Orientador: Neusa Maria Costa Alexandre / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T11:31:10Z (GMT). No. of bitstreams: 1 Toledo_RafaelaCunhaMatheusRodrigues_M.pdf: 1107544 bytes, checksum: add6821e0b03db6a171a46906f66df52 (MD5) Previous issue date: 2007 / Resumo: Atualmente a literatura tem apresentado inúmeras tentativas de prevenção e controle da dor lombar. A natureza multifatorial dos fatores de risco associados a esta afecção representa considerável desafio para a determinação de estratégias de intervenção que sejam realmente efetivas no seu controle. O caráter crônico e incapacitante da lombalgia faz com que esta condição clínica tenha repercussões importantes na vida do sujeito, comprometendo de forma significativa a qualidade de vida de seus portadores. A literatura internacional tem relatado o uso do Quality of Ufe Index - Spitzer (QLI) para avaliar a qualidade de vida de pacientes portadores de dor lombar. A adaptação cultural de escalas e questionários já validados em outra língua tem sido amplamente recomendada, uma vez que facilita a troca de informações entre a comunidade científica. Dessa forma, com a finalidade de disponibilizar para a comunidade científica brasileira um instrumento de avaliação genérica de qualidade de vida, este estudo teve como objetivo realizar a adaptação cultural do instrumento Spitzer Quality of Ufe Index para a língua portuguesa do Brasil, bem como avaliar sua confiabilidade junto a pacientes portadores de dor lombar crônica. Para assegurar a qualidade da adaptação, foram seguidos os passos metodológicos recomendados por publicações especializadas: tradução do instrumento para a língua portuguesa do Brasil, retro-tradução, avaliação por um comitê de juízes, préteste, avaliação da confiabilidade e validade. Inicialmente o questionário foi traduzido por dois tradutores bilíngües de forma independente, que possuíam como língua materna a língua portuguesa do Brasil. Posteriormente, dois outros tradutores cuja língua materna era o inglês, fizeram a retro-tradução. Um comitê composto por seis especialistas revisou e comparou as traduções obtidas, desenvolvendo a versão final para a aplicação do préteste. O pré-teste foi realizado em 40 pacientes portadores de dor lombar crônica. A confiabilidade foi avaliada por meio da consistência interna e da estabilidade (testereteste). A validade foi obtida por meio da análise de correlação entre os escores do instrumento Spitzer (QLI), com o SF-36 e com o Ro/and-Morris. As propriedades psicométricas da versão traduzi da foram avaliadas auto-aplicando o instrumento 'em 120 pacientes com lombalgia crônica. Os resultados demonstraram que o instrumento é confiável apresentando consistência interna satisfatória, indicada pelo coeficiente alfa de Cronbach=0,76 para o teste e 0,77 para o reteste. No teste-reteste os resultados apontaram uma elevada correlação intraclasse ICC=0.960 (p<0,001; IC950/0: 0,943; 0,972). O coeficiente de correlação de Spearman foi de r=0,937 (p<0,001), indicando também elevada concordância entre os valores do escore do Spitzer (QLI) no teste/reteste. As correlações entre o escore do Spitzer (QLI) e as diferentes dimensões do SF-36 mostraram-se significativas. Os coeficientes de correlação mais elevados foram: Dor (r= 0,699), Aspectos Físicos (r=0,687), Capacidade Funcional (r=0,682) e Aspectos Sociais (r=0,680). Também foi constatada correlação significativa entre os escores do Spitzer (QLI) e do questionário Roland-Morris (r=0,730). Conclui-se que o processo de adaptação cultural foi realizado com sucesso e que a versão adaptada apresenta medidas psicométricas confiáveis e válidas na cultura brasileira / Abstract: The current literature has presented innumerable attempts to prevent and controllow back pain. The multifactorial nature of risk factors associated with this affection represents a considerable challenge in the determination of interventional strategies that will be truly effective to control it. The chronic and incapacitating characteristics of low back pain result in important repercussions on the patient' s life significantly compromising the quality of life of those who have this condition. The intemational literature has reported the use of the Quality of Ufe Index - Spitzer (QU) for the evaluation of the quality of life of patients with low back pain. Thecultural adaptation of scales and questionnaires validated in another language has been widely recommended, since it facilitates the scientific information exchange. In this manner, with the purpose of making available to the Brazilian scientific community an instrument for comprehensive evaluation of quality of life, this study had as objective carrying out the cultural adaptation the Spitzer Quality of Ufe Index questionnaire into the Brazilian Portuguese language, and as to evaluate its reliability in patients suffering from low back pain. In order to ensure this adaptation quality, the methodological steps recommended by specialized publications were followed: translation of the instrument into the Brazilian Portuguese language, back-translation, evaluation by a committee of judges, pretest, and reliability and validity assessment. At first, the questionnaire was independently translated by two bilingual translators, who had Brazilian Portuguese as their rnother language. Subsequently, two other translators whose mother language was English did the back-translation. A committee composed of six specialists revised and compareci the translations obtained, developing the final version for pretest application. The pretest was carried out with 40 patients suffering from low back pain. The reliability was estimated through stability (test-retest) and homogeneity assessmenl The validity was tested comparing scores 01' the obtained by means of correlation analysis among thescores of the Spitzer (QU) 'with the SF-36 and the Roland-Morris. The psychometric properties of the translated version were evaluated by the self-application instrument on 120 patients with chronic low back pain. The Cronbach's Alpha was 0.76 for the test and 0.77 for the retest, showing satisfactory internal consistency results. Using the intraclass correlation coefficient for test-retest, the reliability was ICC = 0.960 (p<0.001; IC95%: 0.943; 0.972). The reliability determined by the Spearman's Correlation Coefficient was 0.937 (p<0.001). There was significant correlation between the Spitzer (QU) scores and the different dimensions of the SF-36 questionnaire. The highest correlation coefficients were for Bodily Pain (r = 0.699), Role Functioning (r = 0.687), Physical Functioning (r = 0.682) arid Social Functioning (r = 0.680). A significant correlation was found between the Spitzer (QU) and the Roland-Morris questionnaire scores (r = 0.730). The cultural adaptation .process was conducted successfully and the adapted version presents psychometric rneasures which are reliable and valid in the Brazilian culture / Mestrado / Enfermagem e Trabalho / Mestre em Enfermagem

