Thaís Moreira Spana

Estressores em Unidade de Terapia Intensiva: versão brasileira do The Environmental Stressor Questionnaire

Este estudo teve como objetivo realizar a adaptacao cultural do The Environmental Stressor Questionnaire - (ESQ) para a lingua portuguesa do Brasil e verificar sua confiabilidade e validade. Foram empregadas as etapas metodologicas recomendadas pela literatura para adaptacao cultural. A versao brasileira do ESQ foi aplicada a 106 pacientes de Unidade de Terapia Intensiva (UTI) de dois hospitais, publico e privado, do interior do Estado de Sao Paulo. A confiabilidade foi avaliada quanto a consistencia interna e estabilidade (teste e reteste); a validade convergente foi verificada por meio da correlacao entre o ESQ e questao generica sobre estresse em UTI. A confiabilidade foi satisfatoria com Alfa de Crombach=0,94 e Coeficiente de Correlacao Intraclasse=0,861 (IC95% 0,723; 0,933). Constatou-se correlacao entre o escore total do ESQ e a questao generica sobre estresse (r=0,70), confirmando a validade convergente. A versao brasileira do ESQ mostrou-se uma ferramenta confiavel e valida para avaliacao de estressores em UTI.The objective of the present study was to perform the cultural adaptation of The Environmental Stressor Questionnaire-ESQ for the Brazilian Portuguese, as well as to verify its reliability and validity. In order to ensure the equivalence between the original instrument and the Brazilian version, all methodological steps recommended in the literature regarding cultural adaptation were followed. The Brazilian version of the ESQ was applied to 106 ICU patients in two hospitals (public and private) in the interior of São Paulo State. Reliability was evaluated in relation to internal consistency and stability (test e retest) and the convergent validity was determined by the correlation between ESQ and generic questions about ICU stress. Reliability was satisfactory with Cronbachs Alfa = 0.94 and stability (ICC = 0.861; IC 95% 0.723; 0.933). ESQ total score displayed strong correlation with the generic questions about stress (r = 0.70; p < 0.0001), thus confirming the convergent validity. The conclusion was that the ESQ adapted for Brazilian culture is a reliable instrument for evaluation of stressors in the ICU.

Development of the SALdavel programme to reduce salt intake among hypertensive Brazilian women: an intervention mapping approach

Background: Despite strong evidence for a relationship between high salt intake and hypertension, plus the widespread recommendations for dietary salt restriction among hypertensive subjects, there are no nursing studies describing effective theory-based interventions. Aim: To describe a systematic process for development of a theory-based nursing intervention that is aimed at reducing salt intake among hypertensive women, by applying the ‘intervention mapping’ protocol. Methods: We developed our intervention following the six steps of the ‘intervention mapping’ protocol: assessing needs, creating a matrix of change objectives, selecting theoretical methods and practical applications, defining the intervention programme, organizing the adoption and implementation plan, and defining the evaluation plan. Results: Addition of salt during cooking is identified as the main source for salt consumption, plus women are identified as the people responsible for cooking meals at home. In our study, the motivational predictors of this behaviour were self-efficacy and habit. Guided practice, verbal persuasion, coping barriers, consciousness-raising and counter-conditioning were the theoretical methods we selected for enhancing self-efficacy and promoting habit change, respectively. Brainstorming, role-playing, cookbook use, measuring spoon use, label reading, hands-on skill-building activities and reinforcement phone calls were the chosen practical applications. We designed our intervention programme, and then organized the adoption and implementation plans. Finally, we generated a plan to evaluate our intervention. Conclusions: ‘Intervention mapping’ was a feasible methodological framework to guide the development of a theory-based nursing intervention for dietary salt reduction among hypertensive women.

Action and coping plans related to the behavior of adherence to drug therapy among coronary heart disease outpatients

