Introdução: luto complicado é caracterizado pela procura persistente pelo falecido, tristeza e dor emocional intensos em resposta à morte de ente querido. Luto complicado é frequentemente pouco reconhecido e subtratado. O Texas Inventory Revised of Grief (TRIG) é um instrumento de alta confiabilidade e validade na medida de avaliação do luto. Nosso objetivo foi traduzir, adaptar e validar o TRIG para Português do Brasil e verificar se o mesmo, em uma população enlutada, é capaz de distinguir entre os que têm e os que não tem luto complicado assim como identificar quais elementos da escala contribuem para isso. Métodos: o trabalho foi realizado em duas etapas: a) tradução e adaptação transcultural do TRIG para o português do Brasil e b) estudo em corte transversal para análise da confiabilidade e validação desse instrumento. Participantes: 165 pacientes adultos foram recrutados de: a) Ambulatório de Luto do Departamento e Instituto de Psiquiatria - Universidade de São Paulo, b) Ambulatório de convênio e Particulares no mesmo departamento e, c) Colegas de trabalho que perderam um ente querido. Todos os pacientes foram entrevistados com o TRIG e de acordo com critérios clínicos, 69 dos 165 pacientes enlutados foram diagnosticados com luto complicado. Resultados: quanto à tradução e adaptação transcultural, o TRIG foi traduzido para o português, feito a retrotradução para o inglês e adaptado à cultura local. Esse processo foi realizado por dois psiquiatras bilíngues. A confiabilidade e consistência interna do instrumento foram medidos pelo coeficiente de Alpha de Cronbach que alcançou 0,735 para parte I e 0,896 para a parte II do instrumento. A sensibilidade, especificidade e ponto de corte para identificar enlutados com e sem luto complicado foram medidos pela Curva ROC. Viu-se que usando o ponto de corte encontrado de 104 (escore total das partes I, II, III + variáveis psicográficas), é possível classificar corretamente 71,3% dos indivíduos com e sem luto complicado. A validação do instrumento foi realizada pela análise fatorial exploratória e confirmatória. Pela regressão logística demonstrou-se que nível educacional, idade do falecido, idade do enlutado, perda de filho(a) e morte do tipo inesperada são fatores de risco para luto complicado. Nossos resultados também sugerem que religião pode influenciar luto complicado. Conclusões: a versão traduzida e adaptada do TRIG para o português é confiável e válida como medida do luto tanto quanto a versão original. O TRIG foi capaz de distinguir pacientes com e sem luto complicado. Nós sugerimos o uso do TRIG com ponto de corte igual a 104 para identificar enlutados com luto complicado / Background: Complicated grief is characterized by persistent yearning for the deceased, intense sorrow and emotional pain in response to death causing significant distress. Complicated grief is often underrecognized and under treated. The Texas Revised Inventory of Grief (TRIG) is a questionnaire that has been demonstrated to have high validity and reliability in the assessment of complicated grief. Our objective was to translate, adapt, and validate the TRIG to Brazilian Portuguese and to verify whether the TRIG, in a bereaved population, is able to distinguish between those with and those without complicated grief and to identify which elements in the scale contribute to this. Methods: Two stages: a) cross-culture adaptation of a questionnaire, and b) crosssectional study of reliability and validity. Setting and Participants: 165 adult patients were recruited from a) the Grief Outpatient Clinic at the Department and Institute of Psychiatry - University of São Paulo, b) private practice at the same department, and c) co-workers who have lost a loved one. All the patients were interviewed with the TRIG. According to clinical criteria 69 of 165 bereaved patients were presenting complicated grief. Results: Cross-culture adaptation: the TRIG was translated from American English, then back-translated and finally compared with the Brazilian Portuguese version by two bilingual psychiatrists. Reliability: the Cronbach\'s alpha coefficients (internal consistency) of the TRIG scales were 0,735 (part I) and 0,896 (part II). Sensitivity, specificity as well as cutoff points to identify complicated and non-complicated grief, were measured using the ROC curve Using the total score of 104 (part I + part II + Part III + psychographics variables), we can correctly classify 71.3% of individuals with and without complicated grief. The construct validity was assessed by exploratory factor analysis and confirmatory analysis. Furthermore, by logistic regression, our study demonstrated that a low education level, age of the deceased and age of the bereaved, loss of a son or daughter, and unexpected death were all risk factors for complicated grief. Our results also suggest that religion may influence complicated grief. Conclusions: The TRIG adapted to Brazilian Portuguese is as reliable and valid as the original version. In the evaluation of Brazilian bereaved, it was able to distinguish individuals with and without complicated grief. And, we suggest a cut-off value of 104 for complicated grief