The purpose of this study was to assess the epidemiology of preventable risk factors for NCDs among the adult population in Tigray, Northern Ethiopia. A quantitative descriptive cross-sectional design was employed to describe the distribution of behavioural and biological risk factors for NCDs, assess the status of knowledge, perceptions, attitude and behaviour of the study participants for NCDs and their risk factors, and a matched case-control study to identify the determinants of hypertension. The data was collected using a structured questionnaire for the interview, physical measurements including weight and height scales, non-elastic measuring tape for waist and hip circumferences, Omron digital BP apparatus for blood pressure and heart rate; Accutrend Plus for measuring fasting blood glucose, cholesterol and triglycerides. For the descriptive cross-sectional study a total of 2347 participants were included, and for the matched case control study a total of 117 cases and 235 controls participated. Behavioural and biological risk factors were assessed. Only 0.8% of the study participants used optimal fruit serving per day. The prevalence of low level physical activity (<600 MET-minutes/week) was 44.8%. The magnitude of ever alcohol consumption was 66.8%. However, the magnitude of khat chewing and tobacco smoking among the study participants was not as high as the other risk factors i.e. 3.3% and 2.3% respectively. The magnitude of hypertension, central obesity, hyperglycaemia, hypercholesterolemia and hypertriglyceridemia was 9.9%, 22.2%, 3.5%, 30.3% and 32.2% respectively. Factors associated with the risks aforementioned were gender, age, place of residence, education, knowledge status on NCDs, mental stress and others. The status of knowledge on CVDs, breast and cervical cancers, diabetes and their potential risk factors was low and not comprehensive. Misconceptions on NCDs and body size and shape were pervasive. Risky behaviours underlying NCDs were rampant in the study population. Factors related to poor knowledge on NCDs were gender, age, place of residence, education and misconceptions on NCDs. The determinants of hypertension were physical inactivity, duration of alcohol intake, central obesity and mental stress. Awareness raising interventions on NCDs and their risk factors; improving socio-economic status and accessibility to health care settings have to be in place to curb these formidable problems. / Health Studies / D. Litt. et Phil. (Health Studies)

Les maladies chroniques (dont les maladies cardio-vasculaires (MCV)) constituent dans la majorité des pays en Europe voire dans le monde, une des principales causes de mortalité et de morbidité. En Belgique, ces pathologies sont responsables de 37% des décès (33% des décès chez les hommes et 40% chez les femmes) .<p><p>Les études épidémiologiques ont montré que certaines populations sont plus susceptibles que d’autres de développer ou de décéder des maladies cardio-vasculaires (1). Pendant longtemps, l’Europe a été caractérisée par des écarts importants de mortalité cardio-vasculaire entre le Nord, plus à risque, et le Sud. Ces différences entre populations s’expliquent par des facteurs génétiques, environnementaux, sociaux et culturels. <p><p>Parmi les facteurs culturels et environnementaux, des travaux scientifiques montrent, depuis plusieurs dizaines d’années, que l’alimentation et l’état nutritionnel participent de façon essentielle au développement et à l’expression clinique des maladies dans l’ensemble des pays industrialisés. Un équilibre nutritionnel, une consommation alimentaire variée, avec une répartition satisfaisante des quantités ingérées permettent de préserver un bon état de santé. <p><p>Les études épidémiologiques interethniques ont joué un rôle important dans l’avancée de la recherche de ces facteurs. Les études d’observation révèlent que lorsque des sujets d’un groupe ethnique particulier changent d’environnement, leur statut physique change au contact du nouvel environnement et diffère généralement de ceux restés dans le pays d’origine. La comparaison des taux de mortalité et de morbidité des immigrés de longue date aux taux observés dans le pays d’origine permet d’étudier la contribution des facteurs génétiques et environnementaux dans les variations de morbidité et de mortalité.<p><p>Les différences de morbidité et de mortalité entre ethnies ont été largement documentées pour les immigrés hispaniques, africains et sud-asiatiques en Amérique du Nord et en Grande Bretagne. Ces études ont montré que le profil de santé des immigrés est influencé tant par l’environnement du pays de naissance que par celui du pays d’accueil. L’influence de ces deux environnements peut donner lieu à 3 modèles de morbidité et de mortalité :la sous-mortalité (principalement observée parmi les immigrés de première génération issus de pays moins développés), la convergence (mortalité ou morbidité égale. Ce modèle concerne essentiellement les immigrés de seconde génération) et le dépassement (sur-mortalité ou sur-morbidité). <p><p>La santé des immigrés en Belgique est mal connue et peu étudiée. Dans la majorité des statistiques sanitaires comme dans les recherches épidémiologiques, les critères de nationalité et de naissance soit n'apparaissent pas du tout, soit ne font l'objet d'aucune analyse. L'occultation de ces variables a cependant pour conséquence de laisser dans l'ombre des indications précieuses pour la mise en œuvre de politiques de santé publique. <p><p>Bien que d’un intérêt évident en épidémiologie, les études interethniques posent un certain nombre de problèmes méthodologiques. Difficile à traiter, cette question n'en demeure pas moins essentielle à penser. <p> / Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished