Roberta Alvarenga Reis

Adaptação do módulo genérico DISABKIDS® para crianças e adolescentes brasileiros com condições crônicas

OBJECTIVES: to describe the process of cultural adaptation to Brazil Generic Module DISABKIDS for Chronic Conditions (DCGM-37), a generic instrument for measuring the quality of life of children and adolescents with chronic conditions. METHODS: a cross-cutting methodological study was carried out in pediatric outpatients clinics in Brazil, covering 118 children/adolescents with asthma or diabetes and their parents or carers. Translation, back-translation and cultural adaptation were carried out to obtain conceptual and semantic equivalence at the level of individual items.Equivalence was measured statistically by describing the initial psychometric properties, using validity and reliability criteria. RESULTS: most of the items were considered relevant and 14 of them were modified following the semantic validation phase. Values for Cronbachs alpha were α=0.92 and α=0.93, for the version for children and adolescents and the version for parents and carers, respectively. Analysis of correlations between items and dimensions revealed a satisfactory degree of convergent and discriminant validity. CONCLUSIONS: the initial phase indicates that DISABKIDS module is a valid and reliable tool for measuring quality of life in a Brazilian context.

Standardization of health outcomes assessment for depression and anxiety : Recommendations from the ICHOM Depression and Anxiety Working Group

PurposeNational initiatives, such as the UK Improving Access to Psychological Therapies program (IAPT), demonstrate the feasibility of conducting empirical mental health assessments on a large scale, and similar initiatives exist in other countries. However, there is a lack of international consensus on which outcome domains are most salient to monitor treatment progress and how they should be measured. The aim of this project was to propose (1) an essential set of outcome domains relevant across countries and cultures, (2) a set of easily accessible patient-reported instruments, and (3) a psychometric approach to make scores from different instruments comparable.MethodsTwenty-four experts, including ten health outcomes researchers, ten clinical experts from all continents, two patient advocates, and two ICHOM coordinators worked for seven months in a consensus building exercise to develop recommendations based on existing evidence using a structured consensus-driven modified Delphi technique.ResultsThe group proposes to combine an assessment of potential outcome predictors at baseline (47 items: demographics, functional, clinical status, etc.), with repeated assessments of disease-specific symptoms during the treatment process (19 items: symptoms, side effects, etc.), and a comprehensive annual assessment of broader treatment outcomes (45 items: remission, absenteeism, etc.). Further, it is suggested reporting disease-specific symptoms for depression and anxiety on a standardized metric to increase comparability with other legacy instruments. All recommended instruments are provided online (www.ichom.org).ConclusionAn international standard of health outcomes assessment has the potential to improve clinical decision making, enhance health care for the benefit of patients, and facilitate scientific knowledge.

Adaptação cultural e propriedades psicométricas iniciais do instrumento DISABKIDS® – Cystic Fibrosis Module – versão brasileira

This study aimed to perform the cultural adaptation and describe the initial psychometric properties of the DISABKIDS®-Cystic Fibrosis Module instrument to measure health-related quality of life for children and adolescents and their parents/caregivers. Methodological study of sequential development, including 126 participants in four Brazilian states. Involved translation and back translation of items, semantic and conceptual equivalence, face validity and description of the initial psychometric properties related to the construct and reliability. For semantic equivalence of the adapted version, there were adjustments in the phrasing of an item. The instrument showed satisfactory internal consistency with Cronbachs alpha values between 0.70 and 0.85, convergent validity with correlation values above 0.40 in 85% of the items and divergent validity with scale fit higher than 75%. The Brazilian version of DISABKIDS® - CFM will certainly constitute a valid and reliable instrument for measuring the quality of life of Brazilian children and adolescents with cystic fibrosis.

