A \"World Health Organization Disability Assessment Schedule 2.0\" (WHODAS 2.0) foi desenvolvida pela Organização Mundial da Saúde (OMS) para a avaliação da funcionalidade e incapacidade, conforme a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). O objetivo deste estudo foi avaliar o uso da versão de 12 itens na Estratégia de Saúde da Família (ESF) brasileira. Trata-se de um estudo exploratório, descritivo e baseado em um estudo de caso, que utilizou uma metodologia mista (técnicas quantitativas e qualitativas). Os participantes do estudo foram 9 profissionais de uma equipe de ESF e 120 pessoas acompanhadas por eles. Os profissionais participaram de um treinamento sobre a CIF e a WHODAS 2.0 e aplicaram essa escala nas 120 pessoas. Sete profissionais e todos os pacientes responderam questionários sobre aplicabilidade da escala. 115 (95,8%) dos pacientes apresentaram alguma incapacidade e foram encontrados de 22,5% a 68,5% das pessoas com dificuldade leve até extrema em qualquer item da escala. A avaliação da confiabilidade e da validade concorrente da escala mostrou: 1) alfa de cronbach de 0,83, com diminuição desse valor quando qualquer um dos doze itens foi deletado; 2) coeficientes de correlação intraclasse das confiabilidades interavaliadores dos doze itens e do escore total variando de 0,73 a 0,97; 3) coeficiente de spearman para validade concorrente com a \"World Health Organization Quality of Life Instrument - Bref\" (WHOQOL-Bref) de 0,54. A maioria dos 120 entrevistados considerou como satisfatórias a compreensibilidade das orientações, das perguntas e das respostas da escala (72,5%, 79,2% e 80% respectivamente), assim como a brevidade (97,5%) e a relevância em relação às suas necessidades cotidianas e em relação ao uso por profissionais de saúde (71,7% e 94,2%). Foi encontrada relação estatisticamente significativa entre menor nível de escolaridade dos entrevistados e maior dificuldade na10 compreensibilidade das orientações e da maneira de fornecer as respostas. Todos profissionais consideraram como satisfatórias a compreensibilidade das orientações, das perguntas e das respostas, assim como a facilidade de preenchimento, a brevidade e a relevância quanto às necessidades das pessoas acompanhadas no serviço; 4 consideraram que as informações não poderiam ser obtidas de outras maneiras no seu trabalho cotidiano e 2 consideraram viável a inserção da escala na sua rotina díária de trabalho. A análise qualitativa mostrou \"barreiras\" para o uso da WHODAS 2.0 como: 1) dificuldades pelos profissionais para usar a escala no seu trabalho rotineiro; 2) demandas de adequações em algumas palavras/frases da escala para melhor compreensibilidade; 3) dificuldade da escala realmente refletir o conceito de aplicação universal da CIF pelo fato de avaliar a funcionalidade a partir de condições de saúde, dificultando a expressão de fatores contextuais; 4) necessidade de adequação da tradução do termo \"disability\" para incapacidade (e não deficiência). \"Facilitadores\" do seu uso também foram encontrados: 1) demandas de cuidado incluindo a funcionalidade por parte das pessoas acompanhadas no serviço; 2) a estrutura da WHODAS 2.0 com orientações claras e definidas, destacadas em cores diferentes; 3) o curso e treinamento oferecido sobre CIF e WHODAS 2.0 para os profissionais. A WHODAS 2.0 é um bom instrumento para a avaliação da funcionalidade e incapacidade em relação às condições de saúde, mas apresenta limitações por não abranger a avaliação dos fatores contextuais, que são importantes componentes da CIF. Existe uma demanda significativa de prevenção de incapacidades e promoção da funcionalidade humana na ESF. São necessários mais estudos sobre a aplicação dos conceitos da CIF, incluindo o uso da WHODAS 2.0 nesse nível de atenção. / The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was created by the World Health Organization (WHO) for assessment of functionality and disability, according to the International Classification of Functioning, Disability and Health (ICF). The objective of this study was to evaluate the use of the 12-item version in the Brazilian Family Health Strategy (ESF). It is an exploratory, descriptive study based on a case study, using a mixed methodology (quantitative and qualitative techniques). Participants in the study were 9 professionals from one ESF team and 120 people accompanied by them. The professionals participated in a training on ICF and of the WHODAS 2.0 and applied this scale to 120 people. Seven professionals and all patients answered questionnaires about the applicability of the scale. 115 (95.8%) of the patients presented some disability and 22.5% to 68.5% of people showed slight to extreme difficulty degree in any item on the scale. The evaluation of reliability and concurrent validity of the scale was: 1) Cronbach alpha of 0.83, with the diminishing of this value for all items was erased; 2) Intraclass correlation coefficient of the inter-rater reliability and total score of 0.73 to 0.97; 3) spearman\'s coefficient for concurrent validity with \"World Health Organization\'s Quality of Life Instrument - Bref\" (WHOQOL-Bref) of 0.54. The majority of the 120 interviewees considered full satisfaction with the guidelines, questions and answers of the scale (72.5%, 79.2% and 80% respectively), as well as the briefness (97.5%) and it relevance regarding their daily needs and it use by health professionals (71.7% and 94.2%). It was found a statistically significant relation between lower levels of schooling and higher difficulty in understating the orientations and answering them was found. All professionals considered as satisfactory the understanding of the guidelines, questions and answers, as well as the ease of completion, the