Neusa Maria Costa Alexandre

Development of a Brazilian Portuguese version of the Oswestry Disability Index: cross-cultural adaptation, reliability, and validity.

Study Design. Translation, revision, back-translation, and 3-way validity were performed. Objective. The objective of this study was to translate a version of the Oswestry Disability Index (ODI) into Brazilian Portuguese and evaluate its reliability. Summary of Background Data. Reports in the literature have identified a need for internationally standardized and reliable measurements to analyze back pain. The ODI has become one of the principal outcome measurements used in the management of spinal disorders. Methods. The cross-cultural adaptation was performed according to the internationally recommended methodology, using the following guidelines: translation, back-translation; revision by a committee, and pretesting. The psychometric properties were evaluated by administering the questionnaire to 120 subjects with back pain. Reliability was estimated through stability and homogeneity assessment. The validity was tested comparing ODI scores with the following measurements: Roland-Morris Disability Questionnaire, SF-36, and a Numerical Pain Scale. Results. Good internal consistency was found (Cronbach’s alpha = 0.87). Intraclass correlation coefficient for test-retest reliability was 0.99. The ODI showed moderate correlation with pain measurement (r = 0.66). Relatively high correlation was also found between the ODI and the Roland-Morris scores (r = 0.81). There was significant correlation (P < 0.001) between ODI scores and the 8 scales of the SF-36. Conclusions. The data showed that the cultural adaptation process was successful and that the adapted instrument demonstrated having excellent psychometric properties, reliable in the Brazilian culture.

Evaluation of a program to reduce back pain in nursing personnel

OBJECTIVE To evaluate the effectiveness of a program designed to reduce back pain in nursing aides. METHODS Female nursing aides from a university hospital who had suffered episodes of back pain for at least six months were included in the study. Participants were randomly divided into a control group and an intervention group. The intervention program involved a set of exercises and an educational component stressing the ergonomic aspect, administered twice a week during working hours for four months. All subjects answered a structured questionnaire and the intensity of pain was assessed before and after the program using a visual analogue scale (VAS). Students t-test or the Wilcoxon Rank Sum Test for independent samples, and Chi-square test or the Exact Fisher test for categorical analysis, were used. The McNemar test and the Wilcoxon matched pairs test were used to compare the periods before and after the program. RESULTS There was a statistically significant decrease in the frequency of cervical pain in the last two months and in the last seven days in the intervention group. There was also a reduction in cervical pain intensity in the two periods (2 months, 7 days) and lumbar pain intensity in the last 7 days. CONCLUSIONS The results suggest that a program of regular exercise with an emphasis on ergonomics can reduce musculoskeletal symptoms in nursing personnel.

Adaptación cultural de instrumentos utilizados en salud ocupacional

Se han creado numerosos instrumentos estandarizados para evaluar el estado de salud y la eficacia de los tratamientos. Sin embargo, la mayoria de ellos han sido desarrollados y validados en la lengua inglesa. En la literatura se recomienda la utilizacion de escalas y cuestionarios estandarizados cuyos resultados puedan ser comparados internacionalmente. Las diferencias culturales no permiten hacer una simple traduccion de estos instrumentos. En este articulo se resumen normas sistematizadas para la adaptacion cultural de instrumentos utilizados en salud ocupacional, derivadas de investigaciones especializadas.

Lesões ocupacionais afetando a coluna vertebral em trabalhadores de enfermagem

All occupational accidents (CAT) reported at a University hospital, from January 1990 to December 1997, were analyzed and the characteristics of the vertebral column trauma caused by the occupational accidents involving members of the nursing team were investigated. During this period, 531 accidents were reported and 37 (7%) of these were typical vertebral column traumas. These results suggested that the number of accidents reported were below actual estimates and that the nursing auxiliaries were the most affected. The accidents were mainly caused by falls and during the transport or transfer of patients and equipments.

Construção de instrumentos de medida na área da saúde

Measurement instruments are an integral part of clinical practice, health evaluation and research. These instruments are only useful and able to present scientifically robust results when they are developed properly and have appropriate psychometric properties. Despite the significant increase of rating scales, the literature suggests that many of them have not been adequately developed and validated. The scope of this study was to conduct a narrative review on the process of developing new measurement instruments and to present some tools which can be used in some stages of the development process. The steps described were: I-The establishment of a conceptual framework, and the definition of the objectives of the instrument and the population involved; II-Development of the items and of the response scales; III-Selection and organization of the items and structuring of the instrument; IV-Content validity, V-Pre-test. This study also included a brief discussion on the evaluation of the psychometric properties due to their importance for the instruments to be accepted and acknowledged in both scientific and clinical environments.Measurement instruments are an integral part of clinical practice, health evaluation and research. These instruments are only useful and able to present scientifically robust results when they are developed properly and have appropriate psychometric properties. Despite the significant increase of rating scales, the literature suggests that many of them have not been adequately developed and validated. The scope of this study was to conduct a narrative review on the process of developing new measurement instruments and to present some tools which can be used in some stages of the development process. The steps described were: I-The establishment of a conceptual framework, and the definition of the objectives of the instrument and the population involved; II-Development of the items and of the response scales; III-Selection and organization of the items and structuring of the instrument; IV-Content validity, V-Pre-test. This study also included a brief discussion on the evaluation of the psychometric properties due to their importance for the instruments to be accepted and acknowledged in both scientific and clinical environments.