Made available in DSpace on 2016-04-04T18:27:41Z (GMT). No. of bitstreams: 1 Marcelo Salomao Aros.pdf: 301474 bytes, checksum: fec723691e0499cfd0306cb8994ba743 (MD5) Previous issue date: 2008-02-17 / This study was aimed at evaluating scientific production about depression from 2004 to 2007 with a special focus on male depression and the tools used to assess this condition. By using the entries depression and scales, papers indexed within the Medline database were accessed. Approximately 6,400 abstracts were identified. Among these, 66 depression evaluation instruments were identified. For the study of the remaining variables, a decision was made to restrict the analyses to the production of 2007 due to the limited length of time for research. Among the 988 abstracts of 2007, 656 were regarded as appropriate for the aims of research and were then listed in chronological order. The following variables were analyzed: gender of the sample, country, age, language, type of instrument used for depression evaluation. Results point the Hamilton Depression Rating Scale (HDRS) as the most usual tool. The samples of research are mainly comprised by participants of both genders. Adulthood was the most usual age under study. The United States of America is the nation where most papers were published on the topic within that period of time. English is the most usual language of such publications. The nature of the instruments was mainly of self report type. Among the papers, 1.2% belonged to Brazilian authors and displayed the same profile presented by the global production. Only 3.7% of the papers were devoted to male depression. No tool was identified to measure male gender depression exclusively. Eight issues of interest were identified to study depression in male individuals and all of them referred to high stress situations: biological, social, and occupational. A considerable gap was perceived in the study of depression in male individuals with the most frequent profile found in hospital out-patient departments which assist the community. As a matter of conclusion, it was found that new instruments must be developed to evaluate depression, bringing features concerned with gender into focus, as the psychic demands and dynamics are particular and differentiated either for men or women. / A pesquisa teve como objetivo avaliar a produ??o cient?fica sobre depress?o no per?odo de 2004 a 2007, com especial ?nfase sobre a depress?o masculina e os instrumentos utilizados para avali?-la. Utilizando os verbetes, depress?o e escalas, foram acessados os artigos indexados na base de dados Medline. Foram identificados aproximadamente 6400 resumos. Neles, foram identificados 66 instrumentos de avalia??o de depress?o. Para o estudo das demais vari?veis, decidiu-se limitar as an?lises ? produ??o relativa ao ano de 2007, devido ?s limita??es de tempo. Dentre os 988 resumos do ano de 2007, 656 foram considerados adequados aos objetivos da investiga??o e foram listados pela sua ordem cronol?gica. Foram analisadas as seguintes vari?veis: g?nero da amostra estudada, pa?s, faixa et?ria, idioma, tipo de instrumento utilizado para a avalia??o da depress?o e a natureza dos instrumentos. Os resultados mostram que o instrumento mais utilizado ? a Hamilton Depression Rating Scale (HDRS). As amostras das pesquisas s?o prioritariamente compostas por participantes de ambos os g?neros. Os adultos foram a faixa et?ria mais estudada. Os Estados Unidos da Am?rica s?o a na??o que mais artigos publicou sobre o tema. O ingl?s ? o idioma mais utilizado. A natureza dos instrumentos para mensurar a depress?o foi prioritariamente de tipo self report. Dentre os artigos, 1,2% eram de autores brasileiros e conservavam o mesmo perfil da produ??o mundial. Apenas 3,7% dos artigos estudaram a depress?o no g?nero masculino. Nenhum instrumento foi identificado para mensurar exclusivamente a depress?o no g?nero masculino. Foram identificados oito temas de interesse para se estudar a depress?o no g?nero masculino e todos eles se referiam a situa??es de alto estresse: biol?gico, social e ocupacional. Verificou-se uma consider?vel lacuna no estudo da depress?o em indiv?duos masculinos com o perfil mais freq?entemente encontrado em ambulat?rios que assistem ? comunidade. Conclui-se que devem ser desenvolvidos novos instrumentos para a avalia??o da depress?o, em que caracter?sticas concernentes ao g?nero sejam valorizadas, pois as demandas e din?micas ps?quicas s?o particulares e diferenciadas para homens e mulheres.