briefness and the relevance regarding the needs12 of the people accompanied in the service. Four considered that the information could not be obtained in other ways in their work, and two considered it feasible to insert the scale into their work routine. The qualitative analysis showed \"barriers\" in the use of WHODAS 2.0 such as: 1) difficulties for professionals to use the scale in their routine work; 2) adaptation demands on some scale words/sentences for better understanding; 3) difficulty of the scale to really reflect the concept of universal application of the ICF due to the fact of evaluate functionality based on health conditions, making it difficult to express contextual factors; 4) need to adapt the translation of the term \"disability\" to incapacidade (not deficiência). \"Facilitators\" of its use have also been found: 1) demands for care including the functionality by the people accompanied in the service; 2) the structure of WHODAS 2.0 with clear and defined orientations, highlighted in different colors; 3) The course and training offered on ICF and WHODAS 2.0 to the professionals. The WHODAS 2.0 is a good tool for assessing functionality and disability based on health conditions, but it has limitations because it does not cover the evaluation of the contextual factors, that are important components of the ICF. There is a significant demand for disability prevention and promotion of human functionality in the ESF. Further studies on the application of the ICF concepts are necessary, including the use of WHODAS 2.0 at this level of attention.

A operação segura e confiável de usinas nucleares não depende só da excelência técnica do projeto e construção, mas também das pessoas e da organização. Por essa razão, a importância dos fatores organizacionais nos mecanismos causais de acidentes tem sido reconhecida por uma série de organizações de pesquisas na Europa, EUA e Japão. Deficiências nesses fatores revelam fragilidades na cultura de segurança da organização. Uma preocupação básica na avaliação de uma cultura de segurança é garantir que os instrumentos de pesquisa sejam válidos e confiáveis. Nas áreas de saúde e de segurança do trabalho há uma série de instrumentos para avaliar a cultura de segurança, para os quais são apresentados estudos de suas proporiedades psicométricas (confiabilidade e validade), mas muito pouco com essas qualidades na área nuclear. No caso específico do Brasil, nenhum. Portanto, o principal objetivo deste trabalho foi desenvolver um modelo capaz de avaliar com medidas válidas e confiáveis a cultura de segurança de instalações nucleares. O instrumento de pesquisa foi desenvolvido com base em princípios psicométricos estabelecidos para pesquisas quantitativas e, portanto, foram realizadas a análise da confiabilidade e as validações de conteúdo, de face e de construto. O instrumento foi aplicado nos institutos de pesquisa da Comissão Nacional de Energia Nuclear (CNEN), obtendo-se um total de 226 questionários respondidos. Os resultados da pesquisa possibilitaram caracterizar demograficamente os respondentes e identificar muitos aspectos fortalecidos, mas também algumas fragilidades na cultura de segurança dos institutos avaliados. O instrumento apresentou boas evidências de confiabilidade com o coeficiente alpha de Cronbach de 0,95 para o instrumento como um todo. A validação de construto foi realizada por meio de uma análise fatorial utilizando-se a Análise de Componentes Principais (ACP) e rotação fatorial ortogonal Varimax. Os resultados da análise fatorial permitiram concluir que o instrumento possui boas evidências de validade de construto, mas também sugeriram alguns ajustes no caso de uma nova aplicação do instrumento. / The safe and reliable operation of nuclear power plants does not depend only on technical excellence, but also it depends on people and on the organization. For this reason, the importance of organizational factors in causal mechanisms of accidents has been recognized by a number of research organizations in Europe, USA and Japan. Deficiencies in these factors reveal weaknesses in the organization\'s safety culture. A primary concern in evaluating a safety culture is to ensure that research instruments are valid and reliable. In the areas of occupational health and safety there are series of tools to evaluate the safety culture that present studies of its psychometric properties (reliability and validity), but very few of these qualities in the nuclear area. In the specific case of Brazil, none of these tools exist. Therefore, the main objective of this study is to develop a model to assess the safety culture in nuclear facilities with valid and reliable measures. The survey instrument was developed in accordance with the psychometric principles established for quantitative research and thus were held to analyze the reliability and validation of content, face and construct. The instrument was applied in the research institutes of the Brazilian Nuclear Energy National Commission (CNEN), yielding a total of 226 completed questionnaires answered. The survey results made it possible to characterize demographically the respondents and identify many strengthened aspects, but also some weaknesses in the safety culture of the evaluated institutions. The instrument showed good evidence of reliability with Cronbach\'s alpha coefficient 0,95 for the total instrument. The construct validation was performed by means of a factor analysis with Principal Component Analysis (PCA) extraction method and Varimax orthogonal factor rotation. Although factor analysis results have shown that the instrument has good evidence of construct validity, some adjustments in case of a new application of the instrument have also been suggested.

