Marcia Maria Pires Camargo Novelli

THE IMPACT OF THE TAILORED ACTIVITY PROGRAM (TAP-BR) ON CAREGIVERS’ MENTAL HEALTH IN BRAZIL

while the patient follows the exercises provided by the programme. This setting enables patients and caregivers to control, monitor and register the exercise. The programme contains exercises for strength, balance, coordination as well as tasks to train executive functions and memory. Results: In a pilot study, running from January until June 2017, the implementation of the technical requirement as well as the feasibility will be evaluated. Effects of the programme on physical and cognitive functions, daily activities, and carers burden will be studied in a controlled trial (December 2017-August 2018). Conclusions: The MobiAssist-programme enables patients with dementia, who often have very limited possibilities to take part in external programmes for physical exercise, to get access to an innovate, “at home”training system that makes it possible to preserve and improve their physical and cognitive activity and by this, to keep an individual amount of independence towards care givers.

CROSS-CULTURAL ADAPTATION OF PLEASANT EVENTS SCHEDULE: ALZHEIMER’S DISEASE TO BRAZILIAN PORTUGUESE

Background: Engagement in pleasant activities for elders with cognitive impairment may improve mood and reduce behavior problems. The Pleasant Events Schedule-Alzheimer’s Disease (PES-AD) has been described as a useful tool for this purpose, and its transcultural adaptation allows professionals to aid caretakers and elders in identifying pleasurable activities. Objective: Submit the PES-AD to process of cross-cultural adaptation to Brazilian Portuguese. Methods: The PES-AD was submitted to a five-stage process of cross-cultural adaptation as follows: 1) translation; 2) summary of translation; 3) back-translation; 4) evaluation of equivalences: semantic, idiomatic, cultural, conceptual; and 5) pre-testing. Results: The five-stage process was conducted on 36 items and three were adjusted. In the evaluation of equivalencies, four items had a level of agreement less than 0.8 and so were modified according to judges’ suggestions. Discussion: Submitting the PES-AD to a five-stage, cross-cultural adaptation maintained the original instrument’s content validity. Saviotti KRSS et al. / Arch Clin Psychiatry. 2016;43(5):95-102Background:Due to the increasing prevalence of Mild Cognitive Impairment (MCI) as an early indicator of ADRD and the unique social, financial, and quality of life considerations that this population provides, a re-examination of patient priorities in healthcare decision-making is needed. This study seeks to identify relevant and important concepts in patient care as well as alterations in rates of disease progression by integrating clinical scales with in-depth qualitative interviewing of dyads of individuals caregivers and their partners with MCI. Methods: Indepth, key informant interviews were conducted with dyads of caregivers and their partners with MCI. Our team also used the FAST and QOL-AD scale to evaluate both functional and quality of life measures from both the caregiver and care partners perspective. Qualitative interviews were transcribed verbatim and coded for relevant care decisions and concepts that were important to the caregiver and care recipient. Results:Caregivers rated FAST stages as more progressed than their care recipient partners, but quality of life better than their care recipient partners. Concepts that are most important to caregivers included: advocacy for their loved one, family dynamics and having a support network for assistance, whereas care recipients expressed a need to understand their own reaction and get a diagnosis. Conclusions:The differences in stage identification between caregiver and care recipient has implications in clinical care, as well as in the identification of interventions that may be successful for an individual with MCI. Person-centered care, often reliant in ADRD on the caregiver, may need to shift to a focus on an individual with MCI in their early stages dependent on their impression of successful outcomes in care management.