by Iu Wai-yu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 138-146). / Abstracts in English and Chinese. / ACKNOWLEDGMENTS --- p.i-ii / abstract --- p.iii-iv / ABSTRACT (Chinese version) --- p.v-vi / TABLE OF CONTENTS --- p.vii-xii / LIST OF FIGURES --- p.xiii / LIST OF TABLES --- p.xiv-xvi / LIST OF APPENDICES --- p.xvii-xviii / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Research problem --- p.2-6 / Purpose and objectives of the study --- p.7 / Hypothesis --- p.8-9 / Operational definitions --- p.9 / Significance of the study --- p.10-13 / Overview of the thesis --- p.13 / Chapter CHAPTER 2 --- LITERATURE REVIEW / Introduction --- p.14 / Definition of QOL --- p.15-18 / Measurement of QOL --- p.18 / The use of objective and subjective QOL Measurement --- p.19-23 / Generic vs. Specific instruments --- p.23-24 / Studies on QOL on mentally ill clients --- p.25-29 / Factors influencing QOL --- p.29-33 / Conceptual framework of the study --- p.34-37 / Summary --- p.37 / Chapter CHAPTER 3 --- METHODOLOGY / Introduction --- p.38 / Research design --- p.38-39 / Method --- p.39-41 / Sampling --- p.41-44 / Measurements --- p.45-51 / The Brief Psychiatric Rating Scale --- p.45-46 / The WHOQOL-BREF-HK --- p.47-48 / The Lehman QOLI-brief version --- p.48-51 / Demographic data sheet --- p.51 / Pilot study --- p.52 / Data collection --- p.53-54 / Ethical consideration --- p.55-56 / Data analysis --- p.56-58 / Summary --- p.58 / Chapter CHAPTER 4 --- RESULT / Introduction --- p.59 / Sociodemographic characteristics of the participants --- p.59-65 / Clinical characteristics of the participants --- p.66-70 / Results from QOLI --- p.71-79 / Results from WHOQOL --- p.80-81 / Different perception of QOL in different groups --- p.81-94 / Difference in perception of QOL between different gender --- p.82 / Difference in perception of QOL between among different age ranges --- p.83-85 / Relationships between employment status and perception of QOL --- p.86-87 / Relationships between mental status and perception of QOL --- p.88-90 / Relationships between years of onset of mental illness and perception of QOL --- p.91 / Relationships between number of hospitalization and one's QOL --- p.91-92 / Relationships between CPNS and perception of QOL --- p.93 / Relationships between attending DH and perception of QOL --- p.94 / Predictors of QOL --- p.95-98 / Summary --- p.99 / Chapter CHAPTER 5 --- DISCUSSION / Introduction --- p.100 / Sociodemographic and clinical characteristics of the participants --- p.100-104 / Perception of QOL --- p.104-109 / Social relationships --- p.109-111 / Family relationships --- p.111-112 / Sexual relationships --- p.113 / Environment --- p.113-114 / Financial situation --- p.114-115 / Mental status and QOL --- p.115-116 / Service utilization and QOL --- p.117-118 / Predictors of QOL --- p.118-120 / Objective indicators and subjective perception of QOL --- p.121 / Summary --- p.122 / Chapter chapter 6 --- conclusion and implications / Introduction --- p.123 / Summary of the study --- p.123-124 / Implications to health care policy --- p.125-130 / Implications to nursing practice --- p.130-134 / Implications for future research --- p.135-136 / Limitations of the study --- p.137 / references --- p.138-146 / appendices --- p.147-178

Introdução: luto complicado é caracterizado pela procura persistente pelo falecido, tristeza e dor emocional intensos em resposta à morte de ente querido. Luto complicado é frequentemente pouco reconhecido e subtratado. O Texas Inventory Revised of Grief (TRIG) é um instrumento de alta confiabilidade e validade na medida de avaliação do luto. Nosso objetivo foi traduzir, adaptar e validar o TRIG para Português do Brasil e verificar se o mesmo, em uma população enlutada, é capaz de distinguir entre os que têm e os que não tem luto complicado assim como identificar quais elementos da escala contribuem para isso. Métodos: o trabalho foi realizado em duas etapas: a) tradução e adaptação transcultural do TRIG para o português do Brasil e b) estudo em corte transversal para análise da confiabilidade e validação desse instrumento. Participantes: 165 pacientes adultos foram recrutados de: a) Ambulatório de Luto do Departamento e Instituto de Psiquiatria - Universidade de São Paulo, b) Ambulatório