A \"World Health Organization Disability Assessment Schedule 2.0\" (WHODAS 2.0) foi desenvolvida pela Organização Mundial da Saúde (OMS) para a avaliação da funcionalidade e incapacidade, conforme a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF). O objetivo deste estudo foi avaliar o uso da versão de 12 itens na Estratégia de Saúde da Família (ESF) brasileira. Trata-se de um estudo exploratório, descritivo e baseado em um estudo de caso, que utilizou uma metodologia mista (técnicas quantitativas e qualitativas). Os participantes do estudo foram 9 profissionais de uma equipe de ESF e 120 pessoas acompanhadas por eles. Os profissionais participaram de um treinamento sobre a CIF e a WHODAS 2.0 e aplicaram essa escala nas 120 pessoas. Sete profissionais e todos os pacientes responderam questionários sobre aplicabilidade da escala. 115 (95,8%) dos pacientes apresentaram alguma incapacidade e foram encontrados de 22,5% a 68,5% das pessoas com dificuldade leve até extrema em qualquer item da escala. A avaliação da confiabilidade e da validade concorrente da escala mostrou: 1) alfa de cronbach de 0,83, com diminuição desse valor quando qualquer um dos doze itens foi deletado; 2) coeficientes de correlação intraclasse das confiabilidades interavaliadores dos doze itens e do escore total variando de 0,73 a 0,97; 3) coeficiente de spearman para validade concorrente com a \"World Health Organization Quality of Life Instrument - Bref\" (WHOQOL-Bref) de 0,54. A maioria dos 120 entrevistados considerou como satisfatórias a compreensibilidade das orientações, das perguntas e das respostas da escala (72,5%, 79,2% e 80% respectivamente), assim como a brevidade (97,5%) e a relevância em relação às suas necessidades cotidianas e em relação ao uso por profissionais de saúde (71,7% e 94,2%). Foi encontrada relação estatisticamente significativa entre menor nível de escolaridade dos entrevistados e maior dificuldade na10 compreensibilidade das orientações e da maneira de fornecer as respostas. Todos profissionais consideraram como satisfatórias a compreensibilidade das orientações, das perguntas e das respostas, assim como a facilidade de preenchimento, a brevidade e a relevância quanto às necessidades das pessoas acompanhadas no serviço; 4 consideraram que as informações não poderiam ser obtidas de outras maneiras no seu trabalho cotidiano e 2 consideraram viável a inserção da escala na sua rotina díária de trabalho. A análise qualitativa mostrou \"barreiras\" para o uso da WHODAS 2.0 como: 1) dificuldades pelos profissionais para usar a escala no seu trabalho rotineiro; 2) demandas de adequações em algumas palavras/frases da escala para melhor compreensibilidade; 3) dificuldade da escala realmente refletir o conceito de aplicação universal da CIF pelo fato de avaliar a funcionalidade a partir de condições de saúde, dificultando a expressão de fatores contextuais; 4) necessidade de adequação da tradução do termo \"disability\" para incapacidade (e não deficiência). \"Facilitadores\" do seu uso também foram encontrados: 1) demandas de cuidado incluindo a funcionalidade por parte das pessoas acompanhadas no serviço; 2) a estrutura da WHODAS 2.0 com orientações claras e definidas, destacadas em cores diferentes; 3) o curso e treinamento oferecido sobre CIF e WHODAS 2.0 para os profissionais. A WHODAS 2.0 é um bom instrumento para a avaliação da funcionalidade e incapacidade em relação às condições de saúde, mas apresenta limitações por não abranger a avaliação dos fatores contextuais, que são importantes componentes da CIF. Existe uma demanda significativa de prevenção de incapacidades e promoção da funcionalidade humana na ESF. São necessários mais estudos sobre a aplicação dos conceitos da CIF, incluindo o uso da WHODAS 2.0 nesse nível de atenção. / The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was created by the World Health Organization (WHO) for assessment of functionality and disability, according to the International Classification of Functioning, Disability and Health (ICF). The objective of this study was to evaluate the use of the 12-item version in the Brazilian Family Health Strategy (ESF). It is an exploratory, descriptive study based on a case study, using a mixed methodology (quantitative and qualitative techniques). Participants in the study were 9 professionals from one ESF team and 120 people accompanied by them. The professionals participated in a training on ICF and of the WHODAS 2.0 and applied this scale to 120 people. Seven professionals and all patients answered questionnaires about the applicability of the scale. 