Marielza Regina Ismael Martins

Associations among socio-demographic and clinical factors and the quality of life of ostomized patients

This study identifies the socio-demographic and clinical factors of patients with irreversible colostomy secondary to colorectal cancer and correlates them with quality of life (QOL). It is a cross-sectional study. Socio-demographic and clinical data were collected through interviews and the WHOQOL-bref to assess QOL. The sample comprised 60 patients. Most of the patients were male, elderly individuals, half were married and half did not have a sexual partner, with complete primary education, receiving up to two times the minimum wage, carried a stoma for three months on average, were instructed they would carry a stoma, but did not have their stoma marked prior to surgery. The average QOL score was 75.500, while the psychological, social and physical domains were the most affected. No statistically significant differences were found in QOL in relation to the following socio-demographic and clinical factors: female gender, low income, no sexual partners, and lack of instruction. The patients with an intestinal stoma presented a satisfactory QOL.Os objetivos deste estudo foram identificar os fatores sociodemograficos e clinicos dos pacientes com estoma intestinal definitivo, secundario ao câncer colorretal, e correlaciona-los a qualidade de vida (QV). Como metodos usaram-se o estudo transversal, utilizando a entrevista como instrumento de coleta de dados sociodemograficos e clinicos, e, para avaliacao da QV, o WHOQOL-bref. A amostra foi composta por 60 pacientes. Como resultados tem-se que a maioria dos pacientes era do sexo masculino, idoso, casado, sem parceiro sexual, com ensino fundamental completo, recebia ate dois salarios-minimos, tempo medio de estoma de tres meses, foram orientados que portariam um estoma, mas nao foi demarcado para a cirurgia. A media da QV foi de 75,00, sendo que os dominios psicologico, social e fisico foram os mais afetados. Os fatores sociodemograficos e clinicos: sexo feminino, baixa renda, nao ter parceiros sexuais e falta de orientacao apresentaram diferencas estatisticas significantes na QV. Conclui-s que os pacientes portadores de estoma intestinal demonstraram QV satisfatoria.

Associação dos fatores sociodemográficos e clínicos à qualidade de vida dos estomizados

This study identifies the socio-demographic and clinical factors of patients with irreversible colostomy secondary to colorectal cancer and correlates them with quality of life (QOL). It is a cross-sectional study. Socio-demographic and clinical data were collected through interviews and the WHOQOL-bref to assess QOL. The sample comprised 60 patients. Most of the patients were male, elderly individuals, half were married and half did not have a sexual partner, with complete primary education, receiving up to two times the minimum wage, carried a stoma for three months on average, were instructed they would carry a stoma, but did not have their stoma marked prior to surgery. The average QOL score was 75.500, while the psychological, social and physical domains were the most affected. No statistically significant differences were found in QOL in relation to the following socio-demographic and clinical factors: female gender, low income, no sexual partners, and lack of instruction. The patients with an intestinal stoma presented a satisfactory QOL.Os objetivos deste estudo foram identificar os fatores sociodemograficos e clinicos dos pacientes com estoma intestinal definitivo, secundario ao câncer colorretal, e correlaciona-los a qualidade de vida (QV). Como metodos usaram-se o estudo transversal, utilizando a entrevista como instrumento de coleta de dados sociodemograficos e clinicos, e, para avaliacao da QV, o WHOQOL-bref. A amostra foi composta por 60 pacientes. Como resultados tem-se que a maioria dos pacientes era do sexo masculino, idoso, casado, sem parceiro sexual, com ensino fundamental completo, recebia ate dois salarios-minimos, tempo medio de estoma de tres meses, foram orientados que portariam um estoma, mas nao foi demarcado para a cirurgia. A media da QV foi de 75,00, sendo que os dominios psicologico, social e fisico foram os mais afetados. Os fatores sociodemograficos e clinicos: sexo feminino, baixa renda, nao ter parceiros sexuais e falta de orientacao apresentaram diferencas estatisticas significantes na QV. Conclui-s que os pacientes portadores de estoma intestinal demonstraram QV satisfatoria.