de convênio e Particulares no mesmo departamento e, c) Colegas de trabalho que perderam um ente querido. Todos os pacientes foram entrevistados com o TRIG e de acordo com critérios clínicos, 69 dos 165 pacientes enlutados foram diagnosticados com luto complicado. Resultados: quanto à tradução e adaptação transcultural, o TRIG foi traduzido para o português, feito a retrotradução para o inglês e adaptado à cultura local. Esse processo foi realizado por dois psiquiatras bilíngues. A confiabilidade e consistência interna do instrumento foram medidos pelo coeficiente de Alpha de Cronbach que alcançou 0,735 para parte I e 0,896 para a parte II do instrumento. A sensibilidade, especificidade e ponto de corte para identificar enlutados com e sem luto complicado foram medidos pela Curva ROC. Viu-se que usando o ponto de corte encontrado de 104 (escore total das partes I, II, III + variáveis psicográficas), é possível classificar corretamente 71,3% dos indivíduos com e sem luto complicado. A validação do instrumento foi realizada pela análise fatorial exploratória e confirmatória. Pela regressão logística demonstrou-se que nível educacional, idade do falecido, idade do enlutado, perda de filho(a) e morte do tipo inesperada são fatores de risco para luto complicado. Nossos resultados também sugerem que religião pode influenciar luto complicado. Conclusões: a versão traduzida e adaptada do TRIG para o português é confiável e válida como medida do luto tanto quanto a versão original. O TRIG foi capaz de distinguir pacientes com e sem luto complicado. Nós sugerimos o uso do TRIG com ponto de corte igual a 104 para identificar enlutados com luto complicado / Background: Complicated grief is characterized by persistent yearning for the deceased, intense sorrow and emotional pain in response to death causing significant distress. Complicated grief is often underrecognized and under treated. The Texas Revised Inventory of Grief (TRIG) is a questionnaire that has been demonstrated to have high validity and reliability in the assessment of complicated grief. Our objective was to translate, adapt, and validate the TRIG to Brazilian Portuguese and to verify whether the TRIG, in a bereaved population, is able to distinguish between those with and those without complicated grief and to identify which elements in the scale contribute to this. Methods: Two stages: a) cross-culture adaptation of a questionnaire, and b) crosssectional study of reliability and validity. Setting and Participants: 165 adult patients were recruited from a) the Grief Outpatient Clinic at the Department and Institute of Psychiatry - University of São Paulo, b) private practice at the same department, and c) co-workers who have lost a loved one. All the patients were interviewed with the TRIG. According to clinical criteria 69 of 165 bereaved patients were presenting complicated grief. Results: Cross-culture adaptation: the TRIG was translated from American English, then back-translated and finally compared with the Brazilian Portuguese version by two bilingual psychiatrists. Reliability: the Cronbach\'s alpha coefficients (internal consistency) of the TRIG scales were 0,735 (part I) and 0,896 (part II). Sensitivity, specificity as well as cutoff points to identify complicated and non-complicated grief, were measured using the ROC curve Using the total score of 104 (part I + part II + Part III + psychographics variables), we can correctly classify 71.3% of individuals with and without complicated grief. The construct validity was assessed by exploratory factor analysis and confirmatory analysis. Furthermore, by logistic regression, our study demonstrated that a low education level, age of the deceased and age of the bereaved, loss of a son or daughter, and unexpected death were all risk factors for complicated grief. Our results also suggest that religion may influence complicated grief. Conclusions: The TRIG adapted to Brazilian Portuguese is as reliable and valid as the original version. In the evaluation of Brazilian bereaved, it was able to distinguish individuals with and without complicated grief. And, we suggest a cut-off value of 104 for complicated grief

Thesis (Ph. D.)--University of Oklahoma. / Includes bibliographical references (leaves 148-162).