115 (95.8%) of the patients presented some disability and 22.5% to 68.5% of people showed slight to extreme difficulty degree in any item on the scale. The evaluation of reliability and concurrent validity of the scale was: 1) Cronbach alpha of 0.83, with the diminishing of this value for all items was erased; 2) Intraclass correlation coefficient of the inter-rater reliability and total score of 0.73 to 0.97; 3) spearman\'s coefficient for concurrent validity with \"World Health Organization\'s Quality of Life Instrument - Bref\" (WHOQOL-Bref) of 0.54. The majority of the 120 interviewees considered full satisfaction with the guidelines, questions and answers of the scale (72.5%, 79.2% and 80% respectively), as well as the briefness (97.5%) and it relevance regarding their daily needs and it use by health professionals (71.7% and 94.2%). It was found a statistically significant relation between lower levels of schooling and higher difficulty in understating the orientations and answering them was found. All professionals considered as satisfactory the understanding of the guidelines, questions and answers, as well as the ease of completion, the briefness and the relevance regarding the needs12 of the people accompanied in the service. Four considered that the information could not be obtained in other ways in their work, and two considered it feasible to insert the scale into their work routine. The qualitative analysis showed \"barriers\" in the use of WHODAS 2.0 such as: 1) difficulties for professionals to use the scale in their routine work; 2) adaptation demands on some scale words/sentences for better understanding; 3) difficulty of the scale to really reflect the concept of universal application of the ICF due to the fact of evaluate functionality based on health conditions, making it difficult to express contextual factors; 4) need to adapt the translation of the term \"disability\" to incapacidade (not deficiência). \"Facilitators\" of its use have also been found: 1) demands for care including the functionality by the people accompanied in the service; 2) the structure of WHODAS 2.0 with clear and defined orientations, highlighted in different colors; 3) The course and training offered on ICF and WHODAS 2.0 to the professionals. The WHODAS 2.0 is a good tool for assessing functionality and disability based on health conditions, but it has limitations because it does not cover the evaluation of the contextual factors, that are important components of the ICF. There is a significant demand for disability prevention and promotion of human functionality in the ESF. Further studies on the application of the ICF concepts are necessary, including the use of WHODAS 2.0 at this level of attention.

Os objetivos foram: 1) traduzir e adaptar transculturalmente ao idioma português do Brasil a Scale of Oral Health Outcomes for 5-year-old children (SOHO-5); 2) avaliar as propriedades psicométricas (confiabilidade, validade e responsividade) da versão de pais e versão de crianças do SOHO-5; 3) avaliar o impacto da cárie dentária e leões dentárias traumáticas (LDT) na qualidade de vida relacionada à saúde bucal (QVRSB) da criança desde a percepção de pais e filhos; 4) avaliar a concordância entre relatos de pais e filhos sobre à QVRSB da criança. A adaptação transcultural do SOHO-5 foi testada em dois pilotos com 40 crianças de 5 e 6 anos de idade e seus pais. A validade e confiabilidade foram testadas em 193 crianças e pais. Das 193, 154 completaram o SOHO-5 de 7 a 14 dias após o tratamento odontológico da criança para analisar a responsividade. Para este fim eles também responderam julgamentos de transição global sobre a percepção de mudança na saúde bucal após tratamento. As medidas de responsividade incluíram tamanhos de efeito (TE) e médias de respostas padronizadas (MRP). Para avaliação do impacto, 335 pares de crianças e pais completaram o SOHO-5, e as crianças foram examinadas por três examinadores calibrados. A concordância entre relatos foi avaliada em 298 pares mãe-criança e 37 pares pai-criança. Os resultados obtidos indicam que a consistência interna pelo alfa de Cronbach foi de 0,90 e 0,77 para a versão da criança e dos pais, respectivamente. Para a confiabilidade teste-reteste, o Coeficiente de Correlação Intraclasse (CCI) do escore total da versão da criança foi 0,92 e dos pais 0,98. O SOHO-5 mostrou validade de construto e discriminante satisfatória. Em relação à responsividade, houve melhora na saúde bucal após o tratamento em ambas as versões (p<0,001). Houve diferença significativa entre os escores pré- e pós tratamento nos grupos que relataram ter melhorado um pouco e ter melhorado muito (p<0,05). Para ambas as versões, o TE e MRP das médias de escore de mudança para escores totais e para os julgamentos de transição global foram moderados a grandes. O modelo multivariado mostrou associação entre a cárie dentária e a pior QVRSB na criança, de acordo com as crianças e pais, RTR (Razão de Taxa Robusta) (IC 95%) = 6.37 (4,71; 8.62) e 10.81 (7,65; 15.27), respectivamente. A média da diferença direcional para escore total de -1,35 (IC 95% -2,330; -0,372) foi significativamente diferente entre os relatos de pares pai-criança. O CCI para escores totais foi de 0,84 (IC 95% 0,798; 0,867) e 0,67 (IC 95% 0,445; 0,814) entre pares mãe-criança e pai-criança, respectivamente. A versão brasileira do SOHO-5 é confiável, válida e responsiva para crianças de 5 e 6 anos de idade no Brasil. A cárie dentária na criança, mas não as LDT, está associada à pior QVRSB da criança de 5 e 6 anos de idade. As mães avaliaram a QVRSB dos seus filhos de forma similar às crianças, enquanto que os pais a subestimaram. / The aims were: 1) translate and cross-cultural adapt the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) to the Brazilian Portuguese language; 2) to assess the psychometric properties (reliability, validity