Nas últimas décadas houve o aumento da ocorrência de doenças crônicas no Brasil, dentre elas o Acidente Vascular Encefálico (AVE) se destaca. O AVE frequentemente acarreta perdas funcionais e a dependência por cuidadores. A compreensão da percepção da Qualidade de Vida (QV) e o impacto do AVE sobre os acometidos e seus cuidadores torna-se muito importante, uma vez que se apresenta como um problema de saúde pública no país. Este estudo teve como objetivo avaliar a QV dos indivíduos acometidos por AVE e a de seus cuidadores e também descrever o perfil sociodemográfico e clínico. Tratou-se de um estudo observacional do tipo inquérito transversal, desenvolvido em um município do Triângulo Mineiro envolvendo 83 indivíduos que sofreram um AVE sendo todos assistidos pela Estratégia Saúde da Família (EsSF). Os indivíduos participantes foram separados em 4 grupos, sendo o grupo dos indivíduos com AVE que possuem cuidadores (44), grupo dos indivíduos com AVE sem cuidadores (39), grupo dos cuidadores (44) e um grupo de referência (83) no período de março a maio de 2010. Foi utilizado um questionário contendo dados sociodemográficos e clínicos para os indivíduos com AVE e cuidadores. Para avaliação da QV o instrumento WHOQOL-bref (World Health Organization Quality of Life-bref) foi aplicado à todos os grupos. Para os dois grupos de indivíduos com AVE ainda foi aplicado um instrumento específico denominado SSQOL (Stroke-specific of Quality of Life). Os indivíduos com AVE tinham idade média de 61,93 anos, a maioria do sexo masculino, casados, religião católica, aposentados/pensionistas, baixa renda e responsáveis por ela, baixa escolaridade e 53% possuíam cuidador. Os cuidadores tinham idade média de 49,25 anos, maioria do sexo feminino, filhos (as), casados, religião católica, exerciam outra atividade, baixa renda e escolaridade, longo tempo de cuidado e não tinham dificuldade para o cuidado. O AVE do tipo isquêmico foi o mais encontrado, tempo de diagnóstico de 5 ou mais anos, presença de antecedentes familiares (41%), recidivas (20%) e 51% dos indivíduos possuíam algum grau de dependência. Estavam presentes o tabagismo (54%), etilismo (27%) e a hipertensão arterial (94%). Em relação à QV geral o grupo de AVE com cuidadores apresentou o menor escore. Podemos observar que nos domínios físico, psicológico e meio ambiente o escore médio foi menor para o grupo de AVE com cuidadores. Os maiores escores para estes três domínios foram observados de forma crescente no grupo de AVE sem cuidadores seguido pelo grupo de cuidadores e pelo grupo de referência. No domínio relações sociais observamos que o escore para o grupo de AVE com cuidadores (71,02) foi um pouco maior que o escore médio do grupo de AVE sem cuidadores (70,94). A comparação dos escores em todos os grupos evidenciou que a presença do AVE e o fato de ser cuidador afeta a QV em todos os domínios do WHOQOL-bref. A QV avaliada pelo SSQOL evidenciou que os domínios mais afetados foram o da personalidade, papéis sociais e energia. Ao compararmos os dois grupos com AVE observamos que 6 dos 12 domínios apresentaram diferenças significativas. Esta pesquisa pode ajudar a entender o impacto que o AVE causa na vida dos acometidos e na de seus cuidadores, assim como melhor orientar políticas públicas destinadas a esta população. / There was a raise of chronic diseases occurrence in Brazil in the last decades, among them the stroke detaches itself. The stroke, frequently leads to functional losses and dependency for caregivers. The awareness comprehension of the Quality of Life (QOL) and the stroke impact to the patients and their caregivers become very important, once it shows itself as a healthy problem in the country. This research aimed to evaluate the QOL of patients suffering from strokes and their caregivers and describe the sociodemographic and clinical profile. It was a transversal inquire observational research developed in a city of Triangulo Mineiro involving 83 people who suffered a stroke are all assisted by the Family Health Strategy (EsSF). The participants were separated in 4 different groups: the ones with stroke who had caregivers (44); the ones with stroke without caregivers (39); caregivers group (44) and a reference group (83) from March to May 2010. It was used a questionnaire with the social demographic and clinic dates to the people with stroke and caregivers. To evaluate the QOL it was used the tool WHOQOL-bref (World Health Organization Quality of Life-bref) in all the groups. For both groups with of individuals with stroke has been applied another specific tool called SSQOL (Stroke-specific of Quality of Life). The average age of stroke people was 61,93 years old, most of them male, married, catholic, retired, underpaid and responsible for it, not properly educated and 53% had a caregiver. The caregivers were 49,25 years