The measures studied in this thesis were a measure of disorder, D, and a measure of the individual part of the disagreement, the measure of relative rank variance, RV, proposed by Svensson in 1993. The measure of disorder is a useful measure of order consistency in paired assessments of scales with a different number of possible values. The measure of relative rank variance is a useful measure in evaluating reliability and for evaluating change in qualitative outcome variables. In Paper I an overview of methods used in the analysis of dependent ordinal data and a comparison of the methods regarding the assumptions, specifications, applicability, and implications for use were made. In Paper II an application, and a comparison of the results of some standard models, tests, and measures to two different research problems were made. The sampling distribution of the measure of disorder was studied both analytically and by a simulation experiment in Paper III. The asymptotic normal distribution was shown by the theory of U-statistics and the simulation experiments for finite sample sizes and various amount of disorder showed that the sampling distribution was approximately normal for sample sizes of about 40 to 60 for moderate sizes of D and for smaller sample sizes for substantial sizes of D. The sampling distribution of the relative rank variance was studied in a simulation experiment in Paper IV. The simulation experiment showed that the sampling distribution was approximately normal for sample sizes of 60-100 for moderate size of RV, and for smaller sample sizes for substantial size of RV. In Paper V a procedure for inference regarding relative rank variances from two or more samples was proposed. Pair-wise comparison by jackknife technique for variance estimation and the use of normal distribution as approximation in inference for parameters in independent samples based on the results in Paper IV were demonstrated. Moreover, an application of Kruskal-Wallis test for independent samples and Friedman’s test for dependent samples were conducted. / Statistical methods for ordinal data

This study aimed to develop and validate a rating scale for assessing English First Additional Language essays at Grade 12 level for the final National Senior Certificate examination. The importance of writing as a communicative skill is emphasised with the re-introduction of writing as Paper 3 of the English First Additional Language examination at the end of Grade 12 in South Africa. No empirical evidence, however, is available to support claims of validity for the current rating scale. The literature on the concept of validity and the process of validation was surveyed. Theoretical models and validation frameworks were evaluated to establish a theoretical base for the development and validation of a rating scale for assessing writing. The adopted framework was used to evaluate the adequacy of the current rating scale used for assessing Grade 12 writing in South Africa. The current scale was evaluated in terms of the degree to which it offers an appropriate means of assessing Grade 12 Level essay writing while adhering to requirements of the National Curriculum Statement. It was found lacking and the need for a new, validated rating scale was established. Various approaches to scale development were considered in consideration of factors that impact scores directly, viz. the type of rating scale, rater characteristics, scoring procedures and rater training. A new scale was developed and validated following an empirical procedure comprising four phases. The empirical process was based on an analysis of actual performances of Grade 12 English learner writing. A combination of quantitative and qualitative methods was used in each of the four phases to ensure the validity of the instrument. The outcome of this project was an empirically developed and validated multiple trait rating scale to assess Grade 12 essay writing. The proposed scale distinguishes five criteria assessed by means of a seven-point scale. / Thesis (Ph.D. (English))--North-West University, Potchefstroom Campus, 2009.