Objetivo: analisar os planos de acao e de enfrentamento de obstaculos, relacionados ao comportamento de adesao a terapia medicamentosa, elaborados por pacientes coronariopatas, em seguimento ambulatorial, e identificar as barreiras percebidas para adocao desse comportamento. Metodo: os participantes (n=59) foram convidados a elaborar planos de acao (action planning) e de enfrentamento de obstaculos (coping planning) para o comportamento de adesao aos medicamentos cardioprotetores e de alivio dos sintomas. Resultados: foram evidenciados planos de acao especificos para a tomada dos medicamentos que associaram o comportamento a marcadores temporais e ao ciclo vigilia/sono. Os obstaculos mais frequentemente relatados foram o esquecimento e a ausencia de rotina nas atividades de vida diaria. Os planos de enfrentamento, elaborados para superar o esquecimento, foram os mais especificos. Conclusao: os achados deste estudo subsidiam a aplicacao da implementacao da intencao para otimizar a adesao de coronariopatas a terapia medicamentosa.OBJECTIVE to analyze the action and coping plans related to the behavior of adhering to drug therapy, developed by coronary heart disease (CHD) outpatients, and to identify the barriers perceived to adopting this behavior. METHODS the participants (n=59) were invited to formulate action plans and coping plans for the behavior of adhering to the cardio-protective medications and the symptom-relief medications. RESULTS specific action plans for taking the medications associated with temporal markers and the sleep-wake cycle were shown. The most frequently reported obstacles were forgetfulness and absence of routine in daily living activities. The coping plans for overcoming forgetfulness were the most specific. CONCLUSION this studys findings support the application of implementation intentions aimed at optimizing adherence to drug therapy among patients with CHD.

[Stressors at the intensive care unit: the Brazilian version of The Environmental Stressor Questionnaire].

Este estudo teve como objetivo realizar a adaptacao cultural do The Environmental Stressor Questionnaire - (ESQ) para a lingua portuguesa do Brasil e verificar sua confiabilidade e validade. Foram empregadas as etapas metodologicas recomendadas pela literatura para adaptacao cultural. A versao brasileira do ESQ foi aplicada a 106 pacientes de Unidade de Terapia Intensiva (UTI) de dois hospitais, publico e privado, do interior do Estado de Sao Paulo. A confiabilidade foi avaliada quanto a consistencia interna e estabilidade (teste e reteste); a validade convergente foi verificada por meio da correlacao entre o ESQ e questao generica sobre estresse em UTI. A confiabilidade foi satisfatoria com Alfa de Crombach=0,94 e Coeficiente de Correlacao Intraclasse=0,861 (IC95% 0,723; 0,933). Constatou-se correlacao entre o escore total do ESQ e a questao generica sobre estresse (r=0,70), confirmando a validade convergente. A versao brasileira do ESQ mostrou-se uma ferramenta confiavel e valida para avaliacao de estressores em UTI.The objective of the present study was to perform the cultural adaptation of The Environmental Stressor Questionnaire-ESQ for the Brazilian Portuguese, as well as to verify its reliability and validity. In order to ensure the equivalence between the original instrument and the Brazilian version, all methodological steps recommended in the literature regarding cultural adaptation were followed. The Brazilian version of the ESQ was applied to 106 ICU patients in two hospitals (public and private) in the interior of São Paulo State. Reliability was evaluated in relation to internal consistency and stability (test e retest) and the convergent validity was determined by the correlation between ESQ and generic questions about ICU stress. Reliability was satisfactory with Cronbachs Alfa = 0.94 and stability (ICC = 0.861; IC 95% 0.723; 0.933). ESQ total score displayed strong correlation with the generic questions about stress (r = 0.70; p < 0.0001), thus confirming the convergent validity. The conclusion was that the ESQ adapted for Brazilian culture is a reliable instrument for evaluation of stressors in the ICU.

Physical activity behavior among coronary outpatients according to socio-demographic and clinical profile

Behavior and motivation for physical activity (PA) were assessed among 144 coronary heart disease outpatients according to the sociodemographic and clinical profile. The sample was predominantly male (63.9%), with 59.4(± 8.8) years, with low levels of monthly income and schooling. Behavior and Habitual PA measures revealed sedentary lifestyle with high motivation for future PA. Women, patients with history of angina and non-smokers reported lower levels of behavior and motivation. Higher age, lower income, lower number of associated conditions, less time since last coronary syndrome and higher values of BMI were associated to lower levels of PA. The findings suggest that the pattern of PA and motivation vary among CHD outpatients according to sociodemographic and clinical profile, information that should be considered in educational interventions.Foram avaliados o comportamento e a motivacao para pratica de atividade fisica (AF) entre 144 coronariopatas segundo o perfil sociodemografico/clinico. Houve predominio de homens, com 59,4(±8,8) anos, com baixas renda e escolaridade. Os comportamentos de caminhada e AF habitual evidenciaram estilo de vida pregresso sedentario, com motivacao elevada para realizacao futura de AF. Mulheres com historia pregressa de angina e nao tabagistas relataram niveis menores de comportamento e motivacao para AF. Idade mais elevada, menor renda, numero de condicoes clinicas associadas, tempo desde a ultima sindrome coronaria e maior indice de massa corporal correlacionaram-se a menores niveis de AF. O padrao de AF e a motivacao entre coronariopatas variam segundo o perfil sociodemografico/clinico, o que deve ser considerado no planejamento de atividades educativas.