old, most of them females, daughters and sons, married, catholic, had another activity, underpaid and not properly educated, long care period and had no problems for this activity. The skemical stroke was the most common to be found, 5 or more years of diagnosis time, previous familiar case (41%), repetitions (20%) and 51% 51% of subjects had some degree of dependence. Among them we found, smoking (54%), drinking (27%) and high blood pressure (94%). About general QOL the strokes group with caregivers showed a lower score. We observe that the physical, psychological and environmental domain, the average score was inferior to the strokes groups with caregivers. The highest scores for those three groups were observed increasingly in the strokes group without caregivers followed by caregivers group and the reference group. About the social relation domain, we could see that the strokes group with caregivers score (71,02) was similar the average score from the strokes group without caregivers (70,94). The scores comparison showed that the strokes presence and the fact of being taken care affects QOL in all the domain of the WHOQOL-bref. The QOL evaluated by SSQOL showed the most affected domain were: the personality, social chores and energy. When we compare both groups with stroke we can see that 6 of 12 domains showed significant differences. This research can help o understand the strokes impact in the victims and caregivers lives as well better guidance at public polices for this population.

Home Based Childcare (HBC) workers have demanding work conditions, enjoy no or few social benefits, are paid less than the national average wage, and many of them intend to leave this occupation (Doherty, Lero, Goelman, Tougas, Lagrange, 2000). The available studies on early childcare workers in Canada have often excluded HBC workers from their analyses or grouped them with other types of early childcare workers in their analyses, which make it difficult to tackle the particularities of this specific subgroup of workers. In light of the limited studies on regulated HBC workers in the Canadian context, this thesis aimed to provide insight on these workers' health and broader social determinants of health in two Canadian provinces where they are the most concentrated. The overall purpose of this thesis is to document the perceived health and chronic conditions of HBC workers, highlighting the broader social determinants of their health (e.g. work, lifestyle). This thesis had four objectives: 1. Assess regulated HBC workers' health-related quality of life and investigate the relationships with socio-demographic characteristics. 2. Examine chronic health conditions affecting regulated HBC workers and identify the social determinants of health factors associated with chronic conditions. 3. Draw an overview on broader social determinants of health factors among regulated HBC workers using the Dahlgren and Whitehead model. 4. Undertake a job analysis of regulated HBC workers In the first Manuscript, the perceived health-related quality of life of home-based childcare workers in two Canadian provinces, Quebec and Ontario, was assessed using survey methods. Results show that HBC workers in Quebec positively perceive their overall physical health and negatively perceive their overall mental health. Those working in Ontario report both good overall physical and mental health-related quality of life and also report better mental and physical health-related quality of life compared to those in Quebec. That is, they have fewer problems with work or other daily activities due to their health, feel less physical pain, less fatigue, less nervousness, and are less depressed than workers in Quebec. HBC workers experience more pain, more fatigue, more interference of health problems with social activities, and more psychosocial distress compared to Canadian women in general. Finally, our study supports that being over 40 years old, being married or in a common-law union, and working in Ontario were factors relating positively to the perceived health-related quality of life among HBC workers when controlling for the level of education and the annual gross income. In the second manuscript, chronic health conditions affecting regulated HBC workers in Quebec and in Ontario and the broader social determinants of health factors associated with these were examined using survey methods. The study revealed that one out of two HBC workers had a chronic condition. Chronic back pain, asthma, hypertension, skin diseases, and arthritis are the main five chronic conditions among HBC workers. Also, five out of ten HBC workers with a chronic condition report chronic back pain as their main health condition. Finally, workers over 40 years of age, those who were somewhat physically active or inactive, having poor relationships with their supervisors or parents of children, and working for five years or more reported more chronic conditions as diagnosed by a health professional. In the third manuscript, the broader social determinants of health among regulated HBC workers in Quebec and in Ontario were examined using a mixed methods approach. Results showed significant differences in social determinants of health between HBC workers in Quebec and in Ontario in terms of age and factors related to individual lifestyles, social and community networks, structural factors, and general socio-economic conditions. In the fourth manuscript, HBC workers’ job content, context, and requirements were described and factors that affect their health and well-being were identified using qualitative methods and emphasizing the workers’ perspectives. Results showed that HBC workers’ job differs from centre-based childcare workers. They perform business administration tasks and more housekeeping and domestic work than workers in the centre-based childcare, which affect their health and well-being. They are paid on a per child basis but their level of education, experience or input into care is not taken into consideration. In addition, HBC workers reported factors related to the context and the content of their job such as the high physical and mental efforts, the absence of contact with other adults during working hours, the lack of external help during working hours, the difficulty of filling available spots, the exposure to noise and bad odours, the interference of work with personal and family life, the low and precarious remuneration and the lack of benefits as potential factors that may affect their health. Finally, the thesis conclusion provides an overview of HBC workers’ health and determinants of their health identifying remaining gaps in our knowledge of HBC workers’ health and determinants of health where future research is required. Future studies are encouraged to consider using multiple approaches (e.g. online surveys, paper survey, etc.) and multiple languages (e.g. Chinese) to reach a larger number of participants. Stakeholders and decision makers are encouraged to consider provincial differences in social determinants of health to implement interventions to reduce disparities and health inequities among HBC workers.

No description available.

Wong, Mei Fung Florence. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 178-208). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Palliative care is branch of medicine, which focuses on improving the quality of life (QOL) of patients with chronic illness such as cancer. Patients suffering from cancer are subjected to physical as well as psychological distress associated with their diagnosis and treatment. The purpose of this study was to introduce palliative care and examine its impact on levels of anxiety and depression in cancer patients. Information regarding the current relevance and growth of the palliative profession, as well as expanding areas of research, was included as part of this study. The literature reviewed in this study found that cancer patients are at high risk for psychological comorbidities such as anxiety and depression. Patients with certain cancer types, social factors, and cognitive makeups may be at the greatest risk for psychiatric problems. The data show a strong connection between high emotional distress levels, low QOL, reduced survival time, and adherence to curative treatment plans. Fortunately, there was significant research showing that palliative intervention can improve psychological distress and avoid unwanted effects on QOL and survival. The results of current studies found promising improvements for patients with cancer; however, there remains a need for replication and development of a universal model of care to validate conclusions.

Introdução: O vitiligo é uma doença da pele frequente que afeta cerca de 1% da população em todo o mundo. Ocorre em pessoas de qualquer idade ou etnia, e mais da metade dos pacientes desenvolvem a doença antes dos 20 anos de idade. O vitiligo pode afetar negativamente a qualidade de vida (QoL) do paciente. Um questionário de qualidade de vida específico para vitiligo foi desenvolvido e validado na língua inglesa: the vitiligo-specific quality-of-life instrument (VitiQoL). Objetivo: O objetivo deste estudo é avaliar a QoL em pacientes adultos com o VitiQoL e o DLQI e pediátricos com o CDLQI em uma amostra de pacientes com vitiligo no sul do Brasil. Métodos: Na primeira etapa, o instrumento foi traduzido, adaptado culturalmente e validado para o português falado no Brasil (VitiQoL-PB). Após, foram incluídos pacientes selecionados no Ambulatório de Dermatologia do Hospital de Clínicas de Porto Alegre e numa clínica privada de Porto Alegre. Foi realizada amostragem de conveniência de