Uso de questionários para avaliar a multidimensionalidade e a qualidade de vida do fibromiálgico

Fibromyalgia syndrome (FMS) is a painful condition of unknown etiology, highly prevalent, and associated with other conditions, which causes great impact on daily life and quality of life. OBJECTIVE: To assess, due to the multifactorial character of the FMS, the discriminating power of instruments used to identify good indicators of self-assessment and self-knowledge. PATIENTS AND METHODS: This is a descriptive, exploratory, comparative, cross-sectional study with quantitative approach, and sample comprising a treatment group (T), diagnosed with FMS (n = 63) and a control group (C), undergoing interconsultation at the Pain Outpatient Clinic (n = 75). The following instruments were used: Fibromyalgia Impact Questionnaire (FIQ); visual analogue scale (VAS); McGill Pain Questionnaire; and the Post-Sleep Inventory (PSI). To evaluate the quality of life, Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) was used. RESULTS: In the two groups, female gender predominated. The mean age of the sample was 42.3 ± 4.3 years, 45% were married, and the average schooling was 8 ± 3.5 years. The mean duration of pain was 3.2 years, and a mean time of two years were required for the clinical diagnosis of FMS in group T. Group T had higher levels of pain, anxiety, and depression, worse quality of sleep, less flexibility, and worse quality of life, although some of these symptoms were also present in group C. CONCLUSIONS: All instruments had good discriminating power (P < 0.05), especially FIQ, VAS and PSI, whose areas under the ROC curve were greater

Screening for motor dysgraphia in public schools

OBJECTIVE To screen for warning signs of dysgraphia in schoolchildren at the sixth grade of elementary school. METHOD This was a descriptive, exploratory, cross-sectional cohort study performed with 630 schoolchildren assessed through the (adapted) Analytical Dysgraphia Inventory, which recognizes difficulties in writing through the tracing the graphics. RESULTS A total of 22% (n=138) of the sample presented all indications of dysgraphia; the most prevalent indicator was ascending/descending/fluctuating lines (53.6%). When the indicators were correlated to gender, males showed a significant difference (p<0.05) in most of them. Among the warning signs of co-occurrences, dyslexia was the most prevalent indicator (22%). CONCLUSION Given the large number of warning signs of dysgraphia observed in schoolchildren, it is advisable to screen for these signs, in order to implement early interventions.

Perfil sócio-demográfico e clínico de uma coorte de pacientes encaminhados a uma Clinica de Dor

BACKGROUND AND OBJECTIVES: There is little information in Brazil about the profile of Pain Clinic users and the impact of this demand on health services. This study aimed at identifying the profile of patients referred to a Pain Clinic using socio-demographic and clinical variables obtained by specific screening, correlating such variables to pain duration and intensity. METHOD: This is a cohort descriptive, transversal and exploratory study with 128 individuals seen by an outpatient setting specialized in pain management. Independent variables included age, gender, marital status, labor status, education, religiousness, ethnicity, clinic referring patients, original diagnosis, Pain Clinic diagnosis, pain duration and type. Evaluation tools were an electronic card and the physical evaluation performed by a pain specialist. Data were collected at first visit before the interaction with any health care provider. RESULTS: Pain was more prevalent among females (58.5%), married (66.4%), inactive (62.5%) and in those with mean school attendance of 6.8 ± 3.5 years. Most have religious beliefs (93.7%). Mean pain duration was 32.6 ± 21.9 months. There has been positive correlation between pain intensity and longer duration among females and educational level lower than 5 years. (p < 0.05). CONCLUSION: Chronic pain patients previously under the care of a different specialty and referred to a Pain Clinic supply data which may contribute to control pain with more effective therapeutic approaches, by the interaction of the knowledge of different professionals.

Melhora da qualidade de vida de pacientes com dor neuropática utilizando de monitorização ambulatorial contínua

JUSTIFICATIVA E OBJETIVOS: O manuseio da dor de paciente com dor cronica exige uma abordagem multifuncional, que implica fisica, psicologica, social e ocupacional. O entendimento da fisiopatologia da dor e sua avaliacao precisam otimizar o tratamento. O objetivo deste estudo foi avaliar de forma abrangente os mais fortes preditores de qualidade de vida atraves de registros semanais realizados em regime ambulatorial e domiciliar verificando atividades de vida pratica e diaria. METODO: Foram aplicados os instrumentos: Inventario de Dor de Wisconsin, Grafico de Humor, Questionario de Dor McGill, Protocolo Pos-Sono e Questionario generico de qualidade de vida (Whoqol-bref). RESULTADOS: A atividade fisica, o desempenho ocupacional e o padrao de sono prenunciaram melhor qualidade de vida. A sensibilidade a dor, evitar o medo, e dependencia de outra pessoa sao responsaveis por quantidade significativa da variacao nas atividades propostas. Estes achados sugerem que as fontes externas de reforco e orientacao podem servir para influenciar o comportamento fisico e social alem de pistas internas, tais como evitar o medo ou a dor. CONCLUSAO: A dor cronica neuropatica deve ser avaliada em suas particularidades de apresentacao clinica, comportamental e aspectos sociais, ja que tais elementos sao fundamentais para uma boa evolucao.