and responsiveness) of self- and parental proxy-reports of the SOHO-5; 3) to assess the impact of dental caries and trauma dental injuries (TDI) on childrens oral health-related quality of life (OHRQoL) according to both self- and parental reports; 4) to assess the agreement among parents and children regarding the childs OHRQoL. We tested the cross-cultural adaptation in two pilots with 40 children aged 5- 6-years and their parents. Validity and reliability were tested on 193 children and parents. Of the 193, 154 completed the SOHO-5 7-14 days after the childs dental treatment to assess responsiveness. For this purpose, they also answered global transition judgments on subjects perceptions of change in their oral health following treatment. Measures of responsiveness included standardized effect sizes (ES) and standardized response mean (SRM). To assess the impact, 335 pairs of parents and children completed the SOHO-5 and three calibrated examiners performed the childrens oral examinations. Agreement among reports was assessed in 298 mother-child and 37 father-child pairs. The internal consistency by Cronbach\'s alpha coefficient was 0.90 and 0.77 for the children self- and for parental proxy- reports, respectively. For test-retest reliability, Intraclass Correlation Coefficient (ICC) for total score was 0.92 of of the child version and 0.98 of the parental version. The SOHO-5 showed satisfactory construct and discriminant validity. For responsiveness, there was an improvement of childrens oral health after treatment (p<0.001). There were significant differences in the pre- and post-treatment scores of those who reported improving a little and those who reported improving a lot (p<0.05). For both versions, the ES and SRM based on change scores mean for total scores and for categories of global transitions judgments were moderate to large. The multivariate model showed an association between dental caries and a worse childs OHRQoL, according to children and parents perceptions, (RR (Rate Ratio) (CI95%) = 6.37 (4.71; 8.62) e 10.81 (7.65; 15.27)), respectively. The mean directional difference of the total scores of -1.35 (CI95% -2.330; -0.372) was only significant for the father-child pairs. The ICC for total scores was 0.84 (CI 95% 0.798; 0.867) and 0.67 (CI 95% 0.445; 0.814) among mother-child and father-child pairs, respectively. The Brazilian version of the SOHO-5 is reliable, valid and responsive for 5-6 years-old children in Brazil. Dental caries, but not TDI, is associated with worse OHRQoL in children aged 5-6-years. Mothers do rate their young childrens OHRQoL similarly to childrens self-reports, while fathers tend to underreport.

Os objetivos foram: 1) traduzir e adaptar transculturalmente ao idioma português do Brasil a Scale of Oral Health Outcomes for 5-year-old children (SOHO-5); 2) avaliar as propriedades psicométricas (confiabilidade, validade e responsividade) da versão de pais e versão de crianças do SOHO-5; 3) avaliar o impacto da cárie dentária e leões dentárias traumáticas (LDT) na qualidade de vida relacionada à saúde bucal (QVRSB) da criança desde a percepção de pais e filhos; 4) avaliar a concordância entre relatos de pais e filhos sobre à QVRSB da criança. A adaptação transcultural do SOHO-5 foi testada em dois pilotos com 40 crianças de 5 e 6 anos de idade e seus pais. A validade e confiabilidade foram testadas em 193 crianças e pais. Das 193, 154 completaram o SOHO-5 de 7 a 14 dias após o tratamento odontológico da criança para analisar a responsividade. Para este fim eles também responderam julgamentos de transição global sobre a percepção de mudança na saúde bucal após tratamento. As medidas de responsividade incluíram tamanhos de efeito (TE) e médias de respostas padronizadas (MRP). Para avaliação do impacto, 335 pares de crianças e pais completaram o SOHO-5, e as crianças foram examinadas por três examinadores calibrados. A concordância entre relatos foi avaliada em 298 pares mãe-criança e 37 pares pai-criança. Os resultados obtidos indicam que a consistência interna pelo alfa de Cronbach foi de 0,90 e 0,77 para a versão da criança e dos pais, respectivamente. Para a confiabilidade teste-reteste, o Coeficiente de Correlação Intraclasse (CCI) do escore total da versão da criança foi 0,92 e dos pais 0,98. O SOHO-5 mostrou validade de construto e discriminante satisfatória. Em relação à responsividade, houve melhora na saúde bucal após o tratamento em ambas as versões (p<0,001). Houve diferença significativa entre os escores pré- e pós tratamento nos grupos que relataram ter melhorado um pouco e ter melhorado muito (p<0,05). Para ambas as versões, o TE e MRP das médias de escore de mudança para escores totais e para os julgamentos de transição global foram moderados a grandes. O modelo multivariado mostrou associação entre a cárie dentária e a pior QVRSB na criança, de acordo com as crianças e pais, RTR (Razão de Taxa Robusta) (IC 95%) = 6.37 (4,71; 8.62) e 10.81 (7,65; 15.27), respectivamente. A média da diferença direcional para escore total de -1,35 (IC 95% -2,330; -0,372) foi significativamente diferente entre os relatos de pares pai-criança. O CCI para escores totais foi de 0,84 (IC 95% 0,798; 0,867) e 0,67 (IC 95% 0,445; 0,814) entre pares