casos consecutivos. A qualidade de vida de pacientes pediátricos foi avaliada com o questionário CDLQI. Em pacientes adultos foram aplicados o VitiQoL – PB e o DLQI. Resultados: Observou-se uma forte correlação entre os escores do total de VitiQoL e o DLQI (r = 0,81; p <0,001). O fator que mais contribuiu para a pontuação final do VitiQoL foi estigma. Em nossa amostra, as mulheres apresentaram escores mais elevados do que os homens (p <0,05). Problemas psiquiátricos foram associados com uma pior qualidade de vida. Na população pediátrica, a mediana do escore do CDLQI foi 3 (intervalo interquartil 1,3-7,3). Houve uma correlação estatisticamente significativa entre a idade da criança e o escore no CDLQI (rs = 0,41, p = 0,044). Não houve diferença entre meninos e meninas (p = 0,219). Conclusão: Este estudo confirma não só que o VitiQoL é fácil de administrar, como também, acrescenta informações importantes sobre o impacto do vitiligo na América do Sul. Instrumentos genéricos são úteis e permitem comparações com outras dermatoses, mas não são suficientemente específicos para detectar nuances na maneira como os pacientes lidam com o vitiligo. A autoestima dos pacientes é muito afetada e a estigmatização está bastante presente. Há grupos de pacientes que são mais vulneráveis ao impacto da doença, como as mulheres, os adolescentes e os pacientes com doenças psiquiátricas. / Background: Vitiligo is a common skin disease that has been reported to affect approximately 1 % of the population worldwide. It affects people of any age or ethnicity, more than half of who develop it before the age of 20 years. Vitiligo can negatively affect patient’s quality of life (QoL). A specific questionnaire for vitiligo has been developed and validated in the English language: the vitiligo-specific quality-of-life instrument (VitiQoL). Objective: The aim of this study was to access the QoL in adult patients through VitiQoL and DLQI and pediatric patients through CDLQI in a sample of patients with vitiligo in Southern Brazil. Methods: In the first phase of the study the instrument was translated, cultural adapted and validated into Brazilian Portuguese (VitiQoL-PB). Then patients were selected from a Dermatological Outpatient Clinic from Hospital de Clínicas de Porto Alegre and from a Private Practice in Porto Alegre. In this study, we used convenience sampling of consecutive cases. The QoL of pediatric patients was performed using the CDLQI questionnaire. In adult patients we applied the VitiQoL – PB and the DLQI. Results: A strong correlation between the scores of the total VitiQoL and DLQI was observed (r = 0.81; p <0.001). The factor that most contributed to the final score of VitiQoL was stigma. In our sample, women had higher scores than men (p<0,05). Psychiatric problems were associated with lower QoL. In the pediatric population, the median score of CDLQI was 3 (interquartile range 1.3 to 7.3). There was a statistically significant correlation between the child's age and the score on CDLQI (rs = 0.41, p = 0.044). There was no difference between boys and girls (p = 0.219). Conclusion: This study confirms that VitiQoL is easy to administer and adds important information about the impact of vitiligo on a South American population. Generic instruments are useful and allow comparisons with other dermatoses, but are not specific enough to detect nuances in how patients deal with the overall vitiligo burden. Self-esteem of patients is greatly affected and stigmatization is very present in the disease. There are groups of patients that are more vulnerable to the impact of the disease, like women, patients with psychiatric diseases and adolescents.

This study examines race differences and the relationship between religiosity/ spirituality and social support on quality of life (QOL) among people living with HIV/AIDS in Dallas/Ft. Worth, TX. The data were obtained from the Project VOICES research study conducted by the Center of Psychosocial Health Research at University of North Texas in 2003. This study explores the hypotheses that religiosity/spirituality and social support positively influences quality of life among people living with HIV/AIDS. The current study uses a diverse, gender-balanced sample consisting of African Americans (n = 156), aged 20-68, 47% male, 52% female and 1% transgendered) and Non-African Americans (n = 131), aged 19-65, 50% male, 46% female and 3% transgendered) (Caucasian, Latino, & others) to evaluate the relationship among variables of interest. Multiple regression analyses revealed that social support was a significant factor explaining quality of life (QOL) for African Americans when controlling for medical variables but did not for non-African Americans. Religiosity/spirituality was not found to be significant in this study. The implications of the findings are discussed.