Anxiety, depression and quality of life in individuals with phantom limb pain.

OBJECTIVE: This study aims to evaluate emotional factors such as anxiety and depression, and the Quality of Life of individuals with chronic persistent pain after amputation in order to identify the interindividual variation in response to pain. METHODS: This was a descriptive, exploratory and cross-sectional study with quantitative approach. Twenty seven patients were interviewed. The instruments have rated the sociodemographic, clinical and economic profile (semistructured interview) and the Quality of Life (generic Quality of Life questionnaire SF-12) and emotional factors (HAD scale) of the interviewed patients. RESULTS: It was identified that the most frequent amputations occur in males aged 18-38 years and are related to occupational accidents. The Quality of Life was compromised in both components of physical and mental health. Furthermore, anxiety levels were more prevalent in the range from aged 18 to 38 years old, while the levels of depression were most prevalent among the elderly (60 to 80 years old). CONCLUSION: The impairment of Quality of Life and change in the perception of body image has a major impact on adherence to the rehabilitation program and the functional prognosis. Therapeutic orientation is, therefore, critical after this type of surgery. Level of Evidence II, Descriptive and Exploratory Study.

The prevalence of developmental dyscalculia in Brazilian public school system.

The goal of the study was to assess public school children at the end of the first stage of elementary school. We used a protocol applied concurrently with a writing test in the form of an unexpected activity in 28 public schools; 2,893 children assessed, 687 exhibited performance below 58 points, 184 were excluded due to change of address or lack of consent; 503 children subjected to a test of intellectual capacity and reading assessment and 71 considered intellectually disabled were excluded. 226 (7.8%) children, who could read, write, and had normal intellectual level, met the criteria of developmental dyscalculia (DD), 98 female and 128 male. The most influential factors in the prevalence were socioeconomic levels of the schools neighborhood, education level of parents, and being male, as demonstrated by the odds ratio and multiple logistic regression analysis. Further studies should be done so that educational policies are taken.

Avaliação das habilidades funcionais e de auto cuidado de indivíduos com síndrome de Down pertencentes a uma oficina terapêutica

OBJETIVO: avaliar as habilidades funcionais e de auto cuidado de individuos com Sindrome de Down em uma oficina interdisciplinar terapeutica. METODO: investigacao prospectiva, exploratoria, comparativa, de corte transversal e abordagem quantitativa com amostra de um grupo teste(T), com sindrome de Down (N=17) e, grupo controle (C) sem a sindrome (n= 20). O instrumento utilizado foi o Inventario de avaliacao pediatrica (PEDI) que avalia aspectos funcionais do desempenho de criancas. RESULTADOS: a amostra foi pareada (idade media 5 a 7 ½ anos,desvio padrao 1a 6 meses). O grupo T apresentou um repertorio de habilidades funcionais na area de autocuidado inferior aos participantes do grupo C (p<0,05). Nas areas de mobilidade e funcao social apesar de apresentarem escores menores nao houve diferenca estatistica entre os grupos. CONCLUSAO: a monitoracao continua em atividades coletivas no formato de oficinas pode ser util no conhecimento sobre o impacto destas atividades no perfil funcional destas criancas.

Psychosocial and quality of life impact on patients with failed back surgery syndrome

BACKGROUND AND OBJECTIVES: Triggering and chronicity of failed back surgery syndrome should consider psychosocial and emotional factors which impair quality of life. This study aimed at identifying such factors and at evaluating quality of life of failed back surgery syndrome patients. METHODS: This is a descriptive, exploratory, comparative, cross-sectional study with quantitative approach. Sample was made up of a test group (I) diagnosed with failed back surgery syndrome (n=16) and a control group (II) undergoing inter-consultation in the Pain Clinic (n=15). Tools were the visual analog scale and Fischer dolorimeter. WHOQOL-Bref questionnaire was used to evaluate quality of life and Beck Anxiety Inventory and Depression Inventory were used to evaluate emotional factors anxiety and depression. RESULTS: There has been predominance of females on both groups, mean age was 42.3±5.8 (group I), most were married and mean education was 8.4±3.0 years. Mean pain duration was 0.7±0.3 months after surgery in group I with lower pain threshold. Physical dimensions and social relations were the most affected on quality of life, as well as anxiety and depression levels. CONCLUSION: Our results have shown worse pain, quality of life, anxiety and depression in group I, suggesting a better knowledge of potential postoperative complications aiming at preventing the establishment of an abnormal functionality pattern.