Concordância entre classificação das queixas obtidas nas triagens e diagnóstico fonoaudiológico de crianças de 0-12 anos

Purpose: to analyze the correlation between the classification of speech pathology findings on screening with the results of specific assessments of each area in a speech pathology university clinic in southern Brazil. Methods: a descriptive, retrospective, cross-sectional study with secondary data collected from medical records of 133 children under 12 years old. The classification of complaints found during screening were compared with the diagnoses given after evaluation. They were classified into 3 groups: Group 1 - Full correlation: When the complaints and diagnoses were identical in number and classification; Group 2 - Partial correlation: Equal complaints and diagnoses, however, are others disagreeing in number or in the area of Speech Pathology and Group 3 - No correlation: When there was correlation between complaints and / or diagnosis, in number and classification. Results: there was prevalence of 61 % males. The average age was seven years and two months. There was no significant difference between the values ​​of groups 1 and 2: 47.4 % and 46.6 % respectively. Group 3 had only 6 % correlation. The complaints that were reported during screening were classified as Orofacial Motricity (34.9 %), Speech (23.1 %) , Language (13.4%) and Phonology (8.6%). The most frequent diagnoses were : Orofacial Motricity (39.8%), Phonology (20.4%), Language (11.8%), Speech (6.5%). The complaints and diagnoses that had higher correlation were: Phonology, Orofacial Motricity, Stuttering and Language. There was greater disagreement for complaints about voice. Conclusion: there was correlation between the results for screening and diagnosis, in number and speech pathology areas, with the highest values concerning the classification of complaints and diagnoses for Orofacial Motricity.

Triagem auditiva escolar no município de Porto Alegre: resultados do estudo piloto

OBJETIVO: descrever os resultados do estudo piloto realizado para orientar o processo de implementacao da triagem auditiva escolar, no Municipio de Porto Alegre. METODOS: foram aplicados 134 protocolos em criancas de seis a oito anos de idade de uma Escola Municipal de Ensino Fundamental de Porto Alegre. Os resultados apresentados no protocolo de triagem eram: medida do Nivel de Pressao Sonora no ambiente, durante a realizacao da triagem audiometrica; resposta a triagem audiometrica em 20 dB nas frequencias de 1000Hz, 2000Hz e 4000Hz, em ambas as orelhas; Medidas de Imitância Acustica: curva timpanometrica e reflexos acusticos ipsilaterais nas frequencias de 500Hz, 1000Hz, 2000Hz e 4000Hz, em 100 dB nas duas orelhas, utilizando o criterio passa-falha. RESULTADOS: em relacao ao sexo, 50,75% eram meninos. A idade media foi 6,86 anos (± 0.46). Na triagem audiometrica a grande maioria das criancas passou e a curva timpanometrica mais encontrada foi a Tipo A (51,7%), seguida da Tipo C (24,1%) na orelha direita, e na orelha esquerda 55,7% eram Tipo A e 21,6% Tipo C. O ruido ambiental manteve-se abaixo de 50 dBNA em 90,5%. CONCLUSAO: a maioria das criancas que falharam na TAE tinha seis anos de idade. A curva timpanometrica mais prevalente foi do Tipo A, seguida do Tipo C. Nao se observou diferencas estatisticamente significantes ao comparar as orelhas testadas e os sexos.

BLOG DA PROMOÇÃO DA SAÚDE RELATO DE EXPERIÊNCIA SOBRE A PRODUÇÃO DE UM OBJETO DE APRENDIZAGEM

Este artigo e constituido por um relato de experiencia ligado a elaboracao de um objeto de aprendizagem, no ano de 2011. Tal objeto de aprendizagem abrigou documentos e recursos ligados a Promocao da Saude com o objetivo de se estabelecer um espaco de discussao capaz de promover a compreensao do conceito mencionado e a interacao entre os usuarios da ferramenta. Como forma de validar o objeto de aprendizagem, ao final do ano, foi aplicado um questionario de avaliacao que contou com a participacao de cerca de 100 usuarios. Isso oportunizou aos organizadores uma visao ampla acerca da importância deste tipo de ferramenta no contexto da Educacao em Saude. Assim, o objetivo do texto e apresentar os caminhos percorridos pelo grupo de organizadores e ressaltar a importância do uso de tecnologias para a Educacao em Saude.