Considerando-se a falta de um instrumento de avaliação de qualidade de vida específico para pessoas estomizadas no Brasil, verificado após revisão bibliográfica de estudos sobre o tema em nosso meio, o objetivo deste estudo foi realizar a adaptação cultural e validar o instrumento City of Hope Quality of Life Ostomy Questionnaire (COH-QOL-OQ), para a língua portuguesa no Brasil. Após contato com a autora do instrumento original e obtenção de sua autorização para o desenvolvimento do processo de adaptação cultural e validação, o projeto recebeu também autorização do Comitê de Ética em Pesquisa da Secretaria Municipal de Saúde de Porto Alegre/RS. É um estudo do tipo metodológico, cujas etapas para adaptação cultural foram baseadas em Beaton et al (2002), modificado conforme preconizado e utilizado no Instituto Municipal d´ Investigación Médica de Barcelona (IMIM). Assim o processo de adaptação cultural, que caracterizou a primeira parte deste estudo, seguiu os seguintes passos: tradução, avaliação por comitê de juízes, grupo focal com pessoas estomizadas e retrotradução. A versão retrotraduzida foi aprovada pela autora do instrumento original, Dra. Márcia Grant e essa versão foi aplicada a 215 pessoas estomizadas, em três municípios do estado do Rio Grande do Sul, para avaliação de algumas de suas propriedades psicométricas. A consistência interna do instrumento, analisada por meio do coeficiente alfa de Cronbach (> 0,70), resultou nos escores 0,92 para QV Total e 0,82, 0,86, 0,83, 0,79 para os domínios BES, BEP, BEF, BEE, respectivamente. A validade de conteúdo foi avaliada por meio do nível de concordância entre os juízes, obtendo-se 70% A validade de critério concorrente, avaliada por meio da correlação (Pearson e Spearman) entre o item 16 do domínio BEP e os domínios do COH-QOL-OQ, verificando-se correlações entre 0,26 e 0,66. Quanto à validade de construto convergente por meio da correlação entre os domínios do COH-QOLOQ e do WHOQOL-Abreviado (coeficientes de correlação de Pearson e Spearman > 30) - os resultados variaram de 0,41 a 0,77. Finalmente, a validade de construto discriminante, em que se utilizaram os testes de Mann-Whitney, Kruskal-Wallis, tstudent e ANOVA, obteve-se discriminância na comparação para o tempo de estomizado, o caráter da estomia,, a situação conjugal, a prática da religião. Os resultados permitiram concluir que o COH-QOL-OQ teve desempenho satisfatório, atestando sua confiabilidade e mostrando-se válido para medir a QV de pessoas estomizadas. / One considering the lack of an evaluation tool of specific quality of life for ostomized people in Brazil, verified after a bibliographical review of studies about the theme in our field, the goal of this study was to carry out the cultural adaptation and to valid the instrument City of Hope Quality of Life Ostomy Questionnaire (COH-QOL-OQ). After contacting the author of the original instrument and obtaining her permission, though it was an instrument of free use and developing of the cultural adaptation process, as shown in the site of the City of Hope National Medical Center (COHNMC), the project has also received authorization from the Committee of ethics in researches of the Municipal Health Secretary of Porto Alegre/RS. It is a study of methodological kind that was carried out based on the steps for cultural adaptation of Guillemin, Bombardier and Beaton adapted for Beaton et al and yet adjusted by the steps followed by the Municipal Institute of Medical Investigation of Barcelona (IMIM). Therefore, the process of cultural adaptation, that has described the first phase of this study, followed the following steps: translations, evaluation by a committee of judges, focal group with ostomized people and retro translation. The retro translated version was approved by the author of the original instrument, Dra. Marcia Grant and such version was clinically applied to 215 ostomized people in three towns of the State of Rio Grande do Sul for evaluation of the psychometric properties of measure. Reliability was analyzed through intern consistency given by coefficient alfa of Cronbach ( > 70%), that resulted in scores 0,92 for QV Total and 0,82, 0,86, 0,83, 0,79 for dominions BES, BEP, BEF, BEE, respectively. One has also evaluated the validity of the content with acceptance of the level of agreement among the judges around 70%. The validity of the opponent criteria was evaluated by the correlation among the item 16 of BEP dominion and the dominions of the COH-QOL-OQ and the validity of the convergent construct through the correlation among the dominions of the COH-QOL-OQ and of WHOQOL- Abbreviated (coefficients of correlation of Pearson and Spearman > 30). The results obtained were correlations between 0,26 to 0,66 for the opponent validity and 0,41 to 0,77 for the convergent validity. The validity of the discriminatory construct was evaluated by tests of Mann- Whitney, Kruskal-Wallis, t-student and ANOVA and there was discrimination when the dominions scores were compared with time of ostomized, sort of ostomy, marital status, religion practice. Concerning the type of ostonomy, income, education, work, religion and age there were no discrimination. One is able to conclude that the COH-QOL-OQ had a good performance, certifying its reliability and showing itself valid to measure the QV construct of ostomized people.