mãe-criança e pai-criança, respectivamente. A versão brasileira do SOHO-5 é confiável, válida e responsiva para crianças de 5 e 6 anos de idade no Brasil. A cárie dentária na criança, mas não as LDT, está associada à pior QVRSB da criança de 5 e 6 anos de idade. As mães avaliaram a QVRSB dos seus filhos de forma similar às crianças, enquanto que os pais a subestimaram. / The aims were: 1) translate and cross-cultural adapt the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5) to the Brazilian Portuguese language; 2) to assess the psychometric properties (reliability, validity and responsiveness) of self- and parental proxy-reports of the SOHO-5; 3) to assess the impact of dental caries and trauma dental injuries (TDI) on childrens oral health-related quality of life (OHRQoL) according to both self- and parental reports; 4) to assess the agreement among parents and children regarding the childs OHRQoL. We tested the cross-cultural adaptation in two pilots with 40 children aged 5- 6-years and their parents. Validity and reliability were tested on 193 children and parents. Of the 193, 154 completed the SOHO-5 7-14 days after the childs dental treatment to assess responsiveness. For this purpose, they also answered global transition judgments on subjects perceptions of change in their oral health following treatment. Measures of responsiveness included standardized effect sizes (ES) and standardized response mean (SRM). To assess the impact, 335 pairs of parents and children completed the SOHO-5 and three calibrated examiners performed the childrens oral examinations. Agreement among reports was assessed in 298 mother-child and 37 father-child pairs. The internal consistency by Cronbach\'s alpha coefficient was 0.90 and 0.77 for the children self- and for parental proxy- reports, respectively. For test-retest reliability, Intraclass Correlation Coefficient (ICC) for total score was 0.92 of of the child version and 0.98 of the parental version. The SOHO-5 showed satisfactory construct and discriminant validity. For responsiveness, there was an improvement of childrens oral health after treatment (p<0.001). There were significant differences in the pre- and post-treatment scores of those who reported improving a little and those who reported improving a lot (p<0.05). For both versions, the ES and SRM based on change scores mean for total scores and for categories of global transitions judgments were moderate to large. The multivariate model showed an association between dental caries and a worse childs OHRQoL, according to children and parents perceptions, (RR (Rate Ratio) (CI95%) = 6.37 (4.71; 8.62) e 10.81 (7.65; 15.27)), respectively. The mean directional difference of the total scores of -1.35 (CI95% -2.330; -0.372) was only significant for the father-child pairs. The ICC for total scores was 0.84 (CI 95% 0.798; 0.867) and 0.67 (CI 95% 0.445; 0.814) among mother-child and father-child pairs, respectively. The Brazilian version of the SOHO-5 is reliable, valid and responsive for 5-6 years-old children in Brazil. Dental caries, but not TDI, is associated with worse OHRQoL in children aged 5-6-years. Mothers do rate their young childrens OHRQoL similarly to childrens self-reports, while fathers tend to underreport.

Introduktion: Efter en korsbandsskada är det av vikt att utvärdera knäfunktionen och följa hur den förändras över tid. Det görs oftast med skattningsformulär, som Lysholm knee score, och fysiska tester. Idag saknas det forskning om validiteten för Lysholm knee score lång tid efter skada. Syftet med studien var att undersöka mätegenskaper för Lysholm knee score vid test av knäfunktion 20 år efter främre korsbandsskada. Metod: Undersökningen gjordes på insamlad data från 70 personer som drabbats av korsbandsskada för mer än 20 år sedan (23±2 år). Materialet var mätt vid tre olika tillfällen, vilket var 2 år, 6-10 år samt 20 år efter skada och bestod av Lysholm knee score, KOOS, KT1000, one leg hop, vertical jump och the side hop test. I studien analyserades begreppsvaliditet, samtidig validitet, prediktiv validitet samt förändring över tid. Pearson’s test användes för test av korrelation, en enkel linjär regression för att undersöka prediktiv validitet och reapeted ANOVA för förändring över tid. Resultat: Resultatet visade att begreppsvaliditeten hade obetydlig korrelation mellan Lysholm knee score och de funktionella knätesterna. Den samtidiga validiteten visade på en stark korrelation för KOOS-symtom och en svag korrelation för KOOS-smärta. Den prediktiva validiteten visade att variationen av Lysholm 20 år senare till viss del kan förklaras av skattningen av Lysholm 2 år efter skadan vilket visade på att den har en prediktiv förmåga. Vid undersökning av förändring över tid av Lysholm knee score visade resultatet att funktionen förändrades till det bättre mellan första och andra mättillfället (p=1.06), medan det försämrades fram till det tredje mättillfället (p&lt;0.001). Konklusion: Lysholm knee score är ett formulär som fångar upp förändring över tid och som till viss del kan predicera hur man skattar den upplevda knäfunktionen över en längre tid. I praktiken bör det användas med flera knäfunktionstester för det ska täcka flera dimensioner av knäfunktion.