Estudo dos instrumentos de avaliação funcional em demência comumente utilizados no Brasil

Esta pesquisa objetivou identifi car os instrumentos de avaliacao funcional utilizadosem demencia no Brasil. Foram acessados os bancos de dados LILACS, PUBMED, SciELO e PortalPeriodicos CAPES para o levantamento de estudos que utilizaram instrumentos de avaliacaofuncional em demencia. Os instrumentos identifi cados foram divididos por grupos de atividadesavaliadas, fi nalidade de uso e identifi cado se os mesmos haviam passado pelo processo de adaptacao transcultural e analise da confi abilidade e validade. Foram selecionados 46 artigos e 20 teses,que utilizaram em seus estudos instrumentos de avaliacao funcional. Quinze instrumentos foramidentifi cados: 4 avaliam Atividades Instrumentais da Vida Diaria (AIVD), 3 Atividades Basicas daVida Diaria (ABVD), 4 ABVD e AIVD, 3 ABVD, AIVD e Lazer e 1 ABVD e Lazer, evidenciandoa falta de instrumentos que avaliem o grupo de atividades de trabalho, assim como a falta deuma avaliacao que contemple todos os grupos de atividades. Dos instrumentos identifi cados, 12passaram pelo processo de adaptacao transcultural, 9 apresentavam dados de confi abilidade e 5 devalidade, sendo 4 para uso em demencia. Por fi nalidade de uso 5 instrumentos eram avaliativos e10 descritivos. Este estudo identifi cou que os instrumentos de avaliacao funcional em demencia, comumente utilizados no Brasil, tem sua origem em outros paises, constatando a falta de producoes nacionais, alem disso, a avaliacao das propriedades psicometricas nao esta sendo realizada paratodos os instrumentos adaptados a nossa cultura

P3-430: Impact of cognitive impairment on the reliability and construct validation of the QOL-AD scale

Background: To assess the impact of cognitive impairment on the internal consistency and construct validity of the Brazilian version of the Quality of Life (QOL) in Alzheimer’s disease (AD) evaluation scale (QOL-AD) (Logsdon, 1999). Methods: The scale was administered to a sample of 60 patients with probable AD, with mild (n 30) and moderate (n 30) dementia, according to NINCDS-ADRDA and DSM-III-R criteria, respectively. Internal consistency was evaluated through Cronbach’s alpha coefficient. Construct validity was determined as follows: 1) Correlation between total scores of patients’ and caregivers’ reports about patients’ QOL with the results of the following measures: MMSE, Geriatric depression screening scale (GDS), Cornell scale for depression in dementia, Physical and Instrumental-Self Maintenance scales (IADLs and BADLs), Neuropsychiatric inventory (NPI) and socio-economic level and; 2) Correlation of the total score of the scale with a generic QOL instrument (WHOQOLbrief). All analyses were performed for both groups of severity. Results: The reliability was excellent for both groups of dementia severity. In mild dementia the patient’s and the relative’s versions in relation to the patient’s QOL (alpha 0.81 and 0.75, respectively). In moderate dementia the alpha values were 0.80 for patient’s report and 0.83 for relative’s report in relation to the patient’s QOL. In the construct validation of the patient’s version for mild dementia, we obtained significant correlations with GDS (-0.76, p 0.01), Cornell (-0.53, p 0.01), NPI (-0.46, p 0.05) and the total score of WHOQOL-brief (0.89, p 0.01). In the caregiver’s version about patient’s quality of life we registered significant correlations with the following measures: GDS (-0.48, p 0.01), Cornell (-0.57, p 0.01), IADLs(-0.36, p 0.05), NPI (-0.62, p 0.01) and total score of WHOQOLbrief(1.00, p 0.01). In the patient’s version for moderate dementia we obtained significant correlations with GDS (-0.45, p 0.05), Cornell (-0.46, p 0.05) and total score of WHOQOL-brief (0.90, p 0.01). In the caregiver’s version about patient’s QOL, significant correlations emerged with Cornell (-0.68, p 0.01), IADLs (-0.41, p 0.05), BADLs (-0.49, p 0.01), NPI (-0.67, p 0.01) and total score of WHOQOL-brief (0.69, p 0.01). Conclusions: The reliability and construct validity of QOL-AD were kept independent from the severity of the disease in this sample of AD patients with mild and moderate dementia.