This study aimed to develop and validate a rating scale for assessing English First Additional Language essays at Grade 12 level for the final National Senior Certificate examination. The importance of writing as a communicative skill is emphasised with the re-introduction of writing as Paper 3 of the English First Additional Language examination at the end of Grade 12 in South Africa. No empirical evidence, however, is available to support claims of validity for the current rating scale. The literature on the concept of validity and the process of validation was surveyed. Theoretical models and validation frameworks were evaluated to establish a theoretical base for the development and validation of a rating scale for assessing writing. The adopted framework was used to evaluate the adequacy of the current rating scale used for assessing Grade 12 writing in South Africa. The current scale was evaluated in terms of the degree to which it offers an appropriate means of assessing Grade 12 Level essay writing while adhering to requirements of the National Curriculum Statement. It was found lacking and the need for a new, validated rating scale was established. Various approaches to scale development were considered in consideration of factors that impact scores directly, viz. the type of rating scale, rater characteristics, scoring procedures and rater training. A new scale was developed and validated following an empirical procedure comprising four phases. The empirical process was based on an analysis of actual performances of Grade 12 English learner writing. A combination of quantitative and qualitative methods was used in each of the four phases to ensure the validity of the instrument. The outcome of this project was an empirically developed and validated multiple trait rating scale to assess Grade 12 essay writing. The proposed scale distinguishes five criteria assessed by means of a seven-point scale. / Thesis (Ph.D. (English))--North-West University, Potchefstroom Campus, 2009.

Submitted by GIOVANNA MARIA COELHO null (giovannamcoelho@hotmail.com) on 2017-12-11T15:16:17Z No. of bitstreams: 1 giovanna - mestrado - botucatu.pdf: 3704223 bytes, checksum: 1913a08655010052736bb490b0ed492f (MD5) / Submitted by GIOVANNA MARIA COELHO null (giovannamcoelho@hotmail.com) on 2017-12-11T18:47:11Z No. of bitstreams: 1 giovanna - mestrado - botucatu.pdf: 3704223 bytes, checksum: 1913a08655010052736bb490b0ed492f (MD5) / Approved for entry into archive by ROSANGELA APARECIDA LOBO null (rosangelalobo@btu.unesp.br) on 2017-12-12T13:09:20Z (GMT) No. of bitstreams: 1 coelho_gm_me_bot.pdf: 3704223 bytes, checksum: 1913a08655010052736bb490b0ed492f (MD5) / Made available in DSpace on 2017-12-12T13:09:20Z (GMT). No. of bitstreams: 1 coelho_gm_me_bot.pdf: 3704223 bytes, checksum: 1913a08655010052736bb490b0ed492f (MD5) Previous issue date: 2017-12-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Bases científicas: A laparotomia é um procedimento invasivo que causa grande dano tecidual e provoca dor no período pós-operatório. Embora a analgesia seja um procedimento padrão em cirurgia, a terapêutica ideal para o controle deste sintoma ainda necessita ser investigada. Estudos mostram que há uma correlação significativa entre a queda da impedância tecidual e a dor manifestada por pacientes que sofrem lesões teciduais, sugerindo que a reparação da integridade dos tecidos pode restaurar o equilíbrio bioelétrico das células e controlar a dor dos pacientes. A corrente elétrica contínua (CEC), todavia, quando aplicada em tecidos lesados é capaz de promover a migração direcionada e o alinhamento de células epiteliais, particularmente de fibroblastos, favorecendo o processo de regeneração tecidual. Este tipo de corrente elétrica, porém, não tem sido usado na prática clínica com finalidades analgésicas, o mesmo ocorrendo com a iontoforese transdérmica (ITD), que visa à absorção de íons solúveis através da pele, como o zinco, que participa ativamente da formação do colágeno e da cicatrização. Assim, este estudo se fundamentou na hipótese de que a ação benéfica da CEC sobre a cicatrização poderia aumentar a impedância tecidual e, por consequência, modular inibitoriamente a dor apresentada pelos pacientes. Objetivo: Avaliar os efeitos da CEC isolada e da ITD+Zn sobre o consumo de analgésicos e a intensidade de dor na parede abdominal de pacientes submetidos à laparotomias eletivas. Métodos: Foi realizado um estudo prospectivo envolvendo 45 pacientes adultos, de ambos os sexos, internados no HC/FMB-UNESP, para tratamento cirúrgico