Cross-cultural adaptation of the Pain Medication Questionnaire for use in Brazil.

BACKGROUND: The Pain Medication Questionnaire (PMQ) assesses the risk of opioid abuse in people with non-oncological chronic pain. METHODS: This is a methodological study conducted at a hemotherapy centre in Recife, Pernambuco state, Brazil. A Cross-cultural adaptation was carried out by a committee of nine specialists, and we applied the PMQ to a pre-final sample of 40 individuals with sickle cell anemia, in addition to a sociodemographic and clinical questionnaire. RESULTS: The mean agreement indexes for PMQ equivalences were the following: semantic (0.996), idiomatic (0.970), experiential (0.991), conceptual (0.953), language clarity (0.991), practical relevance (0.906), and theoretical relevance (0.945). Assessment of the PMQ showed that 50% of participants obtained a score equivalent to medium risk of opioid abuse. Cronbach's alpha coefficient for the adapted PMQ instrument was 0.705, ranging from 0.641 to 0.736 among its items. CONCLUSION: The cross-cultural adaptation of the Pain Medication Questionnaire was satisfactory and easy to apply in the Brazilian population. It is clinically relevant, contributing professional practice and enlightening patients with sickle cell anemia on their behavioral dynamics with respect to opioid consumption. It will also contribute to teaching and research, because it is a useful tool for investigating the risk of abusive behavior in people with chronic pain.

The Brief Negative Symptom Scale: Validation in a multicenter Brazilian study.

BACKGROUND: Negative symptoms are a core feature of schizophrenia. The Brief Negative Symptom Scale (BNSS) is a scale developed to measure negative symptoms in schizophrenia. METHODS: The present study aimed to examine the construct validity of BNSS, by using convergent and divergent validities as well as factor analysis, in a Brazilian sample of 111 outpatients diagnosed with schizophrenia by DSM-5. Patients were evaluated by the Brazilian version of the BNSS and positive and negative subscales of the Positive and Negative Syndrome Scale (PANSS). RESULTS: Assessment of patients by both instruments revealed an excellent internal consistency (Cronbach's alpha = 0.938) or inter-rater reliability (ICC = 0.92), as well as a strong correlation between BNSS and Marder negative PANSS (r = 0.866) and a weak correlation of the instrument with the positive PANSS (r = 0.292), thus characterizing convergent and discriminant validities, respectively. The exploratory factor analysis identified two distinct factors, namely, motivation/pleasure and emotional expressivity, accounting for 68.63% of the total variance. CONCLUSION: The study shows that the Brazilian version of the BNSS has adequate psychometric properties and is a reliable instrument for the assessment of negative symptoms in schizophrenia, either for clinical practice or research.

Nursing Diagnoses of the Homeless Population in Light of Self-care Theory.

BACKGROUND: A growing number of people find themselves in conditions of extreme poverty, which often makes living on the streets the only option. Living conditions in this setting exert a direct impact on health and self-care. Health care for the homeless population should be planned in an interdisciplinary and intersectoral manner. In this context, nursing diagnoses constitute an essential part of the systemization of care. OBJECTIVES: The aims of the present study were to identify nursing diagnoses of a homeless population and propose nursing interventions based on the findings in light of the Nursing Outcomes Classification and Nursing Interventions Classification. DESIGN AND SETTING: A descriptive, cross-sectional study with a quantitative approach was conducted on the streets of the city of Recife in northeastern Brazil. PARTICIPANTS: The sample consisted of 274 male and female adult homeless individuals. METHODS: Data collection involved the administration of a semi-structured interview, the Alcohol, Smoking and Substance Involvement Screening Test and the International Neuropsychiatric Interview. RESULTS: The most prevalent diagnoses were related to risk-prone health behaviors (78.1%), inadequate health maintenance (67.1%), along with sleep deprivation (100%), feelings of hopelessness (100%) and low self-esteem (99%). CONCLUSIONS: The experience enabled the identification of the peculiarities of the population, bringing nursing practice closer to health promotion for the homeless. Adequate public policies and training for health teams are needed to address the health needs of the homeless population.

Mephentermine dependence without psychosis: a Brazilian case report.

BACKGROUND: Substance abuse is a serious health concern. This report presents the case of a 22-year-old Brazilian man with a history of mephentermine use who fulfils all the criteria for chemical dependence listed by ICD-10. Mephentermine is a sympathomimetic agent derived from methamphetamine which, in Brazil, is restricted to veterinary use. CASE DESCRIPTION: The subject used the substance at a high dose (120 mg) to improve his physical performance while working out at a gym. His symptoms included anorexia and insomnia. After days of intense activity, he felt fatigue and soreness. A physical examination revealed scars on both forearms from the injections and a psychological examination revealed moderate speech and motor agitation. CONCLUSIONS: Cases such as this may be common among the general public. They should have some bearing upon medical practice and public health policies involving drugs.