúde Study and in similar population groups.

Traduçäo e adaptaçäo para o português da Escala de Compulsäo Alimentar Periódica

INTRODUCAO/OBJETIVOS: Descreve-se o processo de traducao e adaptacao, para a lingua portuguesa, da Binge Eating Scale (BES) ¾ Escala de Compulsao Alimentar Periodica (ECAP) ¾, que avalia a gravidade da compulsao alimentar periodica em individuos obesos. O objetivo foi traduzir, adaptar e avaliar a aplicabilidade da versao para o portugues da ECAP. METODOS: Apos cuidadoso processo de traducao e adaptacao para a lingua portuguesa, foi obtida uma versao final da ECAP. Para avaliar sua aplicabilidade, foi realizado um pre-teste em um grupo de 32 pacientes obesos com transtorno da compulsao alimentar periodica (TCAP) e que procuravam tratamento para emagrecer. RESULTADOS: Os pacientes compreenderam adequadamente os itens da ECAP. A media de pontuacao da ECAP nos pacientes obesos com TCAP foi de 31,2 (±5,8). CONCLUSAO: A versao final para o portugues da ECAP foi considerada adequada para uso clinico.

Validade de peso e estatura informados e índice de massa corporal: estudo pró-saúde

OBJECTIVE Evaluate the validity of self-reported weight and height and the body mass index (BMI). METHODS A study was made of 3,713 employees of a public university in Rio de Janeiro, in which they were participants in Phase 1 of a longitudinal study. Information was obtained through a self-administered questionnaire, and measurements were carried out after its application. Students paired t-test, Bland & Altmans graphs and the intraclass correlation coefficient (ICC) were utilized to evaluate the differences between the measured and the reported parameters. The sensitivity and specificity of the various BMI categories were estimated. RESULTS There was high agreement between the measured and reported weights (ICC=0.977) and heights (ICC=0.943). The BMI sensitivity, in its various categories, was around 80%, and the specificity was close to 92%. There was a slight and uniform tendency toward self-reported weight underestimation and self-reported height overestimation in both sexes. CONCLUSIONS Self-reported and measured weight and height information had good agreement and validity. In similar populations, when few resources are available, it is possible to use self-reported data instead of actual measurements.

Gender and leisure-time physical activity.

This article discusses the relationship between gender and the social construction of the body, specifically focusing on physical exercise during leisure time. The Pró-Saúde Project is a prospective study consisting of 4,030 employees of a university in Rio de Janeiro, in which we analyzed the answers on leisure-time physical activity (LTPA) by 3,740 participants. The results show a prevalence of males in LTPA. Age, schooling, and per capita family income were directly associated with exercise among women, as compared to per capita family among men. Men were more frequently involved in group sports and physical activities that required more strength than women, including football, tennis, volleyball, martial arts, jogging, and weight lifting. Women performed more individual physical activities and those demanding less strength, like walking, dance, gymnastics, and hydrogym. The results suggest that LTPA is a domain of daily life that is organized according to certain conventions, amongst which gender-related conceptions concerning the ideal body, where men and women display distinct behaviors in relation to physical exercise.

Pesquisa Nacional de Saude no Brasil: concepcao e metodologia de aplicacao

The National Health Survey is a household-based nationwide survey carried out by the Ministry of Health in partnership with the Brazilian Institute of Geography and Statistics. The scope of the survey is to establish the health status and lifestyles of the population - as well as how they look after their health - with regard to access and use of services, preventive actions, continuity of care, and health care financing. The sample size is 80,000 households and enables the calculation of some indicators at different geographic levels, namely states, capitals, metropolitan and rural areas. The questionnaire is divided into three parts. The first two are answered by one resident and include questions on the household characteristics and on the social and economic level and health status of all inhabitants. The individual questionnaire is answered by an adult (aged 18 years or more), selected with equal probability among the adult residents, and focuses on morbidity and lifestyle. For this individual, measurements of weight, height, waist circumference and blood pressure are taken, as well as laboratory exams to characterize the lipid profile and blood glucose level, as well as determine the urine sodium content. The laboratory exams are taken in a subsample of 25% of the census sectors selected.

Eventos de vida produtores de estresse e transtornos mentais comuns: resultados do Estudo Pró-Saúde

This study investigates the association between stressful life events (SLE) and common mental disorders (CMD) among university employees in Rio de Janeiro, Brazil. Phase 1 sectional data from a cohort study (the Pro-Saude Study) were collected among 4,030 participants. A standardized self-administered questionnaire (General Health Questionnaire) assessed the presence of CMD during the previous two weeks, the occurrence of SLE in the previous 12 months, and socio-demographic characteristics. After adjustment for gender, age, income, and marital status, severe financial problems were associated with the greatest risk of CMD (OR = 2.6; 95%CI: 2.2-3.0), followed by physical aggression (OR = 2.1; 95%CI: 1.5-2.8), disruption of a love relationship (OR = 1.9; 95%CI: 1.6-2.3), forced change of residence (OR = 1.9; 95%CI: 1.5-2.4), serious disease (OR = 1.8; 95%CI: 1.5-2.1), hold-up or theft (OR = 1.5; 95%CI: 1.2-1.8), and hospitalization (OR = 1.4; 95%CI: 1.1-1.8). Results suggest that long-term effects of SLE should be investigated, as well as other potential modifying factors in the development and maintenance of CMD in order to support more effective mental health interventions.