Measures for low back pain: a proposal for clinical use

Low back pain represents a serious public health problem. Therefore, great efforts have been made in order to improve and assess the efficacy of its treatment. Reports in international literature have presented important studies concerning instruments to assess pain and functional incapacity in patients with low back pain. This study presents a clinical protocol which was developed by a multidisciplinary team. This protocol consists of the evaluation and distribution of pain, The Spitzer Quality of Life, The Oswestry Low Back Pain Disability Questionnaire, and The Center for Epidemiological Studies Depression Scale. Instruments must be urgently developed or adapted in order to be used according to the Brazilian reality.Low back pain represents a serious public health problem. Therefore, great efforts have been made in order to improve and assess the efficacy of its treatment. Reports in international literature have presented important studies concerning instruments to assess pain and functional incapacity in patients with low back pain. This study presents a clinical protocol which was developed by a multidisciplinary team. This protocol consists of the evaluation and distribution of pain, The Spitzer Quality of Life, The Oswestry Low Back Pain Disability Questionnaire, and The Center for Epidemiological Studies Depression Scale. Instruments must be urgently developed or adapted in order to be used according to the Brazilian reality.

Ocorrência de acidente do trabalho por material perfurocortante entre trabalhadores de enfermagem de um hospital universitário da cidade de Campinas, estado de São Paulo

Com o objetivo de estudar aspectos da ocorrencia de acidente do trabalho por material perfurocortante entre trabalhadores de enfermagem de um hospital universitario, foram entrevistados 46 trabalhadores que se acidentaram no periodo de junho a dezembro de 1994. Os resultados forneceram dados importantes que poderao subsidiar programas de prevencao.This study has the objective to evaluate certain aspects of the occurrence of accidents of work with perforative cutting tool in nursing workers of a university hospital. Forty-six workers who had accidental needlesticks and injuries from other sharp objects (from June to/December 1994) were interviewed. The data found are likely to help programs of prevention of accidents with nursing workers.This study has the objective to evaluate certain aspects of the occurrence of accidents of work with perforative cutting tool in nursing workers of a university hospital. Forty-six workers who had accidental needlesticks and injuries from other sharp objects (from. June to /December 1994) were interviewed. The data found are likely to help programs of preventio of accidents with nursing workers.

Dores nas costas e enfermagem

Esse trabalho e parte de um estudo mais abrangente. Apos a realizacao de uma avaliacao clinica especifica executada por um grupo interdisciplinar, entrevistou-se 68 funcionarias de enfermagem de um Hospital Universitario com o objetivo de verificar caracteristicas da ocorrencia de cervicodorsolombalgias em profissionais de enfermagem, bem como sua interferencia na realizacao das atividades cotidianas dessas pessoas.

Acidentes de trabalho afetando a coluna vertebral: um estudo realizado com trabalhadores de enfermagem de um hospital universitário

In order to evaluate certain characteristics of the occurrence of occupational back injury among nursing staff, all workers affected during a period of six months were interviewed. These individuals were 43.2 years old on average and were basically female. There was no statistical significative difference showing a predominance among working turns and among the different nursing ranks involved in the accident. Most of the accidents happened within the hospital unit while they were moving or transporting patients and equipment, because of falls due to slipping floor. The most affected regions of the spinal column were the lumbar and cervical portions. The majority of the subjects affirmed that they had some type of back problem.Com o objetivo de avaliar determinadas caracteristicas da ocorrencia de acidentes do trabalho afetando a coluna vertebral em trabalhadores de enfermagem de um hospital universitario, entrevistou-se todos os funcionarios que sofreram esse tipo de acidente em um periodo de seis meses. Esses trabalhadores eram basicamente do sexo feminino e tinham uma idade media de 43,2 anos. Nao houve uma diferenca estatistica significante que demonstrasse um predominio de acidentes entre os turnos de trabalho e entre as diferentes categorias de enfermagem envolvidas. A maioria dos acidentes ocorreu na propria unidade de trabalho, quando esses trabalhadores estavam movimentando ou transportando pacientes e equipamentos e por quedas devido ao piso escorregadio. As regioes mais atingidas da coluna vertebral foram a lombar e a cervical e a maior parte dos entrevistados afirmou que ja tinha tido algum tipo de problema na regiao dorsal.

Modelo de avaliação físico-funcional da coluna vertebral

The study describes semiological methods that must be employed in posture and spinal cord evaluation, considering primary health care. The methods used in this study involve the patient´s history, and a specific physical examination which includes a static inspection, posture examination, dynamic inspection, palpation, muscle strength and flexibility assessment, neurological examination and special tests.O presente trabalho descreve os metodos semiologicos que devem ser empregados na exploracao postural e na avaliacao da coluna vertebral, dentro da assistencia a saude em nivel primario. Os metodos empregados nessa propedeutica sistematizada englobam o historico e um exame fisico especifico composto de: inspecao estatica e exame postural; inspecao dinâmica; palpacao; avaliacao da forca e flexibilidade musculares; exame neurologico e manobras especiais.