eletivo de enfermidades do abdome, através da laparotomia. Pacientes impossibilitados de realizar a eletroterapia ou com riscos maiores de apresentar efeitos adversos ou complicações foram excluídos. Os pacientes foram distribuídos, por sorteio, em 3 grupos experimentais, com 15 pacientes cada: GC – Grupo Controle, com tratamento simulado das incisões abdominais; GCEC, com incisões tratadas com corrente elétrica contínua isolada; GITD+Zn, com incisões tratadas com CEC e administração tópica de sulfato de zinco, através da iontoforese transdérmica. A eletroterapia foi aplicada uma vez ao dia, em 4 sessões de tratamento, respectivamente, no 1º, 2º, 3º e 4º PO. Pacientes dos 3 grupos experimentais também receberam analgesia pós-operatória, com tramadol, usando bombas de PCA, e também foram submetidos a testes de ansiedade e depressão no pré-operatório. O efeito dos tratamentos foi avaliado pela frequência de doses de analgésico solicitadas e liberadas, quantidade de analgésicos consumida e pela intensidade de dor na parede abdominal, medida pelas escalas de avaliação Verbal (VRS), Numérica (NRS) e Visual Analógica (VAS), aplicadas no pré-operatório e nos 4 dias de pós-operatório, antes e após a movimentação/deambulação. Os dados obtidos foram analisados pela Análise de Variância, com nível de significância nos testes de comparações definido para P<0,05 ou 5%. Resultados: Apesar da predominância de mulheres obesas na amostra, não houve diferenças significantes (P>0,05) entre indivíduos dos 3 grupos experimentais em relação à: idade, escolaridade, índice de massa corpórea, níveis de ansiedade e depressão, porte da cirurgia, duração da cirurgia e anestesia, tamanho da incisão, prevalência de complicações da ferida operatória e tempo de internação. Também não houve variações estatísticas entre homens vs mulheres e obesos vs não-obesos, antes da eletroterapia ter-se iniciado (POI), em relação à frequência de solicitações de analgésico à bomba de PCA, doses efetivamente liberadas e dose total diária de analgésico administrada aos pacientes. Iniciada a eletroterapia, pacientes do GCEC e GITD+Zn tiveram frequência de solicitações de analgésico à bomba de PCA e dose total diária de analgésico significantemente menor (P<0,05) que pacientes do GC, a partir do 2º PO, não havendo diferenças significantes entre os dois tratamentos. Um número menor de doses de analgésico efetivamente liberadas pela bomba também foi observado em pacientes do GCEC e GITD+Zn, nos 4 dias de pós-operatório, porém, as diferenças foram estatisticamente significantes (P<0,05), somente no 2º e 3º PO. Na avaliação da intensidade de dor observou-se que homens vs mulheres e obesos vs não-obesos apresentaram respostas diferentes, antes do início da eletroterapia (POI), onde percentual significantemente maior de mulheres (P<0,05) sentiu dor classificada como “moderada”, enquanto homens a classificaram como “leve”, e percentual significantemente maior de obesos (P<0,05) referiu sentir dor de intensidades “moderada”, “intensa” ou “muito intensa” quando comparado com não-obesos. Estas diferenças, porém, não foram observados com as escalas NRS e VAS. Iniciada a eletroterapia, em geral, observou-se que uma percentagem significantemente maior (P<0,05) de pacientes do GCEC e GITD+Zn, avaliados pela escala VRS, referiu não sentir dor ou ter dor leve, tanto no repouso como após a movimentação, nos 4 períodos do pós-operatório, quando comparado com o GC. Com raras exceções, observadas no 1º PO, os resultados obtidos com a CEC não diferiram estatisticamente (P>0,05) daqueles observados com a ITD+Zn. Quando foram aplicadas as escalas NRS e VAS, pacientes do GCEC e GITD+Zn tiveram uma intensidade de dor menor que a observada entre os pacientes do GC, em todos os períodos do PO, tanto em repouso, como após a movimentação. Porém, as diferenças só foram estatisticamente significantes (P<0,05) a parir do 2º PO, após a movimentação do paciente. Não foram observados eventos adversos ou quaisquer complicações com a aplicação da eletroterapia. Conclusões: A aplicação de CEC e ITD+Zn reduz a frequência de doses solicitadas ou liberadas de analgésico, o consumo de analgésico e, também, a intensidade de dor de pacientes submetidos à laparotomia, principalmente nas fases mais tardias do pós-operatório. Os benefícios, em geral, foram mais evidentes a partir do 2º dia de pós-operatório, após a movimentação do paciente. Com raras exceções, a eficácia de ambos os tratamentos no controle da intensidade de dor foi similar. No entanto, amostra maior de pacientes e o uso de outras metodologias