Decreasing length of limb immobilisation following nonelective transfemoral percutaneous coronary intervention: A randomised clinical trial.

AIMS AND OBJECTIVES: To assess the intensity and frequency of pain, use of analgesic drugs, and the incidence of paraesthesia, urinary retention and vascular complications upon decreasing affected limb immobilisation from 4-2 hrs after sheath removal in patients submitted to transfemoral percutaneous coronary intervention (PCI). BACKGROUND: After sheath removal from the femoral artery following urgent or emergency PCI, patients are maintained with limb immobilisation for a mean period of 4 hr. DESIGN: Randomised clinical trial (RCT) based on the CONSORT guidelines. METHOD: Randomised clinical trial was performed in patients with Acute Coronary Syndrome submitted to transfemoral PCI. The intervention group was submitted to a supine position with the head of the bed elevated (30-degree angle) with affected limb immobilisation for 2 hr after sheath removal and the control group for 4 hrs. The outcomes were pain complaints, need for analgesic drugs, incidence of paraesthesia, urinary retention and vascular complications. The outcomes were assessed immediately, 6, 12 and 24 hr after release from limb immobilisation before the patients were released from bed rest. RESULTS: A total of 150 patients (75 in each group) participated in the study. No significant differences in outcomes were observed between the groups, except in relation to the haematoma formation that was higher in the intervention group. CONCLUSION: A reduced length of limb immobilisation after sheath removal following PCI does not change the frequency and intensity of pain, need of analgesic drugs, urinary retention and paraesthesia. The incidence of haematoma was higher in the intervention group, without significant clinical manifestations. RELEVANCE TO CLINICAL PRACTICE: The results of this study can be considered for patients submitted to elective, urgent or emergency PCI, who have a lower risk of complications, thereby allowing for decreased periods of limb immobilisation.

Quality of life in people with coronary artery disease: translation and cross-cultural adaptation of a questionnaire.

OBJECTIVE: to carry out translation, cross-cultural adaptation to Portuguese and assess the reliability of the four versions of the Coronary Revascularization Outcome Questionnaire - adapted. METHODS: a methodological study of translation and cross-cultural adaptation into Portuguese, as proposed by Beaton et al., and reliability analysis, by calculating Cronbach's alpha coefficient and item-total correlation of the four versions of the Coronary Revascularization Outcome Questionnaire - adapted. RESULTS: the adaptations made facilitated the understanding of the items. All domains had Cronbach's alpha above 0.70, except two in the post-percutaneous coronary intervention version and two in the post-myocardial surgical revascularization version. All items had item-total correlation values greater than 0.20, except two in the post-percutaneous coronary intervention version, one in the pre-coronary intervention version and six in the post-myocardial surgical revascularization version. CONCLUSION: the cross-cultural adaptation to Portuguese was considered satisfactory. Pre-procedure versions were considered reliable, while the post-procedures require other psychometric analyses.

Quality of life in people with coronary artery disease: translation and cross-cultural adaptation of a questionnaire / Calidad de vida em personas con enfermedad de la arteria coronária: traducción y adaptación transcultural de cuestionario / Qualidade de vida em pessoas com doença arterial coronariana: tradução e adaptação transcultural de questionário

ABSTRACT Objective: to carry out translation, cross-cultural adaptation to Portuguese and assess the reliability of the four versions of the Coronary Revascularization Outcome Questionnaire - adapted. Methods: a methodological study of translation and cross-cultural adaptation into Portuguese, as proposed by Beaton et al., and reliability analysis, by calculating Cronbach's alpha coefficient and item-total correlation of the four versions of the Coronary Revascularization Outcome Questionnaire - adapted. Results: the adaptations made facilitated the understanding of the items. All domains had Cronbach's alpha above 0.70, except two in the post-percutaneous coronary intervention version and two in the post-myocardial surgical revascularization version. All items had item-total correlation values greater than 0.20, except two in the post-percutaneous coronary intervention version, one in the pre-coronary intervention version and six in the post-myocardial surgical revascularization version. Conclusion: the cross-cultural adaptation to Portuguese was considered satisfactory. Pre-procedure versions were considered reliable, while the post-procedures require other psychometric analyses.

RESUMEN Objetivo: realizar traducción, adaptación transcultural al portugués y evaluar la confiabilidade de las cuatro versiones del Coronary Revascularisation Outcome Questionnaire - adaptado. Métodos: estudio metodológico de traducción y adaptación transcultural al portugués, propuesto por Beaton et al., y análisis de confiabilidad, mediante el cálculo del coeficiente alfa de Cronbach y la correlación ítem-total de las cuatro versiones del Coronary Revascularisation Outcome Questionnaire - adaptado. Resultados: las adaptaciones realizadas facilitaron la comprensión de los ítems. Todos los dominios mostraron un alfa de Cronbach superior a 0,70, excepto dos en la versión posterior a la intervención coronaria percutánea y dos en la versión posterior a la revascularización miocárdica quirúrgica. Todos los ítems obtuvieron valores de correlación ítem-total superiores a 0,20, excepto dos en la versión posintervención coronaria percutánea, uno en la versión pre y seis en la versión posrevascularización miocárdica. Conclusión: la adaptación transcultural a la lengua portuguesa se consideró satisfactoria. Las versiones previas al procedimiento se consideraron fiables, mientras que las posteriores al procedimiento requieren otros análisis psicométricos.

RESUMO Objetivo: realizar tradução, adaptação transcultural para língua portuguesa e avaliação da confiabilidade das quatro versões do Coronary Revascularisation Outcome Questionnaire - adaptado. Métodos: estudo metodológico de tradução e adaptação transcultural para língua portuguesa, conforme proposto por Beaton et al., e análise da confiabilidade, pelo cálculo do coeficiente de alfa de Cronbach e correlação item-total das quatro versões do Coronary Revascularisation Outcome Questionnaire - adaptado. Resultados: as adaptações realizadas facilitaram a compreensão dos itens. Todos os domínios apresentaram alfa de Cronbach acima de 0,70, exceto dois na versão pós-intervenção coronária percutânea e dois na versão pós-revascularização cirúrgica do miocárdio. Todos os itens obtiveram valores de correlação item-total maiores que 0,20, exceto dois na versão pós-intervenção coronária percutânea, um na versão pré e seis na versão pós-revascularização cirúrgica miocárdica. Conclusão: a adaptação transcultural à língua portuguesa foi considerada satisfatória. As versões pré-procedimento foram consideradas confiáveis, já as pós-procedimento, requerem outras análises psicométricas.