Nosological profile and prevalence of common mental disorders of patients seen at the Family Health Program (FHP) units in Petrópolis, Rio de Janeiro

OBJECTIVES This study aims to detect the prevalence of common mental disorders among patients seen by doctors at family health program units in Petrópolis-RJ, and to establish their nosological profile. METHOD The population of the study included all 18 to 65-year-old patient who attended any family health program units included in the study during a 30-day period, between August and December 2002 (n = 714). The prevalence of common mental disorders was assessed using the General Health Questionnaire, 12 item version. In order to establish the nosological profile, the Composite International Diagnostic Interview was administered to all common mental disorders positive patients who accepted to return (n = 215). RESULTS At the cut-off point of 2/3 the common mental disorders prevalence was 56% and for 4/5, it was 33%. The most frequent nosological categories found among common mental disorders positive patients were depression and anxiety categories along with posttraumatic stress disorder, somatoform pain disorder and dissociative disorders. There was a high frequency of comorbidity, especially between anxiety, depression, somatoform and dissociative disorders. CONCLUSIONS The common mental disorders prevalence and the nosological profile found in FHP were similar to those of other primary care studies in Brazil, but some disorders (posttraumatic stress disorder, somatoform pain disorder and dissociative disorders) that had not been previously studied in this context were also very frequent. The high common mental disorders prevalence found reinforces the urgent need for systematic inclusion of this level of care in mental health assistance planning.

The association between socio-demographic factors and leisure-time physical activity in the Pró-Saúde Study

This study evaluated the relationship between socio-demographic variables and leisure-time physical activity (LTPA). A baseline survey questionnaire was completed by 4,030 employees. LPTA was assessed as engagement in physical activities during the previous two weeks. The metabolic cost of LTPA was calculated based on frequency and amount of time participating in physical activities, assigning weekly metabolic equivalents (METs) to each activity. Odds ratios (OR) to express the relationship between socio-demographic factors and LTPA were estimated from multinomial regression models. The questions used to evaluate LTPA presented moderate reproducibility, with kappa correlation coefficients ranging from 0.45 to 0.88. Prevalence of LTPA was higher among men (52.2% men; 40.8% women). For both men and women, higher educational level and higher income were both associated with engaging in LPTA, this relationship being stronger for the highest tercile of METs as compared to physical inactivity. Men were more engaged in LTPA, and there was a strong association between LTPA and socio-demographic variables for both genders.

O uso prolongado de benzodiazepínicos em mulheres de um centro de convivência para idosos

While experts recommend caution against long-term benzodiazepine use in the elderly, survey data suggests that the use of benzodiazepine increase with age. The patterns of benzodiazepine use and factors associated with long-term use in population at risk were studied with a standarlized questionnaire applied to 634 women over 60, who attended a daycare center for older people in Rio de Janeiro between May, 1992 and December, 1995. Prevalence of benzodiazepine use in the last 15 days was 21.3% (CI 95% 18.1-24.5), and prevalence of daily use for 12 or more months was 7.4% (CI 95% 5.4-9.4). In a multivaried analysis the amount of drugs being consumed displayed an important and progressive association with long-term benzodiazepine use, with OR = 2.77 (CI 95% 1.17-6.57) for those who take from four to six drugs, and OR = 7.62 (CI 95% 3.18-18.26) for those who take more than seven drugs. Insomnia (OR = 8.87 CI 95% 2.53-31.06) and chronic headache (OR = 3.53 CI 95% 1.82-6.89) have also been associated with this pattern of use.

[Pre-school cognitive development of very low birth weight preterm children].

OBJECTIVE To examine the cognitive development of school-aged children born preterm and with very low birthweight. METHODS A cohort of premature infants born between January, 1991, and September, 1993 was examined at pre-school age. All of them were born in a public Neonatal Intensive Care Unit, with birth weight less than 1,500 g. The WPPSI-R Test was used for cognitive evaluation and applied by psychologists. Babies with malformations, genetic syndromes, congenital infections, transferred from other institutions or born at home, and those with conditions which precluded the application of the test were excluded. A group of pre-school children in the same city, born at term, were tested for comparison. RESULTS 79 children were studied, with mean birthweight 1,219.6 g (+/-168.9); of these, 44 (72.1%) attended school. No significant statistical difference was found between the groups (study and loss). The WPPSI-R Test mean scores were: 75.6+/-11.9 (total); 77+/-12.9 (performance) and 78.6+/-11.1 (verbal) for the study group, and 85.1+/-13.2 (total); 85.3+/-13.8 (performance) and 87.7+/-13.9 (verbal) for the comparison group. This difference was significant for total (p < 0.0001), verbal (p < 0.0001) and performance scores (p = 0.002), as well as for the subtests of the WPPSI-R Test. CONCLUSIONS The children who entered this study had borderline intellectual functioning at the moment of the evaluation. Results indicate that they may face learning difficulties at school, thus requiring adequate stimuli that should be provided by the family and the school.