The topic of the study is to asses the larynx cancer patients needs from the viewpoint of the patient, his or her family and nursing personnel, using quantitative and qualitative research methodology. The significance of the reseaarch. The needs and difficulties of larynx patients are very significant in clinical practice. It is important to evaluate if the nursing needs are equally and adequately understood by the patient, family and the nursing personnel. It is a common practice to use the worldly acknowledged instruments. The use of the quantative method in the research improves the quality of the research and allows to deepen the understanding of the needs of the patient. The hypothesis of the research. The needs of the larynx cancer patient can be disclosed using the adapted version of Needs Evaluation Questionnaire and by disclosing the attitude of the family, nursing personnel towards the needs of the patient by means of quantitative research. The aim of the study is to determine the larynx patient needs by using Needs Evaluation Questionnaire and to assess the attitude of the family and the nursing by means of quantitative research. The goals: 1. Determine the suitability and reliability of the Needs Evaluation Questionnaire by evalutaing the needs of the larynx patients. 2. Determine the attitude of the family towards the needs of the patient by using partially structured interview. 3. Determine the attitude of the nursing personnel towards the needs of the... [to full text]

This study, presented in article format, contributed to the development of the science and practice of positive psychology / psychofortology, specifically in the South African multi-cultural context, through (i) a first phase exploration of the validity of several scales, mainly developed in a 'western' context, for applicability of measurement of facets of psychological well-being in the South African (multicultural) context (manuscript I), (ii) an exploration of patterns of psychological wellbeing and satisfaction with life in cultural context (manuscript 2), and (iii) a review of the state of the art of the applicability of knowledge (theory and experimental findings) from the domain of positive psychology, for use in practice to enhance the quality of life for people (manuscript 3). For purposes of this study "cultural context" referred to relatively individualist and relatively collectivist cultural orientations as manifested in shared patterns of behavioural readiness, assumptions, attitudes, beliefs, self-definitions, norms, values, historical background and language groupings. The aim of the first study I article was to do a first phase screening of psychometric properties of several scales measuring facets of psychological wellbeing in a South African context. Most of these scales were developed in a western context, and measure facets of cognitive, affective, conative, social, and spiritual psychological well-being. Data were gathered in two projects including 731 participants from different cultural contexts in the North West Province. The FORTproject (FORT = Clarifying the nature of psychological strengths; -=strength) included a convenience sample of 384 mainly white students and adults from the Potchefstroom area, and a convenience sample of 130 mainly black students from the Mafikeng area. The POWIRS-project (POWIRS = Profiles of Obese Women with the Insulin Resistance Syndrome) included 102 black and 1 15 white adult women. Reliability and validity of scales for use in a South African context were reported. Results indicated that the reliability and validity of scales varied from acceptable to totally unacceptable for use in specific subgroups. It was concluded that the most promising scales for use in all groups were the Affectometer 2 (AFM), the Fortitude Questionnaire (FORQ) (except the FORQ-S), the Cognitive Appraisal Questionnaire (CAQ), the Satisfaction with Life Scale (SWLS) the General Health Questionnaire (GHQ) (the latter measuring pathology), and to some extent the Sense of Coherence Scale (SOC). This second study I article explored the patterns of psychological well-being and satisfaction with life in relatively more individualist and relatively more collectivist cultural contexts in South Africa. Secondary factor analyses were conducted on data obtained in four cross-sectional studies, comprising 1,909 participants. Questionnaires varied in studies, and measured facets of affective, cognitive, physical, spiritual, interpersonal and social well-being. Similarities and differences in patterns of psychological well-being and satisfaction with life were found. Satisfaction with life clusters with intra-psychological well-being in relatively more individualist cultural groups, and with inter-personal factors in relatively more collectivist African groups. Implications for models of psychological well-being and interventions to enhance psychological well-being were indicated. The aim of the third study I article was to review and evaluate the practical applicability of scientific knowledge from the domain of positive psychology / psychofortology, with specific reference to assessment, interventions, lifespan development and application in various contexts. It was shown that knowledge in the scientific domain of positive psychology has great relevance for, and application possibilities on individual, community and public policy levels. Applications were found as far as evaluation (assessment) and interventions are concerned in various life contexts (such as education, psychotherapy, health promotion, work), and in various phases of life (from childhood through adolescence and adulthood to old age). Several specific, empirically validated, strategies for enhancement of facets of psychological well-being were highlighted. It was pointed out that an advantage of positive psychology is that it has the theory, research evidence, and techniques to bring benefit to many people on the total mental health continuum, and not only, but also, to the minority who have a problem or are at risk of developing problems. A main conclusion across the different studies reported in this thesis (articles 1-3), was that cultural contexts and variables certainly need to be taken into account in research and practice of positive psychology. Despite the major developments in the scientific domain of positive psychology / psychofortology, its theories and applications have mainly been developed and explored in a western context, and further research is necessary, specifically in the African context. Several recommendations for future research were made. / Thesis (Ph.D. (Psychology))--North-West University, Potchefstroom Campus, 2007.