Não está esclarecido sobre o real papel da prática regular de atividade física em diferentes níveis de intensidade sobre o perfil somatossensorial mecânico doloroso na região orofacial em indivíduos saudáveis. Adicionalmente, aspectos psicossociais e comportamentais também têm sido descritos como capazes de interferir na percepção da dor. Este estudo buscou avaliar a influência do nível autorrelatado de atividade física no perfil somatossensorial mecânico doloroso e na qualidade de vida. 90 participantes adultos, com idade entre 18-40 anos, de ambos os sexos foram classificados em três grupos que se diferenciaram quanto à frequência, duração e intensidade de atividade física que realizaram nos últimos três meses. A classificação foi feita de acordo com alguns critérios modificados da versão resumida do Questionário Internacional de Atividade Física (IPAQ). Para avaliar a presença de alterações no perfil somatossensorial mecânico doloroso, foram realizados testes sensoriais quantitativos de limiar de dor mecânica (LDM), limiar de dor de pressão (LDP) e teste de somação temporal (WUR) na região do músculo temporal anterior e no músculo tenar da mão não dominante. Uma análise de variância (ANOVA) com os fatores intra-sujeito sítio (2 níveis) e os fatores inter-sujeitos sexo (2 níveis), nível de atividade física (3 níveis) e estilo de vida (2 níveis categorizados de acordo com a mediana da amostra total) foi aplicada para comparação das variáveis somatossensoriais. Para comparação das variáveis psicossociais entre os grupos, foi aplicado uma ANOVA com os fatores inter-sujeito nível de atividade física para avaliação da catastrofização e o teste de H de Kruskal-Wallis para comparar os níveis de ansiedade, estilo de vida e qualidade de vida. Os aspectos psicossociais diferiram de forma significativa entre os grupos, sendo que o grupo com baixo nível de atividade física apresentou os escores mais baixos no questionário sobre estilo de vida (p<0,009), e nos seguintes domínios da avaliação da qualidade de vida foram menores na capacidade funcional (p<0,002) e estado de saúde geral (p<0,014). Os escores relacionados à saúde mental do grupo com baixo nível de atividade física foram menores apenas em comparação ao grupo com moderado nível de atividade física (p=0,034). Embora o domínio vitalidade tenha apresentado um efeito principal do grupo significativo, as comparações múltiplas entre pares não revelaram diferenças entre os grupos (p<0,050). Não houve efeito principal significante do grupo para nenhuma das variáveis somatossensoriais (F<0,34 e p>0,416). Entretanto, houve um efeito principal do sítio para o PPT, em que os limiares da região tenar foram maiores que os do temporal anterior (Tukey: p <0.001). Por fim, embora a interação entre sítio, sexo e qualidade de vida tenha sido significativa para os valores de WUR (F=6,08 e p=0,015), as análises de comparações múltiplas não foram significantes nos principais pontos de comparação (p<0.050). O estudo concluiu que o autorrelato do nível de prática de atividades físicas não influencia de maneira significativa os limiares somatossensoriais mecânicos e a somação temporal na região orofacial, embora piores índices de qualidade de vida estejam presentes em participantes que reportam autorrelato de baixo nível de atividade física. / The actual role of regular practice of physical activity at different levels of intensity on the somatosensory mechanical pain profile in the orofacial region in healthy individuals is still unclear. Psychosocial and behavioral aspects have also been described as capable of interfering with pain perception. This study aimed to evaluate the influence of the self-reported level of physical activity on painful mechanical somatosensory profile and quality of life. 90 adult participants, aged 18-40 years, of both sexes were classified into three groups that differed in the frequency, duration and intensity of physical activity that they performed in the last three months. The classification was made according to a modified criteria of the summary version of the International Physical Activity Questionnaire (IPAQ). In order to evaluate the presence of alterations in the somatosensory mechanical pain profile, quantitative sensory tests of mechanical pain threshold (MPT), pressure pain threshold (PPT) and temporal summation test (WUR) were performed in the anterior temporalis muscle region and the non-dominant hands thenar eminence. An analysis of variance (ANOVA) with intra-subject factors for site (2 levels) and inter-subject factor for sex (2 levels), level of physical activity (3 levels) and lifestyle (2 levels) was applied for comparison of somatosensory variables. To compare the psychosocial variables between the groups, an ANOVA was applied with the inter-subject factors level of physical activity for catastrophic evaluation and the Kruskal-Wallis H test to compare levels of anxiety, lifestyle and quality of life. Psychosocial aspects differed significantly among the groups, and the low level of physical activity had the lowest scores in the lifestyle questionnaire (p <0.009). The following domains of quality of life assessment were lower in functional capacity (p <0.002) and general health status (p <0.014). The scores related to the mental health of the group with low level of physical activity were smaller only in comparison to the group with moderate level of physical activity (p = 0.034). Although the vitality domain had a significant effect within each group, multiple paired comparisons did not reveal differences between groups (p <0.050). There was no significant effect of the group on any of the somatosensory variables (F <0.34 and p>0.416). However, there was a major effect of site for PPT, where the thresholds of the thenar region were higher than those of the anterior temporalis (Tukey: p <0.001). Finally, although the interaction between site, sex and quality of life was significant for WUR values (F = 6.08 and p = 0.015), the multiple comparison analysis were not significant in the main comparison points (p <0.050 ). The study concluded that self-reported level of physical activity does not significantly influence mechanical somatosensory thresholds and temporal summation in the orofacial region, although worse quality of life values are present in participants reporting low level of physical activity.

A busca pela qualidade de vida originou a necessidade de se compreender melhor os aspectos envolvidos no processo de envelhecimento, visando minimizar suas consequências. Embora existam muitos estudos sobre a voz do idoso, a compreensão sobre quais aspectos interferem na qualidade de vida em voz desta população, ainda não é muito explorada. O objetivo do estudo é averiguar o impacto dos aspectos respiratórios e dos aspectos vocais na qualidade de vida em voz de idosos. Participaram 56 idosos acima de 60 anos de idade, sendo 39 mulheres e 17 homens. Foram realizados os procedimentos de avaliação vocal utilizando a Escala Analógica Visual para a análise perceptivo-auditiva da vogal sustentada /a/ e da conversa espontânea e, o programa computadorizado Mult Dimension Voice Program (MDVP), KayPentax, para a análise acústica, dos parâmetros frequência Fundamental (F0), desvio padrão da frequência fundamental (dp F0), shimmer, cociente de perturbação de amplitude (APQ,) jitter, cociente de perturbação de frequência (PPQ) e proporção ruído-harmônico (NHR). Também foi realizada a anamnese quanto aos sintomas e hábitos vocais, avaliação laríngea por meio de exame de nasolaringoscopia para caracterização da amostra; a avaliação da respiração, incluindo medidas de capacidade vital (CV), volume fonatório (VF), fluxo médio fonatório (FMF) e cociente fônico simples (CFS), por meio do espirômetro Pony Fx; a avaliação do tempo máximo de fonação (TMF) durante a emissão de /a/, /s/, /z/ e contagem de números, além da aplicação do Questionário de Qualidade de Vida em Voz (QVV). Foram utilizados o teste t e Mann-Whitney para a comparação dos parâmetros estudados, entre mulheres e homens idosos, e Spearman para correlação entre os dados. Adotou-se nível de significância de 5% para todos os testes.Os idosos do presente estudo apresentaram maior porcentagem de ocorrência de ato de pigarrear, falar alto e ter problemas digestivos e características laríngeas de arqueamento vocal de prega vocal, fenda glótica fusiforme e constrições supraglóticas, sendo mais evidentes no sexo masculino. Os idosos em geral, consideraram suas vozes como sendo boas, além de apresentarem elevado grau de qualidade de vida em voz, com pontuações próximas a 100% para todos os domínios. Quanto à qualidade vocal, os idosos apresentaram características de rugosidade, soprosidade e instabilidade, com diferença estatisticamente significante para o parâmetro rugosidade, sendo maior para os homens. Esta avaliação obteve uma confiabilidade, em sua maioria, excelente, tanto para o julgamento intra como interjuízes. Foi