de avaliação da intensidade de dor tornam-se necessárias para validar o real efeito da CEC e ITD+Zn como terapêuticas alternativas e/ou de suporte à analgesia convencional. / Purpose: To evaluate the effects of continuous electrical current (CEC) and zinc sulphate administered by transdermal iontophoresis (TDI+Zn) on the analgesic consumption and intensity of pain in patients submitted to elective laparotomies. Methods: 45 adult patients of both genders were randomly assigned to 3 experimental groups, with 15 patients each: CG - Control Group, with simulated treatment of abdominal incisions; GCEC, incisions treated with CEC alone; GTDI+Zn, incisions treated with CEC plus topical administration of zinc sulfate, through TDI. Electrotherapy was applied once a day in the morning, in a total of 4 treatment sessions, during 4 postoperative days. All patients also received postoperative analgesia with tramadol, using PCA pumps. Pain intensity was evaluated by the frequency and analgesic consumption, and by Verbal (VRS), Numerical (NRS) and Visual Analogue (VAS) scales, applied in the preoperative period and in the 4 postoperative days, before and after the movement/walking. Results: There were no statistically significant differences (P>0.05) among groups in relation to: age, schooling, body mass index, anxiety and depression levels, preoperative pain, surgery/anesthesia duration, incision size, prevalence of surgical wound complications, inpatient time, frequency of analgesic requested or released to/by the PCA pump, and total daily dose of analgesic administered in pre-, and immediate postoperative period. GCEC and GTDI+Zn patients had a frequency of analgesic requests to PCA pump and total daily dose of analgesic significantly lower (P <0.05) than CG patients, from the 2nd PO. A smaller number of analgesic doses effectively released by the pump were also observed in GCEC and GTDI+Zn patients in the 4 postoperative days, but the differences were statistically significant (P<0.05), only in the 2nd and 3rd PO. A significantly higher percentage (P<0.05) of GCEC and GTDI+Zn patients reported no pain or mild pain in VRS scale, and when NRS and VAS scales were applied they also had a lower pain intensity than that observed among CG patients, both at rest and after movement, in all periods of PO. However, the differences were only statistically significant (P<0.05) from the 2nd PO, after patient movement. Conclusion: CEC and TDI+Zn reduce analgesic consumption and pain intensity of patients undergoing laparotomy, especially in the later phases of the postoperative period. However, a larger sample of patients becomes necessary to validate the real effect of CEC and TDI+Zn as alternative and/or support for conventional analgesia. There were no differences between the two electrotherapeutic methods in reducing the pain intensity of patients.

Remotely-controlled technologies are no longer limited to military applications, such as unmanned military airborne weapons or explosive diffuser robots. Nowadays we can see more and more of remotely controlled devices used as medical equipment, toys, and so forth. One of the most recent areas of interest is robotic telepresence, also known as Mobile Robot Presence (MRP), which provides the ability to interact socially and professionally with other people and even objects in remote locations. One of the known issues with using remotely-controlled devices is the cognitive overload which their operators (pilots) experience and MRP pilots are no exception. However, despite vast research on different ways to address this in military or medical scenarios, little has been done regarding MRPs. This thesis study aims to make a contribution in closing that gap by suggesting a method, developing a prototype implementing it; then conducting an empirical assessment of the method and the prototype as a part of a broader study on MRP, supported by Swedish Research Council. I have suggested a method comprised of a Secondary-task (ST) method and Subjective Rating Scales (SRS), in which the latter act as an evaluation method for the former. Both of them were used in an overarching study in search for the best control device amongst four chosen devices. I collected and analyzed secondary task performance data (e.g. response time, error rates), subjective user ratings, explicit rankings, and observations recordings. My analysis of the collected data shows that using a monitoring and response face recognition secondary task is a plausible method for the assessment of MRP pilot’s cognitive load.