This research was aimed at validating the PHQ–9 in an African context. This study forms part of the project of Psychosocial Health and Biomarkers in an African context (FORT3, Wissing, 2008). The Patient Health Questionnaire (PHQ–9) is a nine–item depression scale that has the potential of being a dual–purpose instrument to establish the diagnosis of a depressive disorder, as well as the grade of symptom severity (Kroenke, Spitzer & Williams, 2001). The PHQ–9 was administered with criterion related measures to a multicultural convenience sample of 2214 participants from the North West Province of South Africa, including two groups of adolescents (n1 = 1480 and n2 = 559) and an availability sample of adults (n3 = 185). Instruments to determine criterion validity were the General Health Questionnaire (GHQ), designed to detect symptoms of mental disorders; the Mental Health Continuum - Short Form for Adults (MHC–SF) which measures the degree of emotional, social and psychological well–being; and the New General Self–Efficacy Scale (NGSE) designed to measure an individual’s general self–efficacy. Descriptive statistics for the PHQ–9 including its reliability in the various groups is reported. The PHQ–9 manifested a Cronbach Alph are liability index of 0.86. Criterion–related validity was supported by significant correlations between the PHQ–9 and criterion measures. Confirmatory factor analysis for the PHQ–9 yielded a one–factor solution in all groups. The percentage variance explained ranged between 34.71% and 46.62%. Exploratory factor analyses yielded two factors in all groups with the second factor comprised of no more than 2 items and thus interpreted as a minor factor. The construct validity obtained in this research indicates that the PHQ–9 may be a valid measure to identify depression in a South African context. Based on the psychometric properties found in this study, it can be concluded that the PHQ–9 is a valid measure of depression in two of the samples selected for this study. Future studies may further validate this instrument in specific language and cultural groups, and explore the cross–cultural measurement equivalence. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.

This research was aimed at validating the PHQ–9 in an African context. This study forms part of the project of Psychosocial Health and Biomarkers in an African context (FORT3, Wissing, 2008). The Patient Health Questionnaire (PHQ–9) is a nine–item depression scale that has the potential of being a dual–purpose instrument to establish the diagnosis of a depressive disorder, as well as the grade of symptom severity (Kroenke, Spitzer & Williams, 2001). The PHQ–9 was administered with criterion related measures to a multicultural convenience sample of 2214 participants from the North West Province of South Africa, including two groups of adolescents (n1 = 1480 and n2 = 559) and an availability sample of adults (n3 = 185). Instruments to determine criterion validity were the General Health Questionnaire (GHQ), designed to detect symptoms of mental disorders; the Mental Health Continuum - Short Form for Adults (MHC–SF) which measures the degree of emotional, social and psychological well–being; and the New General Self–Efficacy Scale (NGSE) designed to measure an individual’s general self–efficacy. Descriptive statistics for the PHQ–9 including its reliability in the various groups is reported. The PHQ–9 manifested a Cronbach Alph are liability index of 0.86. Criterion–related validity was supported by significant correlations between the PHQ–9 and criterion measures. Confirmatory factor analysis for the PHQ–9 yielded a one–factor solution in all groups. The percentage variance explained ranged between 34.71% and 46.62%. Exploratory factor analyses yielded two factors in all groups with the second factor comprised of no more than 2 items and thus interpreted as a minor factor. The construct validity obtained in this research indicates that the PHQ–9 may be a valid measure to identify depression in a South African context. Based on the psychometric properties found in this study, it can be concluded that the PHQ–9 is a valid measure of depression in two of the samples selected for this study. Future studies may further validate this instrument in specific language and cultural groups, and explore the cross–cultural measurement equivalence. / Thesis (M.A. (Research Psychology))--North-West University, Potchefstroom Campus, 2011.