observada correlação positiva do parâmetro rugosidade com o Protocolo QVV no sexo feminino. Quanto às medidas acústicas, também foram observadas diferenças estatisticamente significantes para os parâmetros F0, shimmer e APQ, sendo estes dois últimos maiores para os homens. Foi verificado que estes três parâmetros quando aumentados, interferem negativamente na qualidade de vida em voz das mulheres idosas. As medidas espirométricas evidenciaram diferença significante entre os sexos, tendo valores elevados para os homens. Não foi verificada correlação destas medidas com o Protocolo QVV. Os TMF, assim como a espirometria, evidenciaram diferenças quanto ao sexo, com maiores valores de /a/ e /s/ para os homens. Foi observada correlação do TMF de /a/ e /s/ e da relação s/z com o Protocolo QVV apenas para o sexo masculino. Desta forma, concluiu-se que os aspectos vocais têm impacto negativo na qualidade de vida em voz das mulheres idosas e os aspectos respiratórios são os que mais interferem na qualidade de vida em voz dos homens. / The search for quality of life led to the need to better understand the is aspects involved in the aging process in order to minimize its consequences. Although there are many studies about the aging voice, understanding aspects of which interfere in quality of life in voice this population, still not much explored. The objective of the study is to investigate the impact of respiratory aspects and vocals aspects in quality of life in healthy elderly voice. Participated 56 elderly above 60 years of age, 39 women and 17 men. Was performed the assessment procedures vocal using the Visual Analogue Scale for perceptive analysis - hearing the vowel / a / and spontaneous conversation and, Mult Dimension Voice Program (MDVP) the computerized program, KayPentax, to acoustic analysis, the parameters average fundamental frequency (F0), standard derivation of fundamental frequency (SD F0), shimmer, amplitude perturbation quotient (APQ), jitter, pitch perturbation quotient (PPQ) and harmonic-noise ratio (NHR). Was also performed the interview about symptoms and vocal habits, laryngeal assessment through examination of nasolaryngoscopy for sample characterization, assessment of breathing, including measures of vital capacity (VC), phonation volume (VF), mean flow phonation (FMF ) and phonic simple quotient (CFS) through the spirometer Pony Fx; evaluating the maximum phonation (TMF) for issuing / a /, / s /, / z /, and counting numbers, besides the application of Quality of Life questionnaire in Voice (QLV). Were used the \"t\" test and Mann-Whitney for the compare the parameters studied, among elderly women and men and Spearman used for correlation between the data. Was adopted significance level of 5% for all tests. The elderly of the present study had higher percentage of occurrence of the act of clearing the throat, speak loudly and have problems digestive and laryngeal characteristics of arching vocal fold, glottic fusiform slit and supraglottic constrictions, being more evident in males. The elderly in general considered their voices as being good, besides presenting high level of quality of life in voice, with scores close to 100% for all domains. As the vocal quality presented characteristics of roughness, breathiness and instability, with statistically significant difference for the roughness parameter, being higher for men. This review obtained a trustworthiness, in their majority, excellent, both for the intra judgment as inter judges. Was observed positive correlation the roughness parameter with the Protocol V-RQOL in females. As for acoustic measures have also been observed statistically significant differences to the parameters F0, shimmer and APQ, latter two being larger for men. Was found that these three parameters when increased, negatively affect the quality of life in voice of elderly women. The spirometric measurements showed significant differences between the sexes, having high values for men. No correlation was verified of these measures with the Protocol V-RQOL. The MPT as well as spirometry, showed differences according to the sexes, with higher values of /a/ and /s/ for men. Correlation was observed of MPT /a/ and /s/ and s/z ratio with Protocol V-RQOL only for males. In this way, it was concluded that the vocal aspects have negative impact on quality of life in voice of elderly women and the respiratory aspects are the ones most interfere in the quality of life in men voice.