Integrative review: behavioral interventions for physical activity practice

This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.

Validation of persuasive messages for the promotion of physical activity among people with coronary heart disease

OBJETIVO: validar o conteudo de mensagens persuasivas para promover a caminhada entre pacientes com doenca arterial coronaria (DAC). As mensagens foram construidas com vistas ao fortalecimento/mudanca da atitude do paciente em relacao a caminhada. METODO: a selecao dos argumentos persuasivos foi baseada nas crencas comportamentais (determinantes da atitude), relacionadas a caminhada. As mensagens foram construidas com base no Modelo de Probabilidade de Elaboracao e submetidas a validade de conteudo. RESULTADOS: os dados foram analisados por meio do indice de validade de conteudo e pela importância atribuida pelos pacientes aos argumentos persuasivos das mensagens. As crencas comportamentais positivas (i.e. reforco positivo e negativo) e a autoeficacia foram os apelos considerados importantes pelos pacientes. As mensagens com evidencias de validacao serao testadas em estudo de intervencao para promocao da pratica de atividade fisica entre pacientes com DAC.

Validación de mensajes persuasivos para promoción de actividad física entre pacientes con coronariopatía

OBJETIVO: validar o conteudo de mensagens persuasivas para promover a caminhada entre pacientes com doenca arterial coronaria (DAC). As mensagens foram construidas com vistas ao fortalecimento/mudanca da atitude do paciente em relacao a caminhada. METODO: a selecao dos argumentos persuasivos foi baseada nas crencas comportamentais (determinantes da atitude), relacionadas a caminhada. As mensagens foram construidas com base no Modelo de Probabilidade de Elaboracao e submetidas a validade de conteudo. RESULTADOS: os dados foram analisados por meio do indice de validade de conteudo e pela importância atribuida pelos pacientes aos argumentos persuasivos das mensagens. As crencas comportamentais positivas (i.e. reforco positivo e negativo) e a autoeficacia foram os apelos considerados importantes pelos pacientes. As mensagens com evidencias de validacao serao testadas em estudo de intervencao para promocao da pratica de atividade fisica entre pacientes com DAC.

Revisão integrativa: intervenções comportamentais para realização de atividade física

This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.This study aimed to carry out an integrative literature review on the effectiveness of interventions in physical activity (PA) practice in the general population. The search was carried out in articles indexed in online databases: Scopus, CINAHL and Medline. Studies in English or Brazilian Portuguese were included, with evidence levels 2 or 3, published between 2004 and 2008. The final sample consisted of 14 studies. In 57.1% of the studies, interventions were effective for behavior change to practice PA. The diversity of target populations, assessment instruments and intervention designs makes it difficult to compare results and build evidence on the effectiveness of interventions for PA promotion.

Planos de ação e de enfrentamento de obstáculos relacionados ao comportamento de adesão à terapia medicamentosa em coronariopatas

Objetivo: analisar os planos de acao e de enfrentamento de obstaculos, relacionados ao comportamento de adesao a terapia medicamentosa, elaborados por pacientes coronariopatas, em seguimento ambulatorial, e identificar as barreiras percebidas para adocao desse comportamento. Metodo: os participantes (n=59) foram convidados a elaborar planos de acao (action planning) e de enfrentamento de obstaculos (coping planning) para o comportamento de adesao aos medicamentos cardioprotetores e de alivio dos sintomas. Resultados: foram evidenciados planos de acao especificos para a tomada dos medicamentos que associaram o comportamento a marcadores temporais e ao ciclo vigilia/sono. Os obstaculos mais frequentemente relatados foram o esquecimento e a ausencia de rotina nas atividades de vida diaria. Os planos de enfrentamento, elaborados para superar o esquecimento, foram os mais especificos. Conclusao: os achados deste estudo subsidiam a aplicacao da implementacao da intencao para otimizar a adesao de coronariopatas a terapia medicamentosa.OBJECTIVE to analyze the action and coping plans related to the behavior of adhering to drug therapy, developed by coronary heart disease (CHD) outpatients, and to identify the barriers perceived to adopting this behavior. METHODS the participants (n=59) were invited to formulate action plans and coping plans for the behavior of adhering to the cardio-protective medications and the symptom-relief medications. RESULTS specific action plans for taking the medications associated with temporal markers and the sleep-wake cycle were shown. The most frequently reported obstacles were forgetfulness and absence of routine in daily living activities. The coping plans for overcoming forgetfulness were the most specific. CONCLUSION this studys findings support the application of implementation intentions aimed at optimizing adherence to drug therapy among patients with CHD.